| Does Particulate Air Pollution Contribute to Infant Death? A Systematic Review Svetlana V. Glinianaia, Judith Rankin, Ruth Bell, Tanja Pless-Mulloli, and Denise Howel Public Health Research Group, School of Population and Health Sciences, Faculty of Medical Sciences, University of Newcastle, Newcastle upon Tyne, United Kingdom Abstract
There is now substantial evidence that both short- and long-term increases in ambient air pollution are associated with increased mortality and morbidity in adults and children. Children's health is particularly vulnerable to environmental pollution, and infant mortality is still a major contributor to childhood mortality. In this systematic review we summarize and evaluate the current level of epidemiologic evidence of an association between particulate air pollution and infant mortality. We identified relevant publications using database searches with a comprehensive list of search terms and other established search methods. We included articles in the review according to specified inclusion criteria. Fifteen studies met our inclusion criteria. Evidence of an association between particulate air pollution and infant mortality in general was inconsistent, being reported from locations with largely comparable pollution levels. There was some evidence that the strength of association with particulate matter differed by subgroups of infant mortality. It was more consistent for postneonatal mortality due to respiratory causes and sudden infant death syndrome. Differential findings for various mortality subgroups within studies suggest a stronger association of particulate air pollution with some causes of infant death. Research is needed to confirm and clarify these links, using the most appropriate methodologies for exposure assessment and control of confounders. Key words: infant mortality, particulate air pollution, postneonatal respiratory mortality, sudden infant death syndrome, systematic review. Environ Health Perspect 112: 1365-1370 (2004) . doi:10.1289/ehp.6857 available via http://dx.doi.org/ [Online 3 June 2004]
Address correspondence to S.V. Glinianaia, School of Population and Health Sciences, Faculty of Medical Sciences, University of Newcastle, Newcastle upon Tyne, NE2 4HH, United Kingdom. Telephone: 0191-222-5891. Fax: 0191-222-8211. E-mail: svetlana.glinianaia@ncl.ac.uk The major part of the work on this review was supported by funds from the School of Population and Health Sciences (Epidemiology and Public Health) , University of Newcastle. Additional literature searching and reviewing of articles published in 2002-2003 and revision to the manuscript in response to reviewers' comments were supported by Wellcome Trust grant 072465/Z/03/Z. The authors declare they have no competing financial interests. Received 12 November 2003 ; accepted 3 June 2004.
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