Air Pollution Linked to Preterm Birth, Billions in Associated Healthcare Costs – MedPage Today

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Ambient air pollution cost the United States $5.09 billion dollars in medical expenses and lost economic productivity related to preterm birth in 2010, researchers said.

Of that total, $760 million was attributed to direct medical costs, according to Leonardo Trasande, MD, of New York University School of Medicine, and colleagues, writing in Environmental Health Perspectives.

Their study combined air pollution data from the U.S. Environmental Protection Agency with figures on preterm births from the Institute of Medicine.

Trasande told MedPage Today that while research on air pollution has traditionally focused on its link to cardiovascular outcomes in adults and asthma exacerbation in children, there has been emerging literature that has found associations between air pollution and preterm birth.

“This is the first study to estimate the burden of preterm birth and trace it to a particular environmental source,” he said. “Previous studies have taken small populations and found an association – what we did was look at it on a national scale and put a cost to society in terms of direct medical care of children who have preterm birth and associated medical conditions, but also loss of IQ and loss of economic productivity that can ultimately be traced to preterm birth.”

Specifically, Trasande’s team focused its research on fine particulate matter, which has been linked to preterm birth in prior studies. They found that 12% of births in the U.S. in 2010 were preterm, and estimated that 3.32% of all preterm births could be attributed to fine particulate matter.

Several OB/GYN groups have become involved in the advocacy and education of patients about environmental hazards, such as air pollution, that may be linked to adverse pregnancy outcomes. Most recently, six global public health organizations, including the World Health Organization and the American College of Obstetricians and Gynecologists, released a joint statement regarding the need to limit patient exposure to toxic chemicals. Recent research by Trasande has also estimated the health costs of endocrine-disrupting chemicals on female reproductive systems in Europe.

“This does speak to the need for obstetricians to consider environmental risk factors in general – not simply air pollution, but chemical exposures that can contribute to preterm birth and other adverse health outcomes in the baby,” said Trasande. “It’s fair to say that environmental issues are increasingly on the minds of obstetricians and air pollution is one of those issues that should be on their minds.”

In addition, the authors note that laboratory experiments have documented that oxidant stress, inflammation, and placental insufficiency have been associated with early delivery.

Trasande said that while air pollution is a problem in the U.S., it is even worse in developing countries, so he would like to see these analyses repeated there.

“We need research to study associations of these exposures with health outcomes to confirm findings and look at effects in lower ranges of exposure,” he noted.

Air Pollution Linked to Preterm Birth, Billions in Associated Healthcare Costs – MedPage Today