Accumulating evidence suggests that perinatal air pollutant exposures are associated with increased risk of autism spectrum disorder (ASD), but evidence for traffic pollutants outside the United States is inconclusive. We assessed the association between nitrogen dioxide, a traffic pollution tracer, and risk of ASD. We conducted a nested case-control study among the entire population of children born during 2005-2009 in the central coastal area of Israel. Cases were identified through the National Insurance Institute of Israel (n = 2,098). Controls were a 20% random sample of the remaining children (n = 54,191). Exposure was based on an optimized dispersion model. We estimated adjusted odds ratios and 95% confidence intervals using logistic regression and a distributed-lag model. In models mutually adjusted for the 2 periods, the odds ratio per 5.85-parts per billion (ppb) increment of nitrogen dioxide exposure during pregnancy (median, 16.8 ppb; range, 7.5-31.2 ppb) was 0.77 (95% confidence interval: 0.59, 1.00), and the odds ratio for exposure during the 9 months after birth was 1.40 (95% confidence interval: 1.09, 1.80). A distributed-lag model revealed reduced risk around week 13 of pregnancy and elevated risk around week 26 after birth. These findings suggest that postnatal exposure to nitrogen dioxide in Israel is associated with increased odds of ASD, and prenatal exposure with lower odds. The latter may relate to selection effects.

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Background Exposure to traffic-related air pollution (TRAP) is considered to have a carcinogenic effect. The authors previously reported a nonsignificant association between TRAP and cancer risk in a relatively small cohort of myocardial infarction survivors. This study assessed whether TRAP exposure is associated with subsequent cancer in a large cohort of coronary patients. Methods & results Consecutive patients undergoing percutaneous coronary interventions in a major medical centre in central Israel from 2004 to 2014 were followed for cancer through 2015. Residential levels of nitrogen oxides (NO) - a proxy for TRAP - were estimated based on a high-resolution national land use regression model. Cox proportional hazards models were constructed to study relationships with cancer. Among 12,784 candidate patients, 9816 had available exposure data and no history of cancer (mean age, 68 years; 77% men). During a median (25th-75th percentiles) follow-up of 7.0 (3.9-9.3) years, 773 incident cases of cancer (8%) were diagnosed. In a multivariable-adjusted model, a 10-ppb increase in mean NO exposure was associated with hazard ratios (HRs) of 1.07 (95% confidence interval [CI] 1.00-1.15) for all-site cancer and 1.16 (95% CI 1.05-1.28) for cancers previously linked to TRAP (lung, breast, prostate, kidney and bladder). A stronger association was observed for breast cancer (HR = 1.43; 95% CI 1.12-1.83). Associations were slightly strengthened after limiting the cohort to patients with more precise exposure assessment. Conclusion Coronary patients exposed to TRAP are at increased risk of several types of cancer, particularly lung, prostate and breast. As these cancers are amenable to prevention strategies, identifying highly exposed patients may provide an opportunity to improve clinical care.