RESUMO
BACKGROUND: Birth defects are a major cause of poor health outcomes during both childhood and adulthood. A growing body of evidence demonstrated associations between air pollution exposure during pregnancy and birth defects. To date, there is no study looking at birth defects and exposure to wildfire-related air pollution, which is suggested as a type of air pollution source with high toxicity for reproductive health. OBJECTIVE: Our study addresses this gap by examining the association between birth defects and wildfire smoke exposure in Brazil between 2001 and 2018. Based on known differences of impacts of wildfires across different regions of Brazil, we hypothesized differences in risks of birth defects for different regions. METHODS: We used a logistic regression model to estimate the odds ratios (ORs) for individual birth defects (12 categories) associated with wildfire exposure during each trimester of pregnancy. RESULTS: Among the 16,825,497 birth records in our study population, there were a total of 7595 infants born in Brazil between 2001 and 2018 with birth defects in any of the selected categories. After adjusting for several confounders in the primary analysis, we found statistically significant OR for three birth defects, including cleft lip/cleft palate [OR: 1.007 (95% CI: 1.001; 1.013)] during the second trimester of exposure, congenital anomalies of the respiratory system [OR: 1.013 (95% CI: 1.002; 1.023)] in the second trimester of exposure, and congenital anomalies of the nervous system [OR: 1.002 (95% CI: 1.001; 1.003)] during the first trimester of exposure for the regions South, North, and Midwest, respectively. SIGNIFICANCE: Our results suggest that maternal exposure to wildfire smoke during pregnancy may increase the risk of an infant being born with some congenital anomaly. Considering that birth defects are associated with long-term disability, impacting families and the healthcare system (e.g., healthcare costs), our findings should be of great concern to the public health community. IMPACT STATEMENT: Our study focused on the association between maternal exposure to wildfire smoke in Brazil during pregnancy and the risk of an infant being born with congenital anomalies, which presents serious public health and environmental challenges.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Efeitos Tardios da Exposição Pré-Natal , Incêndios Florestais , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Brasil/epidemiologia , Criança , Feminino , Humanos , Lactente , Recém-Nascido , Exposição Materna/efeitos adversos , Material Particulado/análise , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Fumaça/efeitos adversosRESUMO
Investigations of the educational implications of children's exposure to air pollutants at school are crucial to enhance our understanding of the hazards for children. Most of the existing literature is based on studies performed in North America and Europe. Further investigation is required in low- and middle-income countries, where there are important challenges related to public health, transportation, environment, and education sector. In response, in this present study, we studied the association between proximity of schools to roads and the academic achievement of the students in the Federal District, Brazil. We accessed academic achievement data at the student level. The data consist of 256 schools (all the public schools in the FD) and a total of 344,175 students (all the students enrolled in the public schools in the FD in 2017-2020). We analyzed the association between the length of all roads within buffers around schools and student-level academic performance using mixed-effects regression models. After adjustments for several covariates, the results of the primary analysis indicate that the presence of roads surrounding schools is negatively associated with student-level academic performance in the FD. This association varies significantly depending on the buffer size surrounding schools. We found that the highest effects occur in the first buffer, with 250 m. While in the first buffer we estimated that an increase of 1 km of length of roads around schools was associated with a statistically significant decrease of 0.011 (95%CI: 0.008; 0.013) points in students' grades (students' academic performance varies from 0 to 10), in the buffer of 1 km we found a decrease of 0.002 (95%CI: 0.002; 0.002) points in the student-level academic performance. Findings from our investigation provide support for the creation of effective health, educational and urban planning policies for local intervention in the FD. This is essential to improve the environmental quality surrounding schools to protect children from exposure to environmental hazards.