Residential particulate matter, proximity to major roads, traffic density and traffic volume as risk factors for preterm birth in California

Background While pollution from vehicle sources is an established risk factor for preterm birth, it is unclear whether distance of residence to the nearest major road or related measures like major road density represent useful measures for characterising risk. Objective To determine whether major road proximity measures (including distance to major road, major road density and traffic volume) are more useful risk factors for preterm birth than other established vehicle-related measures (including particulate matter <2.5 mu m in diameter (PM2.5) and diesel particulate matter (diesel PM)). Methods This retrospective cohort study included 2.7 million births across the state of California from 2011-2017; each address at delivery was geocoded. Geocoding was used to calculate distance to the nearest major road, major road density within a 500 m radius and major road density weighted by truck volume. We measured associations with preterm birth using risk ratios adjusted for target demographic, clinical, socioeconomic and environmental covariates (aRRs). We compared these to the associations between preterm birth and PM2.5 and diesel PM by census tract of residence. Results Findings showed that whereas higher mean levels of PM2.5 and diesel PM by census tract were associated with a higher risk of preterm birth, living closer to roads or living in higher traffic density areas was not associated with higher risk. Residence in a census tract with a mean PM2.5 in the top quartile compared with the lowest quartile was associated with the highest observed risk of preterm birth (aRR 1.04, 95% CI 1.04, 1.05). Conclusions Over a large geographical region with a diverse population, PM2.5 and diesel PM were associated with preterm birth, while measures of distance to major road were not, suggesting that these distance measures do not serve as a proxy for measures of particulate matter in the context of preterm birth.

Automated summary

In a large population study in California, it was found that higher levels of PM2.5 and diesel PM were associated with an increased risk of preterm birth, while living closer to major roads or in areas with high traffic density did not increase the risk of preterm birth. This suggests that measures of distance to major roads do not serve as a proxy for particulate matter levels in relation to preterm birth.