Outdoor air pollution and infant mortality: analysis of daily time-series data in 10 English cities

Background: There is growing concern that moderate levels of outdoor air pollution may be associated with infant mortality, representing substantial loss of life-years. To date, there has been no investigation of the effects of outdoor pollution on infant mortality in the UK. Methods: Daily time-series data of air pollution and all infant deaths between 1990 and 2000 in 10 major cities of England: Birmingham, Bristol, Leeds, Liverpool, London, Manchester, Middlesbrough, Newcastle, Nottingham and Sheffield, were analysed. City-specific estimates were pooled across cities in a fixed-effects meta-regression to provide a mean estimate. Results: Few associations were observed between infant deaths and most pollutants studied. The exception was sulphur dioxide (SO2), of which a 10 μg/m3 increase was associated with a RR of 1.02 (95% CI 1.01 to 1.04) in all infant deaths. The effect was present in both neonatal and postneonatal deaths. Conclusions: Continuing reductions in SO2 levels in the UK may yield additional health benefits for infants.