A growing number of international studies have highlighted that ambient air pollution exposures are related to different health outcomes. To do so, researchers need to estimate exposure levels to air pollution throughout everyday life. In the literature, the most commonly used estimate is based on home address only or taking into account, in addition, the work address. However, several studies have shown the importance of daily mobility in the estimate of exposure to air pollutants. In this context, we developed an R procedure that estimates individual exposures combining home addresses, several important places, and itineraries of the principal mobility during a week. It supplies researchers a useful tool to calculate individual daily exposition to air pollutants weighting by the time spent at each of the most frequented locations (work, shopping, residential address, etc.) and while commuting. This task requires the efficient calculation of travel time matrices or the examination of multimodal transport routes. This procedure is freely available from the Equit'Area project website: (https://www.equitarea.org). This procedure is structured in three parts: the first part is to create a network, the second allows to estimate main itineraries of the daily mobility and the last one tries to reconstitute the level of air pollution exposure. One main advantage of the tool is that the procedure can be used with different spatial scales and for any air pollutant.
There is a growing number of international studies on the association between ambient air pollution and adverse pregnancy outcomes, and this systematic review and meta-analysis has been conducted focusing on European countries, to assess the crucial public health issue of this suspected association on this geographical area. A systematic literature search (based on Preferred Reporting Items for Systematic reviews and Meta-Analyses, PRISMA, guidelines) has been performed on all European epidemiological studies published up until 1 April 2020, on the association between maternal exposure during pregnancy to nitrogen dioxide (NO 2 ) or particular matter (PM) and the risk of adverse birth outcomes, including: low birth weight (LBW) and preterm birth (PTB). Fourteen articles were included in the systematic review and nine of them were included in the meta-analysis. Our meta-analysis was conducted for 2 combinations of NO 2 exposure related to birth weight and PTB. Our systematic review revealed that risk of LBW increases with the increase of air pollution exposure (including PM 10 , PM 2.5 and NO 2 ) during the whole pregnancy. Our meta-analysis found that birth weight decreases with NO 2 increase (pooled beta = −13.63, 95% confidence interval (CI) (−28.03, 0.77)) and the risk of PTB increase for 10 µg/m3 increase in NO 2 (pooled odds ratio (OR) = 1.07, 95% CI (0.90, 1.28)). However, the results were not statistically significant. Our finding support the main international results, suggesting that increased air pollution exposure during pregnancy might contribute to adverse birth outcomes, especially LBW. This body of evidence has limitations that impede the formulation of firm conclusions. Further studies, well-focused on European countries, are called to resolve the limitations which could affect the strength of association such as: the exposure assessment, the critical windows of exposure during pregnancy, and the definition of adverse birth outcomes. This analysis of limitations of the current body of research could be used as a baseline for further studies and may serve as basis for reflection for research agenda improvements.
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