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Baharane V, Shatalov AB. Assessment of the health impacts of air pollution exposure in East African countries. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:413. [PMID: 38565772 DOI: 10.1007/s10661-024-12588-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
The health effects of air pollution remain a public concern worldwide. Using data from the Global Burden of Disease 2019 report, we statistically analyzed total mortality, disability-adjusted life years (DALY), and years of life lost (YLL) attributable to air pollution in eight East African countries between 1990 and 2019. We acquired ambient ozone (O3), PM2.5 concentrations and household air pollution (HAP) from the solid fuel from the State of Global Air report. The multilinear regression model was used to evaluate the predictability of YLLs by the air pollutants. We estimated the ratio rate for each health burden attributable to air pollution to compare the country's efforts in the reduction of air pollution health burden. This study found that the total number of deaths attributable to air pollution decreased by 14.26% for 30 years. The drop came from the reduction of 43.09% in mortality related to Lower Respiratory tract Infection (LRI). However, only five out of eight countries managed to decrease the total number of deaths attributable to air pollution with the highest decrease observed in Ethiopia (40.90%) and the highest increase in Somalia (67.49%). The linear regression model showed that HAP is the pollutant of the most concern in the region, with a 1% increase in HAP resulting in a 31.06% increase in regional YLL (R2 = 0.93; p < 0.05). With the increasing ground-level ozone, accompanied by the lack of adequate measures to reduce particulate pollutants, the health burdens attributable to air pollution are still a threat in the region.
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Affiliation(s)
- Valérien Baharane
- Institute of Ecology, Peoples' Friendship University of Russia Named After Patrice Lumumba, 117198, Moscow, Russia.
- Department of Physics, College of Science and Technology, University of Rwanda, KN7 Ave, Kigali, Rwanda.
| | - Andrey Borisovich Shatalov
- Department of Environmental Safety and Product Quality Management of the Institute of Ecology, Peoples' Friendship University of Russia Named After Patrice Lumumba, 117198, Moscow, Russia
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Bowman WS, Schmidt RJ, Sanghar GK, Thompson Iii GR, Ji H, Zeki AA, Haczku A. "Air That Once Was Breath" Part 1: Wildfire-Smoke-Induced Mechanisms of Airway Inflammation - "Climate Change, Allergy and Immunology" Special IAAI Article Collection: Collegium Internationale Allergologicum Update 2023. Int Arch Allergy Immunol 2024:1-17. [PMID: 38452750 DOI: 10.1159/000536578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/23/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Wildfires are a global concern due to their wide-ranging environmental, economic, and public health impacts. Climate change contributes to an increase in the frequency and intensity of wildfires making smoke exposure a more significant and recurring health concern for individuals with airway diseases. Some of the most prominent effects of wildfire smoke exposure are asthma exacerbations and allergic airway sensitization. Likely due to the delayed recognition of its health impacts in comparison with cigarette smoke and industrial or traffic-related air pollution, research on the composition, the mechanisms of toxicity, and the cellular/molecular pathways involved is poor or non-existent. SUMMARY This review discusses potential underlying pathological mechanisms of wildfire-smoke-related allergic airway disease and asthma. We focused on major gaps in understanding the role of wildfire smoke composition in the development of airway disease and the known and potential mechanisms involving cellular and molecular players of oxidative injury at the epithelial barrier in airway inflammation. We examine how PM2.5, VOCs, O3, endotoxin, microbes, and toxic gases may affect oxidative stress and inflammation in the respiratory mucosal barrier. We discuss the role of AhR in mediating smoke's effects in alarmin release and IL-17A production and how glucocorticoid responsiveness may be impaired by IL-17A-induced signaling and epigenetic changes leading to steroid-resistant severe airway inflammation. KEY MESSAGE Effective mitigation of wildfire-smoke-related respiratory health effects would require comprehensive research efforts aimed at a better understanding of the immune regulatory effects of wildfire smoke in respiratory health and disease.
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Affiliation(s)
- Willis S Bowman
- UC Davis Lung Center, University of California, Davis, California, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, Sacramento, California, USA
| | - Rebecca J Schmidt
- Department of Public Health Sciences, School of Medicine, Sacramento, California, USA
| | - Gursharan K Sanghar
- UC Davis Lung Center, University of California, Davis, California, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, Sacramento, California, USA
| | - George R Thompson Iii
- UC Davis Lung Center, University of California, Davis, California, USA
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Sacramento, California, USA
| | - Hong Ji
- UC Davis Lung Center, University of California, Davis, California, USA
- Department of Anatomy, Physiology, and Cell Biology, School of Veterinary Medicine, Davis, California, USA
| | - Amir A Zeki
- UC Davis Lung Center, University of California, Davis, California, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, Sacramento, California, USA
| | - Angela Haczku
- UC Davis Lung Center, University of California, Davis, California, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, School of Medicine, Sacramento, California, USA
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Song Q, Zhang N, Zhang Y, Yin D, Hao J, Wang S, Li S, Xu W, Yan W, Meng X, Xu X, Wu X, Xie D, Zhu Y, Qu Q, Hou X, Jiang Y, Dong Z, Zheng H, Sun Y, Li Z, Zhao B. The development of local ambient air quality standards: A case study of Hainan Province, China. ECO-ENVIRONMENT & HEALTH (ONLINE) 2024; 3:11-20. [PMID: 38169841 PMCID: PMC10758711 DOI: 10.1016/j.eehl.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 01/05/2024]
Abstract
The ambient air quality standard (AAQS) is a vital policy instrument for protecting the environment and human health. Hainan Province is at the forefront of China's efforts to protect its ecological environment, with an official goal to achieve world-leading air quality by 2035. However, neither the national AAQS nor the World Health Organization guideline offers sufficient guidance for improving air quality in Hainan because Hainan has well met the former while the latter is excessively stringent. Consequently, the establishment of Hainan's local AAQS becomes imperative. Nonetheless, research regarding the development of local AAQS is scarce, especially in comparatively more polluted countries such as China. The relatively high background values and significant interannual fluctuations in air pollutant concentrations in Hainan present challenges in the development of local AAQS. Our research proposes a world-class local AAQS of Hainan Province by reviewing the AAQS in major countries or regions worldwide, analyzing the influence of different statistical forms, and carefully evaluating the attainability of the standard. In the proposed AAQS, the annual mean concentration limit for PM2.5, the annual 95th percentile of daily maximum 8-h mean (MDA8) concentration limit for O3, and the peak season concentration limit for O3 are set at 10, 120, and 85 μg/m3, respectively. Our study indicates that, with effective control policies, Hainan is projected to achieve compliance with the new standard by 2035. The implementation of the local AAQS is estimated to avoid 1,526 (1,253-1,789) and 259 (132-501) premature deaths attributable to long-term exposure to PM2.5 and O3 in Hainan in 2035, respectively.
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Affiliation(s)
- Qian Song
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Nannan Zhang
- Institute of Strategic Planning, Chinese Academy of Environmental Planning, Beijing 100041, China
| | - Yanning Zhang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Dejia Yin
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Jiming Hao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Shuxiao Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Shengyue Li
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Wenshuai Xu
- Hainan Research Academy of Environmental Sciences, Haikou 571126, China
- Hainan Provincial Ecological and Environmental Monitoring Center, Haikou 570206, China
| | - Weijun Yan
- Hainan Provincial Ecological and Environmental Monitoring Center, Haikou 570206, China
| | - Xinxin Meng
- Hainan Provincial Ecological and Environmental Monitoring Center, Haikou 570206, China
| | - Xinghong Xu
- Hainan Provincial Ecological and Environmental Monitoring Center, Haikou 570206, China
| | - Xiaochen Wu
- Hainan Research Academy of Environmental Sciences, Haikou 571126, China
| | - Donghai Xie
- Hainan Radiation Environmental Monitoring Station, Haikou 571126, China
| | - Yun Zhu
- Guangdong Provincial Key Laboratory of Atmospheric Environment and Pollution Control, College of Environment and Energy, South China University of Technology, Guangzhou Higher Education Mega Center, Guangzhou 510006, China
| | - Qipeng Qu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Xuan Hou
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Yueqi Jiang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Zhaoxin Dong
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Haotian Zheng
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Yisheng Sun
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Zeqi Li
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Bin Zhao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
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Giammona A, Remedia S, Porro D, Lo Dico A, Bertoli G. The biological interplay between air pollutants and miRNAs regulation in cancer. Front Cell Dev Biol 2024; 12:1343385. [PMID: 38434617 PMCID: PMC10905188 DOI: 10.3389/fcell.2024.1343385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/18/2024] [Indexed: 03/05/2024] Open
Abstract
Air pollution, especially fine particulate matter (PM2.5, with an aerodynamic diameter of less than 2.5 μm), represents a risk factor for human health. Many studies, regarding cancer onset and progression, correlated with the short and/or long exposition to PM2.5. This is mainly mediated by the ability of PM2.5 to reach the pulmonary alveoli by penetrating into the blood circulation. This review recapitulates the methodologies used to study PM2.5 in cellular models and the downstream effects on the main molecular pathways implicated in cancer. We report a set of data from the literature, that describe the involvement of miRNAs or long noncoding RNAs on the main biological processes involved in oxidative stress, inflammation, autophagy (PI3K), cell proliferation (NFkB, STAT3), and EMT (Notch, AKT, Wnt/β-catenin) pathways. microRNAs, as well as gene expression profile, responds to air pollution environment modulating some key genes involved in epigenetic modification or in key mediators of the biological processes described below. In this review, we provide some scientific evidences about the thigh correlation between miRNAs dysregulation, PM2.5 exposition, and gene pathways involved in cancer progression.
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Affiliation(s)
- Alessandro Giammona
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), Segrate, Italy
- National Biodiversity Future Center (NBFC), Palermo, Italy
| | - Sofia Remedia
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), Segrate, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Segrate, Italy
| | - Danilo Porro
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), Segrate, Italy
- National Biodiversity Future Center (NBFC), Palermo, Italy
| | - Alessia Lo Dico
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), Segrate, Italy
- National Biodiversity Future Center (NBFC), Palermo, Italy
| | - Gloria Bertoli
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), Segrate, Italy
- National Biodiversity Future Center (NBFC), Palermo, Italy
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Shairsingh K, Ruggeri G, Krzyzanowski M, Mudu P, Malkawi M, Castillo J, Soares da Silva A, Saluja M, Martínez KC, Mothe J, Gumy S. WHO air quality database: relevance, history and future developments. Bull World Health Organ 2023; 101:800-807. [PMID: 38024249 PMCID: PMC10680116 DOI: 10.2471/blt.23.290188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/11/2023] [Accepted: 10/04/2023] [Indexed: 12/01/2023] Open
Abstract
Air pollution is the second most important risk factor for noncommunicable diseases, but air quality monitoring is lacking in many low- and middle-income countries. The World Health Organization (WHO) recently released its 2022 updated air quality database status report. This report contains data from about 6743 human settlements, a sixfold increase from 1102 settlements in its first publication in 2011, which shows that air pollution is increasingly recognized as a health priority at global and national levels. However, progress varies across the world. More than 90% of the settlements in the database are in high- and middle-income countries and areas mainly in China, Europe, India and North America. The database is crucial for increasing awareness of air pollution, and for calculating global exposures and the corresponding burden of disease attributable to air pollution. This article describes the progress made and challenges in collecting air quality data. The database uses official data sources which can be difficult to access and assess, because air quality monitoring is done by different government bodies or uses varying monitoring methods. These air quality data can be used by the health sector to engage in discussions on monitoring air quality to protect public health, and facilitate multisectoral engagement of United Nations agencies to support countries to conform with the 2021 WHO air quality guidelines. Although air pollution levels in most countries are higher than those recommended in the guidelines, any action policy-makers take to reduce air pollution will help reduce the burden of air pollution on health.
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Affiliation(s)
- Kerolyn Shairsingh
- Department of Environment, Climate Change and Health, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | - Giulia Ruggeri
- Department of Environment, Climate Change and Health, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | | | - Pierpaolo Mudu
- World Health Organization, Regional Office for Europe, European Centre for Environment and Health, Bonn, Germany
| | - Mazen Malkawi
- World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Juan Castillo
- Pan American Health Organization, Washington, DC, United States of America
| | | | - Manjeet Saluja
- World Health Organization, India Country Office, New Delhi, India
| | - Karla Cervantes Martínez
- Department of Environment, Climate Change and Health, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | - Josselyn Mothe
- Department of Environment, Climate Change and Health, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
| | - Sophie Gumy
- Department of Environment, Climate Change and Health, World Health Organization, 20 Avenue Appia, 1211Geneva, Switzerland
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Mokammel A, Malkawi M, Momeniha F, Safi HAM, Niazi S, Yousefian F, Azimi F, Naddafi K, Shamsipour M, Roostaei V, Faridi S, Hassanvand MS. Assessing capabilities of conducted ambient air pollution health effects studies in 22 Eastern Mediterranean countries to adopt air quality standards: a review. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2023; 21:295-304. [PMID: 37869598 PMCID: PMC10584797 DOI: 10.1007/s40201-023-00862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/18/2023] [Indexed: 10/24/2023]
Abstract
Purpose The Eastern Mediterranean Region (EMR) countries suffer from exposure to high levels of ambient air pollutants due to dust storms and have unique climatic as well as topographic and socio-economic conditions which lead to adverse health effects on humans. The purpose of the review was to evaluate the quantity and quality of published articles on air pollution and health-based studies in 22 EMR countries to determine if they can be applied to adopting air quality standards. Methods We designed a review based on a broad search of the literature in the Scopus, PubMed, and web of science (WOS) databases published from January 1, 2000, to January 2, 2022, using combinations of the following relevant terms: air pollution, health, and EMR countries. The generic eligibility criteria for this review were based on the population, exposure, comparator, outcome, and study design (PECOS) statement. Results The search results showed that following the PRISMA approach, of 2947 identified articles, 353 studies were included in this review. The analysis of the types of studies showed that about 70% of the studies conducted in EMR countries were Health Burden Estimation studies (31%), Ecological and time trend ecological studies (23%), and cross-sectional studies (16%). Also, researchers from Iran participated in the most published relevant studies in the region 255 (~ 63%) and just 10 published documents met all the PECOS criteria. Conclusion The lack of sufficient studies which can meet the PECOS appraising criteria and the lack of professionals in this field are some of the issues that make it impossible to use as potential documents in the WHO future studies and adopt air quality standards. Supplementary Information The online version contains supplementary material available at 10.1007/s40201-023-00862-1.
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Affiliation(s)
- Adel Mokammel
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mazen Malkawi
- Centre for Environmental Health Action (CEHA), World Health Organization (WHO), Amman, Jordan
| | - Fatemeh Momeniha
- Center for Solid Waste Research, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Heba Adel Moh’d Safi
- Faculty of Science, School of Earth and Atmospheric Sciences, Queensland University of Technology (QUT), International Laboratory for Air Quality and Health, Brisbane, 4001 Australia
| | - Sadegh Niazi
- Faculty of Science, School of Earth and Atmospheric Sciences, Queensland University of Technology (QUT), International Laboratory for Air Quality and Health, Brisbane, 4001 Australia
| | - Fatemeh Yousefian
- Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Faramarz Azimi
- Environmental Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Roostaei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sasan Faridi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
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Faridi S, Allen RW, Brook RD, Yousefian F, Hassanvand MS, Carlsten C. An updated systematic review and meta-analysis on portable air cleaners and blood pressure: Recommendations for users and manufacturers. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 263:115227. [PMID: 37421892 DOI: 10.1016/j.ecoenv.2023.115227] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/10/2023]
Abstract
Fine particulate matter (PM2.5) air pollution is a leading contributor to the global burden of cardiovascular disease (CVD). One important underlying mechanism is an increase in blood pressure (BP). A growing number of studies have reported a beneficial effect of portable air cleaners (PACs) on systolic and diastolic BP; SBP and DBP. We conducted an updated systematic review and meta-analysis of studies using true versus sham mode filtration reporting the effects on BP. Of 214 articles identified up to February 5, 2023, seventeen (from China, USA, Canada, South Korea and Denmark) enrolling approximately 880 participants (484 female) met the inclusion criteria for meta-analyses. Aside from studies conducted in China, research on PACs and BP has been conducted in relatively low pollution settings. Mean indoor PM2.5 concentrations during the active and sham mode purification were 15.9 and 41.2 µg/m3, respectively. The mean efficiency of PACs against indoor PM2.5 was 59.8 % (ranging from 23 % to 82 %). True mode filtration was associated with a pooled mean difference of - 2.35 mmHg (95 % confidence interval [CI]: - 4.5, - 0.2) and - 0.81 mmHg (95 % CI: - 1.86, 0.24) in SBP and DBP, respectively. After removing the studies with high risk of bias, the magnitude of the pooled benefits on SBP and DBP increased to - 3.62 mmHg (95 % CI: - 6.69, - 0.56) and - 1.35 mmHg (95 % CI: - 2.29, - 0.41), respectively. However, there are several barriers to the use of PACs, specifically in low- and middle-income countries (LMICs), such as the initial purchase cost and filter replacements. There may be several avenues to help overcome these economic burdens and improve cost effectiveness, such as implementing government or other subsidized programs to distribute PACs targeting vulnerable and higher-risk individuals. We propose that environmental health researchers and healthcare providers should be better trained to educate the public regarding the use of PACs to reduce the impacts of PM2.5 on cardiometabolic diseases globally.
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Affiliation(s)
- Sasan Faridi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
| | - Ryan W Allen
- Simon Fraser University, Burnaby, British Columbia, Canada
| | | | - Fatemeh Yousefian
- Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Christopher Carlsten
- Air Pollution Exposure Lab and Legacy for Airway Health, Vancouver Coastal Health Research Institute and University of British Columbia, Vancouver, Canada.
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