Air pollution from incinerators and reproductive outcomes: a multisite study

Epidemiology. 2013 Nov;24(6):863-70. doi: 10.1097/EDE.0b013e3182a712f1.

Abstract

Background: The few studies that have investigated the relationship between emissions from municipal solid-waste incinerators and adverse pregnancy outcomes have had conflicting results. We conducted a study to assess the effects of air emissions from the eight incinerators currently in operation in the Emilia-Romagna Region of Italy on reproductive outcomes (sex ratio, multiple births, preterm births, and small for gestational age [SGA] births).

Methods: We considered all births (n = 21,517) to women residing within a 4-km radius of an incinerator at the time of delivery during the period 2003-2010 who were successfully linked to the Delivery Certificate database. This source also provided information on maternal characteristics and deliveries. Each newborn was georeferenced and characterized by a specific level of exposure to incinerator emissions, categorized in quintiles of PM10, and other sources of pollution (NOx quartiles), evaluated by means of ADMS-Urban system dispersion models. We ran logistic regression models for each outcome, adjusting for exposure to other pollution sources and maternal covariates.

Results: Incinerator pollution was not associated with sex ratio, multiple births, or frequency of SGA. Preterm delivery increased with increasing exposure (test for trend, P < 0.001); for the highest versus the lowest quintile exposure, the odds ratio was 1.30 (95% confidence interval = 1.08-1.57). A similar trend was observed for very preterm babies. Several sensitivity analyses did not alter these results.

Conclusions: Maternal exposure to incinerator emissions, even at very low levels, was associated with preterm delivery.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollutants / adverse effects*
  • Air Pollutants / analysis
  • Air Pollution / adverse effects*
  • Air Pollution / analysis
  • Databases, Factual
  • Female
  • Humans
  • Incineration*
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Italy / epidemiology
  • Male
  • Maternal Exposure / adverse effects*
  • Maternal Exposure / statistics & numerical data
  • Multiple Birth Offspring / statistics & numerical data
  • Pregnancy
  • Premature Birth / chemically induced
  • Premature Birth / epidemiology*
  • Sex Ratio
  • Young Adult

Substances

  • Air Pollutants