Table 1.

Findings From Published Studies Investigating Exposure to Ambient Air Pollution and the Occurrence of Congenital Anomalies

Study	Setting	Design	Exposure Assessment	Main Findings
Savel'eva, 1991 (5)	2 districts in 1 city, Ukraine	Ecologic	Living within or outside a buffer of 600 m from a chemical factory	Increase in infant deaths due to congenital anomalies in population living within 600 m of the factory
Antipenko and Kogut, 1991 (6)	3 cities, Ukraine	Ecologic	Living in 3 cities with different air pollution levels according to industrial and traffic emission rates	Increased risk of autosomal dominant and x-linked mutations and multiple congenital anomalies in proportion to increasing pollution
Reznik et al., 1992 (7)	2 ecologic zones in 1 city, Ukraine	Ecologic	Living in industrial zone vs. agricultural zone	Higher rate of total congenital anomalies and multiple congenital anomalies in the industrial zone having higher levels of air pollution and radioactive radiation
Guminska, 1993 (8)	1 city, Poland			Increased risk of congenital anomalies in more polluted areas
Smrcka and Leznarova, 1998 (9)	1 district, Czech Republic	Ecologic	Living in areas with severe long-term air pollution vs. less-polluted areas	Elevated occurrence of congenital anomalies in areas of severe long-term air pollution compared with less-polluted areas
Ritz et al., 2002 (10)	4 counties, United States	Case-control	Assignment of measured levels of carbon monoxide, nitrogen dioxide, ozone, and PM10 by the nearest monitor to maternal place of residence	Significant association between second-month exposure to carbon monoxide and ozone and the occurrence of specific CHDs
Gilboa et al., 2005 (11)	7 counties, United States	Case-control	Assignment of measured levels of carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and PM10 by the nearest monitor to maternal place of residence	Significant association between second-month exposure to sulfur dioxide, PM10, and carbon monoxide and the occurrence of specific CHDs
Kim et al., 2007 (12)	1 city, South Korea	Cohort	Assignment of measured levels of PM10 by the monitor nearest to maternal place of residence	Significant association between maternal exposure to PM10 during the second trimester and the occurrence of congenital anomalies
Hwang and Jaakkola, 2008 (13)	5 counties, Taiwan	Case-control	Interpolation (inverse distance weighting) of carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and PM10 levels measured by monitoring site	Increased risk of oral cleft due to first- and second-month exposure to ozone
Rankin et al., 2009 (14)	4 counties, England	Case-control	Assignment of the average measured black smoke and sulfur dioxide levels by the monitors within 10 km of the maternal residential postcode	Increased risk of nervous system anomalies in relation to maternal exposure to black smoke
Hansen et al., 2009 (15)	1 city, Australia	Case-control	Assignment of measured levels of carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and PM10 by the monitor nearest to maternal place of residence	Increased risk of aortic artery and valve defects and cleft lip with or without cleft palate due to exposure to sulfur dioxide and pulmonary artery and valve defects in relation to ozone
Strickland et al., 2009 (16)	1 city, United States	Retrospective cohort	Assignment of measured levels of carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and PM10 by the monitor nearest to maternal place of residence	Increased risk of patent ductus arteriosus due to exposure to PM10
Dadvand et al., 2010a	15 local authorities, England	Case-control	Assignment of measured levels of carbon monoxide, nitric oxide, nitrogen dioxide, ozone, sulfur dioxide, and PM10 by the monitor nearest to maternal place of residence	Increased risk of ventricular septal defect and congenital pulmonary valve stenosis due to maternal exposure to carbon monoxide and increased risk of ventricular septal defect and tetralogy of Fallot due to maternal exposure to nitric oxide

Abbreviations: CHD, congenital heart disease; PM₁₀, particulate matter with aerodynamic diameter <10 μm.

^aP. Dadvand, J. Rankin, S. Rushton, and T. Pless-Mulloli, unpublished data, 2010.