Air pollution and health.
TL;DR: The evidence for adverse effects on health of selected air pollutants is discussed, and it is unclear whether a threshold concentration exists for particulate matter and ozone below which no effect on health is likely.
About: This article is published in The Lancet.The article was published on 2002-10-19. It has received 4010 citations till now. The article focuses on the topics: Air quality index & Air pollution.
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TL;DR: A comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonary health.
Abstract: Efforts to understand and mitigate the health effects of particulate matter (PM) air pollution have a rich and interesting history. This review focuses on six substantial lines of research that have been pursued since 1997 that have helped elucidate our understanding about the effects of PM on human health. There has been substantial progress in the evaluation of PM health effects at different time-scales of exposure and in the exploration of the shape of the concentration-response function. There has also been emerging evidence of PM-related cardiovascular health effects and growing knowledge regarding interconnected general pathophysiological pathways that link PM exposure with cardiopulmonary morbidity and mortality. Despite important gaps in scientific knowledge and continued reasons for some skepticism, a comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonary health. Although much of this research has been motivated by environmental public health policy, these results have important scientific, medical, and public health implications that are broader than debates over legally mandated air quality standards.
5,547 citations
TL;DR: Air pollution has both acute and chronic effects on human health, affecting a number of different systems and organs, and ranges from minor upper respiratory irritation to chronic respiratory and heart disease, lung cancer, acute respiratory infections in children and chronic bronchitis in adults.
3,000 citations
TL;DR: Fine particulate air pollution is a risk factor for cause-specific cardiovascular disease mortality via mechanisms that likely include pulmonary and systemic inflammation, accelerated atherosclerosis, and altered cardiac autonomic function.
Abstract: Background— Epidemiologic studies have linked long-term exposure to fine particulate matter air pollution (PM) to broad cause-of-death mortality. Associations with specific cardiopulmonary diseases might be useful in exploring potential mechanistic pathways linking exposure and mortality. Methods and Results— General pathophysiological pathways linking long-term PM exposure with mortality and expected patterns of PM mortality with specific causes of death were proposed a priori. Vital status, risk factor, and cause-of-death data, collected by the American Cancer Society as part of the Cancer Prevention II study, were linked with air pollution data from United States metropolitan areas. Cox Proportional Hazard regression models were used to estimate PM-mortality associations with specific causes of death. Long-term PM exposures were most strongly associated with mortality attributable to ischemic heart disease, dysrhythmias, heart failure, and cardiac arrest. For these cardiovascular causes of death, a 10-...
2,530 citations
TL;DR: The purpose of this statement is to provide healthcare professionals and regulatory agencies with a comprehensive review of the literature on air pollution and cardiovascular disease and practical recommendations for healthcare providers and their patients are outlined.
Abstract: Air pollution is a heterogeneous, complex mixture of gases, liquids, and particulate matter. Epidemiological studies have demonstrated a consistent increased risk for cardiovascular events in relation to both short- and long-term exposure to present-day concentrations of ambient particulate matter. Several plausible mechanistic pathways have been described, including enhanced coagulation/thrombosis, a propensity for arrhythmias, acute arterial vasoconstriction, systemic inflammatory responses, and the chronic promotion of atherosclerosis. The purpose of this statement is to provide healthcare professionals and regulatory agencies with a comprehensive review of the literature on air pollution and cardiovascular disease. In addition, the implications of these findings in relation to public health and regulatory policies are addressed. Practical recommendations for healthcare providers and their patients are outlined. In the final section, suggestions for future research are made to address a number of remaining scientific questions.
2,213 citations
01 Jan 2006
TL;DR: The 2006 A&WMA Critical Review on Health Effects of Fine Particulate Air Pollution: Lines that Connect documents substantial progress since the 1997 Critical Review in the areas of short-term exposure and mortality and time scales of exposure.
Abstract: INTRODUCTION Herein is the discussion of the 2006 A&WMA Critical Review1,2 on “Health Effects of Fine Particulate Air Pollution: Lines that Connect.” In the review, Drs. C. Arden Pope III and Douglas Dockery addressed the epidemiological evidence for the effects of particulate matter (PM) on human health indicators. The review documents substantial progress since the 1997 Critical Review3 in the areas of: (1) short-term exposure and mortality; (2) long-term exposure and mortality; (3) time scales of exposure; (4) the shape of the concentration-response function; (5) cardiovascular disease; and (6) biological plausibility. Invited and contributing discussants agree and disagree with points made in the review. Each discussion is self-contained and adds information relevant to the topic. Joint authorship of this article does not imply that a discussant subscribes to the opinions expressed by others. Commentaries are the opinions of the author only and do not necessarily reflect the positions of their respective organizations. In particular, Dr. Costa’s comments have not been reviewed by U.S. Environmental Protection Agency (EPA) and do not reflect official positions or policies of the agency. CRITICAL REVIEW DISCUSSION ISSN 1047-3289 J. Air & Waste Manage. Assoc. 56:1368–1380
2,011 citations
References
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TL;DR: Fine particulate and sulfur oxide--related pollution were associated with all-cause, lung cancer, and cardiopulmonary mortality and long-term exposure to combustion-related fine particulate air pollution is an important environmental risk factor for cardiopULmonary and lung cancer mortality.
Abstract: ContextAssociations have been found between day-to-day particulate air pollution
and increased risk of various adverse health outcomes, including cardiopulmonary
mortality. However, studies of health effects of long-term particulate air
pollution have been less conclusive.ObjectiveTo assess the relationship between long-term exposure to fine particulate
air pollution and all-cause, lung cancer, and cardiopulmonary mortality.Design, Setting, and ParticipantsVital status and cause of death data were collected by the American
Cancer Society as part of the Cancer Prevention II study, an ongoing prospective
mortality study, which enrolled approximately 1.2 million adults in 1982.
Participants completed a questionnaire detailing individual risk factor data
(age, sex, race, weight, height, smoking history, education, marital status,
diet, alcohol consumption, and occupational exposures). The risk factor data
for approximately 500 000 adults were linked with air pollution data
for metropolitan areas throughout the United States and combined with vital
status and cause of death data through December 31, 1998.Main Outcome MeasureAll-cause, lung cancer, and cardiopulmonary mortality.ResultsFine particulate and sulfur oxide–related pollution were associated
with all-cause, lung cancer, and cardiopulmonary mortality. Each 10-µg/m3 elevation in fine particulate air pollution was associated with approximately
a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer
mortality, respectively. Measures of coarse particle fraction and total suspended
particles were not consistently associated with mortality.ConclusionLong-term exposure to combustion-related fine particulate air pollution
is an important environmental risk factor for cardiopulmonary and lung cancer
mortality.
7,803 citations
TL;DR: It is suggested that fine-particulate air pollution, or a more complex pollution mixture associated with fine particulate matter, contributes to excess mortality in certain U.S. cities.
Abstract: Background Recent studies have reported associations between particulate air pollution and daily mortality rates. Population-based, cross-sectional studies of metropolitan areas in the United States have also found associations between particulate air pollution and annual mortality rates, but these studies have been criticized, in part because they did not directly control for cigarette smoking and other health risks. Methods In this prospective cohort study, we estimated the effects of air pollution on mortality, while controlling for individual risk factors. Survival analysis, including Cox proportional-hazards regression modeling, was conducted with data from a 14-to-16-year mortality follow-up of 8111 adults in six U.S. cities. Results Mortality rates were most strongly associated with cigarette smoking. After adjusting for smoking and other risk factors, we observed statistically significant and robust associations between air pollution and mortality. The adjusted mortality-rate ratio for the most po...
7,194 citations
Journal Article•
TL;DR: The variation in the prevalences of asthma, allergic rhinoconjunctivitis, and atopic-eczema symptoms is striking between different centres throughout the world and will form the basis of further studies to investigate factors that potentially lead to these international patterns.
3,584 citations
TL;DR: In this article, the authors investigated worldwide prevalence of asthma, allergic rhinoconjunctivitis, and atopic disorders in children, and found differences of between 20-fold and 60-fold between centres in the prevalence of symptoms of asthma.
3,019 citations
TL;DR: Increased mortality is associated with sulfate and fine particulate air pollution at levels commonly found in U.S. cities, although the increase in risk is not attributable to tobacco smoking, although other unmeasured correlates of pollution cannot be excluded with certainty.
Abstract: Time-series, cross-sectional, and prospective cohort studies have observed associations between mortality and particulate air pollution but have been limited by ecologic design or small number of subjects or study areas. The present study evaluates effects of particulate air pollution on mortality using data from a large cohort drawn from many study areas. We linked ambient air pollution data from 151 U.S. metropolitan areas in 1980 with individual risk factor on 552,138 adults who resided in these areas when enrolled in a prospective study in 1982. Deaths were ascertained through December, 1989. Exposure to sulfate and fine particulate air pollution, which is primarily from fossil fuel combustion, was estimated from national data bases. The relationships of air pollution to all-cause, lung cancer, and cardiopulmonary mortality was examined using multivariate analysis which controlled for smoking, education, and other risk factors. Although small compared with cigarette smoking, an association between mor...
2,792 citations