title: Ambient air pollution and risk of congenital anomalies in England, 1991-1999.
abstract: OBJECTIVE
  To investigate whether there is an association between risk of congenital anomaly and annual ward level exposure to air pollution in England during the 1990s.
  
  
  METHODS
  A geographical study was conducted across four regions of England using population-based congenital anomaly registers, 1991-1999. Exposure was measured as 1996 annual mean background sulphur dioxide (SO(2)), nitrogen dioxide (NO(2)) and particulate matter (PM(10)) concentrations at census ward level (n=1474). Poisson regression, controlling for maternal age, area socioeconomic deprivation and hospital catchment area, was used to estimate relative risk for an increase in pollution from the 10th to the 90th centile.
  
  
  RESULTS
  For non-chromosomal anomalies combined, relative risks were 0.99 (95% CI 0.93 to 1.05) for SO(2), 0.97 (95% CI 0.84 to 1.11) for NO(2) and 0.89 (95% CI 0.75 to 1.07) for PM(10). For chromosomal anomalies, relative risks were 1.06 (95% CI 0.98 to 1.15) for SO(2), 1.11 (95% CI 0.95 to 1.30) for NO(2) and 1.18 (95% CI 0.97 to 1.42) for PM(10). Raised risks were found for tetralogy of Fallot and SO(2) (RR=1.38, 95% CI 1.07 to 1.79), NO(2) (RR=1.44, 95% CI 0.71 to 2.93) and PM(10) (RR=1.48, 95% CI 0.57 to 3.84), which is of interest in light of previously reported associations between this cardiac anomaly and other air pollutants.
  
  
  CONCLUSIONS
  While air pollution in the 1990s did not lead to sustained geographical differences in the overall congenital anomaly rate in England, further research regarding specific anomalies is indicated.
authors.affiliation: Room 12L09, University of Ulster, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, UK. h.dolk@ulster.ac.uk
authors.forename: H
authors.initials: H
authors.lastname: Dolk
authors.forename: B
authors.initials: B
authors.lastname: Armstrong
authors.forename: K
authors.initials: K
authors.lastname: Lachowycz
authors.forename: M
authors.initials: M
authors.lastname: Vrijheid
authors.forename: J
authors.initials: J
authors.lastname: Rankin
authors.forename: L
authors.initials: L
authors.lastname: Abramsky
authors.forename: P A
authors.initials: PA
authors.lastname: Boyd
authors.forename: D
authors.initials: D
authors.lastname: Wellesley
mesh_terms: D000328:Adult; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology; D004739:England / Q000453:epidemiology; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000009:adverse effects*; D009585:Nitrogen Dioxide / Q000032:analysis / Q000633:toxicity*; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity; D016012:Poisson Distribution; D011247:Pregnancy; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013458:Sulfur Dioxide / Q000032:analysis / Q000633:toxicity*
chemical_list: D052638:Particulate Matter; D013458:Sulfur Dioxide; D009585:Nitrogen Dioxide