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Frederica P. Perera,¹ Deliang Tang,¹ Virginia Rauh,¹ Kristin Lester,¹ Wei Yann Tsai,¹ Yi Hsuan Tu,¹ Lisa Weiss,¹ Lori Hoepner,¹ Jeffrey King,² Giuseppe Del Priore,³ and Sally Ann Lederman¹

¹Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, New York, USA; ²Department of Obstetrics and Gynecology at St. Vincent's Medical Center, New York, New York, USA; ³Department of Obstetrics and Gynecology at New York University Downtown Hospital, New York, New York, USA

Abstract
Polycyclic aromatic hydrocarbons (PAHs) are toxic pollutants released by the World Trade Center (WTC) fires and various urban combustion sources. Benzo[a]pyrene (BaP) is a representative member of the class of PAHs. PAH-DNA adducts, or BaP-DNA adducts as their proxy, provide a measure of chemical-specific genetic damage that has been associated with increased risk of adverse birth outcomes and cancer. To learn whether PAHs from the WTC disaster increased levels of genetic damage in pregnant women and their newborns, we analyzed BaP-DNA adducts in maternal (n = 170) and umbilical cord blood (n = 203) obtained at delivery from nonsmoking women who were pregnant on 11 September 2001 and were enrolled at delivery at three downtown Manhattan hospitals. The mean adduct levels in cord and maternal blood were highest among newborns and mothers who resided within 1 mi of the WTC site during the month after 11 September, intermediate among those who worked but did not live within this area, and lowest in those who neither worked nor lived within 1 mi (reference group) . Among newborns of mothers living within 1 mi of the WTC site during this period, levels of cord blood adducts were inversely correlated with linear distance from the WTC site (p = 0.02) . To learn whether PAHs from the WTC disaster may have affected birth outcomes, we analyzed the relationship between these outcomes and DNA adducts in umbilical cord blood, excluding preterm births to reduce variability. There were no independent fetal growth effects of either PAH-DNA adducts or environmental tobacco smoke (ETS) , but adducts in combination with in utero exposure to ETS were associated with decreased fetal growth. Specifically, a doubling of adducts among ETS-exposed subjects corresponded to an estimated average 276-g (8%) reduction in birth weight (p = 0.03) and a 1.3-cm (3%) reduction in head circumference (p = 0.04) . The findings suggest that exposure to elevated levels of PAHs, indicated by PAH-DNA adducts in cord blood, may have contributed to reduced fetal growth in women exposed to the WTC event. Key words: DNA adducts, fetal growth, newborns, PAHs, World Trade Center. Environ Health Perspect 113:1062-1067 (2005) . doi:10.1289/ehp.7908 available via http://dx.doi.org/ [Online 20 April 2005]

Address correspondence to F. Perera, Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, 100 Haven Ave., #25F, Tower 3, New York, NY 10032 USA. Telephone: (212) 304-7280. Fax: (212) 544-1943. E-mail: fpp1@columbia.edu

We thank J.L. Stein, Department of Obstetrics and Gynecology, Beth Israel Medical Center ; the staff of the Elizabeth Seton Childbearing Center ; and the staff of the obstetrics and pediatric departments and the administrations of the three recruitment hospitals, who made this study possible on very short notice. Thanks also to L. Qu and Y. Jin for laboratory assistance ; M. Becker and T. Chai-Onn for the geographic information system ; R. Day, C. Fields, M. Horton, S.B. Joy, K. Wan, E. Wong, and A. Sanchez, who assisted in enrolling participants ; H. Andrews for statistical advice ; G. Simpson for assistance with data management ; and K. Sims for office assistance to the project. And we thank the women who were willing to consider our project while they were in labor and to participate at a difficult and busy time.

This work was supported by grants from the September 11th Fund of The New York Community Trust and United Way of New York City and by the New York Times 9/11 Neediest Fund ; National Institute of Environmental Health Sciences (NIEHS) grants, 5P01 ES09600 and 5RO1 ES08977, and U.S. Environmental Protection Agency grant R827027, awarded to the Columbia Center for Children's Environmental Health ; and supplemental grant NIEHS ES09089 awarded to the NIEHS Center for Environmental Health in Northern Manhattan. The funders listed had no role in the design and conduct of the study, in the collection, analysis, or interpretation of the data, or in reviewing or approving the manuscript.

The authors declare they have no competing financial interests.

Received 5 January 2005 ; accepted 20 April 2005.