By Molly Rauch
What a pregnant mom eats, drinks, and breathes can obviously affect her baby. We know this from studies of alcohol consumption and cigarette smoking, among other things. But how does air pollution affect her baby? Can the pollution a pregnant mom inhales, such as fine particles or soot, unknowingly cause health problems years down the line, when that baby is a teenager?
Dr. Frederica Perera, a professor at Columbia University’s Mailman School of Public Health and director of the Columbia Center for Children’s Environmental Health, focuses her research on just this question. She has been examining the effects of environmental exposures on pregnant women and their children for 15 years. Using personal air monitoring “backpacks” combined with ambient air monitors, Dr. Perera has been investigating the effects of air pollution on more than 700 mothers and their children in Northern Manhattan, with other ongoing studies in Poland and China.
Dr. Perera’s research explores the relationship between air pollution – specifically, exposure to polycyclic aromatic hydrocarbons (PAHs) – and birth weight, cancer markers, asthma, learning and behavior, obesity, and other health effects. PAHs are a group of chemicals released into the air when organic matter is burned, such as coal, gasoline, diesel fuel, firewood, and tobacco.
I spoke with her recently about her research.
Why do you study air pollution?
I study air pollution because it is a common and widespread exposure, in this country and of course globally. We have learned during the last several decades that exposure to air pollution has multiple adverse outcomes. Our work is focused on the prenatal window of susceptibility and the early period of child development because we know from many lines of evidence that this is a particularly important period for the potential disruption of normal development by environmental exposures. That’s been shown experimentally [in laboratory animals] and also in some studies, such as ours, in humans.
What are the major sources of air pollution for the population that you study?
We can talk about indoor and outdoor air pollution and sometimes people think that they’re completely separate, but they’re not. There is a great deal of exchange of air between the outdoor and indoor environment. Buildings are quite permeable, surprisingly so. The major sources of air pollution are combustion of organic material. Of course, fossil fuel combustion is a major source in urban areas. We’re talking about diesel, oil for heating, gasoline for vehicles, and coal burning. In addition, tobacco smoking causes air pollution. That’s a major indoor source, and it’s an indoor source of some of the very pollutants found in outdoor air from these other combustion sources.
Correlations between the levels of indoor and outdoor pollutants indicate that there is a considerable transfer from the outdoor to the indoor environment.
What are the health effects that you’re looking for?
Birth outcomes is the first thing we look at – birth weight, length, head circumference – and then we look at child development using standardized, validated measurements and instruments. We do the assessments periodically from the time the child is born all the way through adolescence. Our oldest children in the study are now 14. Of course the instruments change over time. They are age-appropriate tests and we’re able to gather more and more information, more refined information, on child development in different domains that are not accessible or would not have emerged at the early ages. Neurobehavioral development and cognitive development are important outcomes of interest for us in our research.
[What are Dr. Perera's findings on fetal growth and developmental effects? From her Center's website:]
Also we’re looking at asthma as an outcome. We have been publishing results on our findings with respect to both prenatal and postnatal exposure to Polycyclic Aromatic Hydrocarbons [PAHs] and asthma in childhood. We’re continuing to follow the kids to be able to look at whether these conditions are persisting, are resolving, or even worsening. So respiratory health is a major outcome.
[What are Dr. Perera's findings on asthma and air pollution? From her Center's website:]
We’re also interested in potential risk of cancer. In our cohort we’re not able to look at cancer as an outcome because we don’t have the very large sample sizes needed for such studies. But we are able to look at what we call “procarcinogenic biomarkers.” We’re evaluating those particular chromosomal abnormalities, or chromosomal changes, attributable to or associated with the exposures. We look at this prenatally, we look at cord blood, and then we take repeat blood samples as the children are getting older, and are looking further at the chromosomal abnormalities in those older samples.
Research from our center has shown that in newborns, PAHs were associated with chromosomal aberrations. It’s not cancer per se, but it is a biomarker that has been shown in adults to be related to risk of cancer, so it’s a biomarker of concern.
[What are Dr. Perera's findings on cancer and air pollution? From her Center's website:]
The other endpoints that we’re looking at are obesity and metabolic disorder. We are following up on some work in laboratories that had suggested that air pollution we’re interested in, the PAH, might be associated with increased weight and obesity. We have published from the Center the first finding that in fact there was a significant link between prenatal PAH exposure as we measured it and later body mass index of the children.
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