title: APPLICATION OF MERSEYSIDE COMMUNITY CHILD HEALTH SURVEY DATA FOR ESTIMATING HEALTH RISKS FROM AIR POLLUTION AND EXPOSURE TO CIGARETTE SMOKE DURING PREGNANCY
Creators: name: Koshy, G
Publisher: name: University of Liverpool Repository
Year: 2018

description: Introduction: Air pollution is a serious public and environmental health risk that can result in child health problems. Environmental exposures have been well documented in the Sefton area of Liverpool with increased concern about air pollution effects on child health near to the Bootle Dock area. Rationale: The main priority is to improve child environmental health indicators using existing information and to identify the knowledge gaps and risk groups for developing new policies. There is need for improving linkage and analysis of data from currently available resources. Aim: To develop and establish a combined database of air pollution indicators, cigarette smoke exposure and health variables for the first time in UK using the 2006 Sefton Community Child Health Survey, and to complete a descriptive analysis of environmental exposures and child health. Objectives: (1) To compute odds ratio estimates for adverse birth and child health outcomes in relation to PM10, NOx emissions and PM10, NO2 concentrations and combined with pregnancy smoking categories and to estimate mean emissions for NOX and PM10, and mean concentrations for PM10 and NO2 in areas with high and low prevalence of adverse birth and child health outcomes. (2) To estimate population attributable risks for relevant child health outcomes and to develop Venn diagrams and spatial maps of health risk profiles. Methodology: A descriptive cross-sectional study was conducted by linking air pollution data from Sefton area with data available from the Community Child Health Survey in 2006 using postcode sectors. PM10 and NOx monitoring data were available as total and average emissions measured in tonnes per annum and NO2 and PM10 concentrations data in microgram per metre3. Outcome variables included birth and child health outcomes. SPSS 20 was used for univariate analysis and backward stepwise logistic regression, and results were illustrated using Venn diagram and spatial mapping techniques. The research project had ethical approval from the Royal Liverpool Children’s Hospital NHS Trust Ethical Committee, Alder Hey. Results: Data from 792 school children aged 5 to 11 years from 10 schools combined with corresponding air pollution data were used. There was independent association of childhood obesity with combined high NOX-PM10 emissions + maternal pregnancy smoking (Adjusted OR 4.47, 95% CI 1.22-16.43, p = 0.024); and croup with high NOX-PM10 emissions + paternal smoking during pregnancy (AOR 0.02, 95% CI 0.01-0.84, p=0.034), and high NOX-PM10 emissions + household smoking during pregnancy (AOR 0.15, 95% CI 0.04-0.70, p=0.015) after adjustment for confounding factors. Conclusion: Combined high NOx-PM10 emissions and maternal smoking during pregnancy were associated with an increased risk of childhood obesity. Sequential community surveys of child health linked with air pollution data have an important role in assessing air pollution exposures and outcomes with the potential use of visual illustrations in child health promotion activities.