The Asian Games, air pollution and birth outcomes in South China: An instrumental variable approach

We estimate the effects of air-pollution exposure on low birthweight, birthweight, and prematurity risk in South China, for all expectant mothers and by maternal age group and child sex. We do so by exploiting exogenous improvement in air quality during the 2010 Guangzhou Asian Games, when strict regulations were mandated to assure better air quality. We use daily air-pollution levels collected from monitoring stations in Guangzhou, the Asian Games host city, and Shenzhen, a nearby control city, between 2009 and 2011. We first show that air quality during the Asian Games significantly improved in Guangzhou, relative to Shenzhen. Next, using birth-certificate data for both cities for 2009-2011 and using expected pregnancy overlap with the Asian Games as an instrumental variable, we study the effects of three pollutants (PM₁₀, SO₂, and NO₂) on birth outcomes. Four main conclusions emerge: 1) air pollutants significantly reduce average birthweight and increase preterm risk; 2) for birthweight, late pregnancy is most sensitive to PM₁₀ exposure, but there is not consistent evidence of a sensitive period for other pollutants and outcomes; 3) for birthweight, babies of mothers who are at least 35 years old show more vulnerability to all three air pollutants; and 4) male babies show more vulnerability than female babies to PM₁₀ and SO₂, but birthweights of female babies are more sensitive than those of male babies to NO₂.