Air Pollution and Birth Outcomes: Health Impact and Economic Value Assessment in Spain

Int J Environ Res Public Health. 2023 Jan 27;20(3):2290. doi: 10.3390/ijerph20032290.

Abstract

Air pollution is considered an ongoing major public health and environmental issue around the globe, affecting the most vulnerable, such as pregnant women and fetuses. The aim of this study is to estimate the health impact and economic value on birth outcomes, such as low birthweight (LBW), preterm birth (PTB), small for gestational age (SGA), attributable to a reduction of PM10 levels in Spain. Reduction based on four scenarios was implemented: fulfillment of WHO guidelines and EU limits, and an attributable reduction of 15% and 50% in annual PM10 levels. Retrospective study on 288,229 live-born singleton children born between 2009-2010, using data from Spain Birth Registry Statistics database, as well as mean PM10 mass concentrations. Our finding showed that a decrease in annual exposure to PM10 appears to be associated with a decrease in the annual cases of LBW, SGA and PTB, as well as a reduction in hospital cost attributed to been born with LBW. Improving pregnancy outcomes by reducing the number of LBW up to 5% per year, will result in an estimate associated monetary saving of 50,000 to 7,000,000 euros annually. This study agrees with previous literature and highlights the need to implement, and ensure compliance with, stricter policies that regulate the maximum exposure to outdoor PM permitted in Spain, contributing to decreased environmental health risk, especially negative birth outcomes.

Keywords: air quality; low birthweight; particulate matter; preterm birth; small for gestational age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Air Pollutants*
  • Air Pollution*
  • Child
  • Female
  • Fetal Growth Retardation
  • Humans
  • Infant, Newborn
  • Maternal Exposure
  • Particulate Matter
  • Pregnancy
  • Premature Birth* / epidemiology
  • Retrospective Studies
  • Spain / epidemiology

Substances

  • Air Pollutants
  • Particulate Matter

Grants and funding

This work was supported by the Spanish Consortium for Research on Epidemiology and Public Health (ESP20PI01/2020). The air pollution models were developed within the framework of a project funded by the Health Effects Institute (HEI) (Assistance Award No. R-82811201) and a project funded by the Spanish Institute of Health Carlos III (PI16/00118). Mònica Guxens is funded by a Miguel Servet II fellowship (CPII18/00018) awarded by the Spanish Institute of Health Carlos III. We also acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program.