Cardiorespiratory health effects of particulate ambient air pollution exposure in low-income and middle-income countries: a systematic review and meta-analysis

Katherine Newell, Christiana Kartsonaki, Kin Bong Hubert Lam, Om P. Kurmi

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Most prospective studies on the health effects of particulate ambient air pollution exposure have focused on high-income countries, which have much lower pollutant concentrations than low-income and middle-income countries (LMICs) and different sources of pollution. We aimed to investigate the cardiorespiratory health effects of particulate ambient air pollution exposure in LMICs exclusively. Methods: For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, LILACS, Global Health, and Proquest for studies published between database inception and Nov 28, 2016, investigating the cardiorespiratory health effects of particulate ambient air pollution exposure in LMICs. Data were extracted from published studies by one author, and then checked and verified by all authors independently. We pooled estimates by pollutant type (particulate matter with a diameter of <2·5 μm [PM2·5] or 2·5–10 μm [PM10]), lag, and outcome, and presented them as excess relative risk per 10 μg/m3 increase in particulate ambient air pollution. We used a random-effects model to derive overall excess risk. The study protocol is registered with PROSPERO, number CRD42016051733. Findings: Of 1553 studies identified, 91 met the full eligibility criteria. Only four long-term exposure studies from China were identified and not included in the meta-analysis. A 10 μg/m3 increase in same-day PM2·5 was associated with a 0·47% (95% CI 0·34–0·61) increase in cardiovascular mortality and a 0·57% (0·28–0·86) increase in respiratory mortality. A 10 μg/m3 increase in same-day PM10 was associated with a 0·27% (0·11–0·44) increase in cardiovascular mortality and a 0·56% (0·24–0·87) increase in respiratory mortality. Interpretation: Short-term exposure to particulate ambient air pollution is associated with increases in cardiorespiratory morbidity and mortality in LMIC's, with apparent regional-specific variations. Funding: None.

Original languageEnglish
Pages (from-to)e368-e380
Number of pages13
JournalThe Lancet Planetary Health
Volume1
Issue number9
DOIs
Publication statusPublished - 1 Dec 2017
Externally publishedYes

Bibliographical note

Copyright © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health

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