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Review
. 2024 May 9;22(1):75-95.
doi: 10.1007/s40201-024-00900-6. eCollection 2024 Jun.

Long-term exposure to air pollution on cardio-respiratory, and lung cancer mortality: a systematic review and meta-analysis

Affiliations

Affiliations

  • 1 Department of Environmental Health Engineering, School of Health, Arak University of Medical Sciences, Arak, Iran.
  • 2 Department of Occupational Health and safety, School of Health, Arak University of Medical Sciences, Arak, Iran.
Review

Long-term exposure to air pollution on cardio-respiratory, and lung cancer mortality: a systematic review and meta-analysis

Behrooz Karimi et al. J Environ Health Sci Eng. .
. 2024 May 9;22(1):75-95.
doi: 10.1007/s40201-024-00900-6. eCollection 2024 Jun.

Affiliations

  • 1 Department of Environmental Health Engineering, School of Health, Arak University of Medical Sciences, Arak, Iran.
  • 2 Department of Occupational Health and safety, School of Health, Arak University of Medical Sciences, Arak, Iran.

Abstract

Air pollution is a major cause of specific deaths worldwide. This review article aimed to investigate the results of cohort studies for air pollution connected with the all-cause, cardio-respiratory, and lung cancer mortality risk by performing a meta-analysis. Relevant cohort studies were searched in electronic databases (PubMed/Medline, Web of Science, and Scopus). We used a random effect model to estimate the pooled relative risks (RRs) and their 95% CIs (confidence intervals) of mortality. The risk of bias for each included study was also assessed by Office of Health Assessment and Translation (OHAT) checklists. We applied statistical tests for heterogeneity and sensitivity analyses. The registration code of this study in PROSPERO was CRD42023422945. A total of 88 cohort studies were eligible and included in the final analysis. The pooled relative risk (RR) per 10 μg/m3 increase of fine particulate matter (PM2.5) was 1.080 (95% CI 1.068-1.092) for all-cause mortality, 1.058 (95% CI 1.055-1.062) for cardiovascular mortality, 1.066 (95%CI 1.034-1.097) for respiratory mortality and 1.118 (95% CI 1.076-1.159) for lung cancer mortality. We observed positive increased associations between exposure to PM2.5, PM10, black carbon (BC), and nitrogen dioxide (NO2) with all-cause, cardiovascular and respiratory diseases, and lung cancer mortality, but the associations were not significant for nitrogen oxides (NOx), sulfur dioxide (SO2) and ozone (O3). The risk of mortality for males and the elderly was higher compared to females and younger age. The pooled effect estimates derived from cohort studies provide substantial evidence of adverse air pollution associations with all-cause, cardiovascular, respiratory, and lung cancer mortality.

Supplementary information: The online version contains supplementary material available at 10.1007/s40201-024-00900-6.

Keywords: Air pollution; All-cause mortality; Cardiovascular mortality; Lung cancer; Respiratory mortality.

PubMed Disclaimer

Conflict of interest statement

Competing interestsThe authors declare that they have no known competing financial interests.

Figures

Fig. 1

Fig. 1

Summary of the study selection…

Fig. 1

Summary of the study selection procedures by the PRISMA flow diagram

Fig. 1
Summary of the study selection procedures by the PRISMA flow diagram
Fig. 2

Fig. 2

A Geographic location of included…

Fig. 2

A Geographic location of included studies and ( B ) the number of…
Fig. 2
A Geographic location of included studies and (B) the number of publications reporting the association between air pollutants with mortality
Fig. 3

Fig. 3

The pooled concentration of PM

Fig. 3

The pooled concentration of PM 2.5 ( A ), PM 10 ( B

Fig. 3
The pooled concentration of PM2.5 (A), PM10 (B), NO2 (C), and O3 (µg/m3) (D) stratified by location
Fig. 4

Fig. 4

The pooled relative risk of…

Fig. 4

The pooled relative risk of all-cause mortality associated with PM 2.5 ( A

Fig. 4
The pooled relative risk of all-cause mortality associated with PM2.5 (A), PM10 (B), BC (C), NO2 (D), SO2 (E), and O3 (F) exposure stratified by cause-specific mortality, gender (male and female) and age (< 64 years and ≥ 65 years)
Fig. 4

Fig. 4

The pooled relative risk of…

Fig. 4

The pooled relative risk of all-cause mortality associated with PM 2.5 ( A

Fig. 4
The pooled relative risk of all-cause mortality associated with PM2.5 (A), PM10 (B), BC (C), NO2 (D), SO2 (E), and O3 (F) exposure stratified by cause-specific mortality, gender (male and female) and age (< 64 years and ≥ 65 years)

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