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International Journal of Environmental... Jul 2022Air pollution affects health, but much of the focus to this point has been on outdoor air. Higher indoor pollution is anticipated due to increasingly energy-efficient... (Review)
Review
Indoor Air Pollution and the Health of Vulnerable Groups: A Systematic Review Focused on Particulate Matter (PM), Volatile Organic Compounds (VOCs) and Their Effects on Children and People with Pre-Existing Lung Disease.
Air pollution affects health, but much of the focus to this point has been on outdoor air. Higher indoor pollution is anticipated due to increasingly energy-efficient and less leaky buildings together with more indoor activities. Studies of indoor air pollution focusing on children and people with respiratory disease from the database Web of Science (1991-2021) were systemically reviewed according to the PRISMA guidelines, with 69 studies included in the final selection. Emissions from building materials affected indoor air quality, and ventilation also had an influence. The main indoor air pollutants are Volatile Organic Compounds (VOCs) and Particulate Matter (PM). PM sources included smoking, cooking, heating, candles, and insecticides, whereas sources of coarse particles were pets, housework and human movements. VOC sources included household products, cleaning agents, glue, personal care products, building materials and vehicle emissions. Formaldehyde levels were particularly high in new houses. Personal exposure related to both indoor and outdoor pollutant levels, highlighting home characteristics and air exchange rates as important factors. Temperature, humidity, educational level, air purifiers and time near sources were also related to personal exposure. There was an association between PM and Fractional exhaled Nitric Oxide (FeNO), lung function, oxygen saturation, childhood asthma and symptoms of chronic obstructive pulmonary disease (COPD) patients. High VOCs were associated with upper airways and asthma symptoms and cancer. Effective interventional studies for PM in the future might focus on human behavior together with air purifiers and increased ventilation, whereas VOC interventions might center more on building materials and household products, alongside purification and ventilation.
Topics: Air Pollutants; Air Pollution, Indoor; Asthma; Child; Environmental Monitoring; Humans; Lung; Lung Diseases; Particulate Matter; Volatile Organic Compounds
PubMed: 35886604
DOI: 10.3390/ijerph19148752 -
Neurotoxicology Dec 2022Accumulating data suggest that air pollution increases the risk of internalizing psychopathology, including anxiety and depressive disorders. Moreover, the link between... (Review)
Review
Accumulating data suggest that air pollution increases the risk of internalizing psychopathology, including anxiety and depressive disorders. Moreover, the link between air pollution and poor mental health may relate to neurostructural and neurofunctional changes. We systematically reviewed the MEDLINE database in September 2021 for original articles reporting effects of air pollution on 1) internalizing symptoms and behaviors (anxiety or depression) and 2) frontolimbic brain regions (i.e., hippocampus, amygdala, prefrontal cortex). One hundred and eleven articles on mental health (76% human, 24% animals) and 92 on brain structure and function (11% human, 86% animals) were identified. For literature search 1, the most common pollutants examined were PM (64.9%), NO (37.8%), and PM (33.3%). For literature search 2, the most common pollutants examined were PM (32.6%), O (26.1%) and Diesel Exhaust Particles (DEP) (26.1%). The majority of studies (73%) reported higher internalizing symptoms and behaviors with higher air pollution exposure. Air pollution was consistently associated (95% of articles reported significant findings) with neurostructural and neurofunctional effects (e.g., increased inflammation and oxidative stress, changes to neurotransmitters and neuromodulators and their metabolites) within multiple brain regions (24% of articles), or within the hippocampus (66%), PFC (7%), and amygdala (1%). For both literature searches, the most studied exposure time frames were adulthood (48% and 59% for literature searches 1 and 2, respectively) and the prenatal period (26% and 27% for literature searches 1 and 2, respectively). Forty-three percent and 29% of studies assessed more than one exposure window in literature search 1 and 2, respectively. The extant literature suggests that air pollution is associated with increased depressive and anxiety symptoms and behaviors, and alterations in brain regions implicated in risk of psychopathology. However, there are several gaps in the literature, including: limited studies examining the neural consequences of air pollution in humans. Further, a comprehensive developmental approach is needed to examine windows of susceptibility to exposure and track the emergence of psychopathology following air pollution exposure.
Topics: Pregnancy; Female; Humans; Adult; Air Pollutants; Environmental Exposure; Air Pollution; Anxiety Disorders; Brain; Particulate Matter
PubMed: 36280190
DOI: 10.1016/j.neuro.2022.10.011 -
Environmental Pollution (Barking, Essex... Jan 2022We provide a comprehensive and updated systematic review and meta-analysis of the association between air pollution exposure and depression, searching PubMed, Embase,... (Meta-Analysis)
Meta-Analysis Review
We provide a comprehensive and updated systematic review and meta-analysis of the association between air pollution exposure and depression, searching PubMed, Embase, and Web of Sciences for relevant articles published up to May 2021, and eventually including 39 studies. Meta-analyses were performed separately according to pollutant type [particulate matter with diameter ≤10 μm (PM) and ≤2.5 μm (PM), nitrogen dioxide (NO), sulfur dioxide (SO), ozone (O), and carbon monoxide (CO)] and exposure duration [short- (<30 days) and long-term (≥30 days)]. Test for homogeneity based on Cochran's Q and I statistics were calculated and the restricted maximum likelihood (REML) random effect model was applied. We assessed overall quality of pooled estimates, influence of single studies on the meta-analytic estimates, sources of between-study heterogeneity, and publication bias. We observed an increased risk of depression associated with long-term exposure to PM (relative risk: 1.074, 95% confidence interval: 1.021-1.129) and NO (1.037, 1.011-1.064), and with short-term exposure to PM (1.009, 1.006-1.012), PM (1.009, 1.007-1.011), NO (1.022, 1.012-1.033), SO (1.024, 1.010-1.037), O (1.011, 0.997-1.026), and CO (1.062, 1.020-1.105). The publication bias affecting half of the investigated associations and the high heterogeneity characterizing most of the meta-analytic estimates partly prevent to draw very firm conclusions. On the other hand, the coherence of all the estimates after excluding single studies in the sensitivity analysis supports the soundness of our results. This especially applies to the association between PM and depression, strengthened by the absence of heterogeneity and of relevant publication bias in both long- and short-term exposure studies. Should further investigations be designed, they should involve large sample sizes, well-defined diagnostic criteria for depression, and thorough control of potential confounding factors. Finally, studies dedicated to the comprehension of the mechanisms underlying the association between air pollution and depression remain necessary.
Topics: Air Pollutants; Air Pollution; Depression; Environmental Exposure; Humans; Nitrogen Dioxide; Ozone; Particulate Matter
PubMed: 34600062
DOI: 10.1016/j.envpol.2021.118245 -
Environmental Pollution (Barking, Essex... Dec 2020Exposure to outdoor air pollution has been linked to lung cancer, and suspicion arose regarding bladder, kidney, and urinary tract cancer (urological cancers). However,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Exposure to outdoor air pollution has been linked to lung cancer, and suspicion arose regarding bladder, kidney, and urinary tract cancer (urological cancers). However, most of evidence comes from occupational studies; therefore, little is known about the effect of exposure to air pollution on the risk of urological cancers in the general population.
METHOD
We systematically searched Medline, Scopus, and Web of Science for articles investigating the associations between long-term exposure to air pollution and the risk of urological cancer (incidence or mortality). We included articles using a specific air pollutant (PM, PM, …) or proxies (traffic, proximity index …). We assessed each study's quality with the Newcastle-Ottawa scale and rated the quality of the body of evidence for each pollutant-outcome with the GRADE approach. The different study methodologies regarding exposure or outcome prevented us to perform a meta-analysis.
RESULTS
twenty articles (four case-control, nine cohort, and seven ecologic) met our inclusion criteria and were included in this review: eighteen reported bladder, six kidney, and two urinary tract. Modeling air pollutants was the most common exposure assessment method. Most of the included studies reported positive associations between air pollution and urological cancer risk. However, only a few reached statistical significance (e.g. for bladder cancer mortality, adjusted odds-ratio of 1.13 (1.03-1.23) for an increase of 4.4 μg.m-3 of PM). Most studies inadequately addressed confounding, and cohort studies had an insufficient follow-up.
DISCUSSION
Overall, studies suggested positive (even though mostly non-significant) associations between air pollution exposure and bladder cancer mortality and kidney cancer incidence. We need more studies with better confounding control and longer follow-ups.
Topics: Air Pollutants; Air Pollution; Environmental Exposure; Humans; Particulate Matter; Urinary Bladder; Urologic Neoplasms
PubMed: 32871482
DOI: 10.1016/j.envpol.2020.115328 -
Environmental Health Perspectives Jul 2023Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent.
OBJECTIVES
We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences.
METHODS
Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants (, , , , CO, ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results.
RESULTS
Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk , 95% confidence interval (CI): 1.011, 1.025] and 1.6% (, 95% CI: 1.011, 1.020) per increment of and , respectively. HF was also significantly associated with , , and CO, but not . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0-1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per increment in , 1.212 (1.010, 1.454) per increment in , and 1.204 (1.069, 1.356) per increment in , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results.
DISCUSSION
Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506.
Topics: Humans; Particulate Matter; Environmental Exposure; Air Pollution; Air Pollutants; Heart Failure
PubMed: 37399145
DOI: 10.1289/EHP11506 -
Journal of Alzheimer's Disease : JAD 2019Both air pollution and dementia are current and growing global issues. There are plausible links between exposure to specific air pollutants and dementia.
BACKGROUND
Both air pollution and dementia are current and growing global issues. There are plausible links between exposure to specific air pollutants and dementia.
OBJECTIVE
To systematically review the evidence base with respect to the relationship between air pollution and later cognitive decline and dementia.
METHODS
Medline, Embase, and PsychINFO® were searched from their inception to September 2018, for publications reporting on longitudinal studies of exposure to air pollution and incident dementia or cognitive decline in adults. Studies reporting on exposure to tobacco smoke including passive smoking or on occupational exposure to pollutants were excluded. Using standard Cochrane methodology, two readers identified relevant abstracts, read full text publications, and extracted data into structured tables from relevant papers, as defined by inclusion and exclusion criteria. Papers were also assessed for validity. CRD42018094299Results:From 3,720 records, 13 papers were found to be relevant, with studies from the USA, Canada, Taiwan, Sweden, and the UK. Study follow-up ranged from one to 15 years. Pollutants examined included particulate matter ≤2.5 μ (PM2.5), nitrogen dioxide (NO2), nitrous oxides (NOx), carbon monoxide (CO), and ozone. Studies varied in their methodology, population selection, assessment of exposure to pollution, and method of cognitive testing. Greater exposure to PM2.5, NO2/NOx, and CO were all associated with increased risk of dementia. The evidence for air pollutant exposure and cognitive decline was more equivocal.
CONCLUSION
Evidence is emerging that greater exposure to airborne pollutants is associated with increased risk of dementia.
Topics: Air Pollutants; Air Pollution; Cognitive Dysfunction; Dementia; Environmental Exposure; Humans; Particulate Matter
PubMed: 30775976
DOI: 10.3233/JAD-180631 -
Environmental Research Apr 2022Allergic rhinitis (AR) is one of the most common allergic diseases in the world, and usually persists throughout the activity. Epidemiological studies have shown a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Allergic rhinitis (AR) is one of the most common allergic diseases in the world, and usually persists throughout the activity. Epidemiological studies have shown a positive association between air pollution and allergic rhinitis. However, we could not find any meta-analysis of the risk of air pollutants (PM, PM, NO, SO, O and CO) on the prevalence of AR in people of all ages.
OBJECTIVES
Carry out a meta-analysis on the results of recent studies (up to 2020) to present valid information about exposure to air pollution and risk of prevalence of AR.
METHODS
We systematically searched three databases for studies up to December 17, 2020, including air pollution and AR. Random effect models were conducted to estimate the pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). Subgroup analysis, funnel plot, Egger's test, and the trim-and-fill method were also conducted.
RESULTS
Thirty-five studies across 12 countries, including a total of 453,470 participants, were included. The OR per 10 μg/m increase of pollutants was 1.13 (1.04-1.22) for PM and 1.12 (1.05-1.20) for PM. The OR per 10 μg/m increment of gaseous pollutants were 1.13 (1.07-1.20) for NO, 1.13 (1.04-1.22) for SO and 1.07 (1.01-1.12) for O. No significant association was observed between CO and AR. Children or adolescents are more sensitive to air pollution than adults. The effects of PM and SO were significantly stronger in Europe than Asia. The effects of air pollutants were more significant and higher in developing countries than in developed countries, except for PM. A significant difference of subgroup test was found between developed and developing countries of NO.
CONCLUSION
This meta-analysis showed a positive association between air pollution and the prevalence of allergic rhinitis, and identified geographic area and economic level as the potential modifiers for the association.
Topics: Adolescent; Adult; Air Pollutants; Air Pollution; Child; Environmental Exposure; Humans; Particulate Matter; Rhinitis, Allergic
PubMed: 34863689
DOI: 10.1016/j.envres.2021.112472 -
Environment International Oct 2020As new scientific evidence on health effects of air pollution is generated, air quality guidelines need to be periodically updated. The objective of this review is to... (Meta-Analysis)
Meta-Analysis
As new scientific evidence on health effects of air pollution is generated, air quality guidelines need to be periodically updated. The objective of this review is to support the derivation of updated guidelines by the World Health Organization (WHO) by performing a systematic review of evidence of associations between long-term exposure to particulate matter with diameter under 2.5 µm (PM) and particulate matter with diameter under 10 µm (PM), in relation to all-cause and cause-specific mortality. As there is especially uncertainty about the relationship at the low and high end of the exposure range, the review needed to provide an indication of the shape of the concentration-response function (CRF). We systematically searched MEDLINE and EMBASE from database inception to 9 October 2018. Articles were checked for eligibility by two reviewers. We included cohort and case-control studies on outdoor air pollution in human populations using individual level data. In addition to natural-cause mortality, we evaluated mortality from circulatory diseases (ischemic heart disease (IHD) and cerebrovascular disease (stroke) also specifically), respiratory diseases (Chronic Obstructive Pulmonary Disease (COPD) and acute lower respiratory infection (ALRI) also specifically) and lung cancer. A random-effect meta-analysis was performed when at least three studies were available for a specific exposure-outcome pair. Risk of bias was assessed for all included articles using a specifically developed tool coordinated by WHO. Additional analyses were performed to assess consistency across geographic region, explain heterogeneity and explore the shape of the CRF. An adapted GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment of the body of evidence was made using a specifically developed tool coordinated by WHO. A large number (N = 107) of predominantly cohort studies (N = 104) were included after screening more than 3000 abstracts. Studies were conducted globally with the majority of studies from North America (N = 62) and Europe (N = 25). More studies used PM (N = 71) as the exposure metric than PM (N = 42). PM was significantly associated with all causes of death evaluated. The combined Risk Ratio (RR) for PM and natural-cause mortality was 1.08 (95%CI 1.06, 1.09) per 10 µg/m. Meta analyses of studies conducted at the low mean PM levels (<25, 20, 15, 12, 10 µg/m) yielded RRs that were similar or higher compared to the overall RR, consistent with the finding of generally linear or supra-linear CRFs in individual studies. Pooled RRs were almost identical for studies conducted in North America, Europe and Western Pacific region. PM was significantly associated with natural-cause and most but not all causes of death. Application of the risk of bias tool showed that few studies were at a high risk of bias in any domain. Application of the adapted GRADE tool resulted in an assessment of "high certainty of evidence" for PM with all assessed endpoints except for respiratory mortality (moderate). The evidence was rated as less certain for PM and cause-specific mortality ("moderate" for circulatory, IHD, COPD and "low" for stroke mortality. Compared to the previous global WHO evaluation, the evidence base has increased substantially. However, studies conducted in low- and middle- income countries (LMICs) are still limited. There is clear evidence that both PM and PM were associated with increased mortality from all causes, cardiovascular disease, respiratory disease and lung cancer. Associations remained below the current WHO guideline exposure level of 10 µg/m for PM. Systematic review registration number (PROSPERO ID): CRD42018082577.
Topics: Air Pollutants; Air Pollution; Cause of Death; Environmental Exposure; Europe; Humans; North America; Particulate Matter
PubMed: 32703584
DOI: 10.1016/j.envint.2020.105974 -
Environment International Jun 2022The health effects of traffic-related air pollution (TRAP) continue to be of important public health interest. Following its well-cited 2010 critical review, the Health... (Meta-Analysis)
Meta-Analysis
The health effects of traffic-related air pollution (TRAP) continue to be of important public health interest. Following its well-cited 2010 critical review, the Health Effects Institute (HEI) appointed a new expert Panel to systematically evaluate the epidemiological evidence regarding the associations between long-term exposure to TRAP and selected adverse health outcomes. Health outcomes were selected based on evidence of causality for general air pollution (broader than TRAP) cited in authoritative reviews, relevance for public health and policy, and resources available. The Panel used a systematic approach to search the literature, select studies for inclusion in the review, assess study quality, summarize results, and reach conclusions about the confidence in the evidence. An extensive search was conducted of literature published between January 1980 and July 2019 on selected health outcomes. A new exposure framework was developed to determine whether a study was sufficiently specific to TRAP. In total, 353 studies were included in the review. Respiratory effects in children (118 studies) and birth outcomes (86 studies) were the most commonly studied outcomes. Fewer studies investigated cardiometabolic effects (57 studies), respiratory effects in adults (50 studies), and mortality (48 studies). The findings from the systematic review, meta-analyses, and evaluation of the quality of the studies and potential biases provided an overall high or moderate-to-high level of confidence in an association between long-term exposure to TRAP and the adverse health outcomes all-cause, circulatory, ischemic heart disease and lung cancer mortality, asthma onsetin chilldren and adults, and acute lower respiratory infections in children. The evidence was considered moderate, low or very low for the other selected outcomes. In light of the large number of people exposed to TRAP - both in and beyond the near-road environment - the Panel concluded that the overall high or moderate-to-high confidence in the evidence for an association between long-term exposure to TRAP and several adverse health outcomes indicates that exposures to TRAP remain an important public health concern and deserve greater attention from the public and from policymakers.
Topics: Adult; Air Pollutants; Air Pollution; Asthma; Bias; Child; Environmental Exposure; Humans; Traffic-Related Pollution
PubMed: 35569389
DOI: 10.1016/j.envint.2022.107262 -
American Journal of Physiology. Heart... Apr 2021Air pollution is a global health concern. Particulate matter (PM), a component of ambient air pollution, has been identified by the World Health Organization as one of...
Air pollution is a global health concern. Particulate matter (PM), a component of ambient air pollution, has been identified by the World Health Organization as one of the pollutants that poses the greatest threat to public health. Cardiovascular health effects have been extensively documented, and these effects are still being researched to provide an overview of recent literature regarding air pollution-associated cardiovascular morbidity and mortality in humans. Additionally, potential mechanisms through which air pollutants affect the cardiovascular system are discussed based on human and additional animal studies. We used the strategy of a narrative review to summarize the scientific literature of studies that were published in the past 7 yr. Searches were carried out on PubMed and Web of Science using predefined search queries. We obtained an initial set of 800 publications that were filtered to 78 publications that were relevant to include in this review. Analysis of the literature showed significant associations between air pollution, especially PM, and the risk of elevated blood pressure (BP), acute coronary syndrome, myocardial infarction (MI), cardiac arrhythmia, and heart failure (HF). Prominent mechanisms that underlie the adverse effects of air pollution include oxidative stress, systemic inflammation, endothelial dysfunction, autonomic imbalance, and thrombogenicity. The current review underscores the relevance of air pollution as a global health concern that affects cardiovascular health. More rigorous standards are needed to reduce the cardiovascular disease burden imposed by air pollution. Continued research on the health impact of air pollution is needed to provide further insight.
Topics: Air Pollutants; Air Pollution; Animals; Cardiovascular Diseases; Cardiovascular System; Environmental Monitoring; Hemodynamics; Humans; Inhalation Exposure; Risk Assessment; Risk Factors; Signal Transduction
PubMed: 33513082
DOI: 10.1152/ajpheart.00706.2020