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Ambient air pollution and apnea and bradycardia in high-risk infants on home monitors
Jennifer L Peel1, Mitchel Klein, W Dana Flanders
1Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado 80523, USA. jennifer.peel@colostate.edu
Insights
Higher air pollution, including ozone and nitrogen dioxide, is linked to increased apnea and bradycardia events in infants. These findings highlight potential risks for vulnerable newborns exposed to poor air quality.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Neonatology
Background:
- Growing evidence links ambient air pollution to adverse health outcomes.
- Few studies have specifically investigated the impact of air pollution on infants.
- Infants, particularly premature and low birth weight (LBW) infants, are a vulnerable population.
Purpose of the Study:
- To examine the association between daily ambient air pollution concentrations and central apnea and bradycardia events in infants.
- To investigate the impact of specific air pollutants, including ozone and nitrogen dioxide, on infant cardiorespiratory events.
Main Methods:
- Utilized data from home cardiorespiratory monitors recording electrocardiogram, heart rate, and respiratory effort for 4,277 high-risk infants.
- Analyzed over 179,000 days of follow-up, focusing on 8,960 apnea and 29,450 bradycardia event-days.
- Assessed pollutant levels using a 2-day average of speciated particulate matter and gaseous air pollution, adjusting for confounding factors.
Main Results:
- Found associations between bradycardia and increased concentrations of 8-hr maximum ozone (OR=1.049 per 25-ppb) and 1-hr maximum nitrogen dioxide (OR=1.025 per 20-ppb).
- The association with ozone remained significant despite various statistical controls.
- Secondary analyses indicated stronger associations in full-term, normal birth weight infants compared to premature, LBW infants.
Conclusions:
- Higher ambient air pollution concentrations are suggested to increase the occurrence of apnea and bradycardia in high-risk infants.
- These findings underscore the potential respiratory and cardiovascular risks posed by air pollution to vulnerable infant populations.
- Further research may inform public health strategies to mitigate air pollution exposure in infants.
Background:
Evidence suggests that increased ambient air pollution concentrations are associated with health effects, although relatively few studies have specifically examined infants.
Objective:
We examined associations of daily ambient air pollution concentrations with central apnea (prolonged pauses in breathing) and bradycardia (low heart rate) events among infants prescribed home cardiorespiratory monitors.
Methods:
The home monitors record the electrocardiogram, heart rate, and respiratory effort for detected apnea and bradycardia events in high-risk infants [primarily premature and low birth weight (LBW) infants]. From August 1998 through December 2002, 4,277 infants had 8,960 apnea event-days and 29,450 bradycardia event-days in > 179,000 days of follow-up. We assessed the occurrence of apnea and bradycardia events in relation to speciated particulate matter and gaseous air pollution levels using a 2-day average of air pollution (same day and previous day), adjusting for temporal trends, temperature, and infant age.
Results:
We observed associations between bradycardia and 8-hr maximum ozone [odds ratio (OR) = 1.049 per 25-ppb increase; 95% confidence interval (CI), 1.021-1.078] and 1-hr maximum nitrogen dioxide (OR =1.025 per 20-ppb increase; 95% CI, 1.000-1.050). The association with ozone was robust to different methods of control for time trend and specified correlation structure. In secondary analyses, associations of apnea and bradycardia with pollution were generally stronger in infants who were full term and of normal birth weight than in infants who were both premature and LBW.
Conclusions:
These results suggest that higher air pollution concentrations may increase the occurrence of apnea and bradycardia in high-risk infants.
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