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Residential Proximity to Major Roads and Term Low Birth Weight: The Roles of Air Pollution, Heat, Noise, and Road-Adjacent Trees

Dadvand, Payama,b; Ostro, Bartc; Figueras, Francescd; Foraster, Mariaa,b,e; Basagaña, Xaviera,b; Valentín, Antòniaa,b; Martinez, Davida,b; Beelen, Robf; Cirach, Martaa,b; Hoek, Gerardf; Jerrett, Michaelg; Brunekreef, Bertf,h; Nieuwenhuijsen, Mark J.a,b

doi: 10.1097/EDE.0000000000000107
Air Pollution

Background: Maternal residential proximity to roads has been associated with adverse pregnancy outcomes. However, there is no study investigating mediators or buffering effects of road-adjacent trees on this association. We investigated the association between mothers’ residential proximity to major roads and term low birth weight (LBW), while exploring possible mediating roles of air pollution (PM2.5, PM2.5–10, PM10, PM2.5 absorbance, nitrogen dioxide, and nitrogen oxides), heat, and noise and buffering effect of road-adjacent trees on this association.

Methods: This cohort study was based on 6438 singleton term births in Barcelona, Spain (2001–2005). Road proximity was measured as both continuous distance to and living within 200 m from a major road. We assessed individual exposures to air pollution, noise, and heat using, respectively, temporally adjusted land-use regression models, annual averages of 24-hour noise levels across 50 m and 250 m, and average of satellite-derived land-surface temperature in a 50-m buffer around each residential address. We used vegetation continuous fields to abstract tree coverage in a 200-m buffer around major roads.

Results: Living within 200 m of major roads was associated with a 46% increase in term LBW risk; an interquartile range increase in heat exposure with an 18% increase; and third-trimester exposure to PM2.5, PM2.5–10, and PM10 with 24%, 25%, and 26% increases, respectively. Air pollution and heat exposures together explained about one-third of the association between residential proximity to major roads and term LBW. Our observations on the buffering of this association by road-adjacent trees were not consistent between our 2 measures of proximity to major roads.

Conclusion: An increased risk of term LBW associated with proximity to major roads was partly mediated by air pollution and heat exposures.

Supplemental Digital Content is available in the text.

From the aCentre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; bCIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; cOffice of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA; dDepartment of Maternal-Foetal Medicine, ICGON, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain; eUniversitat Pompeu Fabra (UPF), Barcelona, Spain; fInstitute for Risk Assessment Sciences, Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands; gSchool of Public Health, University of California Berkeley, Berkeley, CA; and hJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.

Submitted 4 April 2013; accepted 28 January 2014; posted 30 April 2014.

The authors report no conflicts of interest.

This study was funded by an FIS grant (grant no. PI081109) from the Instituto de Salud Carlos III FEDER. The research leading to the modeling framework for the air pollution exposure assessment in this study has received funding from the European Community’s Seventh Framework Program (FP7/2007–2011) under grant agreement number: 211250. The assessment of road-adjacent tree coverage was carried out as part of European Community’s Seventh Framework Program-funded project PHENOTYPE (grant no. 282996). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. P.D. is funded by a Ramón y Cajal fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and Competitiveness. M.F. is funded by a Instituto de Salud Carlos III predoctoral fellowship.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( This content is not peer-reviewed or copy-edited; it is the sole responsibility of the author.

Editors’ note: A commentary on this article appears on page 526.

Correspondence: Payam Dadvand, CREAL, Barcelona Biomedical Research Park, Dr. Aiguader, 88, 08003 Barcelona, Spain; E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc