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Particulate Matter Exposure, Prenatal and Postnatal Windows of Susceptibility, and Autism Spectrum Disorders

Kalkbrenner, Amy E.a; Windham, Gayle C.b; Serre, Marc L.c; Akita, Yasuyukic; Wang, Xuexiaa; Hoffman, Kated; Thayer, Brian P.a; Daniels, Julie L.c

doi: 10.1097/EDE.0000000000000173
Air Pollution

Background: Recent studies suggest that exposure to traffic-related air pollutants, including particulate matter (PM), is associated with autism spectrum disorder (autism).

Methods: Children with autism were identified by records-based surveillance (n = 645 born in North Carolina in 1994, 1996, 1998, or 2000, and n = 334 born in the San Francisco Bay Area in California in 1996). They were compared with randomly sampled children born in the same counties and years identified from birth records (n = 12,434 in North Carolina and n = 2,232 in California). Exposure to PM less than 10 μm (PM10) at the birth address was assigned to each child by a geostatistical interpolation method using daily concentrations from air pollution regulatory monitors. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for a 10 μg/m3 increase in PM10 within 3-month periods from preconception through the child’s first birthday, adjusting for year, state, maternal education and age, race/ethnicity, and neighborhood-level urbanization and median household income, and including a nonparametric term for week of birth to account for seasonal trends.

Results: Temporal patterns in PM10 were pronounced, leading to an inverse correlation between the first- and third-trimester concentrations (r = −0.7). Adjusted ORs were, for the first trimester, 0.86 (95% CI = 0.74–0.99), second trimester, 0.97 (0.83–1.15), and third trimester, 1.36 (1.13–1.63); and, after simultaneously including first- and third-trimester concentrations to account for the inverse correlation, were: first trimester, 1.01 (0.81–1.27) and third trimester, 1.38 (1.03–1.84).

Conclusions: Our study adds to previous work in California showing a relation between traffic-related air pollution and autism, and adds similar findings in an eastern US state, with results consistent with increased susceptibility in the third-trimester.

From the aJoseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI; bCalifornia Department of Public Health, Richmond, CA; cGillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; and dNicholas School of the Environment, Duke University, Durham, NC.

Submitted 23 October 2013; accepted 8 June 2014; posted 3 October 2014.

The North Carolina Autism and Developmental Disabilities Monitoring Project was supported by the Centers for Disease Control and Prevention (grants DD000089, DD000184, and U10DD000184, P30ES10126). This work was also supported by the National Institute of Environmental Health Sciences through a training grant (T32 ES007018), the center grant of the Milwaukee Children’s Environmental Health Sciences Core Center (P30 ES004184), and funding from the Joseph J. Zilber School of Public Health.

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Correspondence: Amy E. Kalkbrenner, Department of Epidemiology, University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, 1240 N. 10th Street, Milwaukee, WI 53205. E-mail:

© 2015 by Lippincott Williams & Wilkins, Inc