Environment/Climate Change
Investigating the relationship between lead in private drinking well water and climate change factors on preterm birth risk in North Carolina Eric Brown Jr.* Eric Brown JR. Rebecca Fry Lauren Eaves
Prenatal exposure to various environmental chemicals, including lead in drinking water, is associated with increased risk of preterm birth. With a rapidly changing climate, the toxicity and distribution of environmental chemicals are projected to increase. The effects of these varied exposures on the health of infants are understudied. North Carolina birth certificates between 2003-2014 (n = 1,148,438) were geocoded based on maternal residence at delivery. Pregnancies were assigned exposures for air toxicants (e.g., PM2.5 and ozone), average tract-level lead well water concentrations, and ambient temperature. We evaluated associations between single climate change-related factors and preterm birth using adjusted logistic regression models. Climate change-related mixtures were assessed using quantile-based g-computation. Individually, air pollutants exposure within the first trimester increased the risk for preterm birth (PM2.5: 1.48 OR (1.48, 1.49), Ozone: 1.01 OR (1.01,1.01)). Exposure to a mixture of PM2.5, ozone and lead was modified by heat; with pregnancies exposed to average ambient temperature above 70.7°F in the last two weeks of pregnancy having the greatest risk of preterm birth (7.15 OR (6.27, 8.16)). Socioeconomic factors, specifically neighborhood deprivation, enhanced this risk, with higher deprived areas having 7.17 OR (5.97, 8.62). In a cohort of over 1 million births, this study identified that individual climate-related stressors are associated individually and in mixtures with preterm birth. This study is among the first to examine how a mixture of climate change-related factors (heat and air pollution) and a chemical exposure (lead in drinking water) are associated with preterm birth.