Study finds Connection between Air Pollution and Autism
Two new studies suggest that rising autism rates might be connected at least in part to air pollution from traffic. They are not the first to show a link between exposure to pollutants during pregnancy or early life and the diagnosis of autism spectrum disorders. But both studies look at large populations and find a link with relatively low levels of pollutants.
In a study of 132,256 births in Vancouver, Canada, published Monday in JAMA Pediatrics, researchers detected an association between exposure to roadway pollution in utero and later diagnosis with autism. The study’s strengths were its large size and its method of diagnosing autism, which can be inconsistent.
The second study, published earlier this fall in Environmental Epidemiology (but not yet available online), found a link between pollution exposures during the first months of life and later diagnosis with autism. That study looked at more than 15,000 infants born between 1989 and 2013 in Denmark.
Most of the 10 previous studies examining air pollution and autism, including one published earlier this year using data from Israel, found a similar connection.
Although no one study is definitive, the accumulation of research suggests that the link is real and that more needs to be done to reduce emissions, said Amy Kalkbrenner, an associate professor and environmental epidemiologist at the University of Wisconsin, Milwaukee, who was not involved in either study.
Kalkbrenner said she does not want to alarm young families, but does want to get the word out that pollution from cars and trucks may pose a risk. “If we care about autism, we should be concerned,” she said.
Small exposures may be one of the cascading triggers for autism — along with genetics and other causes, such as infections during pregnancy, Kalkbrenner said.
It’s possible, she and others said, that exposure to high levels of pollution cause early fetal death — the pregnancies simply don’t survive. Low-level exposures, meanwhile, could have more subtle effects on brain development, she said.
This finding is consistent with other research into air pollution that shows different health effects from different levels of exposure, she and others said.
Paradoxically, autism diagnosis rates have skyrocketed as pollution rates have plummeted. Both Vancouver and Denmark are considered to have very clean air.
There’s no good explanation for that yet, said Dr. Bruce Lanphear, a co-author of the Vancouver study, and a professor at Simon Fraser University in British Columbia, Canada. “Part of the way it might make sense,” he said, “is that the composition of air pollution may have changed.”
Traffic is not the only pollutant linked to autism. In the study in Denmark, researchers found a connection between autism and higher levels of sulfur dioxide, potentially connected to the shipping industry, according to first author Beate Ritz. Other research in rural areas has connected autism to a mother’s exposure to certain pesticides. None of these epidemiological studies can prove that pollution causes autism, but any research intentionally exposing children to pollutants in order to definitively show a link would be unethical.
In the Danish study, which was conducted before a change in the definition of autism, researchers found a connection between air pollution and full-blown autism as well as Asperger’s, but not with something called pervasive developmental disorder. Autism is defined by social and communication difficulties, and repetitive behaviors. Asperger’s includes the same symptoms, but usually with less severe communication challenges. PDD is a group of disorders characterized by delays in socialization and communication skills. All three are now folded into one condition called autism spectrum disorders. The difference researchers found suggests that pollution may have a more specific effect on autism than previously realized, said Ritz, a professor of epidemiology in
She and Lanphear both said they became interested in the topic from personal experience. Ritz’s first child was born below ideal weight, and Lanphear’s second child suffered respiratory problems in infancy — both while living near a highway. Lower birth weight and respiratory issues are also linked to pollution.
Ritz said she moved out from under a freeway before her second pregnancy. Although noting that one person’s experience doesn’t prove anything, Ritz said her second child was born at a healthier weight. “I was the lucky one who could actually act,” she said, “and feel better about having acted.”
Governments should also take notice of this data, Lanphear added, saying that schools and new residential developments should be located away from busy roadways to avoid a variety of potential problems from pollution.
“There is an urgency over the next decade or two to find ways to dramatically reduce our exposures to air pollution, and in this case particularly in pregnant woman,” he said. “I would reiterate that we don’t have definitive evidence, but collectively, we have enough.”
This story has been updated to say that Beate Ritz’ research found an association between air pollutant exposure during early infancy and later autism diagnosis.
Utah study: Pollution presents higher health risks for childhood cancer survivors
By Lauren Bennett Published: April 23, 2019 6:06 pm
SALT LAKE CITY — Childhood cancer survivors are at a higher risk for respiratory-related hospitalizations on poor air quality days, according to new research from the Huntsman Cancer Institute.
"Cancer treatments are a miracle of modern medicine and we're able to cure a lot of people that we couldn't save before," said Dr. Judy Ou, lead author of the study. "Because of this growing survivor population, preserving their health and making sure they can live their lives in a high-quality fashion is really important."
About 80 percent of children diagnosed with cancer will survive their disease according to the cancer institute. With the childhood cancer-surviving population on the rise, researchers thought it was important to better understand health concerns that could impact this growing group.
The Huntsman Cancer Institute in Salt Lake City is pictured on Tuesday, April 23, 2019. During a press conference Tuesday, Huntsman Cancer Institute researchers spoke about their findings on the negative effects of Utah’s air pollution on childhood cancer survivors.
Researchers used the Utah Population Database to study a sample of nearly 4,000 child, adolescent and young adult cancer survivors who were treated at Primary Children's Hospital between 1986 and 2012.
The study, titled "Fine Particulate Matter and Respiratory Healthcare Encounters among Survivors of Childhood Cancers," had three groups: those who received chemotherapy as part of treatment, those who did not, and a cancer-free control group.
Researchers tracked medical records for participants, paying special attention to hospitalizations or emergency room visits for respiratory illnesses that occurred on unhealthy air days.
The Utah Department of Environmental Quality tracks air quality conditions by area and rates air quality for that day on a color scale where red indicates unhealthy air and green indicates healthy air.
The results of the study showed cancer survivors were at a higher risk for respiratory-related hospitalizations when air pollution was below the standard considered unhealthy for sensitive groups.
In other words, researchers saw cancer survivors were at a higher risk for hospitalization on yellow days, or a moderately healthy day, rather than orange days, which are considered unhealthy for sensitive groups.
The chemotherapy group was twice as likely to need medical attention for respiratory issues.
Ou noted that respiratory issues are a leading non-cancer cause of death among survivors. Air pollution can contribute to respiratory problems, Ou said.
The Salt Lake City skyline is pictured on Tuesday, April 23, 2019. During a press conference Tuesday, Huntsman Cancer Institute researchers spoke about their findings on the negative effects of Utah’s air pollution on childhood cancer survivors.
"There's I think an increasing amount of research showing that the thresholds we use for air pollution may not really be protecting everyone the way that they should be," added Dr. Anne Kirchhoff, researcher on the study and a pediatrics professor at the University of Utah.
The research was funded by St. Baldrick's Foundation, a nonprofit dedicated to childhood cancer research. Ou and Kirchhoff said they plan to conduct future studies examining adult cancer survivors.
A majority of hospitalizations, at 91 percent, and 75 percent of emergency room visits occurred along the Wasatch Front in Salt Lake, Davis, Utah and Weber counties.
The study examined acute, or short-term respiratory issues and the pair said they plan to conduct future studies that look at long-term problems for childhood cancer survivors potentially caused by low air quality.
Ou said reducing air pollution is a win-win for everybody — it would protect both the vulnerable and the general population, create a healthier environment and potentially reduce economic impacts.
"We know that people who had cancer are susceptible to respiratory health issues, cardiac issues as well as second cancers," she said. "And so just from an economics perspective, if we can reduce their burden of disease, we'll be saving our society a lot of money in the long run. And compared to the cost of medical care, reducing particulate matter could be a very cost-effective way to reduce their impact on our health care system."
Dr. Douglas Fair, a pediatric oncologist at Primary Children's Hospital, advised childhood cancer survivors to speak with their physicians if they are concerned, they're at risk for air pollution-related respiratory issues.
"I would also encourage them to advocate for cleaner air in Utah," he said. "I think we can all work in this state to improve air quality because I think there are lots of vulnerable populations."
Doctors and health care providers work hard to cure these patients of cancer, he added, and said survivors deserve a high quality of life.
"I think it's important for all of us to really try to help them live the healthiest lives possible after that," he said. "And in Utah, one of the things that we really can do is decrease the air pollution that they're exposed to."