Air pollution exposure and social responsiveness in childhood: The cincinnati combined childhood cohorts

Autism Spectrum Disorder (ASD) affects about 1 in 44 children and environmental exposures may contribute to disease onset. Air pollution has been associated with adverse neurobehavioral outcomes, yet little research has examined its association with autistic-like behaviors. Therefore, our objective was to examine the association between exposure to air pollution, including NO2 and PM2.5, during pregnancy and the first year of life to ASD-like behaviors during childhood. Participants (n = 435) enrolled in the Cincinnati Childhood Allergy and Air Pollution Study and the Health Outcomes and Measures of the Environment Study were included in the analysis. Daily exposures to NO2 and PM2.5 at the residential addresses of participants were estimated using validated spatiotemporal models and averaged to obtain prenatal and first year exposure estimates. ASD-like behaviors were assessed via the Social Responsiveness Scale (SRS) questionnaire at age 12. Linear regression models adjusting for confounders were applied to estimate the association between pollutants and SRS scores. After adjusting for covariates, the association between NO2 and PM2.5 and SRS scores remained positive but were no longer statistically significant. Prenatal and first year exposure to NO2 were associated with total SRS T-scores with an estimated 0.4 point increase (95% CI:-0.7, 1.6) per 5.2 ppb increase in NO2 exposure and 0.7 point (95% CI:-0.3, 1.6) per 4.2 ppb increase in NO2 exposure, respectively. For PM2.5, a 2.6 mu g/m3 increase in prenatal exposure was associated with a 0.1 point increase (95% CI:-1.1, 1.4) in SRS Total T-scores and a 1.3 mu g/m3 increase first year of life was associated with a 1 point increase (95% CI:-0.2, 2.3). In summary, exposure to NO2 and PM2.5 during pregnancy and the first year of life were not significantly associated with higher autistic-like behaviors measured with SRS scores after adjustment of covariates. Additional research is warranted given prior studies suggesting air pollution contributes to ASD.

Automated summary

Exposure to air pollutants NO2 and PM2.5 during pregnancy and the first year of life may increase the risk of Autism Spectrum Disorder (ASD) in children, but this association is no longer significant after controlling for confounding factors.