Evaluating an intervention for neural tube defects in coal mining cites in China: a temporal and spatial analysis

BACKGROUND: Neural tube defects (NTDs) are congenital birth defects of the central nervous system that affect 0.5–2 per 1000 pregnancies worldwide. Therefore effective interventions for birth defects, especially NTDs, are very important. METHODS: Yuanping City is a coal mining city in Shanxi Province, China, with a high incidence of NTDs. This study evaluates the effects of NTD interventions in this city after adjusting for covariates that characterize the native environment. The number of NTD cases and births for the 18 towns in Yuanping City from 2007 to 2014 were included in the study. A shared-component zero-inflated Poisson regression was applied to analyse the temporal–spatial variance among the incidence rates of NTDs in Yuanping City before and after the interventions. RESULTS: The results showed that existing interventions to mitigate birth defects, such as folic acid supplementation, reduced the incidence of NTDs by 53.5% in coal mining areas in Yuanping City. However, the NTD risk in areas near coal mines, especially unrestored coal mines, was still high, even after the intervention. CONCLUSIONS: The government should focus on health hazards related to mining and agricultural production and should provide education and resources to reduce environmental exposure. Reducing environmental risks should be regarded as an early intervention strategy to mitigate birth defects.