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International Journal of Environmental... Jul 2021Given health threats of climate change, a comprehensive review of the impacts of ambient temperature and ar pollution on suicide is needed. We performed systematic... (Meta-Analysis)
Meta-Analysis Review
Given health threats of climate change, a comprehensive review of the impacts of ambient temperature and ar pollution on suicide is needed. We performed systematic literature review and meta-analysis of suicide risks associated with short-term exposure to ambient temperature and air pollution. Pubmed, Scopus, and Web of Science were searched for English-language publications using relevant keywords. Observational studies assessing risks of daily suicide and suicide attempts associated with temperature, particulate matter with aerodynamic diameter ≤10 μm (PM) and ≤2.5 mm (PM), ozone (O), sulfur dioxide (SO), nitrogen dioxide (NO), and carbon monoxide (CO) were included. Data extraction was independently performed in duplicate. Random-effect meta-analysis was applied to pool risk ratios (RRs) for increases in daily suicide per interquartile range (IQR) increase in exposure. Meta-regression analysis was applied to examine effect modification by income level based on gross national income (GNI) per capita, national suicide rates, and average level of exposure factors. In total 2274 articles were screened, with 18 studies meeting inclusion criteria for air pollution and 32 studies for temperature. RRs of suicide per 7.1 °C temperature was 1.09 (95% CI: 1.06, 1.13). RRs of suicide per IQR increase in PM, PM, and NO were 1.02 (95% CI: 1.00, 1.05), 1.01 (95% CI: 1.00, 1.03), and 1.03 (95% CI: 1.00, 1.07). O, SO, and CO were not associated with suicide. RR of suicide was significantly higher in higher-income than lower-income countries (1.09, 95% CI: 1.07, 1.11 and 1.20, 95% CI: 1.14, 1.26 per 7.1 °C increased temperature, respectively). Suicide risks associated with air pollution did not significantly differ by income level, national suicide rates, or average exposure levels. Research gaps were found for interactions between air pollution and temperature on suicide risks.
Topics: Air Pollutants; Air Pollution; Environmental Exposure; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Sulfur Dioxide; Temperature
PubMed: 34300149
DOI: 10.3390/ijerph18147699 -
Neurology Jan 2023Studies of association between air pollution and incidence of dementia have shown discrepant results. The aim of this study was to evaluate the association between air... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Studies of association between air pollution and incidence of dementia have shown discrepant results. The aim of this study was to evaluate the association between air pollution and dementia.
METHODS
In this systematic review and meta-analysis, PubMed, MEDLINE, EMBASE, PsycINFO, Scopus, and Web of Science were searched and updated in August 2021. Population-based cohort studies that reported on hazard ratio (HR) of dementia in association with exposure to fine particulate matter (PM), nitrogen oxides (NO), nitrogen dioxide (NO), or ozone (O) in those aged >40 years were included. Data were extracted by 2 independent investigators. The main outcome was the pooled HR for dementia per increment of pollutant, calculated using a random-effects model. Results were reported in accordance with PRISMA guidelines. The protocol was registered in PROSPERO (registration number: CRD42020219036).
RESULTS
A total of 20 studies were included in the systematic review, and 17 provided data for the meta-analysis. The total included population was 91,391,296, with 5,521,111 (6%) being diagnosed with dementia. A total of 12, 5, 6, and 4 studies were included in the meta-analyses of PM, NO, NO, and O, respectively. The risk of dementia increased by 3% per 1 μg/m increment in PM (HR, 1.03; 95% CI [1.02-1.05]; I = 100%). The association between dementia per 10 μg/m increment in NO (HR, 1.05; 95% CI [0.99-1.13]; I = 61%), NO (HR, 1.03; 95% CI [1.00-1.07]; I = 94%), and O levels (HR, 1.01; 95% CI [0.91-1.11]; I = 82%) was less clear, although a significant association could not be ruled out, and there was high heterogeneity across studies.
DISCUSSION
Existing evidence suggests a significant association between exposure to PM and incidence of dementia and nonsignificant association between dementia and NO, NO, and O exposure. However, results should be interpreted in light of the small number of studies and high heterogeneity of effects across studies.
Topics: Humans; Air Pollutants; Incidence; Nitrogen Dioxide; Environmental Exposure; Air Pollution; Particulate Matter; Dementia
PubMed: 36288998
DOI: 10.1212/WNL.0000000000201419 -
The Science of the Total Environment Dec 2023Growing studies have focused on the effects of ambient air pollution on thyroid hormones (THs), but the results were controversial. Therefore, a systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Growing studies have focused on the effects of ambient air pollution on thyroid hormones (THs), but the results were controversial. Therefore, a systematic review and meta-analysis was conducted by pooling current evidence on this association.
METHODS
Four databases were searched for studies examining the associations of particulate matter [diameter ≤10 μm (PM) or ≤2.5 μm (PM)] and gaseous [sulfur dioxide (SO), nitrogen dioxide (NO), ozone (O), carbon monoxide (CO)] pollutants with THs levels. Random effects models were used to pool the changes in THs levels with increasing air pollutant concentrations. Subgroup analyses were constructed by region, design, sample size, pollutant concentrations, evaluated methods, and potential risk exposure windows.
RESULTS
A total of 14 studies covering 357,226 participants were included in this meta-analysis. The pooled results showed significant associations of exposure to PM, PM, NO, SO, and CO with decreases in free thyroxine (FT4) with percent changes (PC) ranging from -0.593 % to -3.925 %. PM, NO, and CO were negatively associated with levels of FT4/FT3 (PC: from -0.604 % to -2.975 %). In addition, results showed significant associations of PM with hypothyroxinemia and high thyroid-stimulating hormone (TSH). Subgroup analyses indicated that PM and NO were significantly associated with FT4 in studies of Chinese, and similar significant findings were found in studies of PM and FT4/FT3 in areas with higher concentrations of air pollutants and larger samples. PM exposure in the first trimester was found to be associated with lower FT4 levels in pregnant women.
CONCLUSION
Our findings suggest that exposure to air pollution is associated with changes in THs levels. Enhanced management of highly polluted areas, identification of harmful components and sources of PM, and protection from harmful exposures in early pregnancy may be of great public health importance for the population's thyroid function.
Topics: Female; Humans; Pregnancy; Nitrogen Dioxide; Thyroid Gland; Environmental Exposure; Air Pollution; Air Pollutants; Particulate Matter; Ozone; Sulfur Dioxide; Thyroid Hormones; Environmental Pollutants
PubMed: 37660827
DOI: 10.1016/j.scitotenv.2023.166780 -
Environment International Aug 2023The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury... (Meta-Analysis)
Meta-Analysis
The prevalences and levels of occupational exposure to dusts and/or fibres (silica, asbestos and coal): A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.
BACKGROUND
The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from human, animal and mechanistic data suggests that occupational exposure to dusts and/or fibres (silica, asbestos and coal dust) causes pneumoconiosis. In this paper, we present a systematic review and meta-analysis of the prevalences and levels of occupational exposure to silica, asbestos and coal dust. These estimates of prevalences and levels will serve as input data for estimating (if feasible) the number of deaths and disability-adjusted life years that are attributable to occupational exposure to silica, asbestos and coal dust, for the development of the WHO/ILO Joint Estimates.
OBJECTIVES
We aimed to systematically review and meta-analyse estimates of the prevalences and levels of occupational exposure to silica, asbestos and coal dust among working-age (≥ 15 years) workers.
DATA SOURCES
We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts.
STUDY ELIGIBILITY AND CRITERIA
We included working-age (≥ 15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (< 15 years) and unpaid domestic workers. We included all study types with objective dust or fibre measurements, published between 1960 and 2018, that directly or indirectly reported an estimate of the prevalence and/or level of occupational exposure to silica, asbestos and/or coal dust.
STUDY APPRAISAL AND SYNTHESIS METHODS
At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, then data were extracted from qualifying studies. We combined prevalence estimates by industrial sector (ISIC-4 2-digit level with additional merging within Mining, Manufacturing and Construction) using random-effects meta-analysis. Two or more review authors assessed the risk of bias and all available authors assessed the quality of evidence, using the ROB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates.
RESULTS
Eighty-eight studies (82 cross-sectional studies and 6 longitudinal studies) met the inclusion criteria, comprising > 2.4 million measurements covering 23 countries from all WHO regions (Africa, Americas, Eastern Mediterranean, South-East Asia, Europe, and Western Pacific). The target population in all 88 included studies was from major ISCO groups 3 (Technicians and Associate Professionals), 6 (Skilled Agricultural, Forestry and Fishery Workers), 7 (Craft and Related Trades Workers), 8 (Plant and Machine Operators and Assemblers), and 9 (Elementary Occupations), hereafter called manual workers. Most studies were performed in Construction, Manufacturing and Mining. For occupational exposure to silica, 65 studies (61 cross-sectional studies and 4 longitudinal studies) were included with > 2.3 million measurements collected in 22 countries in all six WHO regions. For occupational exposure to asbestos, 18 studies (17 cross-sectional studies and 1 longitudinal) were included with > 20,000 measurements collected in eight countries in five WHO regions (no data for Africa). For occupational exposure to coal dust, eight studies (all cross-sectional) were included comprising > 100,000 samples in six countries in five WHO regions (no data for Eastern Mediterranean). Occupational exposure to silica, asbestos and coal dust was assessed with personal or stationary active filter sampling; for silica and asbestos, gravimetric assessment was followed by technical analysis. Risk of bias profiles varied between the bodies of evidence looking at asbestos, silica and coal dust, as well as between industrial sectors. However, risk of bias was generally highest for the domain of selection of participants into the studies. The largest bodies of evidence for silica related to the industrial sectors of Construction (ISIC 41-43), Manufacturing (ISIC 20, 23-25, 27, 31-32) and Mining (ISIC 05, 07, 08). For Construction, the pooled prevalence estimate was 0.89 (95% CI 0.84 to 0.93, 17 studies, I 91%, moderate quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing, the pooled prevalence estimate was 0.85 (95% CI 0.78 to 0.91, 24 studies, I 100%, moderate quality of evidence) and the pooled level estimate was rated as of very low quality of evidence. The pooled prevalence estimate for Mining was 0.75 (95% CI 0.68 to 0.82, 20 studies, I 100%, moderate quality of evidence) and the pooled level estimate was 0.04 mg/m (95% CI 0.03 to 0.05, 17 studies, I 100%, low quality of evidence). Smaller bodies of evidence were identified for Crop and animal production (ISIC 01; very low quality of evidence for both prevalence and level); Professional, scientific and technical activities (ISIC 71, 74; very low quality of evidence for both prevalence and level); and Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level). For asbestos, the pooled prevalence estimate for Construction (ISIC 41, 43, 45,) was 0.77 (95% CI 0.65 to 0.87, six studies, I 99%, low quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing (ISIC 13, 23-24, 29-30), the pooled prevalence and level estimates were rated as being of very low quality of evidence. Smaller bodies of evidence were identified for Other mining and quarrying (ISIC 08; very low quality of evidence for both prevalence and level); Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level); and Water supply, sewerage, waste management and remediation (ISIC 37; very low quality of evidence for levels). For coal dust, the pooled prevalence estimate for Mining of coal and lignite (ISIC 05), was 1.00 (95% CI 1.00 to 1.00, six studies, I 16%, moderate quality of evidence) and the pooled level estimate was 0.77 mg/m (95% CI 0.68 to 0.86, three studies, I 100%, low quality of evidence). A small body of evidence was identified for Electricity, gas, steam and air conditioning supply (ISIC 35); with very low quality of evidence for prevalence, and the pooled level estimate being 0.60 mg/m (95% CI -6.95 to 8.14, one study, low quality of evidence).
CONCLUSIONS
Overall, we judged the bodies of evidence for occupational exposure to silica to vary by industrial sector between very low and moderate quality of evidence for prevalence, and very low and low for level. For occupational exposure to asbestos, the bodies of evidence varied by industrial sector between very low and low quality of evidence for prevalence and were of very low quality of evidence for level. For occupational exposure to coal dust, the bodies of evidence were of very low or moderate quality of evidence for prevalence, and low for level. None of the included studies were population-based studies (i.e., covered the entire workers' population in the industrial sector), which we judged to present serious concern for indirectness, except for occupational exposure to coal dust within the industrial sector of mining of coal and lignite. Selected estimates of the prevalences and levels of occupational exposure to silica by industrial sector are considered suitable as input data for the WHO/ILO Joint Estimates, and selected estimates of the prevalences and levels of occupational exposure to asbestos and coal dust may perhaps also be suitable for estimation purposes. Protocol identifier: https://doi.org/10.1016/j.envint.2018.06.005. PROSPERO registration number: CRD42018084131.
Topics: Humans; Adolescent; Occupational Diseases; Dust; Prevalence; Silicon Dioxide; Cross-Sectional Studies; Coal; Steam; Asbestos; Occupational Exposure; World Health Organization; Cost of Illness
PubMed: 37487377
DOI: 10.1016/j.envint.2023.107980 -
The Journal of Hospital Infection Sep 2023This systematic review and network meta-analysis (NMA) comprehensively compared the effectiveness of different mouth rinses in reducing the viral load/infectivity of... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review and network meta-analysis (NMA) comprehensively compared the effectiveness of different mouth rinses in reducing the viral load/infectivity of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (Part I), alleviating clinical symptoms or severity of disease (Part II), and decreasing the incidence of SARS-CoV-2 infection (Part III).
METHODS
Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) with restrictions were searched up to 3 March 2023. Twenty-three studies (22 RCTs and one NRCT) met the inclusion criteria for this systematic review.
RESULTS
Five RCTs (454 patients and nine interventions) in Part I were eligible for NMA. The NMA results showed that, in comparison with no rinse, sodium chloride (NaCl) was the most effective mouth rinse for reducing the viral load, followed by povidone-iodine (PVP-I), ß-cyclodextrin + citrox (CDCM), hydrogen peroxide (HP), chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), placebo and hypochlorous acid (HClO). However, these results were not significant. Based on surface under the cumulative ranking curve scores, PVP-I was likely to be the most efficacious mouth rinse for reducing SARS-CoV-2 viral load, followed by CDCM, HP, NaCl, CHX, CPC, placebo, no rinse and HClO.
CONCLUSION
Due to heterogeneity of the primary studies, the effectiveness of different mouth rinses to reduce viral infectivity, improve clinical symptoms or prevent SARS-CoV-2 infection remains inconclusive.
Topics: Humans; COVID-19; Mouthwashes; Povidone-Iodine; SARS-CoV-2; Sodium Chloride; Network Meta-Analysis; Hydrogen Peroxide; Mouth
PubMed: 37419189
DOI: 10.1016/j.jhin.2023.06.022 -
Cells Apr 2023Betel quid and areca nut are complex mixture carcinogens, but little is known about whether their derived single-agent arecoline or arecoline -oxide (ANO) is...
Betel quid and areca nut are complex mixture carcinogens, but little is known about whether their derived single-agent arecoline or arecoline -oxide (ANO) is carcinogenic, and the underlying mechanisms remain unclear. In this systematic review, we analyzed recent studies on the roles of arecoline and ANO in cancer and strategies to block carcinogenesis. In the oral cavity, flavin-containing monooxygenase 3 oxidizes arecoline to ANO, and both alkaloids conjugate with -acetylcysteine to form mercapturic acid compounds, which are excreted in urine, reducing arecoline and ANO toxicity. However, detoxification may not be complete. Arecoline and ANO upregulated protein expression in oral cancer tissue from areca nut users compared to expression levels in adjacent normal tissue, suggesting a causal relationship between these compounds and oral cancer. Sublingual fibrosis, hyperplasia, and oral leukoplakia were diagnosed in mice subjected to oral mucosal smearing of ANO. ANO is more cytotoxic and genotoxic than arecoline. During carcinogenesis and metastasis, these compounds increase the expression of epithelial-mesenchymal transition (EMT) inducers such as reactive oxygen species, transforming growth factor-β1, Notch receptor-1, and inflammatory cytokines, and they activate EMT-related proteins. Arecoline-induced epigenetic markers such as sirtuin-1 hypermethylation, low protein expression of miR-22, and miR-886-3-p accelerate oral cancer progression. Antioxidants and targeted inhibitors of the EMT inducers used reduce the risk of oral cancer development and progression. Our review findings substantiate the association of arecoline and ANO with oral cancer. Both of these single compounds are likely carcinogenic to humans, and their mechanisms and pathways of carcinogenesis are useful indicators for cancer therapy and prognosis.
Topics: Arecoline; Cyclic N-Oxides; Mouth Neoplasms; Carcinogenesis; Humans; Animals; Mice; Areca; Oxygenases; Oxidation-Reduction; Acetylcysteine; Epigenesis, Genetic; Carcinogens
PubMed: 37190117
DOI: 10.3390/cells12081208 -
EBioMedicine Dec 2022A growing number of studies have reported an increased risk of cardiovascular disease (CVD) and respiratory disease (RD) within hours after exposure to ambient air... (Meta-Analysis)
Meta-Analysis
A systematic review and meta-analysis of intraday effects of ambient air pollution and temperature on cardiorespiratory morbidities: First few hours of exposure matters to life.
BACKGROUND
A growing number of studies have reported an increased risk of cardiovascular disease (CVD) and respiratory disease (RD) within hours after exposure to ambient air pollution or temperature. We assemble published evidence on the sub-daily associations of CVD and RD with ambient air pollution and temperature.
METHODS
Databases of PubMed and Web of Science were searched for original case-crossover and time-series designs of English articles examining the intra-day effects of ambient air pollution [particulate matter with aerodynamic diameter ≤2.5 μm (PM), ≤10 μm (PM), 2.5-10μm (PM), and < 7 μm (SPM), O, SO, NO, CO, and NO] and temperatures (heat and cold) on cardiorespiratory diseases within 24 h after exposure in the general population by comparing with exposure at different exposure levels or periods. Meta-analyses were conducted to pool excess risks (ERs, absolute percentage increase in risk) of CVD and RD morbidities associated with an increase of 10 μg/m in particulate matters, 0.1 ppm in CO, and 10 ppb in other gaseous pollutants.
FINDINGS
Final analysis included thirty-three papers from North America, Europe, Oceania, and Asia. Meta-analysis found an increased risk of total CVD morbidity within 3 h after exposure to PM [ER%: 2.65% (95% CI: 1.00% to 4.34%)], PM [0.31% (0.02% to 0.59%)], O [1.42% (0.14% to 2.73%)], and CO [0.41% (0.01% to 0.81%)]. The risk of total RD morbidity elevated at lag 7-12 h after exposure to PM [0.69% (0.14% to 1.24%)] and PM [0.38% (0.02% to 0.73%)] and at lag 12-24 h after exposure to SO [2.68% (0.94% to 4.44%)]. Cause-specific CVD analysis observed an increased risk of myocardial infarction morbidity within 6 h after exposure to PM, PM, and NO, and an increased risk of out-of-hospital cardiac arrest morbidity within 12 h after exposure to CO. Risk of total CVD also increased within 24 h after exposure to heat.
INTERPRETATION
This study supports a sudden risk increase of cardiorespiratory diseases within a few hours after exposure to air pollution or heat, and some acute and highly lethal diseases such as myocardial infarction and cardiac arrest could be affected within a shorter time.
FUNDING
The National Natural Science Foundation of China (Grant No. 42105165; 81773518), the High-level Scientific Research Foundation of Anhui Medical University (Grant No. 0305044201), and the Discipline Construction of Anhui Medical University (Grant No. 0301001836).
Topics: Humans; Temperature; Nitrogen Dioxide; Air Pollutants; Air Pollution; Particulate Matter; Respiratory Tract Diseases; Morbidity; Myocardial Infarction; China; Environmental Exposure
PubMed: 36323182
DOI: 10.1016/j.ebiom.2022.104327 -
Journal of Hazardous Materials Aug 2022Chlorine dioxide (ClO) has emerged as a broad-spectrum, safe, and effective disinfectant due to its high oxidation efficiency and reduced formation of organochlorinated... (Review)
Review
Chlorine dioxide (ClO) has emerged as a broad-spectrum, safe, and effective disinfectant due to its high oxidation efficiency and reduced formation of organochlorinated by-products during application. This article provides an updated overview of ClO-based oxidation processes used in water treatment. A systematic review of scientific information and experimental data on ClO-based water purification procedures is presented. Concerning ClO-based oxidation derivative problems, the pros and cons of ClO-based combined processes are assessed and disinfection by-product (DBP) control approaches are proposed. The kinetic and mechanistic data on ClO reactivity towards micropollutants are discussed. ClO selectively reacts with electron-rich moieties (anilines, phenols, olefins, and amines) and eliminates certain inorganic ions and microorganisms with high efficiency. The formation of chlorite and chlorate during the oxidation process is a crucial concern when utilizing ClO. Future applications include the combination of ClO with ferrous ions, activated carbon, ozone, UV, visible light, or persulfate processes. The combined process can reduce by-product generation while still ensuring ClO sterilization and disinfection. Overall, this research could provide useful information and new insights into the application of ClO-based technologies.
Topics: Chlorine; Chlorine Compounds; Disinfectants; Disinfection; Oxides; Water Purification
PubMed: 35739725
DOI: 10.1016/j.jhazmat.2022.129195 -
Conservation Biology : the Journal of... Feb 2021Amphibian populations globally are in decline. One great threat is the abstraction of water resources that alter surface-water hydrology. Conservation actions aimed at... (Review)
Review
Amphibian populations globally are in decline. One great threat is the abstraction of water resources that alter surface-water hydrology. Conservation actions aimed at restoring or manipulating surface water are employed as a management tool, but empirical evidence on the effectiveness of these approaches is scarce. In this systematic review, we summarized the global experience of manipulating water for amphibian conservation. We explored examples of manipulating water to conserve amphibian species and communities. Approaches varied in their frequency of implementation and in their success. Extending hydroperiod to match larval requirements showed encouraging results, as did off-season drying to control predators. Spraying water into the environment showed several potential applications, but successes were limited. Despite some promising interventions, we identified few (n = 17) empirically supported examples of successful water manipulation to benefit amphibians. It is unclear whether this stems from publication bias or if it is an artifact of language selection. However, manipulating water shows some potential in amphibian conservation, particularly at sites with a proximal water source and in regions where aridity is increasing due to climate change. Regardless of the scale of the intervention or its perceived probability of success, high-quality reporting of empirical results will further understanding of how water manipulations can benefit threatened amphibian populations.
Topics: Amphibians; Animals; Climate Change; Conservation of Natural Resources; Water
PubMed: 32189374
DOI: 10.1111/cobi.13501 -
The Science of the Total Environment Nov 2023Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIM
Infant mortality is a widely reported indicator of population health and a leading public health concern. In this systematic review and meta-analysis, we review the available literature for epidemiologic evidence of the association between short-term air pollution exposure and infant mortality.
METHODS
Relevant publications were identified through PubMed and Web of Science databases using comprehensive search terms and screened using predefined inclusion/exclusion criteria. We extracted data from included studies and applied a systematic rubric for evaluating study quality across domains including participant selection, outcome, exposure, confounding, analysis, selective reporting, sensitivity, and overall quality. We performed meta-analyses, using both fixed and random-effect methods, and estimated pooled odds ratios (ORs) and 95 % confidence intervals (95%CI) for pollutants (nitrogen dioxide (NO), sulfur dioxide (SO), coarse particulate matter (PM), fine particulate matter (PM), ozone (O), carbon monoxide (CO)) and infant mortality, neonatal mortality, or postneonatal mortality.
RESULTS
Our search returned 549 studies. We excluded 490 studies in the abstract screening phase and an additional 37 studies in the full text screening phase, leaving 22 studies for inclusion. Among these 22 studies, 14 included effect estimates for PM, 13 for O, 11 for both NO and CO, 8 for SO, and 3 for PM. We did not calculate a pooled OR for PM due to the limited number of studies available and demonstrated heterogeneity in the effect estimates. The pooled ORs (95%CI) with the greatest magnitudes were for a 10-ppb increase in SO or NO concentration in the days before death (1.07 [95%CI: 1.02, 1.12], 1.04 [95%CI: 1.01, 1.08], respectively). The pooled OR for PM was 1.02 (95%CI: 1.00, 1.03), and the pooled ORs for CO and O were 1.01 (95%CI: 1.00, 1.02) and 0.99 (95%CI: 0.97, 1.01).
CONCLUSIONS
Increased exposure to SO, NO, PM, or CO is associated with infant mortality across studies.
Topics: Infant; Infant, Newborn; Humans; Air Pollutants; Nitrogen Dioxide; Environmental Exposure; Air Pollution; Particulate Matter; Ozone; Infant Mortality; Sulfur Dioxide
PubMed: 37459995
DOI: 10.1016/j.scitotenv.2023.165522