Wildfire
smoke exposure during pregnancy increases preterm birth risk,
Stanford study finds
Smoke
from wildfires may have contributed to thousands of additional
premature births in California between 2007 and 2012. The findings
underscore the value of reducing the risk of big, extreme wildfires
and suggest pregnant people should avoid very smoky air.
Exposure
to wildfire smoke during pregnancy increases the risk that a baby
will be born too early, a new Stanford University study suggests.
The
study, published Aug. 14 in Environmental
Research,
finds there may have been as many as 7,000 extra preterm births in
California attributable to wildfire smoke exposure between 2007 and
2012. These births occurred before 37 weeks of pregnancy when
incomplete development heightens risk of various neurodevelopmental,
gastrointestinal and respiratory complications, and even death.
Wildfire
smoke contains high levels of the smallest and deadliest type of
particle pollution, known as PM 2.5. These specks of toxic soot, or
particulate matter, are so fine they can embed deep in the lungs and
pass into the bloodstream, just like the oxygen molecules we need to
survive.
The
research comes as massive wildfires are again blazing through parched
landscapes in the western U.S. – just a year after a historic
wildfire season torched more than 4 million acres of California and
produced some
of the worst daily air pollution ever
recorded in the state. During the 2020 fire season, more than half of
the state’s population experienced a month of wildfire smoke levels
in the range of unhealthy to hazardous.
This
year could be worse, said Stanford environmental economist Marshall
Burke,
a co-author of the new study. And yet much remains unknown about the
health impacts of these noxious plumes, which contribute a
growing portion of
fine particle pollution nationwide and have a different
chemical makeup from
other ambient sources of PM 2.5, such as agriculture, tailpipe
emissions and industry.
One
possible explanation for the link between wildfire smoke exposure and
preterm birth, the authors say, is that the pollution may trigger an
inflammatory response, which then sets delivery in motion. The
increase in risk is relatively small in the context of all the
factors that contribute to the birth of a healthy, full-term baby.
“However, against a backdrop where we know so little about why some
women deliver too soon, prematurely, and why others do not, finding
clues like the one here helps us start piecing the bigger puzzle
together,” said co-author Gary
Shaw,
DrPH, a professor of pediatrics and co-primary investigator of
Stanford’s March of Dimes Prematurity Research Center.
Extreme
wildfires
The
new results show wildfire smoke may have contributed to more than 6
percent of preterm births in California in the worst smoke year of
the study period, 2008, when a severe lightning storm, powerful
winds, high temperatures and a parched landscape combined for a
deadly and destructive fire season – one that has now been dwarfed
by the record-setting infernos of 2020 and ongoing blazes like the
Dixie fire in Northern California.
“In
the future, we expect to see more frequent and intense exposure to
wildfire smoke throughout the West due to a confluence of factors,
including climate change, a century of fire suppression and
construction of more homes along the fire-prone fringes of forests,
scrublands and grasslands. As a result, the health burden from smoke
exposure – including preterm births – is likely to increase,”
said lead author Sam
Heft-Neal,
a research scholar at Stanford’s Center
on Food Security and the Environment.
The
research provides new evidence for the value of investing in
prescribed burns, mechanical thinning, or other efforts to reduce the
risk of extreme wildfires. Given that premature births cost the U.S.
healthcare system an estimated $25 billion per year, even modest
reductions in preterm birth risk could yield “enormous societal
benefits,” said Burke, an associate professor of Earth system
science at Stanford’s School
of Earth, Energy & Environmental Sciences (Stanford
Earth). “Our research highlights that reducing wildfire risk and
the air pollution that accompanies it is one way of achieving these
societal benefits.”
‘No
safe level of exposure’
The
researchers analyzed satellite data of smoke plumes from the National
Oceanic and Atmospheric Administration (NOAA) to identify smoke days
for each of 2,610 zip codes. They paired these data with estimates of
ground-level PM 2.5 pollution, which were developed using a machine
learning algorithm that incorporates data from air quality sensors,
satellite observations and computer models of how chemicals move
through Earth’s atmosphere. They pulled additional data from
California birth records, excluding twins, triplets and higher
multiples, which commonly arrive early.
After
accounting for other factors known to influence preterm birth risk,
such as temperature, baseline pollution exposure and the mother’s
age, income, race or ethnic background, they looked at how patterns
of preterm birth within each zip code changed when the number and
intensity of smoke days rose above normal for that location.
They
found every additional day of smoke exposure during pregnancy raised
the risk of preterm birth, regardless of race, ethnicity or income.
And a full week of exposure translated to a 3.4 percent greater risk
relative to a mother exposed to no wildfire smoke. Exposure to
intense smoke during the second trimester – between 14 and 26 weeks
of pregnancy – had the strongest impact, especially when smoke
contributed more than 5 additional micrograms per cubic meter to
daily PM 2.5 concentrations. “If one can avoid smoke exposure by
staying indoors or wearing an appropriate mask while outdoors, that
would be good health practice for all,” Shaw said.
The
findings build on an established link between particle pollution and
adverse birth outcomes, including preterm birth, low birth weight and
infant deaths. But the study is among the first to isolate the effect
of wildfire smoke on early births and to tease out the importance of
exposure timing.
“Our
work, together with a number of other recent papers, clearly shows
that there’s no safe level of exposure to particulate matter. Any
exposure above zero can worsen health impacts,” said Burke, who is
also deputy director of the Center
on Food Security and the Environment and
a senior fellow at Stanford’s Freeman
Spogli Institute for International Studies.
“While as a society it will be extremely difficult to fully
eliminate all pollutants from the air, our research suggests that
further reductions in key pollutants below current ‘acceptable’
levels could be massively beneficial for public health.”
This
work was supported by the Robert Wood Johnson Foundation and the
March of Dimes Prematurity Research Center at Stanford University
School of Medicine.
Source / Credit: Stanford University