title: Spatiotemporal association between birth outcomes and coke production and steel making facilities in Alabama, USA: a cross-sectional study.
abstract: BACKGROUND
  Previous research has shown exposure to air pollution increases the risk of adverse birth outcomes, although the effects of residential proximity to significant industrial point sources are less defined. The objective of the current study was to determine whether yearly reported releases from major industrial point sources are associated with adverse birth outcomes.
  
  
  METHODS
  Maternal residence from geocoded Alabama birth records between 1991 and 2010 were used to calculate distances from coke and steel production industries reporting emissions to the U.S. Environmental Protection Agency. Logistic regression models were built to determine associations between distance or yearly fugitive emissions (volatile organic compounds, polycyclic aromatic compounds, and metals) from reporting facilities and preterm birth or low birth weight, adjusting for covariates including maternal age, race, payment method, education level, year and parity.
  
  
  RESULTS
  A small but significant association between preterm birth and residential proximity (≤5.0 km) to coke and steel production facilities remained after adjustment for covariates (OR 1.05 95% CI: 1.01,1.09). Above average emissions from these facilities of volatile organic compounds during the year of birth were associated with low birth weight (OR 1.17 95% CI: 1.06, 1.29), whereas metals emissions were associated with preterm birth (OR 1.07 95% CI: 1.01, 1.14).
  
  
  CONCLUSIONS
  The present investigation suggests fugitive emissions from industrial point sources may increase the risk of adverse birth outcomes in surrounding neighborhoods. Further research teasing apart the relationship between exposure to emissions and area-level deprivation in neighborhoods surrounding industrial facilities and their combined effects on birth outcomes is needed.
authors.forename: Travis R
authors.initials: TR
authors.lastname: Porter
authors.forename: Shia T
authors.initials: ST
authors.lastname: Kent
authors.forename: Wei
authors.initials: W
authors.lastname: Su
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Beck
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA. jgohlke@uab.edu.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Gohlke
mesh_terms: D000293:Adolescent; D000328:Adult; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000407:Alabama / Q000453:epidemiology; D001555:Benzene Derivatives / Q000032:analysis / Q000633:toxicity; D003077:Coke; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D018811:Maternal Exposure; D008670:Metals / Q000032:analysis / Q000633:toxicity; D011084:Polycyclic Aromatic Hydrocarbons / Q000032:analysis / Q000633:toxicity; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012111:Residence Characteristics; D013232:Steel; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D001555:Benzene Derivatives; D003077:Coke; D008670:Metals; D011084:Polycyclic Aromatic Hydrocarbons; D013232:Steel