Congenital Malformations (CM) impose a heavy burden on families and society. Identification of spatial patterns of CM is useful for understanding the epidemiology of this public health issue. In Israel, about 1,000,000 births and 25,000 CM cases at 37 groups were geocoded during 2000–2006. These were geo-analyzed using global-Moran’s-I statistics. Eight groups demonstrated geospatial heterogeneity and were further analyzed at both the census tract (Local Indicator of Spatial Association (LISA) and hot spot analyses) and street levels (spatial scan statistics with two population threshold sizes). The positional definition of results is further discussed in relevance to possible exposure to teratogenic sources in the region. Limitations of data and methods used are presented as well.
References
[1]
Christianson, A.; Howson, C.P.; Modell, B. March of Dimes—Global Report on Birth Defects; White Plains: New York, NY, USA, 2006.
[2]
Davies, K. Economic costs of childhood diseases and disabilities attributable to environmental contaminants in Washington State, USA. Ecohealth 2006, 3, 86–94, doi:10.1007/s10393-006-0020-1.
[3]
Anselin, L. Local indicators of spatial association—Lisa. Geogr. Anal. 1995, 27, 93–115, doi:10.1111/j.1538-4632.1995.tb00338.x.
[4]
Crighton, E.J.; Elliott, S.J.; Moineddin, R.; Kanaroglou, P.; Upshur, R.E.G. An exploratory spatial analysis of pneumonia and influenza hospitalizations in Ontario by age and gender. Epidemiol. Infect. 2007, 135, 253–261, doi:10.1017/S095026880600690X.
[5]
Kieffer, E.; Alexander, G.; Lewis, N.; Mor, J. Geographic patterns of low-birth-weight in Hawaii. Soc. Sci. Med. 1993, 36, 557–564, doi:10.1016/0277-9536(93)90416-2.
[6]
Pouliou, T.; Elliott, S.J. An exploratory spatial analysis of overweight and obesity in Canada. Prev. Med. 2009, 48, 362–367, doi:10.1016/j.ypmed.2009.01.017.
[7]
Auchincloss, A.H.; Gebreab, S.Y.; Mair, C.; Diez Roux, A.V. Review of spatial methods in epidemiology, 2000-2010. Annu. Rev. Public Health 2012, doi:10.1146/annurev-publhealth-031811-124655.
[8]
Curtis, A.; Leitner, M. Geographic Information Systems and Public Health: Eliminating Perinatal Disparity; IRM Press: Hershey, PA, USA, 2006.
[9]
Besag, J.; Newell, J. The detection of clusters in rare diseases. J. Roy. Statist. Soc. Ser. A Stat. 1991, 154, 143–155, doi:10.2307/2982708.
Getis, A.; Ord, J. The analysis of spatial association by use of distance statistics. Geogr. Anal. 1992, 24, 189–206, doi:10.1111/j.1538-4632.1992.tb00261.x.
[12]
Kulldorff, M. A spatial scan statistic. Commun. Stat. Theor. Method. 1997, 26, 1481–1496, doi:10.1080/03610929708831995.
[13]
Barchana, M.; Liptshitz, I.; Fishler, Y.; Green, M. Geographical Mapping of Malignant Diseases in Israel 2001-2005; Israel National Cancer Registry: Jerusalem, Israel, 2007.
[14]
Eitan, O.; Yuval; Barchana, M.; Dubnov, J.; Linn, S.; Carmel, Y.; Broday, D.M. Spatial analysis of air pollution and cancer incidence rates in Haifa Bay, Israel. Sci. Total Environ. 2010, 408, 4429–4439, doi:10.1016/j.scitotenv.2010.06.031.
[15]
Bentov, Y.; Kordysh, E.; Hershkovitz, R.; Belmaker, I.; Polyakov, M.; Bilenko, N.; Sarov, B. Major congenital malformations and residential proximity to a regional industrial park including a national toxic waste site: An ecological study. Environ. Health 2006, doi:10.1186/1476-069X-5-8.
[16]
Armstrong, B.G.; Dolk, H.; Pattenden, S.; Vrijheid, M.; Loane, M.; Rankin, J.; Dunn, C.E.; Grundy, C.; Abramsky, L.; Boyd, P.A.; et al. Geographic variation and localised clustering of congenital anomalies in Great Britain. Emerg. Themes Epidemiol. 2007, doi:10.1186/1742-7622-4-14.
[17]
Chi, W.; Wang, J.; Li, X.; Zheng, X.; Liao, Y. Analysis of geographical clustering of birth defects in Heshun county, Shanxi province. Int. J. Environ. Health Res. 2008, 18, 243–252, doi:10.1080/09603120701824524.
[18]
Forand, S.P.; Talbot, T.O.; Druschel, C.; Cross, P.K. Data quality and the spatial analysis of disease rates: Congenital malformations in New York State. Health Place 2002, 8, 191–199, doi:10.1016/S1353-8292(01)00037-5.
[19]
Kuehl, K.S.; Loffredo, C.A. A cluster of hypoplastic left heart malformation in Baltimore, Maryland. Pediatr. Cardiol. 2006, 27, 25–31, doi:10.1007/s00246-005-0859-x.
[20]
Liao, Y.; Wang, J.; Wu, J.; Wang, J.; Zheng, X. A comparison of methods for spatial relative risk mapping of human neural tube defects. Stoch. Environ. Res. Risk Assess. 2011, 25, 99–106, doi:10.1007/s00477-010-0439-3.
[21]
Morris, J.K.; Alberman, E.; Mutton, D. Is there evidence of clustering in Down syndrome? Int. J. Epidemiol. 1998, 27, 495–498, doi:10.1093/ije/27.3.495.
[22]
Poletta, F.A.; Castilla, E.E.; Orioli, I.M.; Lopez-Camelo, J.S. Regional analysis on the occurrence of oral clefts in South America. Amer. J. Med. Genet. A 2007, 143A, 3216–3227, doi:10.1002/ajmg.a.32076.
[23]
Root, E.D.; Meyer, R.E.; Emch, M.E. Evidence of localized clustering of gastroschisis births in North Carolina, 1999–2004. Soc. Sci. Med. 2009, 68, 1361–1367, doi:10.1016/j.socscimed.2009.01.034.
[24]
Rushton, G.; Lolonis, P. Exploratory spatial analysis of birth defect rates in an urban population. Stat. Med. 1996, 15, 717–726, doi:10.1002/(SICI)1097-0258(19960415)15:7/9<717::AID-SIM243>3.0.CO;2-0.
[25]
Siffel, C.; Strickland, M.J.; Gardner, B.R.; Kirby, R.S.; Correa, A. Role of geographic information systems in birth defects surveillance and research. Birth Defects Res. A. Clin. Mol. Teratol. 2006, 76, 825–833, doi:10.1002/bdra.20325.
[26]
Canaku, D.; Tulchinsky, T.H.; Neumark, Y. Regional Analysis of Congenital Malformation in Israel, 2001 and 2005. Master Thesis, Hebrew University, Jerusalem, Israel, 2007.
[27]
Agay-Shay, K.; Peretz, C.; Friger, M.; Peled, A.; Amitai, Y.; Linn, S. Congenital Malformation and Air Pollution in Israel, 2000–2006. Ph.D. Thesis, Haifa University, Haifa, Israel, 2013.
[28]
Zlotogora, J.; Haklai, Z.; Rotem, N.; Georgi, M.; Rubin, L. The impact of prenatal diagnosis and termination of pregnancy on the relative incidence of malformations at birth among Jews and Muslim Arabs in Israel. Isr. Med. Assoc. J. 2010, 12, 539–542.
[29]
Apple, A. Pre-Natal Diagnostic of CM and Pregnancy Termination among Orthodox Women; Knesset Research and Information Center: Jerusalem, Israel, 2003.
[30]
Gurrieri, F.; Kjaer, K.; Sangiorgi, E.; Neri, G. Limb anomalies: Developmental and evolutionary aspects. Am. J. Med. Genet. 2002, 115, 231–244, doi:10.1002/ajmg.10981.
[31]
Engel, L.S.; O’Meara, E.S.; Schwartz, S.M. Maternal occupation in agriculture and risk of limb defects in Washington State, 1980–1993. Scand. J. Work Environ. Health 2000, 26, 193–198, doi:10.5271/sjweh.531.
[32]
Elliott, P.; Richardson, S.; Abellan, J.J.; Thomson, A.; de Hoogh, C.; Jarup, L.; Briggs, D.J. Geographic density of landfill sites and risk of congenital anomalies in England. Occup. Environ. Med. 2009, 66, 81–89.
[33]
Dolk, H.; Vrijheid, M.; Armstrong, B.; Abramsky, L.; Bianchi, F.; Garne, E.; Nelen, V.; Robert, E.; Scott, J.E.; Stone, D.; et al. Risk of congenital anomalies near hazardous-waste landfill sites in Europe: The EUROHAZCON study. Lancet 1998, 352, 423–427.
[34]
Dummer, T.J.; Dickinson, H.O.; Parker, L. Adverse pregnancy outcomes near landfill sites in Cumbria, northwest England, 1950–1993. Arch. Environ. Health 2003, 58, 692–698, doi:10.3200/AEOH.58.11.692-698.
[35]
Yiee, J.H.; Baskin, L.S. Environmental factors in genitourinary development. J. Urol. 2010, 184, 34–41, doi:10.1016/j.juro.2010.03.051.
[36]
Reuters Israel to phase out civilian atomic reactor by 2018. Ynetnews 20/3/2012, Available online: http://www.ynetnews.com/articles/0,7340,L-4205587,00.html (accessed on 16 July 2012).
[37]
Elliott, P. Spatial Epidemiology: Methods and Applications; Oxford University Press: Oxford, UK, 2000.
[38]
Mazumdar, S.; King, M.; Liu, K.; Zerubavel, N.; Bearman, P. The spatial structure of autism in California, 1993–2001. Health Place 2010, 16, 539–546, doi:10.1016/j.healthplace.2009.12.014.
[39]
Main, K.M.; Skakkebaek, N.E.; Virtanen, H.E.; Toppari, J. Genital anomalies in boys and the environment. Best Pract. Res. Clin. Endoc. Metab. 2010, 24, 279–289.
[40]
Garcia, L. Escaping the Bonferroni iron claw in ecological studies. Oikos 2004, 105, 657–663, doi:10.1111/j.0030-1299.2004.13046.x.
[41]
Ord, J.K.; Getis, A. Local spatial autocorrelation statistics—Distributional issues and an application. Geogr. Anal. 1995, 27, 286–306.
[42]
Getis, A.; Morrison, A.; Gray, K.; Scott, T. Characteristics of the spatial pattern of the dengue vector, Aedes aegypti, in Iquitos, Peru. Amer. J. Trop. Med. Hyg. 2003, 69, 494–505.
