Preconception and gestational versus postnatal exposure to air pollutants and risk of autism spectrum disorder: a systematic review and meta-analysis

Mohammed A Mamun; Firoj Al-Mamun; Nitai Roy; Ahsan Raquib; Mark Mohan Kaggwa; Moneerah Mohammad ALmerab; David Gozal; Md Shakhaoat Hossain

doi:10.1007/s00420-024-02112-9

Preconception and gestational versus postnatal exposure to air pollutants and risk of autism spectrum disorder: a systematic review and meta-analysis

Int Arch Occup Environ Health. 2024 Dec 15. doi: 10.1007/s00420-024-02112-9. Online ahead of print.

Authors

Mohammed A Mamun^{1

2

3

4}, Firoj Al-Mamun^{1

2

3

4}, Nitai Roy⁵, Ahsan Raquib⁶, Mark Mohan Kaggwa⁷, Moneerah Mohammad ALmerab⁸, David Gozal⁹, Md Shakhaoat Hossain^{10

11}

Affiliations

¹ Air Quality, Climate Change and Health (ACH) Lab, Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
² Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Dhaka, Bangladesh.
³ CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh.
⁴ Department of Public Health, University of South Asia, Dhaka, Bangladesh.
⁵ Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh.
⁶ Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada.
⁷ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
⁸ Department of Psychology, College of Education and Human Development, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
⁹ Department of Pediatrics and Dean's Office, Joan C. Edwards School of Medicine, Marshall University, 25701, Huntington, WV, United States.
¹⁰ Air Quality, Climate Change and Health (ACH) Lab, Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh. shakhaoat@juniv.edu.
¹¹ Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Dhaka, Bangladesh. shakhaoat@juniv.edu.

PMID: 39676091
DOI: 10.1007/s00420-024-02112-9

Abstract

Purpose: The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM_2.5, PM₁₀, NO₂, and O₃) and the risk of ASD was therefore performed.

Methods: Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.

Results: Preconception exposure to air pollutants showed a protective trend for PM_2.5, PM₁₀, and O₃ with a 10%, 5%, and 19% reduced risk of ASD, whereas NO₂ had a 28% higher likelihood of ASD. During gestation, PM_2.5 exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM_2.5 and NO₂ for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM_2.5, PM₁₀, NO₂, and O₃, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.

Conclusions: In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM_2.5 and NO₂. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.

Keywords: ASD; Air pollution; Neurodevelopmental disorders; Nitrogen dioxide; Ozone; Particulate matter.

Publication types

Review