“…Others caution that negative externalities may exist for populations living nearby in the form of reduced quality of life (Fisher et al, 2018;Jacquet et al, 2018;Perry, 2013), migraine headache and fatigue (Tustin et al, 2017), asthma exacerbations (Rasmussen et al, 2016), and worse cardiovascular health (McKenzie et al, 2019). Studies in Colorado, Oklahoma, and Pennsylvania have found associations between residential proximity to UNGD and adverse birth outcomes (Casey et al, 2016;Currie et al, 2017;Hill, 2018;Janitz et al, 2019;McKenzie et al, 2014;Stacy et al, 2015;Whitworth et al 2017bWhitworth et al , 2018. While Currie et al, 2017 andHill, 2018 implemented analytic strategies designed to support causal inference, no large epidemiologic studies have attempted to disentangle the complex pathways that may link UNGD to adverse birth outcomes.…”