Early-life exposure to ambient fine particulate air pollution and infant mortality: pooled evidence from 43 low- and middle-income countries

Nihit Goyal, Mahesh Karra, David Canning

Research output: Contribution to journalArticleScientificpeer-review

37 Citations (Scopus)

Abstract

Background: Many low- and middle-income countries are experiencing high and increasing exposure to ambient fine particulate air pollution (PM 2.5). The effect of PM 2.5 on infant and child mortality is usually modelled using concentration response curves extrapolated from studies conducted in settings with low ambient air pollution, which may not capture its full effect. Methods: We pool data on more than half a million births from 69 nationally representative Demographic and Health Surveys that were conducted in 43 low- and middle-income countries between 1998 and 2014, and we calculate early-life exposure (exposure in utero and post partum) to ambient PM 2.5 using high-resolution calibrated satellite data matched to the child's place of residence. We estimate the association between the log of early-life PM 2.5 exposure, both overall and separated by type, and the odds of neonatal and infant mortality, adjusting for child-level, parent-level and household-level characteristics. Results: We find little evidence that early-life exposure to overall PM 2.5 is associated with higher odds of mortality relative to low exposure to PM 2.5. However, about half of PM 2.5 is naturally occurring dust and sea-salt whereas half is from other sources, comprising mainly carbon-based compounds, which are mostly due to human activity. We find a very strong association between exposure to carbonaceous PM 2.5 and infant mortality, particularly neonatal mortality, i.e. mortality in the first 28 days after birth. We estimate that, at the mean level of exposure in the sample to carbonaceous PM 2.5 - 10.9 μg/m 3 - the odds of neonatal mortality are over 50% higher than in the absence of pollution. Conclusion: Our results suggest that the current World Health Organization guideline of limiting the overall ambient PM 2.5 level to less than 10 μg/m should be augmented with a lower limit for harmful carbonaceous PM 2.5.

Original languageEnglish
Article numberdyz090
Pages (from-to)1125-1141
Number of pages17
JournalInternational journal of epidemiology
Volume48
Issue number4
DOIs
Publication statusPublished - Aug 2019
Externally publishedYes

Keywords

  • Ambient air pollution
  • Demographic and Health Survey (DHS)
  • Geographic Information System (GIS)
  • child mortality
  • fine particulate matter
  • infant mortality
  • neonatal mortality
  • pregnancy outcome

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