Effect of PM(10) and O(3) on infant mortality among residents in the Mexico City Metropolitan Area: a case-crossover analysis, 1997-2005

Abstract

Introduction: Consistent evidence has shown a positive association between air pollution and daily mortality among adults. Less is known about its effect on infant mortality and the modification of this association by socioeconomic status (SES).

Objective: To assess the association of particulate matter with an aerodynamic diameter of ≤10μm (PM(10)) and ozone (O(3)) on infant mortality and its modification by SES.

Methods: We evaluated the relationship of 24 h mean PM(10) and 1h daily maximum O(3) levels with 12 079 all-cause deaths (3903 respiratory deaths) among 1- to 11-month-old infants residing in the Mexico City Metropolitan Area between January 1997 and December 2005 using a case-crossover approach. The data were analysed using conditional logistic regression models, controlling for weather conditions and day of the week.

Results: Single-effect models showed, for all-cause mortality, increases of 5.5% (95% CI 1% to 10%) at lag1 and 6.6% (2% to 11.4%) at lag2; cumulative exposure models (0-2 days) showed an increase of 6.3% (0.01% to 32.7%). Respiratory mortality increased marginally at 5.3% (-0.02% to 13.2%) with a 1-day lag and 10% (2.1% to 18%) with a 2-day lag per increase of 38.7 μg/m(3) (IQR) in PM(10) levels. When data were stratified by SES (low, medium, and high), only infants with low and medium SES presented a significant increase in risk of all-cause mortality and respiratory mortality in relation to PM(10). O(3) was only significantly related to respiratory mortality in low SES.

Conclusion: Our results suggest that in the Mexico City Metropolitan Area, infants with lower SES (low to medium) are at higher risk of mortality when exposed to ambient PM(10) and O(3).