Health Effects of Long-Term Exposure to Ambient PM2.5 in Asia-Pacific: a Systematic Review of Cohort Studies

Abstract

Purpose of Review Health effects of long-term exposure to ambient PM2.5 vary with regions, and 75% of the deaths attributable to PM2.5 were estimated in Asia-Pacific in 2017. This systematic review aims to summarize the existing evidence from cohort studies on health effects of long-term exposure to ambient PM2.5 in Asia-Pacific. Recent Findings In Asia-Pacific, 60 cohort studies were conducted in Australia, Mainland China, Hong Kong, Taiwan, and South Korea. They consistently supported associations of long-term exposure to PM2.5 with increased all-cause/non-accidental and cardiovascular mortality as well as with incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Evidence for other health effects was limited. Inequalities were identified in PM2.5-health associations. Summary To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM2.5 exposure in understudied regions, the health effects of long-term PM2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM2.5-health associations. Study design, especially exposure assessment methods, should be improved.

Health and economic benefits of WHO air quality guidelines, Western Pacific Region

“…ground-level monitoring) should be improved. 3 Nevertheless, it may be useful to assess emissions inventories per country, sector or source, if available (or modelled inventory data if not), to advocate for air pollution mitigation measures targeting specific sectors and sources. For example, policy-makers may refer to the Climate Trace independent greenhouse gas emissions tracking database.…”

“…A systematic review of cohort studies conducted in the Region and a worldwide meta-analysis support the association between long-term exposure to PM 2.5 and increased all-cause mortality. 3 , 4 While PM 2.5 concentrations are decreasing in some areas of the Western Pacific Region, 5 the increases in major sources of PM 2.,5 , such as traffic, industry, energy production and agriculture, are putting populations at higher risk from ambient compared to indoor levels of PM 2.5 . 6 Thus, assessing outdoor PM 2.5 concentrations’ impact on public health is important to protect populations.…”

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“…Acute PM2.5 exposure can trigger an inflammatory response, oxidative stress, and apoptosis in lung tissue [ 2 ]. Long-term exposure to PM2.5 may increase the incidence of cardiovascular diseases, renal disease, type 2 diabetes mellitus, and chronic obstructive pulmonary disease (COPD) [ 3 ]. PM also increases the risk of myocardial infarction, stroke, cardiac failure, coronary heart disease, pneumonia, acute respiratory distress syndrome, renal failure, hepatic injury, cerebrovascular diseases, gastrointestinal disorders, and inflammation in humans [ 4 ].…”