The Association of Air Pollution With Pubertal Development: Evidence From Hong Kong's “Children of 1997” Birth Cohort

Many pollutants are endocrine disruptors with impacts on reproduction and health in animals, but evidence in humans, of which sex-specific effects on pubertal development may be an indicator, is less clear. We examined the association of air pollution in utero and during early life with pubertal development in Hong Kong, China, an area with a high level of air pollution compared with other similarly developed cities. We assessed sex-specific associations of particulate matter less than or equal to 10 μm in diameter (PM10), nitric oxide, sulfur dioxide, and nitrogen dioxide in different growth phases with clinically assessed pubertal stage at approximately age 11 years (as indicated by Tanner stage) in a large population-representative birth cohort, the "Children of 1997." We used partial least squares regression to account for colinearity between air pollutants. Among 1,938 girls, PM10 exposure in utero and during infancy was negatively associated with pubertal stage and breast development, whereas among 2,136 boys, sulfur dioxide and nitrogen dioxide exposure in utero, during infancy, and in childhood were negatively associated with pubertal stage. These sex-specific associations with pubertal development are consistent with endocrine-disrupting effects. Given the health impact of altered pubertal timing, further investigation across the life course may help quantify the full effects and the corresponding need for preventive measures.