The results of a study published in the Environmental Health Perspectives journal last week have shown that air pollution leads to 16,000 premature births each year in the US. A collaboration between Leonardo Trasande and colleagues from a number of Schools at New York University entitled ‘Particulate Matter Exposure and Preterm Birth: Estimates of US Attributable Burden and Economic Costs’, this study defines premature birth as at least three weeks earlier than 37 weeks gestation, and is the first to estimate the number of premature births per year due to air pollution.

Approximately 4 million births from 2010 were examined, of which approximately 480,000 (12%) were premature. Air pollution data from the US Environmental Protection Agency, premature birth data from the Centres for Disease Control and Prevention (CDCP) and studies of air pollution exposure were used to determine the number of premature births in the US.

Premature birth is a critical public health concern and a significant cause of early death in children in the US

Premature birth is a critical public health concern and a significant cause of early death in children in the US. It is more prevalent among women of lower socioeconomic status and women from ethnic minorities. Reducing the frequency of premature birth can not only prevent neonatal complications such as respiratory distress syndrome, sepsis and intraventricular haemorrhage; it can also reduce the likelihood of adverse psychological, behavioural and education outcomes such as cerebral palsy and neurodevelopmental delay, plus systematic hypertension, diabetes and stroke later in life.

The study notes a range of factors known to increase the likelihood of premature births, including the age of the mother, prenatal care, socioeconomic status and preeclampsia. It also found that reducing vehicle emissions, filtering emissions from coal fired power plants, and limiting household use of coal for heating and wood for cooking are also important factors that can and should be implemented to reduce the likelihood of premature birth. The study’s authors discussed a number of research findings that link prenatal exposure to PM2.5 particulate matter of less than 2.5 microns in diameter to premature birth.

In addition to investigating how environmental factors may impact premature births in the US, the study discusses the economic costs associated with premature births attributable to PM2.5 exposure. This information should be taken into account by decision makers when considering regulatory instruments to reduce air pollution exposure, with the authors of this study highlighting a flawed perception that reducing air pollution exposure will impair economic productivity.

The authors put forward that as with costs associated with air pollution exposure, the costs of adverse birth outcomes are borne by society rather than by the companies emitting air pollution as part of their operations. The study estimates that premature births in 2010 cost $760 million in medical care and $4.33 billion in lost economic productivity; with results showing that the risk of premature birth due to air pollution is highest in parts of Southern California, the Ohio River Valley, Alabama, Georgia, New York City and southern Pennsylvania.

Read the ‘Particulate Matter Exposure and Preterm Birth: Estimates of US Attributable Burden and Economic Costs’ study here

As a scientist with a background in air pollution monitoring and management, I applaud the authors of this study into environmental factors that may be contributing to premature births. Within the current air pollution literature (especially literature focused on air pollution and epidemiology), study after study typically investigates the burden of a particular air pollutant or suite of air pollutants on either the general public or a specific group within the general public – as opposed to pre and immediately postnatal subjects.

Research into every area and test group in terms of environmental impact is important, especially given the research attention on PM2.5 in recent years (which is completely justified). The reality that as a body of science, the study of air pollution on people (a subsection of epidemiology) is most powerful when it can examine the effects on a group or groups of people as they develop from children to adults and then to elderly people. I am enough of a realist to know that such studies can be extremely expensive and logistically complex, however the impact of cost and logistics can be minimised with appropriate funding and study design/implementation.

We all need to play our part in reducing air pollution exposure and do everything in power to protect ourselves and the next generation.

The results of this study published in the Environmental Health Perspectives journal can and should inform regulator decisions with respect to monitoring, reporting, compliance and Environmental Impact Assessment (EIA) procedures – not just in the US but also across the globe. Researchers, regulators and individuals need to take stock of how they are exposed to air pollutants and be aware of the impacts of varying degrees and types of exposure. It is difficult to ignore the medical ($760 million) and lost productivity ($4.33 billion) costs of air pollution exposure as presented in this study. We all need to play our part in reducing air pollution exposure and do everything in power to protect ourselves and the next generation.

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