title: Nitrogen Dioxide pollution and hazardous household environment: what impacts more congenital malformations.
abstract: Nitrogen Dioxide (NO2) is a product of fuel combustion originating mainly from industry and transportation. Studies suggest an association between NO2 and congenital malformations (CM). We investigated an independent effect of NO2 on CM by adjusting to individual factors and household environment in 1024 Bedouin-Arab pregnant women in southern Israel. This population is characterised by high rates of CMs, frequent consanguineous marriages, paternal smoking, temporary housing and usage of open fire for heat cooking. Information on household risk factors was collected during an interview. Ambient measurements of 24-h average NO2 and meteorological conditions were obtained from 13 local monitors. Median value of daily NO2 measured in the area was 6.78ppb. CM was diagnosed in 8.0% (82) of offspring. Maternal NO2 exposure during the 1st trimester >8.6ppb was significantly associated with minor CM (RR=2.68, p=0.029). Major CM were independently associated with maternal juvenile diabetes (RR=9.97, p-value=0.002) and heating by open fire (RR=2.00, p-value=0.049), but not NO2 exposure. We found that NO2 emissions had an independent impact only on minor malformations, whereas major malformations depended mostly on the household environment. Antepartum deaths were associated by maternal morbidity.
authors.affiliation: Department of Neonatology, Soroka University Medical Center, Beer-Sheva, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Landau
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: novack@bgu.ac.il.
authors.forename: L
authors.initials: L
authors.lastname: Novack
authors.affiliation: Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Yitshak-Sade
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Sarov
authors.affiliation: Department of Geography, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Kloog
authors.affiliation: Department of Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Hershkovitz
authors.affiliation: Public Health Services, Ministry of Health, Jerusalem, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Grotto
authors.affiliation: Environmental Epidemiology Department, Ministry of Health, Jerusalem, Israel; Ashkelon Academic College, Ashkelon, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Karakis
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000032:analysis*; D018912:Arabs; D000013:Congenital Abnormalities / Q000453:epidemiology*; D003296:Cooking; D004784:Environmental Monitoring / Q000379:methods*; D005260:Female; D015386:Hazardous Substances / Q000032:analysis* / Q000633:toxicity; D006361:Heating; D006798:Housing / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn; D007557:Israel; D018811:Maternal Exposure; D009585:Nitrogen Dioxide / Q000032:analysis* / Q000633:toxicity; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D015386:Hazardous Substances; D009585:Nitrogen Dioxide
keywords: Congenital malformations; Household environment; Nitrogen Dioxide; Socio-economic status