Información de la revista
Vol. 21. Núm. 2.
Páginas 162-171 (marzo - abril 2007)
Respuestas rápidas
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 21. Núm. 2.
Páginas 162-171 (marzo - abril 2007)
Artículo especial
Open Access
Exposición a contaminantes atmosféricos durante el embarazo y desarrollo prenatal y neonatal: protocolo de investigación en el proyecto INMA (Infancia y Medio Ambiente)
Air pollutant exposure during pregnancy and fetal and early childhood development. Research protocol of the INMA [Childhood and Environment Project]
Visitas
1110
Ana Espluguesa,b, Rosalía Fernández-Patierc, Inma Aguilerad, Carmen Iñígueza, Saúl García Dos Santosc, Amelia Aguirre Alfaroc, Marina Lacasañab, Marisa Estarlicha,b, Joan O. Grimalte, Marieta Fernándezf, Marisa Rebagliatog, María Salah, Adonina Tardóni, Maties Torrentj, María Dolores Martínezk, Núria Ribas-Fitód, Jordi Sunyerd, Ferran Ballestera,
Autor para correspondencia
ballester_fer@gva.es

Correspondencia: Dr. Ferran Ballester Díez. Escola Valenciana d’Estudis en Salut. Joan de Garay, 21. 46017 València. España.
a Escola Valenciana d’Estudis en Salut (EVES), Valencia, España
b Hospital Universitari La Fe, Valencia, España
c Instituto de Salud Carlos III (ISCIII), Centro Nacional de Sanidad Ambiental, Madrid, España
d Institut Municipal d’Investigació Mèdica (IMIM), Barcelona, España
e Institut d’Investigacions Químiques i Ambientals, CSIC, Barcelona, España
f Hospital Universitario San Cecilio, Universidad de Granada, Granada, España
g Departamento de Salud Pública, Universidad Miguel Hernández, Alicante, España
h Ajuntament de Sabadell, Barcelona, España
i niversidad de Oviedo, Asturias, España
j Àrea de Salut de Menorca, Islas Baleares, España
k Subdirección de Salud Pública de Guipúzcoa, España
Ver más
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Resumen
Introducción

El proyecto INMA (Infancia y Medio Ambiente) es una red de investigación cooperativa que tiene como objetivos estudiar los efectos del medio ambiente y la dieta en el desarrollo fetal e infantil. El objetivo de este artículo es presentar el protocolo de exposición a contaminantes atmosféricos durante el embarazo y desarrollo prenatal y neonatal en el proyecto INMA.

Métodos

La información para la evaluación de la exposición a contaminación atmosférica durante el embarazo se basa en mediciones de contaminantes atmosféricos en el exterior (dióxido de nitrógeno [NO2], compuestos orgánicos volátiles [COV], ozono, partículas [PM10, PM2,5] y su composición [hidrocarburos aromáticos policíclicos]), medición de contaminantes de exposición individual (en el interior de la vivienda y captadores personales [COV y NO2]), determinación de un marcador biológico de exposición a hidrocarburos (1-hidroxipireno), en información recogida mediante cuestionarios y en la utilización de sistemas de información geográfica. Esta información permite elaborar índices de exposición individual a contaminación atmosférica con los que analizar su posible relación con el desarrollo fetal y la salud del recién nacido.

Discusión

El protocolo que se presenta y el tipo de estudio permiten obtener una aproximación a la exposición individual a contaminantes atmosféricos. Por último, el elevado número de participantes (n=4.000), así como la heterogeneidad de las características ambientales y sociodemográficas, acrecienta el potencial del estudio.

Palabras clave:
Contaminación atmosférica
Embarazo
Infancia
Abstract
Introduction

The INMA (INfancia y Medio Ambiente [Spanish for Environment and Childhood]) project is a cooperative research network. This project aims to study the effects of environment and diet on fetal and early childhood development. This article aims to present the air pollutant exposure protocol during pregnancy and fetal and early childhood development of the INMA project.

Methods

The information to assess air pollutant exposure during pregnancy is based on outdoor measurement of air pollutants (nitrogen dioxide [NO2], volatile organic compounds [VOC], ozone, particulate matter [PM10, PM2,5] and of their composition [polycyclic aromatic hydrocarbons]); measurement of indoor and personal exposure (VOC and NO2); urinary measurement of a biological marker of hydrocarbon exposure (1-hydroxypyrene); and data gathered by questionnaires and geographic information systems. These data allow individual air pollutant exposure indexes to be developed, which can then be used to analyze the possible effects of exposure on fetal development and child health.

Conclusion

This protocol and the type of study allow an approximation to individual air pollutant exposure to be obtained. Finally, the large number of participants (N=4,000), as well as their geographic and social diversity, increases the study's potential.

Key words:
Air pollution
Pregnancy
Childhood
Fetal development
Cohort study
INMA
El Texto completo está disponible en PDF
Bibliografía
[1.]
J. Schwartz.
Air pollution and children's health.
Pediatrics, 113 (2004), pp. 1037-1043
[2.]
The effects of air pollution on children health and development World Health Organization. Report, 2004. Disponibleen: http://www.euro.who.int/childhealthenv/Risks/20050713_1
[3.]
M. Lacasana, A. Esplugues, F. Ballester.
Exposure to ambientair pollution and prenatal and early childhood health effects.
Eur J Epidemiol, 20 (2005), pp. 183-199
[4.]
S.V. Glinianaia, J. Rankin, R. Bell, T. Pless-Mulloli, D. Howel.
Particulate air pollution and fetal health. A systematic review of the epidemiologic evidence.
[5.]
M. Maisonet, A. Correa, D. Misra, J.J. Jaakkola.
A review of the literature on the effects of ambient air pollution on fetal growth.Enviro?.
Res, 95 (2004), pp. 106-115
[6.]
R.J. Sram, B. Binkova, J. Dejmek, M. Bobak.
Ambient air pollution and pregnancy outcomes: a review of the literature.
Envion Health Perspect, 113 (2005), pp. 375-382
[7.]
M. Bobak, D.A. Leon.
Pregnancy outcomes and outdoor air pollution: an ecological study in districts of the Czech Republic 1986-8.
Occup Environ Med, 56 (1999), pp. 539-543
[8.]
Z.P. Vassilev, M.G. Robson, J.B. Klotz.
Outdoor exposure to airborne polycyclic organic matter and adverse reproductive outcomes: a pilot study.
Am J Ind Med, 40 (2001), pp. 255-262
[9.]
K. Landgren.
Environmental pollution and delivery outcome in southern Sweden: a study with central registries.
Acta Paediatr, 63 (1996), pp. 1361-1364
[10.]
X. Wang, H. Ding, L. Ryan, X. Xu.
Association between air pollution and low birth weight: a community-based study.
Environ Health Perspect, 105 (1997), pp. 514-520
[11.]
B. Ritz, F. Yu.
The effect of ambient carbon monoxide on low birth weight among children born in southern California between 1989 and 1993.
Environ Health Perspect, 107 (1999), pp. 17-25
[12.]
M. Bobak.
Outdoor air pollution, low birth weight, and prematurity.
Environ Health Perspect, 108 (2000), pp. 173-176
[13.]
J.F. Rogers, S.J. Thompson, C.L. Addy, R.E. McKeown, D.J. Cowen, P. Decouflé.
Association of very low birth weight with exposures to envioronmental sulfur dioxide and total suspended particles.
Am J Epidemiol, 151 (2000), pp. 602-613
[14.]
M. Maisonet, T.J. Bush, A. Correa, J.J. Jaakkola.
Relation betweenambient air pollution and low birth weight in the northeastern United States.
Environ Health Perspect, 109 (2001), pp. 351-356
[15.]
M.C. Lin, H.S. Yu, S.S. Tsai, B.H. Cheng, T.Y. Hsu, T.N. Wu, et al.
Adverse pregnancy outcome in a petrochemical polluted area in Taiwan.
J Toxicol Environ Health A, 63 (2001), pp. 565-574
[16.]
E.H. Ha, Y.C. Hong, B.E. Lee, B.H. Woo, J. Schwartz, D.C. Christiani.
Is air pollution a risk factor for low birth weight in Seoul?.
Epidemiology, 12 (2001), pp. 643-648
[17.]
H. Dolk, S. Pattenden, M. Vrijheid, B. Thakrar, B. Amstrong.
Perinatal and Infant mortality and low birth weight among residents near coke Britain.
Arch Environ Health, 55 (2000), pp. 26-30
[18.]
M. Bobak, M. Richards, M. Wadsworth.
Air Pollution and birth weight in Britain in 1946.
Epidemiology, 16 (2001), pp. 358-359
[19.]
L. Maroziene, R. Grazuleviciene.
Maternal exposure to low-level air pollution and pregnancy outcomes: a population-based study.
Environ Health, 1 (2002), pp. 6
[20.]
F.P. Perera, V. Rauh, W.Y. Tsai, P. Kinney, D. Camann, D. Barr, et al.
Effects of transplacental exposure to environmental pollutants on birth outcomes in a multiethnic population.
Environ Health Perspect, 111 (2003), pp. 201-206
[21.]
M. Wilhelm, B. Ritz.
Residential proximity to traffic and adverse birth outcomes in los angeles county, california, 1994-1996.
Environ Health Perspect, 111 (2003), pp. 207-216
[22.]
C.Y. Yang, Y.T. Tseng, C.C. Chang.
Effects of air pollution on birth weight among children born between 1995 and 1997 in Kaohsiung, Taiwan.
J Toxicol Environ Health A, 66 (2003), pp. 807-816
[23.]
J. Dejmek, I. Solansky, I. Benes, J. Lenicek, R.J. Sram.
The impact of polycyclic aromatic hydrocarbons and fine particles on pregnancy outcome.
Environ Health Perspect, 108 (2000), pp. 1159-1164
[24.]
J. Dejmek, S.G. Selevan, I. Benes, I. Solansky, R.J. Sram.
Fetal growth and maternal exposure to particulate matter during pregnancy.
Environ Health Perspect, 107 (1999), pp. 475-480
[25.]
M.C. Lin, H.F. Chiu, H.S. Yu, S.S. Tsai.
Increased risk ofpreterm delivery in areas with air pollution from a petroleum refinery plant in Taiwan..
J Toxicol Environ Health, 64 (2001), pp. 637-644
[26.]
X. Xu, H. Ding, X. Wang.
Acute effects of total suspended particlesand sulfur dioxides on preterm delivery: a communitybased cohort study.
Arch Environ Health, 50 (1995), pp. 407-415
[27.]
B. Ritz, F. Yu, G. Chapa, S. Fruin.
Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993.
Epidemiology, 11 (2000), pp. 502-511
[28.]
C.Y. Yang, H.F. Chiu, S.S. Tsai, C.C. Chang, H.Y. Chuang.
Increasedrisk of preterm delivery in areas with cancer mortality problems from petrochemical complexes.
Environ Res, 89 (2002), pp. 195-200
[29.]
S.S. Tsai, H.S. Yu, C.C. Liu, C.Y. Yang.
Increased incidence of preterm delivery in mothers residing in an industrialized area in Taiwan.
J Toxicol Environ Health A, 66 (2003), pp. 987-994
[30.]
T.J. Woodruff, J.D. Parker, A.D. Kyle, K.C. Schoendorf.
Disparities in exposure to air pollution during pregnancy.
Environ Health Perspect, 111 (2003), pp. 942-946
[31.]
J.D. Parker, T.J. Woodruff, R. Basu, K.C. Schoendorf.
Air pollution and birth weight among term infant in California.
Pediatrics, 115 (2005), pp. 121-128
[32.]
S. Liu, D. Krewski, Y. Shi, Y. Chen, R.T. Burnett.
Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancuver, Canada.
Environ Health Perspect, 111 (2003), pp. 1773-1778
[33.]
W. Jedrychowski, I. Bendkowska, E. Flak, A. Penar, R. Jacek, I. Kaim, et al.
Estimated risk for altered fetal growth resulting from exposure to fine particles during pregnancy: an epidemiologicprospective cohort study in Poland.
Environ Health Perspect, 12 (2004), pp. 1398-1402
[34.]
F. Dominici, A. McDermott, M. Daniels, S.l. Zeger, J.M. Samet.
Revised analyses of the National Morbidity, Mortality and Air Pollution Study: mortality among residents of 90 cities.
J Toxicol Environ Health A, 68 (2005), pp. 1071-1092
[35.]
R.M. Ramón, F. Ballester, M. Rebagliato, N. Ribas, M. Torrent, M. Fernández, et al.
La Red de Investigación «Infancia y MedioAmbiente» (Red INMA): protocolo de estudio.
ev Esp Salud Pública, 79 (2005), pp. 203-220
[36.]
Infancia y Medio Ambiente [citado 6 Mar 2006] Disponible en: http://www.infanciaymedioambiente.org/
[37.]
Calidad del aire Determinación de la fracción PM10 de la material particulada en suspensión. Método de referencia y procedimiento de ensayo de campo para demostrar la equivalencia de los métodos de medida al de referencia. UNE-EN 12341 1999
[38.]
J. Sunyer, C. Puig, M. Torrent, O. García-Algar, I. Calico, L. Munoz-Ortiz, et al.
Nitrogen dioxide is not associated with respiratory infection during the first year of life.
Int J Epidemiol, 33 (2004), pp. 116-120
[39.]
I. Carvajal-Ureña, L. García-Marcos, R. Busquets-Monge, M. Morales Suárez-Varela, N. García de Andoín, J. Batlles-Garrido, et al.
Geographic variation in the prevalence of asthma symptoms in spanish children and adolescents. International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3, Spain.
Arch Bronconeumol, 41 (2005), pp. 659-666
[40.]
F.P. Perera, V. Rauh, R.M. Whyatt, D. Tang, W.Y. Tsai, J.T. Bernert, et al.
A summary of recent findings on birth outcomes and developmental effects of prenatal ETS, PAH, and pesticide exposures.
Neurotoxicology, 26 (2005), pp. 573-587
[41.]
F. Perera, R. Tang D Whyatt, S.A. Lederman, W. Jedrychowski.
DNA damage from polycyclic aromatic hydrocarbons measured by benzo[a]pyrene-DNA adducts in mothers and newborns from NorthernManhattan, the World Trade Center Area, Poland, and China.
Cancer Epidemiol Biomarkers Prev, 14 (2005), pp. 709-714
[42.]
R.J. Šram, B. Binkova, P. Rossner, J. Rubes, J. Topinka, J. Dejmek.
Adverse reproductive outcomes from exposure to environmental mutagens.
Mutat Res, 428 (1999), pp. 203-215
[43.]
E. Sanderson, D. Briggs, M. Jantunen, B. Forsberg, M. Svartengren, R. Šram.
Human exposure to transport-related air pollution.
Health effects of transport-related air pollution, pp. 89-90
[44.]
Avon Longitudinal Study of Parents and Children (ALSPAC) [citado 6 Mar 2006] Disponible en: http://www.alspac.bristol.ac.uk/protocol/default
[45.]
J. Olsen, M. Melbye, S.F. Olsen, T.IA. Sorensen, P. Aaby, A.M. Nybo Andersen.
The Danish National Birth Cohort: its background, structure and aim.
Scand J Public Health, 29 (2001), pp. 300-307
[46.]
Nacional Children Study [citado 6 Mar 2006] Disponible en: http://www.nationalchildrensstudy.gov
[47.]
Etude longitudinale française depuis l’enfance (ELFE) [consultado 6 Mar 2006] Disponible en http://www.elfe.ined.fr/
Copyright © 2007. Sociedad Española de Salud Pública y Administración Sanitaria
Descargar PDF
Idiomas
Gaceta Sanitaria
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?