Spatial identification of environmental health hazards potentially associated with adverse birth outcomes
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Reduced birth weight (RBW) and reduced head circumference (RHC) are adverse birth outcomes (ABOs), often linked to environmental exposures. However, spatial identification of specific health hazards, associated with these ABOs, is not always straightforward due to presence of multiple health hazards and sources of air pollution in urban areas. In this study, we test a novel empirical approach to the spatial identification of environmental health hazards potentially associated with the observed RHC and RBW patterns. The proposed approach is implemented as a systematic search, according to which alternative candidate locations are ranked based on the strength of association with the observed birth outcome patterns. For empirical validation, we apply this approach to the Haifa Bay Area (HBA) in Israel, which is characterized by multiple health hazards and numerous sources of air pollution. We identified a spot in the local industrial zone as the main risk source associated with the observed RHC and RBW patterns. Multivariate regressions, controlling for personal, neighborhood, and geographic factors, revealed that the relative risks of RHC and RBW tend to decline, other things being equal, as a function of distance from the identified industrial spot. We recommend the proposed identification approach as a preliminary risk assessment tool for environmental health studies, in which detailed information on specific sources of air pollution and air pollution dispersion patterns is unavailable due to limited reporting or insufficient monitoring.
KeywordsAdverse birth outcomes (ABOs) Reduced birth weight (RBW) Reduced head circumference (RHC) Air pollution Distance gradient method (DGM) Wind adjustment Environmental hazards Haifa Bay Area (HBA) Israel
The authors express their gratitude to the members of the study’s steering committee of the Israel Ministry of Health, specifically to Dr. Jonathan Dubnov, Ms. Batia Madjar, and Ms. Riki Shemer for consultations, quality control of birth records, and initial processing of data for this research. Our gratitude is also due to Mr. Shahar Fertig for his valuable help with database preparation.
The first author thanks the Israel Ministry of Absorption and the Rieger Foundation-Jewish National Fund Program for Environmental Studies for their financial support of this study.
Compliance with ethical standards
The authors declare that they have no competing interests.
The study was approved by the Helsinki committee of the Ministry of Health (MoH 084-2016) and the Ethical Board of University of Haifa (394/15).
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