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      Fine particulate matter (PM 2.5): The culprit for chronic lung diseases in China

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          Abstract

          Air pollution is a world public health problem. Particulate matter (PM), a mix of solid and liquid particles in the air, becomes an increasing concern in the social and economic development of China. For decades, epidemiological studies have confirmed the association between fine particle pollutants and respiratory diseases. It has been reported in different populations that increased Fine particulate matter (PM 2.5) concentrations cause elevated susceptibility to respiratory diseases, including acute respiratory distress, asthma, chronic obstructive pulmonary disease, and lung cancer. This review will discuss the pathophysiology of PM 2.5 in respiratory diseases, which are helpful for the prevention of air pollution and treatment of respiratory tract inflammatory diseases.

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          Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis

          R Atkinson, S S Kang, H R Anderson … (2014)
          Background Short-term exposure to outdoor fine particulate matter (particles with a median aerodynamic diameter <2.5 μm (PM2.5)) air pollution has been associated with adverse health effects. Existing literature reviews have been limited in size and scope. Methods We conducted a comprehensive, systematic review and meta-analysis of 110 peer-reviewed time series studies indexed in medical databases to May 2011 to assess the evidence for associations between PM2.5 and daily mortality and hospital admissions for a range of diseases and ages. We stratified our analyses by geographical region to determine the consistency of the evidence worldwide and investigated small study bias. Results Based upon 23 estimates for all-cause mortality, a 10 µg/m3 increment in PM2.5 was associated with a 1.04% (95% CI 0.52% to 1.56%) increase in the risk of death. Worldwide, there was substantial regional variation (0.25% to 2.08%). Associations for respiratory causes of death were larger than for cardiovascular causes, 1.51% (1.01% to 2.01%) vs 0.84% (0.41% to 1.28%). Positive associations with mortality for most other causes of death and for cardiovascular and respiratory hospital admissions were also observed. We found evidence for small study bias in single-city mortality studies and in multicity studies of cardiovascular disease. Conclusions The consistency of the evidence for adverse health effects of short-term exposure to PM2.5 across a range of important health outcomes and diseases supports policy measures to control PM2.5 concentrations. However, reasons for heterogeneity in effect estimates in different regions of the world require further investigation. Small study bias should also be considered in assessing and quantifying health risks from PM2.5.
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            Fine Particulate Air Pollution and Daily Mortality. A Nationwide Analysis in 272 Chinese Cities.

            Peng Yin, Xia Meng, Cong Liu … (2017)
            Evidence concerning the acute health effects of air pollution caused by fine particulate matter (PM2.5) in developing countries is quite limited.
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              Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis

              Pablo Orellano, Nancy Quaranta, Julieta Reynoso … (2017)
              Background Several observational studies have suggested that outdoor air pollution may induce or aggravate asthma. However, epidemiological results are inconclusive due to the presence of numerous moderators which influence this association. The goal of this study was to assess the relationship between outdoor air pollutants and moderate or severe asthma exacerbations in children and adults through a systematic review and multilevel meta-analysis. Material and methods We searched studies published in English on PubMed, Scopus, and Google Scholar between January 2000 and October 2016. Studies following a case-crossover design with records of emergency departments and/or hospital admissions as a surrogate of moderate or severe asthma exacerbations were selected. A multilevel meta-analysis was employed, taking into account the potential clustering effects within studies examining more than one lag. Odds ratios (ORs) and 95% confidence intervals were estimated. A subgroup analysis in children aged 0 to 18 years and a sensitivity analysis based on the quality of the included studies as defined in the Newcastle-Ottawa Scale were performed. Publication bias was evaluated through visual inspection of funnel plots and by a complementary search of grey literature. (Prospero Registration number CRD42015032323). Results Database searches retrieved 208 records, and finally 22 studies were selected for quantitative analysis. All pollutants except SO2 and PM10 showed a significant association with asthma exacerbations (NO2: 1.024; 95% CI: 1.005,1.043, SO2: 1.039; 95% CI: 0.988,1.094), PM10: 1.024; 95% CI: 0.995,1.053, PM2.5: 1.028; 95% CI: 1.009,1.047, CO: 1.045; 95% CI: 1.005,1.086, O3: 1.032; 95% CI: 1.005,1.060. In children, the association was significant for NO2, SO2 and PM2.5. Conclusion This meta-analysis provides evidence of the association between selected air pollutants and asthma exacerbations for different lags.
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                Author and article information

                Contributors
                Lin-Fu Zhou
                Journal
                Journal ID (nlm-ta): Chronic Dis Transl Med
                Journal ID (iso-abbrev): Chronic Dis Transl Med
                Title: Chronic Diseases and Translational Medicine
                Publisher: Chinese Medical Association
                ISSN (Print): 2095-882X
                ISSN (Electronic): 2589-0514
                Publication date PMC-release: 28 August 2018
                Publication date Collection: September 2018
                Publication date (Electronic): 28 August 2018
                Volume: 4
                Issue: 3
                Pages: 176-186
                Affiliations
                [a ]Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
                [b ]Section of Allergy and Clinical Immunology, Internal Medicine and Pediatrics, Yale University School of Medicine, New Haven, CT 06511, USA
                [c ]Department of Translational Medicine, Medical College of Xiamen University, Xiamen, Fujian 361102, China
                [d ]Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45249, USA
                [e ]Institute of Integrative Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China
                [f ]Department of Respiratory Medicine, Jiangsu Shengze Hospital, Nanjing Medical University, Suzhou, Jiangsu 215228, China
                Author notes
                [∗ ]Corresponding author. lfzhou@ 123456njmu.edu.cn
                [g]

                These authors contributed equally to this article.

                Article
                Publisher ID: S2095-882X(17)30128-7
                DOI: 10.1016/j.cdtm.2018.07.002
                PMC ID: 6160608
                PubMed ID: 30276364
                SO-VID: 1e9fbb96-937f-4675-8331-091d6665fd24
                Copyright © © 2018 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 31 December 2017
                Categories
                Subject: Perspective

                Keywords: air pollution,particulate matter,lung diseases,chronic obstructive pulmonary disease
                Data availability:
                Keywords: air pollution, particulate matter, lung diseases, chronic obstructive pulmonary disease

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