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Low-Level Exposure to Air Pollution and Risk of Adverse Birth Outcomes in Hillsborough County, Florida

Mainolfi, Maria B. MD; Salihu, Hamisu M. MD, PhD; Wilson, Roneé E. MPH; Mbah, Alfred K. PhD

Journal of Occupational and Environmental Medicine: May 2013 - Volume 55 - Issue 5 - p 490–494
doi: 10.1097/JOM.0b013e31828df013
Original Articles

Objective: In this retrospective cohort (1998 to 2007), 145,445 singleton live births in Hillsborough, Florida, were analyzed to elucidate the relationship between fetal morbidity and prenatal exposure to six criteria air pollutants.

Methods: This study was based on three linked databases: Florida Hospital Discharge, vital statistics records, and air pollution meteorological data from the Environmental Protection Agency. The primary outcomes of interest were low birth weight, preterm births, and small for gestational age. This study used structural equation modeling and trimester groupings to evaluate the relationship between air pollution and birth outcomes of pregnant residents.

Results: The latent variables of structural equation modeling yielded a significant B value of 0.35, indicating that exposure to the criteria pollutants in pregnancy may have a significant relationship to fetal morbidity.

Conclusion: Exposure to criteria air pollutants in pregnancy is associated with fetal morbidity outcomes.

From the Occupational Environmental Medicine Residency (Dr Mainolfi), Department of Epidemiology and Biostatistics (Drs Salihu and Mbah and Ms Wilson), College of Public Health, and Department of Obstetrics and Gynecology (Dr Salihu), College of Medicine, University of South Florida, Tampa, Fla.

Address correspondence to: Maria B. Mainolfi, MD, Occupational Environmental Medicine Residency, College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, MDC 56, Tampa, FL 33612 (

Authors Mainolfi, Salihu, Wilson, and Mbah have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

©2013The American College of Occupational and Environmental Medicine