Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis

Short-term and lagged effects of ambient air pollutants on CVD hospitalization: A two-decade population-based study in Tehran

OBJECTIVES

To evaluate the relationship between short-term exposure to ambient air pollutants and cardiovascular disease (CVD) hospitalizations.

METHODS

A time-series analysis was conducted using data from the Tehran Lipid and Glucose Study cohort of 3454 residents (1880 women) aged 50-70 from District 13 of Tehran. Follow-up data from January 1999 to March 2018 were analyzed. Daily mean temperatures and air pollution levels (CO, O3, PM10, NO2, and SO2) were recorded, and distributed lag non-linear models (DLNMs) assessed the lagged effects on outcome.

RESULTS

Over a median follow-up of 14.7 years, 2200 CVD hospitalizations occurred among 3454 participants (mean age 58.7 years, women = 1880). Among the general population, the DLNM models indicated that PM10 concentrations at 73 μg/m3 was associated with a 12 % increased risk of the outcome, with an RR of 1.12 (95 % CI: 1.01-1.24), and higher PM10 levels corresponded to increasing RRs. PM10 indicated a short-term exposure effect at 1-day lag on the outcome risk. SO2 concentrations reached significance at 24 μg/m3, with an RR of 1.06 (95 % CI: 1.04-1.07); the effect persisted up to 65 μg/m3, with an increased risk of the outcome observed at a 6-day lag. CO showed the highest RR of 1.92 (95 % CI: 1.65-2.23) for the concentration of 5 mg/m3. Exposure to CO was linked to an increased risk of the outcome with a 1-day lag. Sex as well as presence of metabolic syndrome and CKD did not modify the association between air pollutants with the outcome.

CONCLUSIONS

Short-term exposure to PM10, SO2 and CO significantly increased risk of CVD hospitalization.

Smoke Exposure and Respirator Use Among Wildland Firefighters: A Narrative Review

Climate change contributes to warm, dry conditions, which leads to longer and more active fire seasons. Wildland firefighters work long hours in smoky conditions without regulations requiring respiratory protection. Wildfire smoke has many toxic components, including high levels of fine particulate matter (PM2.5). Regular monitoring for short- and long-term health outcomes in wildland firefighter populations is uncommon. However, extrapolating from knowledge about the individual components of smoke, it is likely that the firefighters' health is negatively affected. Firefighters are routinely exposed to dangerous levels of smoke, which may lead to both acute and chronic health consequences. Current guidelines from Occupational Safety and Health Administration (OSHA), the U.S. Forest Service (USFS), and the Interagency Standards for Fire and Fire Aviation Operations do not recommend respirator use for wildland firefighters. The methodologies used to quantify exposure and harm likely underestimate actual risks. Although there are no respirators that can filter all known harmful components of wildfire smoke, this review examines the potential benefit of respirator use by reducing some of the most harmful components of the smoke. Smoke exposure among wildland firefighters needs to be further characterized and quantified. Regulations should be reassessed to accurately reflect the exposure and potential harm that firefighters face. This narrative review gathers information from peer-reviewed scientific literature, government publications, news articles, and personal conversations with both public- and private-sector professionals. The objectives are to describe the likely health effects of wildland firefighting, evaluate the evidence behind current respiratory protection guidelines, and propose potential solutions.

"Gut Microbiota as a Therapeutic Target for Hypertension: Challenges and Insights for Future Clinical Applications" "Gut Microbiota and Hypertension Therapy"

PURPOSE OF REVIEW

Systemic hypertension is a major risk factor for cardiovascular disease and remains challenging to manage despite the widespread use of antihypertensive medications and lifestyle modifications. This review explores the role of gut microbiota in hypertension development and regulation, highlighting key mechanisms such as inflammation, gut-brain axis modulation, and bioactive metabolite production. We also assess the potential of microbiota-targeted therapies for hypertension management.

RECENT FINDINGS

Emerging evidence indicates that microbial dysbiosis, high-salt diets, and gut-derived metabolites such as short-chain fatty acids (SCFAs) and bile acids significantly influence blood pressure regulation. Preclinical and early clinical studies suggest that interventions targeting gut microbiota, including probiotics, prebiotics, synbiotics, fecal microbiota transplantation (FMT), and dietary modifications, may help modulate hypertension. However, variability in gut microbiota composition among individuals and limited human trial data pose challenges to translating these findings into clinical practice. While microbiota-based therapies show promise for hypertension management, further research is needed to establish their efficacy and long-term effects. Large-scale, standardized clinical trials are crucial for understanding the therapeutic potential and limitations of gut microbiota interventions. A deeper understanding of the gut-hypertension axis could lead to novel, personalized treatment strategies for hypertension.

Association Between Area-Level Deprivation and Cardio-Metabolic Risk Factors Among the Adult Population in Russia

BACKGROUND

Cardiovascular diseases have been the leading cause of death in the Russian population to date.

METHODS

Using generalized estimating equations, we examined the links of area-level socio-economic and environmental deprivation with cardiovascular disease risk factors in the adult population as a whole, as well as in men and women separately.

RESULTS

People living in more economically deprived areas had 61 percent higher odds of being obese (Q4: odds ratio (OR) 1.61; 95% confidence interval (CI): 1.20-2.16), 2.32 times higher odds of having chronic kidney disease (OR 2.32; 95% CI: 1.56-3.44), up to 57 percent higher odds of having hyperuricemia (OR 1.57; 95% CI: 1.31-1.88), and up to 80 percent higher odds of having diabetes mellitus (OR 1.80; 95% CI: 1.71-1.89), compared to those in the least deprived areas. Individuals living in the most environmentally deprived areas were associated with higher odds of hypertension (OR 1.37; 95% CI: 1.19-1.57) and these associations persisted for both when considering men (OR 1.38; 95% CI: 1.19-1.61) and women (OR 1.37; 95% CI: 1.14-1.65) separately.

CONCLUSIONS

This is the first study to examine the relationship of area characteristics with cardio-metabolic risk factors such as elevated blood pressure and prediabetes, taking into account individual characteristics among the Russian population.

Calcium, magnesium, and vitamin D supplementations as complementary therapy for hypertensive patients: a systematic review and meta-analysis

BACKGROUND

Hypertension, the first global modifiable risk factor for cardiovascular disease (CVD) morbidity and mortality, is a consequential and remediable threat to the health of individuals and society. Therefore, we conducted this study to explore the role of calcium (Ca++), magnesium (Mg++), and vitamin D (Vit-D) supplementation as complementary therapies for hypertension, focusing on their effects on systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate.

METHODS

This systematic review and meta-analysis examined relevant 6509 articles in PubMed, Scopus, Web of Science, and Cochrane CENTRAL up to October 2024. The primary outcome was the difference in blood pressure measurements (systolic and diastolic) and the pulse rate. The extracted data were analyzed using Open Meta Analyst software.

RESULTS

This systematic review and meta-analysis included 40 studies; of them, 24 studies were analyzed. Ca++ was associated with a significant drop in the DBP (MD: -2.04, 95% CI [-3.39, -0.69], P = 0.01), but not in the SBP (P = 0.34) or pulse rate (P = 0.84). Mg++ significantly reduced DBP (MD: -1.64, 95% CI [-3.19, -0.09], P = 0.04), but had no significant effect on the SBP (P = 0.16) or pulse rate (P = 0.81). The estimated effect of Vit-D showed a significant reduction in SBP (MD: -2.83, 95% CI [-5.47, -0.199], P = 0.04) and DBP (MD: -1.64, 95% CI [-2.97, -0.3], P = 0.01).

CONCLUSION

Ca++ and Mg++ significantly reduced DBP but had no significant effect on SBP or the pulse rate. Whereas, vitamin D significantly reduced SBP and DBP.

Causal Relationship Between Air Pollutants and Blood Pressure Phenotypes: A Mendelian Randomization Study

Objectives

Hypertension is a chronic disease widely prevalent around the world. While previous observational studies have suggested a link between air pollutants and an increased risk of hypertension, causality has not been established. Our study aimed to investigate potential causal relationships between five air pollutants and four blood pressure phenotypes through two-sample Mendelian randomization.

Methods

Two-sample Mendelian randomization (MR) analyses were performed using genome-wide association studies (GWAS) data from the IEU OpenGWAS project. The main analysis method was the inverse variance weighting (IVW) method. Heterogeneity was assessed by Cochran's Q test, while pleiotropy was assessed by MR-Egger regression. Sensitivity analysis was performed by weighted median method, MR-Egger method, simple mode method, weighted mode method, and leave-one-out analysis method.

Results

Mendelian randomization results showed positive causal associations between PM10 with hypertension (OR: 1.49; 95%CI: 1.06, 2.09; P: 2.23 × 10-2) and systolic blood pressure (β: 1.89; 95%CI: 0.32, 3.47; P: 1.85 × 10-2), positive causal associations between PM2.5 and hypertension (OR: 1.26; 95%CI: 1.01, 2.58; P: 4.30 × 10-2), and negative causal associations between NO2 and systolic blood pressure (β: -1.71; 95%CI: -3.39, -0.02; P: 4.74 × 10-2). None of the above associations were subject to pleiotropic bias, and all associations were heterogeneous except for PM10 and hypertension. The leave-one-out analysis showed that no single SNP affected the stability of the results.

Conclusion

Elevated levels of PM2.5 and PM10 have been associated with an increased risk of developing hypertension, with PM10 specifically linked to higher systolic blood pressure levels. Interestingly, NO2 has shown potential as a protective factor in lowering systolic blood pressure. This study clarifies the causal relationship between five air pollutants and elevated blood pressure. Ensuring good ambient air quality is essential in preventing hypertension and reducing the overall disease burden.

Household Air Pollution Exposures Over Pregnancy and Maternal Blood Pressure Trajectories through 8 Years Postpartum: Evidence from the Ghana Randomized Air Pollution and Health Study (GRAPHS)

Background

Household air pollution is a major contributor to cardiovascular disease burden in women in Sub-Saharan Africa. However, little is known about exposures during pregnancy or the effect of clean cooking interventions on postpartum blood pressure trajectories.

Methods

The Ghana Randomized Air Pollution and Health Study (GRAPHS) randomized 1414 non-smoking women in the first and second trimesters to liquefied petroleum gas (LPG) or improved biomass stoves - vs control (traditional three-stone open fire). Personal exposure to carbon monoxide was measured at four prenatal timepoints and three times over the first postpartum year. Participants were prospectively followed with annual resting BP measurements at 2, 4, 5, 6, 7, and 8 years postpartum. We employed linear mixed effects models to determine effect of GRAPHS interventions on postpartum BP, and to examine associations between prenatal and postnatal CO and postpartum BP.

Results

LPG intervention was associated with 3.54mmHg (95% CI -5.55, -1.53) lower change in systolic BP from enrolment through 8 years postpartum, and 2.27mmHg (95% CI -3.61, -0.93) lower change in diastolic BP from enrolment through 8 years postpartum, as compared to control. In exposure-response analysis, average prenatal CO was positively associated with change in systolic BP from enrolment (β=0.71mmHg, 95% CI 0.08, 1.30, per doubling of CO).

Conclusions

LPG cookstove intervention initiated in early pregnancy and maintained through the first postpartum year was associated with lower systolic and diastolic BP trajectories through 8 years postpartum. These findings support the need to integrate clean cooking solutions into existing antenatal care packages.

Ozone exposure and cardiovascular disease: A narrative review of epidemiology evidence and underlying mechanisms

Ozone (O3) poses a significant global public health concern as it exerts adverse effects on human cardiovascular health. Nevertheless, there remains a lack of comprehensive understanding regarding the relationships between O3 exposure and the risk of cardiovascular diseases (CVD), as well as the underlying biological mechanisms. To address this knowledge gap, this narrative review meticulously summarizes the existing epidemiological evidence, susceptibility, and potential underlying biological mechanisms linking O3 exposure with CVD. An increasing body of epidemiological studies has demonstrated that O3 exposure heightens the incidence and mortality of CVD, including specific subtypes such as ischemic heart disease, hypertension, and heart failure. Certain populations display heightened vulnerability to these effects, particularly children, the elderly, obese individuals, and those with pre-existing conditions. Proposed biological mechanisms suggest that O3 exposure engenders respiratory and systemic inflammation, oxidative stress, disruption of autonomic nervous and neuroendocrine systems, as well as impairment of coagulation function, glucose, and lipid metabolism. Ultimately, these processes contribute to vascular dysfunction and the development of CVD. However, some studies have reported the absence of associations between O3 and CVD, or even potentially protective effects of O3. Inconsistencies among the literature may be attributed to inaccurate assessment of personal O3 exposure levels in epidemiologic studies, as well as confounding effects stemming from co-pollutants and temperature. Consequently, our findings underscore the imperative for further research, including the development of reliable methodologies for assessing personal O3 exposure, exploration of O3 exposure's impact on cardiovascular health, and elucidation of its biological mechanisms. These endeavors will consolidate the causal relationship between O3 and cardiovascular diseases, subsequently aiding efforts to mitigate the risks associated with O3 exposure.

Preconception and gestational versus postnatal exposure to air pollutants and risk of autism spectrum disorder: a systematic review and meta-analysis

PURPOSE

The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM2.5, PM10, NO2, and O3) and the risk of ASD was therefore performed.

METHODS

Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.

RESULTS

Preconception exposure to air pollutants showed a protective trend for PM2.5, PM10, and O3 with a 10%, 5%, and 19% reduced risk of ASD, whereas NO2 had a 28% higher likelihood of ASD. During gestation, PM2.5 exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM2.5 and NO2 for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM2.5, PM10, NO2, and O3, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.

CONCLUSIONS

In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM2.5 and NO2. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.

PM2.5 associates with blood pressure: a Mendelian randomization analysis

The relationship between fine particulate matter (PM2.5) and blood pressure (BP) is a controversial issue. We conducted a two-sample Mendelian randomization (MR) analysis and identified 58 genome-wide significant single-nucleotide polymorphisms associated with PM2.5 as instrument variables. Inverse-variance weighted (IVW) was used as the primary analysis approach. MR-Egger, weighted median, simple model, and weighted model methods were selected for quality control. We found a significant negative causal association of higher genetically predicted PM2.5 levels with lower systolic BP (SBP), while no causal relationship was identified between PM2.5 and diastolic BP (DBP). For each 1 standard deviation increase in genetically predicted PM2.5 levels, the beta value (95% CI) of SBP was -0.14 (-0.25, -0.03) for IVW (p=0.02), and -0.13 (-0.22, -0.04) for weighted median (p=0.005). Increased PM2.5 concentrations can lead to decreased SBP levels. Our findings provided novel insights into the controversial topic on the causal relationship between PM2.5 and BP.

The association between ozone exposure and blood pressure in a general Chinese middle-aged and older population: a large-scale repeated-measurement study

BACKGROUND

The relationship between ozone (O3) exposure and blood pressure (BP) remains inconclusive. Given the scarcity of Chinese epidemiological data, more research on this association is of paramount importance, particularly among middle-aged and older Chinese populations.

METHODS

This study involved 10,875 participants (median age: 60.0 years) in Xiamen, China, from 2013 to 2019, with 34,939 repeated BP measurements. Air pollutant exposure data, including O3, particulate matter, nitrogen dioxide, sulfur dioxide, and carbon monoxide were derived from China High Air Pollutants and High-resolution Air Quality Reanalysis datasets using a k-nearest neighbor algorithm. The relationship between mixed air pollutant exposure and BP was evaluated using Bayesian kernel machine regression model. The effects of daily-specific O3 exposure on BP were assessed by distributed lag models integrated into a linear mixed-effects framework. The mediating role of total cholesterol (TC), serum total bilirubin (STB), triglyceride (TG), and low-density lipoprotein (LDL) were examined using multilevel mediation analysis with a fully adjusted model.

RESULTS

Mixed air pollutant exposure was positively correlated with BP, with O3 being a predominant contributor exhibiting an inverse effect. O3 exposure had immediate effects on pulse pressure (PP), while systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) showed delayed responses, with 3-, 14-, and 8-day lags, respectively. During the study period of up to 30 days, each 10 μg/m3 increase in maximum daily 8-h average O3 concentration was associated with reductions in SBP (β =  - 1.176 mm Hg), DBP (- 0.237 mm Hg), PP (β =  - 0.973 mm Hg), and MAP (β =  - 0.544 mm Hg). Stronger correlations were observed in the older participants (aged ≥ 65 years), overweight/obese individuals, smokers and alcohol consumers, and those with hypertension or type 2 diabetes mellitus. STB and LDL mediated these effects, while TC and TG played mitigating roles.

CONCLUSIONS

Short-term O3 exposure is negatively associated with BP in middle-aged and older Chinese individuals. The findings provide preliminary evidence for the impact of O3 exposure on BP regulation and underscore the urgent need to reassess public health policies in response to O3 pollution.

Association between air pollution and hypertension hospitalizations: a time series analysis in Lanzhou

BACKGROUND

Air pollution is a major environmental risk factor. Hypertension is one of the most important modifiable risk factors for cardiovascular diseases. However, few studies have evaluated the impact of exposure to ambient air pollution on hypertension hospitalizations.

OBJECTIVE

This study aims to explore the correlation between exposure to air pollution and hospital admissions for hypertension, to evaluate the short-term effects of air pollution on hypertension hospitalizations and its lag effects.

METHODS

We collected air pollution concentration and hypertension hospitalization data from 2013 to 2020. Distributed lag non-linear models were employed to assess the impact of air pollution on hypertension hospitalizations in Lanzhou City. We also performed subgroup analyses and sensitivity analyses.

RESULTS

A total of 47,884 cases of hypertension hospitalizations were included. Short-term exposure to NO2 and CO increased the risk of hypertension hospitalization. For each 10 µg/m3 increase in NO2 and each 1 mg/m3 increase in CO, the relative risk (RR) for hypertension hospitalization were highest at lag0-3 (RR: 1.0427; 95% CI: 1.0196, 1.0663) and lag3 (RR: 1.0986; 95% CI: 1.0350, 1.1661), respectively. SO2 at different lag structures showed opposite effects on hypertension hospitalization. O3 was significantly negatively associated with hypertension hospitalization. No correlation was observed between PM2.5 and PM10 and hypertension hospitalization. Females and individuals aged ≥ 65 were more susceptible to air pollution. The harmful effects of air pollution are greater in the cold season.

CONCLUSION

Short-term exposure to ambient air pollution increases risk of hypertension hospitalization.

Long-term exposure to low-level ozone and the risk of hypertension: A prospective cohort study conducted in a low-pollution region of southwestern China

BACKGROUND

The current evidence regarding the association between long-term exposure to ozone (O3) and hypertension incidence is limited and inconclusive, particularly at low O3 concentrations. Therefore, our research aims to investigate the potential link between long-term O3 exposure and hypertension in a region with low pollution levels.

METHODS

From 2010 to 2012, we conducted a cohort prospective study by recruiting nearly 10,000 attendees through multistage cluster random sampling in Guizhou Province, China. These individuals were followed up from 2016 to 2020, and 5563 cases were finally included in the analysis. We employed a high-resolution model with both temporal and spatial accuracy to estimate the maximum daily 8-h average O3 and utilized annual average O3 concentrations for three exposure periods (2009_10, 2007_10, 2005_10) as the exposure indicator. Time-dependent covariates Cox regression model was exerted to estimate the hazard ratios (HRs) of hypertension incidence. Generalized linear model was employed to assess the association between O3 and systolic, diastolic, pulse, and mean arterial pressure. The dose-response curve was explored using a restricted cubic spline function.

RESULTS

1213 hypertension incidents occurred during 39,001.80 person-years, with an incidence density of 31.10/1000 Person Years (PYs). The average O3 concentrations during the three exposure periods were 66.76 μg/m3, 67.85 μg/m3, and 67.21 μg/m3, respectively. Per 1 μg/m3 increase in O3 exposure was associated with 11 % increase in the incidence of hypertension in the single-pollution model, and the association was more pronounced in Han, urban, and higher altitude areas. SBP, PP, and MAP were increased by 0.619 (95 % CI, 0.361-0.877) mm Hg, 0.477 (95 % CI, 0.275-0.679) mm Hg, 0.301 (95 % CI, 0.127-0.475) mm Hg, respectively. Furthermore, we observed a nonlinear exposure-response relationship between O3 and hypertension incidence.

CONCLUSIONS

Long-term exposure to low-level O3 exposure is associated with an increased risk of hypertension.

Air pollution generated in an industrial region: Effect on the cardiovascular health of humans and damage caused to a plant species, Piper gaudichaudianum (Piperaceae), used for biomonitoring

Atmospheric pollution due to anthropogenic activities is a complex mixture of gasses and particulate matter (PM) that is currently one of the main causes of premature death in the world. Similarly, it is also capable of directly interfering with plant species by reducing their photosynthetic capacity and growth and killing cells. This work is about an observational study conducted in a region with two industries: a mine and an automobile parts manufacturer. Mining rocks is a source of PM in the air like that caused by other industrial activities. Twenty-five people that work or live in the industrial region cited (area A) and 25 people that live further away (area B) were selected to evaluate their vital signs and conduct a transthoracic echocardiogram. Leaves of Piper gaudichaudianum (Piperaceae), a native plant species, were also collected in both areas and evaluated in a laboratory. The PM accumulated on the leaves was evaluated using scanning electron microscopy (SEM) and inductively coupled plasma-optical emission spectrometry (ICP-OES). A statistical difference (P < 0.05) was verified for the levels of systolic blood pressure (SBP), diastolic blood pressure (DBP), and left ventricular mass index by echocardiography; the values were greater in people in area A. For the plant analysis, there was a statistical difference for all characters evaluated, chlorophyll levels, fresh mass, dry mass and leaf area were reduced, and thickness was greater in area A (P < 0.001). The PM analysis revealed a predominance of silicon, iron, and aluminum chemical elements. The present study suggests that particulate matter pollution is harmful to both humans and the flora.

Association Between Long-Term Exposure to Ambient Air Pollution and Fasting Blood Glucose: A Systematic Review and Meta-Analysis

Increasing studies are indicating a potential association between ambient air pollution exposure and fasting blood glucose (FBG), an indicator of prediabetes and diabetes. However, there is inconsistency within the existing literature. The aim of this study was to summarize the associations of exposures to particulate matters (PMs) (with aerodynamic diameters of ≤1 μm (PM1), ≤2.5 μm (PM2.5), and ≤10 μm (PM10), respectively) and gaseous pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3)) with FBG based on the existing epidemiological research for a better understanding of the relationship between air pollution and diabetes. Up to 2 July 2024, we performed a comprehensive literature retrieval from various electronic databases (PubMed, Web of Science, Scopus, and Embase). Random-effect and fixed-effect models were utilized to estimate the pooled percent changes (%) and 95% confidence intervals (CIs). Then, subgroup meta-analyses and meta-regression analyses were applied to recognize the sources of heterogeneity. There were 33 studies eligible for the meta-analysis. The results showed that for each 10 μg/m3 increase in long-term exposures to PM1, PM2.5, PM10, and SO2, the pooled percent changes in FBG were 2.24% (95% CI: 0.54%, 3.96%), 1.72% (95% CI: 0.93%, 2.25%), 1.19% (95% CI: 0.41%, 1.97%), and 0.52% (95% CI:0.40%, 0.63%), respectively. Long-term exposures to ambient NO2 and O3 were not related to alterations in FBG. In conclusion, our findings support that long-term exposures to PMs of various aerodynamic diameters and SO2 are associated with significantly elevated FBG levels.

The Effects of Environmental Factors on General Human Health: A Scoping Review

Background/Objectives: The external environment constantly influences human health through many factors, including air quality, access to green spaces, exposure to pollutants, and climate change. Contamination poses a substantial threat to human well-being; conversely, environmental factors also positively impact health. The purpose of this study is to provide a comprehensive review of the complex relationship between various environmental factors and human health. While individual studies have explored specific aspects, a broader integrative understanding is lacking. Methods: Through databases (PubMed, Cochrane, Copernicus), 4888 papers were identified, with 166 selected for detailed analysis. Results: We summarized recent research, identifying multiple associations between environmental factors such as air pollution, climate change, solar radiation, and meteorological conditions and their impact on various health outcomes, including respiratory, cardiovascular, metabolic and gastrointestinal, renal and urogenital, neurological and psychological health, infectious and skin diseases, and major cancers. We use chord diagrams to illustrate these links. We also show the interaction between different environmental factors. Findings begin with exploring the direct impact of environmental factors on human health; then, the interplay and combined effects of environmental factors, elucidating their (often indirect) interaction and collective contribution to human health; and finally, the implications of climate change on human health. Conclusions: Researchers and policymakers need to consider that individuals are exposed to multiple pollutants simultaneously, the "multipollutant exposure phenomenon". It is important to study and regulate environmental factors by considering the combined impact of various pollutants rather than looking at each pollutant separately. We emphasize actionable recommendations and solutions.

A longitudinal study on the effect of PM2.5 components on blood pressure in the hypertensive patients from 2011 to 2019

Extensive research has established the link between PM2.5 exposure and blood pressure (BP) levels among normal individuals. However, the association between PM2.5 components and BP levels in hypertensive patients has not been fully explored. In this study, 12 971 hypertensive cases from Jinchang cohort (in Jinchang City, China) with nearly 9 years of follow-up were enrolled. Based on the linear mixed-effect model, the effects of fine particulate matter (PM2.5) and five major components [sulfate (SO42-), nitrate (NO3-), ammonium (NH4+), black carbon (BC) and organic matter (OM)]on BP [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP)]were evaluated by single-component model, component-joint model and component-residual model, respectively. A positive correlation was found between PM2.5 as well as its components (SO42-, NO3-, NH4+, BC and OM) exposure and BP levels. The effects of SO42-, BC and OM on BP were observed to be the most robust among the three models. Based on the results of interaction effects and stratified analysis, the effect of BC exposure on SBP, and the effect of PM2.5 and its five components on PP were greater in female than in males. Compared with elderly hypertensive patients, OM had more significant effects on SBP, DBP and MAP in young and (or) middle-aged hypertensive patients. During the heating season, the effect of PM2.5 and its components on BP was grater compared to the non-heating season. Meanwhile, PM2.5 and its components have a greater influence on BP in patients with hypertension combined with diabetes. Therefore, the findings suggested that both PM2.5 exposure and its components had a significant effect on BP in patients with hypertension. Women and young and middle-aged hypertensive patient were the sensitive population. The implementation of source control and reduction of PM2.5 emission (mainly for SO42-, BC and OM) may be of great significance to control BP level and could reduce the risk of cardiovascular disease in patients with hypertension.

Effects of long-term exposure to air pollutant mixture on blood pressure in typical areas of North China

BACKGROUND

Studies about the combined effects of gaseous air pollutants and particulate matters are still rare.

OBJECTIVES

This study was performed based on baseline survey of the Diverse Life-Course Cohort in the Beijing-Tianjin-Hebei (BTH) Region of North China to evaluate the association of long-term air pollutants with blood pressure and the combined effect of the air pollutants mixture among 32821 natural han population aged 20 years or above.

METHODS

Three-year average exposure to air pollutants (PM10, PM2.5, PM1, O3, SO2, NO2, and CO) and PM2.5 components [black carbon (BC), ammonium (NH4+), nitrate (NO3-), sulfate (SO42-), and organic matter (OM)] of residential areas were calculated based on well-validated models. Generalized linear mixed models (GLMMs) were used to estimate the associations of air pollutants exposure with the systolic blood pressure (SBP), diastolic blood pressure (DBP), Mean arterial pressure (MAP), pulse pressure (PP) and prevalent hypertension. Quantile g-Computation and Bayesian Kernel Machine Regression (BKMR) were employed to assess the combined effect of the air pollutant mixture.

RESULTS

We found that long-term exposures of O3, PM2.5, and PM2.5 components were stably and strongly associated with elevated SBP, DBP, and MAP and prevalent hypertension. O3 increased SBP, DBP, and MAP at a similar extent, but with greater effects; while, PM2.5 and PM2.5 components had a greater impact on SBP than DBP, which increased PP simultaneously. In multi-pollutant models, the combined effects of the air pollutant mixture on blood pressure and prevalent hypertension was predominantly influenced by O3, PM2.5, and O3, OM in different models, respectively. For example, O3, PM2.5 contributed 57.25 %, 39.22 % of the positive combined effect of the air pollutant mixture on SBP; and O3, OM positively contributed 70.00 %, 30.00 % on prevalent hypertension, respectively. There were interactions between O3, CO, SO2 and PM2.5 components on hbp, SBP and PP.

CONCLUSIONS

The results showed positive associations of air pollutant mixtures with blood pressure, where O3 and PM2.5 (especially OM) might be primary contributors. There were interactions between gaseous air pollutants and PM2.5 components on blood pressure and prevalent hypertension.

Effect of air pollution on the global burden of cardiovascular diseases and forecasting future trends of the related metrics: a systematic analysis from the Global Burden of Disease Study 2021

BACKGROUND

This study assesses the worldwide cardiovascular disease (CVD) burden attributed to air pollution, utilizing data from the Global Burden of Disease Study 2021.

METHODS

We explored the impact of air pollution on CVDs globally, regionally, and nationally, while considering correlations with age, gender, and socio-demographic index (SDI). A decomposition analysis was conducted to discern the contributions of aging, population growth, and epidemiological shifts to the changes in disability-adjusted life years (DALYs) from 1990 to 2021. Additionally, an ARIMA model was used to forecast the future CVD burden through 2050.

RESULTS

In 2021, air pollution was responsible for approximately 2.46 million deaths and 58.3 million disability-adjusted life years (DALYs) attributable to CVDs, with a discernible decrease over the period studied. The greatest impacts were observed in individuals aged 75-79 and over 80, particularly among males. The decomposition analysis indicated that shifts in epidemiology were the primary factors driving these changes. Future projections suggest potential increases in mortality and DALY rates in regions with low and high-middle SDI, alongside rising age-standardized death and mortality rates in high SDI areas.

CONCLUSION

These findings underscore the urgency of implementing targeted CVD prevention and air pollution control strategies to mitigate the impact on public health.

Particle-ozone complex pollution under diverse synoptic weather patterns in the Yangtze River Delta region: Synergistic relationships and the effects of meteorology and chemical compositions

There is considerable academic interest in the particle-ozone synergistic relationship (PO) between fine particulate matter (PM2.5) and ozone (O3). Using various synoptic weather patterns (SWPs), we quantitatively assessed the variations in the PO, which is relevant to formulating policies aimed at controlling complex pollution in the air. First, based on one-year sampling data from March 2018 to February 2019, the SWPs classification of the Yangtze River Delta (YRD) was conducted using the sum-of-squares technique (SS). Five dominant SWPs can be found in the YRD region, including the Aleutian low under SWP1 (occurring 45 % of the year), a tropical cyclone under SWP2 (21 %), the tropical cyclone and western Pacific Subtropical High (WPSH) under SWP3 (15.4 %), the WPSH under SWP4 (6.9 %), and a continental high pressure under SWP5 (3.1 %). The phenomenon of a "seesaw" between PM2.5 and O3 concentrations exhibited significant spatial heterogeneity, which was influenced by meteorological mechanisms. Second, the multi-linear regression (MLR) model and the partial correlation (PCOR) analysis were employed to quantify the effects of dominant components and meteorological factors on the PO. Meteorological variables could collectively explain only 33.0 % of the PM2.5 variations, but 58.0 % for O3. O3 promoted each other with low concentrations of PM2.5 but was inhibited by high concentrations of PM2.5. High relative humidity (RH) was conducive to the generation of PM2.5 secondary components and enhanced the radiative effects of aerosols and the negative correlation of PO. In addition, attention should be paid to assessing the combined effects of precursor levels, weather, and chemical reactions on the particle-ozone complex pollution. The control of O3 pollutants should be intensified in summer, while the focus should be on reducing PM2.5 pollutants in winter. Prevention and control measures need to reflect the differences in weather conditions and pollution characteristics, with a focus on RH and secondary components of PM2.5.

Long-term effects of air quality on hospital readmission for heart failure in patients with acute myocardial infarction

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of death worldwide, with air pollution posing significant risks to cardiovascular health. The effect of air quality on heart failure (HF) readmission in acute myocardial infarction (AMI) patients is unclear.The aim of this study was to evaluate the role of a single measure of air pollution exposure collected on the day of first hospitalization.

METHODS

We retrospectively analyzed data from 12,857 acute coronary syndrome (ACS) patients (January 2015-March 2023). After multiple screenings, 4023 AMI patients were included. The air pollution data is updated by the automatic monitoring data of the national urban air quality monitoring stations in real time and synchronized to the China Environmental Monitoring Station. Cox proportional hazards regression assessed the impact of air quality indicators on admission and outcomes in 4013 AMI patients. A decision tree model identified the most susceptible groups.

RESULTS

After adjusting for confounders, NO2 (HR 1.009, 95% CI 1.004-1.015, P = 0.00066) and PM10 (HR 1.006, 95% CI 1.002-1.011, P = 0.00751) increased the risk of HF readmission in ST-segment elevation myocardial infarction (STEMI) patients. No significant effect was observed in non-STEMI (NSTEMI) patients (P > 0.05). STEMI patients had a 2.8-fold higher risk of HF readmission with NO2 > 13 μg/m3 (HR 2.857, 95% CI 1.439-5.670, P = 0.00269) and a 1.65-fold higher risk with PM10 > 55 μg/m3 (HR 1.654, 95% CI 1.124-2.434, P = 0.01064).

CONCLUSION

NO2 and PM10 are linked to increased HF readmission risk in STEMI patients, particularly when NO2 exceeds 13 μg/m3 and PM10 exceeds 55 μg/m3. Younger, less symptomatic male STEMI patients with fewer underlying conditions are more vulnerable to these pollutants.

The relationship between air pollution and the occurrence of hypertensive disorders of pregnancy: Evidence from a study in Wuhan, China

Ambient air pollution has been reported to be a risk factor for hypertensive disorders of pregnancy (HDP). Past studies have reported supportive evidence, but evidence from China is scarce and does not integrate the different periods of the pregnancy course. In this study, 1945 pregnant women with HDP and healthy pregnancies between 2016 and 2022 from the Renmin Hospital of Wuhan University registry network database were analysed. The geographic information, biological information and demographic information of the case were fused in the analysis. Machine learning methods were used to obtain the weight of the variable. Then, we used the generalized linear mixed model to evaluate the relationship between increased exposure to each pollutant at different periods of HDP and examined it in different groups. The results showed that SO2 had the predominate impact (12.65 %) on HDP compared with other air pollutants. SO2 exposure was associated with an increased risk of HDP. Increased unit SO2 concentrations were accompanied by an increased risk of HDP (OR = 1.33, 95 % CI: 1.13, 1.566), and the susceptible window for this effect was mainly in the first trimester (OR = 1.242, 95 % CI: 1.092, 1.412). In addition, SO2 exposure was associated with an increased risk of HDP in urban maternity (OR = 1.356, 95 % CI: 1.112, 1.653), obese maternity (OR = 3.58, 95 % CI: 1.608, 7.971), no higher education maternity (OR = 1.348, 95 % CI: 1.065, 1.706), nonzero delivery maternity (OR = 1.981, 95 % CI: 1.439, 2.725), maternal with first time maternity (OR = 1.247, 95 % CI: 1.007, 1.544) and other groups. In summary, SO2 exposure in early pregnancy is one of the risk factors for HDP, and the increased risk of HDP due to increased SO2 exposure may be more pronounced in obese, urban, low-education, and nonzero delivery populations.

Uncovering the impact and mechanisms of air pollution on eye and ear health in China

Increasing air pollution could undermine human health, but the causal link between air pollution and eye and ear health has not been well-studied. Based on four-week-level records of eye and ear health over 1991-2015 provided by the China Health and Nutrition Survey, we estimate the causal effect of air pollution on eye and ear health. Using two-stage least squares estimation, we find that eye or ear disease possibility rises 1.48% for a 10 μg/m3 increase in four-week average PM2.5 concentration. The impacts can last about 28 weeks and will be insignificant afterward. Females, individuals aged 60 years and over, with high exposure environments, relatively poor economic foundations, and low knowledge levels are more vulnerable to such negative influences. Behavioral channels like more smoking activities and less sleeping activities could partly explain this detrimental effect. Our findings enlighten how to minimize the impact of air pollution and protect public health.

Effect of PM2.5 on burden of mortality from non-communicable diseases in northern Thailand

Background

Particulate pollution, especially PM2.5from biomass burning, affects public and human health in northern Thailand during the dry season. Therefore, PM2.5exposure increases non-communicable disease incidence and mortality. This study examined the relationship between PM2.5and NCD mortality, including heart disease, hypertension, chronic lung disease, stroke, and diabetes, in northern Thailand during 2017-2021.

Methods

The analysis utilized accurate PM2.5data from the MERRA2 reanalysis, along with ground-based PM2.5measurements from the Pollution Control Department and mortality data from the Division of Non-Communicable Disease, Thailand. The cross-correlation and spearman coefficient were utilized for the time-lag, and direction of the relationship between PM2.5and mortality from NCDs, respectively. The Hazard Quotient (HQ) was used to quantify the health risk of PM2.5to people in northern Thailand.

Results

High PM2.5 risk was observed in March, with peak PM2.5concentration reaching 100 µg/m3, with maximum HQ values of 1.78 ± 0.13 to 4.25 ± 0.35 and 1.45 ± 0.11 to 3.46 ± 0.29 for males and females, respectively. Hypertension significantly correlated with PM2.5levels, followed by chronic lung disease and diabetes. The cross-correlation analysis showed a strong relationship between hypertansion mortality and PM2.5at a two-year time lag in Chiang Mai (0.73) (CI [-0.43-0.98], p-value of 0.0270) and a modest relationship with chronic lung disease at Lampang (0.33) (a four-year time lag). The results from spearman correlation analysis showed that PM2.5concentrations were associated with diabetes mortality in Chiang Mai, with a coefficient of 0.9 (CI [0.09-0.99], p-value of 0.03704). Lampang and Phayao had significant associations between PM2.5 and heart disease, with coefficients of 0.97 (CI [0.66-0.99], p-value of 0.0048) and 0.90 (CI [0.09-0.99], p-value of 0.0374), respectively, whereas Phrae had a high coefficient of 0.99 on stroke.

Inhibitory neuron links the causal relationship from air pollution to psychiatric disorders: a large multi-omics analysis

Psychiatric disorders are severe health challenges that exert a heavy public burden. Air pollution has been widely reported as related to psychiatric disorder risk, but their casual association and pathological mechanism remained unclear. Herein, we systematically investigated the large genome-wide association studies (6 cohorts with 1,357,645 samples), single-cell RNA (26 samples with 157,488 cells), and bulk-RNAseq (1595 samples) datasets to reveal the genetic causality and biological link between four air pollutants and nine psychiatric disorders. As a result, we identified ten positive genetic correlations between air pollution and psychiatric disorders. Besides, PM2.5 and NO2 presented significant causal effects on schizophrenia risk which was robust with adjustment of potential confounders. Besides, transcriptome-wide association studies identified the shared genes between PM2.5/NO2 and schizophrenia. We then discovered a schizophrenia-derived inhibitory neuron subtype with highly expressed shared genes and abnormal synaptic and metabolic pathways by scRNA analyses and confirmed their abnormal level and correlations with the shared genes in schizophrenia patients in a large RNA-seq cohort. Comprehensively, we discovered robust genetic causality between PM2.5, NO2, and schizophrenia and identified an abnormal inhibitory neuron subtype that links schizophrenia pathology and PM2.5/NO2 exposure. These discoveries highlight the schizophrenia risk under air pollutants exposure and provide novel mechanical insights into schizophrenia pathology, contributing to pollutant-related schizophrenia risk control and therapeutic strategies development.

Graphical Abstract

Green space modified the association between air pollutants and hypertension in China

Evidence regarding the combined effects of green space and air pollutants on hypertension remains limited and complex. This study aims to investigate the varying effects of greenness under different air pollution levels in China, using data from the wave 2018 China Health and Retirement Longitudinal Study (CHARLS) involving 17 468 adults (aged ≥ 45 years). As a result, the prevalence rate of hypertension was 42.04%. Logistic regression analyses revealed the positive associations between air pollution concentrations at the city level and prevalent hypertension and the negative associations between NDVI and prevalent hypertension, all of which were more prominent in the populations of the eastern and rural regions. Notably, the negative effect of green space was greater at the lowest quartiles of each air pollutant (OR for PM2.5 quartiles = 0.724, 0.792, 0.740, and 0.931)  . Improving air quality and greenness could potentially reduce hypertension risk, and minimizing air pollution might optimize the protective effects of greenness.

Short-term Exposure to Wildfire-Specific PM2.5 and Diabetes Hospitalization: A Study in Multiple Countries and Territories

OBJECTIVE

To evaluate associations of wildfire fine particulate matter ≤2.5 mm in diameter (PM2.5) with diabetes across multiple countries and territories.

RESEARCH DESIGN AND METHODS

We collected data on 3,612,135 diabetes hospitalizations from 1,008 locations in Australia, Brazil, Canada, Chile, New Zealand, Thailand, and Taiwan during 2000-2019. Daily wildfire-specific PM2.5 levels were estimated through chemical transport models and machine-learning calibration. Quasi-Poisson regression with distributed lag nonlinear models and random-effects meta-analysis were applied to estimate associations between wildfire-specific PM2.5 and diabetes hospitalization. Subgroup analyses were by age, sex, location income level, and country or territory. Diabetes hospitalizations attributable to wildfire-specific PM2.5 and nonwildfire PM2.5 were compared.

RESULTS

Each 10 µg/m3 increase in wildfire-specific PM2.5 levels over the current day and previous 3 days was associated with relative risks (95% CI) of 1.017 (1.011-1.022), 1.023 (1.011-1.035), 1.023 (1.015-1.032), 0.962 (0.823-1.032), 1.033 (1.001-1.066), and 1.013 (1.004-1.022) for all-cause, type 1, type 2, malnutrition-related, other specified, and unspecified diabetes hospitalization, respectively. Stronger associations were observed for all-cause, type 1, and type 2 diabetes in Thailand, Australia, and Brazil; unspecified diabetes in New Zealand; and type 2 diabetes in high-income locations. An estimate of 0.67% (0.16-1.18%) and 1.02% (0.20-1.81%) for all-cause and type 2 diabetes hospitalizations were attributable to wildfire-specific PM2.5. Compared with nonwildfire PM2.5, wildfire-specific PM2.5 posed greater risks of all-cause, type 1, and type 2 diabetes and were responsible for 38.7% of PM2.5-related diabetes hospitalizations.

CONCLUSIONS

We show the relatively underappreciated links between diabetes and wildfire air pollution, which can lead to a nonnegligible proportion of PM2.5-related diabetes hospitalizations. Precision prevention and mitigation should be developed for those in advantaged communities and in Thailand, Australia, and Brazil.

Differing associations of PM2.5 exposure with systolic and diastolic blood pressures across exposure durations in a predominantly non-Hispanic Black cohort

Environmental health research has suggested that fine particulate matter (PM2.5) exposure can lead to high blood pressures, but it is unclear whether the impacts remain the same for systolic and diastolic blood pressures (SBP and DBP). This study aimed to examine whether the effects of PM2.5 exposure on SBP and DBP differ using data from a predominantly non-Hispanic Black cohort collected between 2013 and 2019 in the US. PM2.5 exposure was assessed based on a satellite-derived model across exposure durations from 1 to 36 months. The average PM2.5 exposure level was between 9.5 and 9.8 μg/m3 from 1 through 36 months. Mixed effects models were used to estimate the association of PM2.5 with SBP, DBP, and related hypertension types, adjusted for potential confounders. A total of 6381 participants were included. PM2.5 exposure was positively associated with both SBP and DBP. The association magnitudes depended on exposure durations. The association with SBP was null at the 1-month duration (β = 0.05, 95% CI: - 0.23, 0.33), strengthened as duration increased, and plateaued at the 24-month duration (β = 1.14, 95% CI: 0.54, 1.73). The association with DBP started with β = 0.29 (95% CI: 0.11, 0.47) at the 1-month duration, and plateaued at the 12-month duration (β = 1.61, 95% CI: 1.23, 1.99). PM2.5 was associated with isolated diastolic hypertension (12-month duration: odds ratio = 1.20, 95% CI: 1.07, 1.34) and systolic-diastolic hypertension (12-month duration: odds ratio = 1.18, 95% CI: 1.10, 1.26), but not with isolated systolic hypertension. The findings suggest DBP is more sensitive to PM2.5 exposure and support differing effects of PM2.5 exposure on SBP and DBP. As elevation of SBP and DBP differentially predict CVD outcomes, this finding is relevant for prevention and treatment.

Effect of air pollutants particulate matter (PM2.5, PM10), sulfur dioxide (SO2) and ozone (O3) on cognitive health

Impaired cognitive health is the leading cause of various disabilities and disorders. Air pollution has been dramatically increasing over the last few decades and has been identified as a potential risk factor for impaired cognitive health. This study investigates the effect of air pollutants, particulate matter (PM2.5, PM10), sulfur dioxide (SO2), and ground-level ozone, on global cognitive health. The data on environmental pollutants and cognitive health were recorded from PubMed, Web of Science, Scopus, and Google Scholar. Initially, 790 articles were identified after screening for duplicates and applying the inclusion and exclusion criteria, 21 studies were included, and data was synthesized to get a pooled result. The overall results revealed that increased exposure to PM2.5 was positively and significantly associated with cognitive decline (OR 1.49; 95% CI 1.11, 1.99; p = 0.01). The risk of cognitive impairment due to PM10 (OR 1.30; 95% CI 1.00-1.70, p = 0.05), and SO2 (OR 1.39; 95% CI 1.27-1.51; p < 0.01) exposure were also significantly heightened. The study findings show that overall exposure to particulate matter PM2.5, PM10, and SO2 was associated with an increased risk of a decrease in global cognitive functions. The findings suggest that reducing levels of air pollutants could be a strategic approach to mitigate cognitive health risks in populations worldwide.

Dietary Flavonoids: Mitigating Air Pollution's Cardiovascular Risks

Air pollution significantly impacts cardiovascular health, yet pollution reduction strategies in cardiovascular disease prevention remain limited. Dietary flavonoids show promise in protecting cardiovascular health, but their potential to mitigate air-pollution-induced risks is unexplored. This study investigates this research gap. Following PRISMA-ScR guidelines, literature from 2014-2024 was searched across MedLine/PubMed, ScienceDirect, and MDPI databases. Of 463 identified studies, 53 were eligible for analysis based on PICO criteria. Findings revealed significant impacts of air pollution on cardiovascular health, including increased disease risks and mortality. Flavonoid intake demonstrated protective effects against these risks. Flavonoid mechanisms include improved endothelial function, antioxidant and anti-inflammatory effects, blood pressure regulation, antiplatelet effects, cardioprotection, and enhanced lipid and glucose metabolism. Higher flavonoid intake was consistently associated with reduced cardiovascular risks. While reducing pollution remains crucial, promoting flavonoid-rich diets is a promising complementary strategy. Public health initiatives should raise awareness about these benefits. Further research on direct interactions between flavonoid intake and air pollution exposure is needed. Current evidence supports integrating dietary interventions into broader strategies to reduce air pollution's cardiovascular impacts.

Multiple Environmental Exposures and the Development of Hypertension in a Prospective US-Based Cohort of Female Nurses: A Mixture Analysis

We investigated the independent and joint associations between multiple environmental exposures and incident hypertension in a US nationwide prospective cohort of women: the Nurses' Health Study II. We followed 107,532 nonhypertensive participants from 1989 to diagnosis of hypertension, loss to follow-up, death, or end of follow-up in June 2019. We applied Cox proportional hazards models to assess associations of incident hypertension with time-varying residential exposure to air pollution, noise, surrounding greenness, temperature, and neighborhood socioeconomic status (nSES), adjusting for potential confounders and coexposures. We evaluated the joint association of simultaneous exposure using quantile g-computation. We observed 38,175 hypertension cases over 2,062,109 person-years. Increased hypertension incidence was consistently associated with lower nSES and higher levels of fine particles (PM2.5) and nighttime noise exposures: hazard ratio (HRs) and 95% confidence intervals (CIs) of 1.06 (1.04, 1.08), 1.04 (1.01, 1.07), and 1.01 (1.00, 1.03), respectively, per interquartile range change. Joint HR for a one-quartile change in simultaneous exposure to the mixture was 1.05 (95% CI: 1.02, 1.09), assuming additivity, or 1.13 (95% CI: 1.06, 1.20), considering potential interactions within the mixture. Hypertension prevention should focus on enhancing nSES and reducing PM2.5 and noise levels, recognizing that reducing the overall exposures may yield additional benefits.

Associations between short-term exposure to air pollution and thyroid function in a representative sample of the Korean population

BACKGROUND

Disruption of thyroid function can profoundly affect various organ systems. However, studies on the association between air pollution and thyroid function are relatively scarce and most studies have focused on the long-term effects of air pollution among pregnant women.

OBJECTIVES

This study aimed to explore the associations between short-term exposure to air pollution and thyroid function in the general population.

METHODS

Data from the Korea National Health and Nutrition Examination Survey (2013-2015) were analyzed (n = 5,626). Air pollution concentrations in residential addresses were estimated using Community Multiscale Air Quality models. The moving averages of air pollution over 7 days were set as exposure variables through exploratory analyses. Linear regression and quantile g-computation models were constructed to assess the effects of individual air pollutants and air pollution mixture, respectively.

RESULTS

A 10-ppb increase in NO2 (18.8-μg/m3 increase) and CO (11.5-μg/m3 increase) was associated with 2.43% [95% confidence interval (CI): 0.42, 4.48] and 0.19% (95% CI: 0.01, 0.36) higher thyroid-stimulating hormone (TSH) levels, respectively. A 10-μg/m3 increase in PM2.5 and a 10-ppb increase in O3 (19.6-μg/m3 increment) were associated with 0.87% (95% CI: 1.47, -0.27) and 0.59% (95% CI: 1.18, -0.001) lower free thyroxine (fT4) levels, respectively. A simultaneous quartile increase in PM2.5, NO2, O3, and CO levels was associated with lower fT4 but not TSH levels.

CONCLUSIONS

As the subtle changes in thyroid function can affect various organ systems, the present results may have substantial public health implications despite the relatively modest effect sizes. Because this was a cross-sectional study, it is necessary to conduct further experimental or repeated-measures studies to consolidate the current results.

Air Pollution and Blood Pressure: Evidence From Indonesia

Indonesia faces significant air quality issues due to multiple emissions sources, including rapid urbanization and peatland fires associated with agricultural land management. Limited prior research has estimated the episodic shock of intense fires on morbidity and mortality in Indonesia but has largely ignored the impact of poor air quality throughout the year on biomarkers of cardiovascular disease risk. We conducted a cross-sectional study of the association between particulate matter less than 2.5 microns in diameter (PM2.5) and blood pressure. Blood pressure measurements were obtained from the fifth wave of the Indonesian Family Life Survey (IFLS5), an ongoing population-based socioeconomic and health survey. We used the GEOS-Chem chemical transport model to simulate daily PM2.5 concentrations at 0.5° × 0.625° resolution across the IFLS domain. We assessed the association between PM2.5 and diastolic and systolic blood pressure, using mixed effects models with random intercepts for regency/municipality and household and adjusted for individual covariates. An interquartile range increase in monthly PM2.5 exposure was associated with a 0.234 (95% CI: 0.003, 0.464) higher diastolic blood pressure, with a greater association seen in participants age 65 and over (1.16 [95% CI: 0.24, 2.08]). For the same exposure metric, there was a 1.90 (95% CI: 0.43, 3.37) higher systolic blood pressure in participants 65 and older. Our assessment of fire-specific PM2.5 yielded null results, potentially due to the timing and locations of health data collection. To our knowledge, this is the first study to provide evidence for an association between PM2.5 and blood pressure in Indonesia.

Bibliometric analysis of global research on air pollution and cardiovascular diseases: 2012-2022

Background

The relationship between air pollution and cardiovascular diseases (CVDs) has garnered significant interest among researchers globally. This study employed bibliometric analysis to provide an overview of current research on the association between air pollution and CVDs, offering a comprehensive analysis of global research trends in this area.

Methods

An exhaustive scrutiny of literature pertaining to the nexus between air pollution and CVDs from 2012 to 2022 was conducted through rigorous screening of the Web of Science Core Collection (WoSCC). Publications were exclusively considered in English. Subsequently, sophisticated analytical tools including CiteSpace 6.2.4R, Vosviewer 1.6.19, HistCite 2.1, Python 3.7.5, Microsoft Charticulator, and Bibliometrix Online Analysis Platform were deployed to delineate research trends in this domain.

Results

The analysis of the dataset, comprising 1710 documents, unveiled a consistent escalation in scientific publications, peaking in 2022 with a total of 248 publications. Moreover, Environmental Science and Toxicology stood out as the predominant categories. Examination of keyword frequency highlighted the terms 'air pollution', 'cardiovascular disease', and 'particulate matter' as the most prevalent. Notably, the most prolific entities, in terms of authors, journals, organizations, and countries, were identified as Robert D. Brook, Environmental Health Perspectives, Harvard University, and the United States, respectively.

Conclusion

The findings presented a notable increase in high-quality publications on this topic over the past 11 years, suggesting a positive outlook for future research. The study concluded with an examination of three key themes in research trends related to air pollution and CVDs: the initial physiological response to pollutant exposure, the pathways through which pollutants are transmitted, and the subsequent effects on target organs. Additionally, various air pollutants, such as particulate matter, nitric dioxide, and ozone, could contribute to multiple CVDs, including coronary heart disease, hypertension, and heart failure. Although some hypotheses have been put forward, the mechanisms of air pollution-related CVDs still need to be explored in the future.

Social and environmental stressors of cardiometabolic health

Exposures to social and environmental stressors arise individual behavioural response and thus indirectly affect cardiometabolic health. The aim of this study was to investigate several social and environmental stressors and the paths of their influence on cardiometabolic health. The data of 2154 participants (aged 25-64 years) from the cross-sectional population-based study were analysed. The composite score of metabolic disorders (MS score) was calculated based on 5 biomarkers: waist circumference, blood pressure, fasting blood glucose, HDL-cholesterol, triglycerides. The effects of social stressors (education level, income), environmental stressors (NO2, noise) and behavioural factors (unhealthy diet, smoking, alcohol consumption, sedentary behaviours) on MS score were assessed using a structural model. We observed a direct effect of education on MS score, as well as an indirect effect mediated via an unhealthy diet, smoking, and sedentary behaviours. We also observed a significant indirect effect of income via sedentary behaviours. The only environmental stressor predicting MS was noise, which also mediated the effect of education. In summary, the effect of social stressors on the development of cardiometabolic risk had a higher magnitude than the effect of the assessed environmental factors. Social stressors lead to an individual's unhealthy behaviour and might predispose individuals to higher levels of environmental stressors exposures.

Health-related quality of life 1 year after a large-scale industrial fire among exposed inhabitants of Rouen, France: 'The Post Fire 76 Health' study

BACKGROUND

A large-scale industrial fire occurred in Rouen, France, in 2019. This study assessed the health-related quality of life of people exposed to its consequences 1 year later.

METHODS

The study population comprised inhabitants of the exposed area and a non-exposed area. A representative sample was randomly selected using a stratified design. Data were collected using a standardized questionnaire to describe fire exposure and to calculate three health-related quality of life scores according to the SF12-v2 scale. After adjustment, descriptive and multivariate analyses were conducted.

RESULTS

The sample comprised 4773 participants (response rate 47.7%). In the exposed area, the average mental, physical and overall health scores were 47.5, 52.0 and 73.8 out of 100, respectively. Mean mental and overall health scores were higher in the non-exposed area (49.0 and 76.0, respectively). After adjustment, a lower mental health score was associated with a higher number of perceived types of exposure, reaching -3.72 points [-5.41; -2.04] for five or more different types of perceived exposure. A lower mental health score was associated with soot deposits (-1.04 [-1.70; -0.39]), perceiving odours [(-2.04 [-3.22; -0.86]) up to the day of data collection], and having seen, heard or been awakened by the fire (-1.21 [-1.90; -0.52]). A slightly lower physical health score was associated with soot deposits (-0.57 [-1.07; -0.08]).

CONCLUSION

This study highlighted associations between exposure to the consequences of the industrial fire in Rouen and a deterioration of perceived health-related quality of life 1 year later, particularly the mental health dimension.

Association between residential air pollution exposure and cardiovascular risk factors in adults living in northern France

Air pollution is associated with elevated cardiovascular mortality and an increase in cardiovascular risk factors. However, the literature data on associations between air pollution and cardiovascular risk factors are contradictory. To explore the relationship between residential exposure to atmospheric pollutants and cardiovascular risk factors (lipid biomarker and blood pressure levels). We studied a sample of 2339 adult participants in the ELISABET study from the Dunkirk and Lille urban areas of France. The mean annual exposure to atmospheric pollutants (PM10, NO2 and SO2) at the home address was estimated via an air dispersion model. The associations were probed in multivariate linear regression models. The mean NO2 level was 26.05 μg/m3 in Lille and 19.96 µg/m3 in Dunkirk. The mean PM10 level was 27.02 μg/m3 in Lille and 26.53 μg/m3 in Dunkirk. We detected a significant association between exposure to air pollutants and the high-density lipoprotein (HDL) (which is a protective factor against cardiovascular diseases) level: for a 2 µg/m3 increment in PM10, the HDL level decreased by 1.72% (p = 0.0037). None of the associations with other lipid variables or with blood pressure were significant. We didn't find evidence significant associations for most of the risk factors but, long-term exposure of adults to moderate levels of ambient air pollution was associated with a decrement in HDL.

Long-term exposure to PM2.5 and its components is associated with elevated blood pressure and hypertension prevalence: Evidence from rural adults

INTRODUCTION

The toxicity of fine particulate matter (PM2.5) is determined by its components, while the evidence regarding associations of PM2.5 components with blood pressure (BP) is limited, especially in rural areas.

OBJECTIVES

This study aimed to explore the associations of PM2.5 and its chemical components with systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), mean artery pressure (MAP) levels and hypertension prevalence, and to identify key components in Chinese rural areas.

METHODS

39,211 adults from the Henan Rural Cohort were included during 2015-2017. Different periods of PM2.5 and chemical components were estimated by hybrid satellite model. The single-pollutant, component-PM2.5 model, component-residual model and component-proportion model were applied to explore the associations of pollutants with BP levels and hypertension prevalence. Exposure-response (E-R) relationships, stratified analyses and sensitivity analyses were used to explore these associations further.

RESULTS

12,826 (32.71%) were identified with hypertension. For each 1 μg/m3 increase of pollutants, the adjusted odds ratio (OR) for hypertension prevalence was 1.03 for PM2.5 mass, 1.40 for BC, 1.16 for NH4+, 1.08 for NO3-, 1.17 for OM, 1.12 for SO42- and 1.25 for SOIL in the single-pollutant model. BC and SOIL were statistically significant in the component-PM2.5 model, component-residual model and component-proportion model. Similarly, associations of these pollutants with elevated BP levels were also found in aforementioned four models. These pollutants produced a stronger association with SBP than DBP, PP and MAP. Most of associations were non-linear in E-R relationships. The groups of older, the men, with lower per capita monthly income, lower educational level and higher BMI were more vulnerable to these pollutants in stratified analyses. The results remained stable in sensitivity analyses.

CONCLUSION

Long-term exposure to PM2.5 and its components, especially BC and SOIL, was associated with elevated BP and hypertension prevalence in rural adults, and decreasing pollutants may provide additional benefits.

An assessment of the mediating role of hypertension in the effect of long-term air pollution exposure on dementia

Background

Growing evidence links air pollution exposure to the risk of dementia. We hypothesized that hypertension may partially mediate this effect.

Methods

We previously documented an association between air pollution and dementia in the Ginkgo Evaluation of Memory Study, a randomized, placebo-controlled trial of 3069 adults ≥75 years across four US sites who were evaluated for dementia every 6 months from 2000-2008. We utilized a two-stage regression approach for causal mediation analysis to decompose the total effect of air pollution on dementia into its natural direct and indirect effect through prevalent hypertension. Exposure to air pollution in the 10 or 20 years before enrollment was assigned using estimates from fine-scale spatial-temporal models for PM2.5, PM10, and NO2. We used Poisson regression models for hypertension and Cox proportional hazard models for time-to-incident all-cause dementia, adjusting for a priori confounders.

Results

Participants were free of mild cognitive impairment at baseline (n = 2564 included in analyses); 69% had prevalent hypertension at baseline. During follow-up, 12% developed all-cause dementia (Alzheimer's disease [AD] = 212; vascular dementia with or without AD [VaD/AD mixed] = 97). We did not find an adverse effect of any air pollutant on hypertension. Hypertension was associated with VaD/AD mixed (HR, 1.92 [95% CI = 1.14, 3.24]) but not AD. We did not observe mediation through hypertension for the effect of any pollutant on dementia outcomes.

Conclusions

The lack of mediated effect may be due to other mechanistic pathways and the minimal effect of air pollution on hypertension in this cohort of older adults.

Associations between long-term exposure to air pollution, diabetes, and hypertension in metropolitan Iran: an ecologic study

Epidemiological studies on air pollution, diabetes, and hypertension conflict. This study examined air pollution, diabetes, and hypertension in adults in 11 metropolitan areas of Iran (2012-2016). Local environment departments and the Tehran Air Quality Control Company provided air quality data. The VIZIT website and Stepwise Approach to Chronic Disease Risk Factor Surveillance study delivered chronic disease data. Multiple logistic regression and generalized estimating equations evaluated air pollution-related diabetes and hypertension. In Isfahan, Ahvaz, and Tehran, PM2.5 was linked to diabetes. In all cities except Urmia, Yasuj, and Yazd, PM2.5 was statistically related to hypertension. O3 was connected to hypertension in Ahvaz, Tehran, and Shiraz, whereas NO2 was not. BMI and gender predict hypertension and diabetes. Diabetes, SBP, and total cholesterol were correlated. Iran's largest cities' poor air quality may promote diabetes and hypertension. PM2.5 impacts many cities' outcomes. Therefore, politicians and specialists have to control air pollution.

Influence of type of cooking fuel on risk of hypertension among reproductive-age women in sub-Saharan Africa: insights from nationally representative cross-sectional surveys

BACKGROUND

Nearly one-third of the world's population (2.4 billion people) rely on unclean cooking fuel sources. The study assessed the association of the type of cooking fuel and hypertension risk in sub-Saharan Africa (SSA).

METHODS

The study analysed pooled data from 97 942 individuals in the Demographic and Health Survey (DHS) between 2014 and 2021 in 10 SSA countries. Univariate, bivariate and multivariate analyses were performed, including basic descriptive statistics and binary logistic regression. The independent variable of interest was the type of cooking fuel, while hypertension served as the outcome variable.

RESULTS

Women using unclean cooking fuel were 1.21 times more likely to be hypertensive compared with those using clean cooking fuel (adjusted odds ratio [aOR] 1.21 [95% confidence interval {CI} 1.11 to 1.31]). Older age (aOR 5.78 [95% CI 5.04 to 6.62]), higher education (aOR 1.14 [95% CI 1.05 to 1.23]), being married (aOR 1.64 [95% CI 1.49 to 1.80]), working in sales and services occupations (aOR 1.34 [95% CI 1.24 to 1.44]), frequent health facility visits (aOR 1.59 [95% CI 1.51 to 1.68]), higher wealth index and exposure to media were significantly associated with hypertension risk.

CONCLUSIONS

Efforts to reduce reliance on unclean cooking fuel at both the household and population levels need to be intensified in SSA countries. Promoting the use of clean cooking technologies and fuels and implementing supportive policies for transitioning from unclean cooking fuels are crucial. Targeted interventions to reduce hypertension risk in SSA should focus on women using unclean cooking fuel, older women, individuals from wealthier households and those with higher education levels.

Association of pulmonary black carbon accumulation with cardiac fibrosis in residents of Sao Paulo, Brazil

Evidence suggests that myocardial interstitial fibrosis, resulting from cardiac remodeling, may possibly be influenced by mechanisms activated through the inhalation of airborne pollutants. However, limited studies have explored the relationship between lifetime exposure to carbon-based particles and cardiac fibrosis, specially using post-mortem samples. This study examined whether long-term exposure to air pollution (estimated by black carbon accumulated in the lungs) is associated with myocardial fibrosis in urban dwellers of megacity of Sao Paulo. Data collection included epidemiological and autopsy-based approaches. Information was obtained by interviewing the next of kin and through the pathologist's report. The individual index of exposure to carbon-based particles, which we designed as the fraction of black carbon (FBC), was estimated through quantification of particles on the macroscopic lung surface. Myocardium samples were collected for histopathological analysis to evaluate the fraction of cardiac fibrosis. The association between cardiac fibrosis and FBC, age, sex, smoking status and hypertension was assessed by means of multiple linear regression models. Our study demonstrated that the association of FBC with cardiac fibrosis is influenced by smoking status and hypertension. Among hypertensive individuals, the cardiac fibrosis fraction tended to increase with the increase of the FBC in both groups of smokers and non-smokers. In non-hypertensive individuals, the association between cardiac fibrosis fraction and FBC was observed primarily in smokers. Long-term exposure to tobacco smoke and environmental particles may contribute to the cardiac remodeling response in individuals with pre-existing hypertension. This highlights the importance of considering hypertension as an additional risk factor for the health effects of air pollution on the cardiovascular system. Moreover, the study endorses the role of autopsy to investigate the effects of urban environment and personal habits in determining human disease.

Global air pollution exposure and congenital anomalies: an updated systematic review and meta-analysis of epidemiological studies

A systematic review and meta-analysis was conducted to evaluate recent epidemiological evidence on the association of air pollution with congenital anomalies (CAs). Of 11,014 records, 49 were finally included in this meta-analysis. Per 10 μg/m3 increase in air pollutant, PM10 exposure during the 1st month of pregnancy and at the first trimester (T1) was associated with increased overall CAs. Further, exposure to PM10 was associated with congenital heart disease (OR = 1.055, 95% CI: 1.035, 1.074) and patent ductus arteriosus (OR = 1.094, 95% CI: 1.020, 1.168) at T1, with chromosomal anomalies during the entire pregnancy and with nervous system anomalies when exposure occurred 3 months prior to pregnancy, during the 1st, 2nd months of pregnancy and at T1. Besides, a significant association with overall CAs was observed for a combined exposure of PM10 and SO2 during the 1st month of gestation (OR: 1.101, 95% CI: 1.023, 1.180). A combined exposure of PM10 and CO was also associated with tetralogy of Fallot during 3-8 weeks of gestation (OR: 1.016, 95% CI: 1.005, 1.027). No significant associations were observed between PM2.5, NO2, and O3 exposure and CAs.

Early-life exposure to ambient air pollution with cardiovascular risk factors in adolescents: Findings from the "Children of 1997" Hong Kong birth cohort

BACKGROUND

Long-term exposure to ambient air pollution is associated with cardiovascular disease (CVD) risk. Little is known about the impact of early-life exposure to air pollutants on CVD risk factors in late adolescence, which may track into adulthood. To clarify, we examined this question in a unique setting with high air pollution and a high level of economic development.

METHODS

This study leveraged the "Children of 1997" Hong Kong birth cohort (N = 8327), including here 3350 participants. We estimated ambient air pollutant exposure including inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2) and nitrogen monoxide (NO) by growth phase (in utero, infancy, childhood) and overall based on residential address. Generalized linear regression was used to assess the associations of air pollutants exposure by growth phase and sex with CVD risk factors (fasting blood glucose, glycosylated hemoglobin, lipid profile, blood pressure, and body mass index) at 17.6 years. We also assessed whether associations varied by sex.

RESULTS

Early life exposed had little association with glucose metabolism, blood pressure or body mass index, but after considering multiple comparisons early exposure to PM10 was associated with low density lipoprotein (LDL) in boys, with β and 95 % confidence intervals (95 % CI) of 0.184 (0.069 to 0.298) mmol/l, 0.151 (0.056 to 0.248) mmol/l, and 0.157 (0.063 to 0.252) mmol/l by per interquartile range (IQR) increment of PM10 for in utero, infancy, and overall, respectively. No such associations were evident for girls, differences by sex were evident.

CONCLUSIONS

Our study suggested sex-specific associations of early-life PM10 exposure with elevated LDL in adolescence, especially exposure in utero and infancy.

The relationship between maternal exposure to ambient air pollutants and premature rupture of membranes: A systematic review and meta-analysis

Air pollution is an environmental stimulus that may predispose pregnant women to preterm rapture of membrane (PROM). However, the relationship of maternal exposure to air pollutants and PROM is still unclear. To investigate the relationship between the long-term and short-term maternal exposure to air pollution and PROM. We searched all studies published in PubMed, Embase and Web of Science up to February 2024. The studies provided quantitative effect estimates with 95% confidence intervals, for the impact of short-term (<30 days) or long-term (≥30 days) maternal exposure to air pollutants on PROM, preterm PROM (PPROM) or term PROM (TPROM). The odds ratio (OR), risk ratio (RR), or hazard ratio (HR), with 95% confidence intervals was extracted, and RR or HR were deemed as OR because of the low prevalence of PROM. Fixed- or random-effects meta-analyses performed. In total, 17 relevant studies were included. Maternal exposure to PM2.5 in the second trimester increases the risk of PROM (pooled OR = 1.15, 95%CI: 1.05-1.26). Maternal exposure to PM10, NO2, NO, CO and SO2 during pregnancy and short-term maternal exposure to PM2.5, NO2, SO2 and O3 also associate with PROM occurrence. The results of the study show that both long-term maternal exposure in the second or third trimester and short-term maternal exposure to ambient air pollution can increase the risk of PROM.

Outdoor fine particulate matter exposure and telomere length in humans: A systematic review and meta-analysis

Although the association between changes in human telomere length (TL) and ambient fine particulate matter (PM2.5) has been documented, there remains disagreement among the related literature. Our study conducted a systematic review and meta-analysis of epidemiological studies to investigate the health effects of outdoor PM2.5 exposure on human TL after a thorough database search. To quantify the overall effect estimates of TL changes associated with every 10 μg/m3 increase in PM2.5 exposure, we focused on two main topics, which were outdoor long-term exposure and prenatal exposure of PM2.5. Additionally, we included a summary of short-term PM2.5 exposure and its impact on TL due to limited data availability. Our qualitative analysis included 20 studies with 483,600 participants. The meta-analysis showed a statistically significant association between outdoor PM2.5 exposure and shorter human TL, with pooled impact estimates (β) of -0.12 (95% CI: -0.20, -0.03, I2= 95.4%) for general long-term exposure and -0.07 (95% CI: -0.15, 0.00, I2= 74.3%) for prenatal exposure. In conclusion, our findings suggest that outdoor PM2.5 exposure may contribute to TL shortening, and noteworthy associations were observed in specific subgroups, suggesting the impact of various research variables. Larger, high-quality studies using standardized methodologies are necessary to strengthen these conclusions further.

Effect of PM2.5 exposure on adhesion molecules and systemic nitric oxide in healthy adults: The role of metals, PAHs, and oxidative potential

Since there is limited evidence on the impact of PM2.5 content on cardiovascular biomarkers, we conducted a cross-sectional study on 89 healthy adults from October 12 to November 21, 2021. We measured daily PM2.5 in two distinct regions during different time windows: a high-traffic urban area and an industrial suburb. The concentrations of metals, PAHs, and oxidative potential (OP) were determined using ICP-MS, GC-MS, and dithiothreitol (DTT), respectively. Systemic biomarkers, including NO, sICAM-1, sVCAM-1, MDA, and CRP, were quantified in each subject simultaneously. A generalized linear model was used to examine the association between PM2.5 toxicity and each health endpoint. Our findings indicated that daily PM2.5 concentrations exceeded the WHO-recommended level by approximately sevenfold. We found that PM2.5 exposure was associated with adverse cardiovascular outcomes. Moreover, exposure to PM2.5 mass, total PAHs, and certain trace metals (Ni, Fe, V, As, and Pb) resulted in a decline in serum NO levels. At lag 3, exposure to PM2.5 mass resulted in a significant decrease in NO levels [1.32% (95% CI: -2.27, -0.12)] and total PAHs [2.05% (95% CI: -3.93, -0.12)]. In contrast, OP exhibited a mild correlation with NO level increases. Positive associations were observed between PM2.5 and its chemical constituents (PAHs, As, Cu, OP) and adhesion molecules at different lag times. An increase of 0.16 ppb in PAH concentrations at an interquartile range was associated with a 4.74% decline (95% CI, -7.80, -0.55) in the sVCAM-1 level. However, our study did not reveal any significant trend between pollutants and other biomarkers (sICAM-1, MDA, and CRP). Consequently, our findings suggest that different PM2.5 chemical compositions exhibit diverse behavior in biological responses.

Prenatal Exposure to Air Pollutants Associated with Allergic Diseases in Children: Which Pollutant, When Exposure, and What Disease? A Systematic Review and Meta-analysis

This systematic review aims to identify the association between prenatal exposure to air pollutants and allergic diseases in children, focusing on specific pollutants, timing of exposure, and associated diseases. We searched PubMed, Scopus, and Web of Science for English articles until May 1, 2023, examining maternal exposure to outdoor air pollutants (PM1, PM2.5, PM10, NO, NO2, SO2, CO, and O3) during pregnancy and child allergic diseases (atopic dermatitis (AD), food allergy (FA), asthma (AT) and allergic rhinitis (AR)/hay fever (HF)). The final 38 eligible studies were included in the meta-analysis. Exposure to PM2.5 and NO2 during pregnancy was associated with the risk of childhood AD, with pooled ORs of 1.34 (95% confidence interval (CI), 1.10-1.63) and 1.10 (95%CI, 1.05-1.15) per 10 µg/m3 increase, respectively. Maternal exposure to PM1, PM2.5, and NO2 with a 10 µg/m3 increase posed a risk for AT, with pooled ORs of 1.34 (95%CI, 1.17-1.54), 1.11 (95%CI, 1.05-1.18), and 1.07 (95%CI, 1.02-1.12), respectively. An increased risk of HF was observed for PM2.5 and NO2 with a 10 µg/m3 increase, with ORs of 1.36 (95%CI, 1.17-1.58) and 1.26 (95%CI, 1.08-1.48), respectively. Traffic-related air pollutants (TRAP), particularly PM2.5 and NO2, throughout pregnancy, pose a pervasive risk for childhood allergies. Different pollutants may induce diverse allergic diseases in children across varying perinatal periods. AT is more likely to be induced by outdoor air pollutants as a health outcome. More research is needed to explore links between air pollution and airway-derived food allergies.