Air pollution interventions and respiratory health: a systematic review

BACKGROUND: Indoor and ambient air pollution exposure is a major risk to respiratory health worldwide, particularly in low- and middle-income countries (LMICs). Interventional trials have mainly focused on alternatives to cooking stoves, with mixed results. Beyond cooking, additional sources of particulate matter also contribute to the burden of air pollution exposure. This review explores evidence from current randomised controlled trials (RCTs) on the clinical effectiveness of interventions to reduce particulate matter in LMICs.METHODS: Twelve databases and the grey literature (e.g., Government reports and policy papers) were searched. Eligible studies were RCTs conducted in LMICs aiming to reduce particulate exposure from any source and reporting on at least one clinical respiratory outcome (respiratory symptoms, lung function or clinical diagnoses). Data from relevant studies were systematically extracted, the risk of bias assessed and narrative synthesis provided.RESULTS: Of the 14 included studies, 12 tested ‘improved' cookstoves, most using biomass, but solar and bioethanol cookers were also included. One trial used solar lamps and another was an integrated intervention incorporating behavioural and environmental components for the treatment and prevention of chronic obstructive pulmonary disease. Of the six studies reporting child pneumonia outcomes, none demonstrated significant benefit in intention-to-treat analysis. Ten studies reported respiratory symptom outcomes with some improvements seen, but self-reporting made these outcomes highly vulnerable to bias. Substantial inter-study clinical and methodological heterogeneity precluded calculation of pooled effect estimates.CONCLUSION: Evidence from the RCTs performed to date suggests that individual household-level interventions for air pollution exposure reduction have limited benefits for respiratory health. More comprehensive approaches to air pollution exposure reduction must be developed so their potential health benefits can be assessed.

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The association between high ambient air pollution exposure and respiratory health of young children: A cross sectional study in Jinan, China

The Science of The Total Environment ◽

10.1016/j.scitotenv.2018.11.368 ◽

2019 ◽

Vol 656 ◽

pp. 740-749 ◽

Cited By ~ 33

Author(s):

Zhangjian Chen ◽

Liangliang Cui ◽

Xiaoxing Cui ◽

Xinwei Li ◽

Kunkun Yu ◽

...

Keyword(s):

Air Pollution ◽

Young Children ◽

Respiratory Health ◽

Ambient Air ◽

Cross Sectional Study ◽

Ambient Air Pollution ◽

Sectional Study ◽

Cross Sectional ◽

Air Pollution Exposure ◽

Pollution Exposure

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A STUDY ON AMBIENT AIR POLLUTION AND HOSPITAL VISITS OF PATIENTS IN TERTIARY HOSPITAL AT NORTH CHENNAI – AN OBSERVATIONAL STUDY

10.36106/gjra/9209247 ◽

2021 ◽

pp. 55-57

Author(s):

Vengada Krishnaraj S. P ◽

Roshan Kumar. M ◽

Vinod Kumar. V

Keyword(s):

Air Pollution ◽

Particulate Matter ◽

Air Pollutants ◽

Respiratory Diseases ◽

Hospital Admissions ◽

Ambient Air ◽

Ambient Air Pollution ◽

Air Pollution Exposure ◽

Pollution Exposure ◽

Respiratory Conditions

BACKGROUND: Air pollution is an important environmental risk factor for human health. Evidence is mounting that ambient air pollution exposure is signicantly associated with respiratory diseases. Ambient air pollution, such as nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM), is associated with mortality and morbidity induced by respiratory diseases. The relationship between air pollutants and respiratory hospital admissions has been reported both in developed countries and in developing countries. Other studies have shown an adverse effect of ambient air pollution exposure on morbidity and mortality, as well as on healthcare costs. AIM OF THE STUDY: To investigate the association between ambient air pollutant exposure and daily hospital admissions for respiratory diseases in both childrens and Adults. METHODOLOGY: The daily emergency hospital admissions for respiratory conditions in the north part of Chennai during 2019- 2020 were recorded. Daily counts of hospital admissions for total respiratory conditions (43 admissions day(-1)), acute respiratory infections including pneumonia (18 day(-1)), chronic obstructive pulmonary disease (COPD) (13 day(-1)), and asthma (4.5 day(-1)) among residents of all ages and among children (0-14 yrs) were analysed. The generalized additive models included spline smooth functions of the day of study, mean temperature, mean humidity, inuenza epidemics, and indicator variables for days of the week and holidays. Total respiratory admissions were signicantly associated with the same-day level of NO2 (2.5% increase per interquartile range (IQR) change, 22.3 microg x m(-3)) and CO (2.8% increase per IQR, 1.5 mg x m(-3)). RESULTS: The daily mean concentrations of pollutants across all studies were 65.2 µg/m3 for PM10, 45.8 µg/m3 for PM2.5, 27.7 µg/m3 for SO2, 35.0 µg/m3 forNO2and1698µg/m3for CO, and 81.1µg/m3for O3. For the single variable models, the linear effect of PM10, PM2.5, and PM1 was evaluated by adjusting for the inuence of temperature. The association between hospital admissions for respiratory disease and the level of particulate matter was statistically signicant at 0-3 daylag in females and overall. In males, no statistically signicant effect was found at lag 3 for PM10 or at lag2-3 for PM2.5 and PM1.The associations between PM2.5 and PM1, and risk of admission were no longer signicant at some lags after adjusting for NO2, SO2, CO, and O3 separately. No associations were found at lag 3 after adjusting for NO2 or at lag 2 and 3 after adjusting for O3. The effects of PM2.5 and PM1 were not changed after adjusting for CO but were weaker after adjusting for other air pollutants (NO2, SO2,and O3). CONCLUSION: The ndings of this study demonstrated that O3 was associated with an increased risk of respiratory-related admissions, especially for children <5years old. The effect was stronger in the winter than in the summer with each increase of 10 µg/m3 of O3 in winter, the risk of admissions for respiratory diseases after 5 days of exposure increased by 6.2% (95% CI3.7% - 8.8%). No signicant association between O3 and hospital admissions for wheeze-associated disorders specically was observed in children.

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