| Air Pollution and Postneonatal Infant
Mortality in the United States, 1999–2002 Tracey J. Woodruff,1* Lyndsey A.
Darrow,2 and Jennifer D. Parker3 1Department
of Obstetrics, Gynecology, and Reproductive Sciences,
University of California, San Francisco, California, USA; 2Department
of Epidemiology, Emory University, Atlanta, Georgia, USA; 3National
Center for Health Statistics, Centers for Disease Control and
Prevention, Hyattsville, Maryland, USA Abstract
Objective: Our goal was to evaluate the relationship between cause-specific postneonatal infant mortality and chronic early-life exposure to particulate matter and gaseous air pollutants across the United States. Methods: We linked county-specific monitoring data for particles with aerodiameter of ≤ 2.5 µm (PM2.5) and ≤ 10 µm (PM10) , ozone, sulfur dioxide, and carbon monoxide to birth and death records for infants born from 1999 to 2002 in U.S. counties with > 250,000 residents. For each infant, we calculated the average concentration of each pollutant over the first 2 months of life. We used logistic generalized estimating equations to estimate odds ratios of postneonatal mortality for all causes, respiratory causes, sudden infant death syndrome (SIDS) , and all other causes for each pollutant, controlling for individual maternal factors (race, marital status, education, age, and primiparity) , percentage of county population below poverty, region, birth month, birth year, and other pollutants. This analysis includes about 3.5 million births, with 6,639 postneonatal infant deaths. Results: After adjustment for demographic and other factors and for other pollutants, we found adjusted odds ratios of 1.16 [95% confidence interval (CI) , 1.06–1.27] for a 10-µg/m3 increase in PM10 for respiratory causes and 1.20 (95% CI, 1.09–1.32) for a 10-ppb increase in ozone and deaths from SIDS. We did not find relationships with other pollutants and for other causes of death (control category) . Conclusions: This study supports particulate matter air pollution being a risk factor for respiratory-related postneonatal mortality and suggests that ozone may be associated with SIDS in the United States. Key words: carbon monoxide, ozone, particulate matter air pollution, postneonatal infant mortality, respiratory-related deaths, sudden infant death syndrome, sulfur dioxide. Environ Health Perspect 116:110–115 (2008) . doi:10.1289/ehp.10370 available via http://dx.doi.org/ [Online 24 October 2007]
Address correspondence to T.J. Woodruff, Institute for Health Policy Studies, 3333 California St., Suite 265, San Francisco, CA 94118 USA. Telephone: (415) 476-1890. Fax: (415) 476-0705. E-mail: woodrufft@obgyn.ucsf.edu *This work was conducted primarily while at the U.S. Environmental Protection Agency. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the U.S. Environmental Protection Agency or the National Center for Health Statistics, Centers for Disease Control and Prevention ; reference to commercial products or trade names does not constitute endorsement or recommendation for use. The authors declare they have no competing financial interests. Received 17 April 2007 ; accepted 23 October 2007.
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