Exploring relationships between smoke exposure, housing characteristics, and preterm birth in California

Rachel Sklar; Sally Picciotto; Dan Meltzer; Dana E Goin; ShihMing Huang; Frederick Lurmann; Elizabeth Noth; Nathan Pavlovic; Rachel Morello-Frosch; Amy M Padula

doi:10.1016/j.envpol.2024.125022

Exploring relationships between smoke exposure, housing characteristics, and preterm birth in California

Environ Pollut. 2024 Sep 27;363(Pt 1):125022. doi: 10.1016/j.envpol.2024.125022. Online ahead of print.

Authors

Affiliations

¹ Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA. Electronic address: rachel.sklar@ucsf.edu.
² Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
³ Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, USA.
⁴ Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
⁵ Sonoma Technology Inc., Petaluma, CA, USA.
⁶ Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, CA, USA.
⁷ Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.

PMID: 39343350
DOI: 10.1016/j.envpol.2024.125022

Abstract

Pregnant people are vulnerable to air pollution exposure, including risk of preterm birth, low birth weight, and stillbirth. Understanding the infiltration of outdoor wildfire smoke into a residential space is critical for the accurate assessment of wildfire smoke exposure and associated health effects in pregnant people. Relying on ambient measurements of wildfire smoke alone can result in exposure misclassification. In this study, we examine the role of physical housing characteristics in the relationship between smoke exposure and preterm birth. In particular, we examine the effect of home size, year of construction, cooling type, and renovation status, as effect modifiers in the relationship between smoke exposure during pregnancy and preterm birth from 2007 to 2015 in California. To do this, we combined data on home characteristics from the California Tax Assessor, birth outcomes from the California birth records database, and the number of smoke days for each pregnancy from theNOAA (National Oceanic and Atmospheric Administration) Hazard Mapping System (HMS). We estimated the association between smoke day exposures and odds of preterm birth using logistic regression models and stratified by air basin and housing characteristics. Our findings reveal that cooling type and renovation status are key factors modifying the smoke exposure-preterm birth relationship. Notably, we found elevated associations for people living in unrenovated homes, those using evaporative cooling systems, and those using central air conditioning units. While we observed elevated odds of preterm birth associated with increasing smoke day exposure for residents of large and new homes, this effect does not significantly differ across home size and age quartiles. This study highlights the need to further examine the relative roles of housing characteristics as well as factors not measured here including behavioral factors, time spent outdoors, window use, and occupational exposures in driving adverse birth outcomes related to wildfire smoke exposure.

Keywords: Air pollution; Housing; Housing quality; Pregnancy; Preterm birth; Wildfire smoke.