Author(s): Aniceto, Carlos ; Machado, Ausenda ; Braz, Paula ; Matias Dias, Carlos
Date: 2023
Persistent ID: http://hdl.handle.net/10400.18/8868
Origin: Repositório Científico do Instituto Nacional de Saúde
Subject(s): Congenital Anomaly; Spatial Multicriteria Analysis; Susceptibility to Atmospheric Pollution; Geographic Information System; Programa de Vigilância Nacional da Paralisia Cerebral; RENAC; Observação em Saúde e Vigilância; Portugal
Background & objectives. Environmental exposure to teratogenic factors during pregnancy is associated with some congenital anomalies (CA). In 2015, a cluster of anorectal anomalies in newborns (NB) was detected in the district of Setúbal, so an epidemiological study was developed with the aim of studying the association of births with CA and atmospheric pollution, having developed a susceptibility map Methods. An observational case-control study was developed between 2016 and 2021. It was adopted a spatial multicriteria analysis using Geographic Information System software to identify the susceptibility to atmospheric pollution in pregnant women's residences. The variables used for the susceptibility map were: (i) Euclidean distance to the PRTR industrial units, defining 3 levels of susceptibility: high -<2000m, moderate ->2000m and < 4000m, low -> 4000m; (ii) density of PRTR industrial units per km2, by kernel estimation; (iii) type of land occupation: high susceptibility - industrial areas, roads, landfills and dumps; moderate susceptibility - residencial areas; low susceptibility - natural, forest and agricultural areas; (iv) Euclidean distance to the main roads, defining 3 levels of susceptibility: high <100m, moderate >100m and <300m, and low >300m; (v) areas of low elevation subject to fog, modeled by the digital terrain model and classified into 3 classes by Jenks' Natural Break method. The variables were normalized, weighted and crossed in raster matrices using the weighted linear combination, originating the map of susceptibility to atmospheric pollution, divided into three classes (High, Moderate and Low) Results. In geographical terms, 3 areas of greater susceptibility to atmospheric pollution stand out, the consolidated urban core of Barreiro and Baixa da Banheira, the peri-urban area of Palhais, and the southern zone of the urban core of Montijo. 21 cases (21%) and 53 controls (25%) were observed in high susceptibility sites; 77 cases (75%) and 146 controls (70%) located in areas of moderate susceptibility; 4 cases (9%) and 9 controls (5%) referred to areas of low susceptibility Conclusion. The creation of a map of susceptibility to atmospheric pollution proved to be useful to assess the possible environmental exposure of newborns to chemical agents during pregnancy. The results, integrated into a more complex analysis, may contribute to the establishment of causal links in NBs with anorectal CA in the territory under analysis
