Article

Ambient particulate air pollution and acute lower respiratory infections: a systematic review and implications for estimating the global burden of disease.

Health Effects Institute, 101 Federal Street, Suite 500, Boston, MA 02110 USA.
Air Quality Atmosphere & Health 03/2013; 6(1):69-83. DOI:10.1007/s11869-011-0146-3 pp.69-83
Source: PubMed

ABSTRACT Acute lower respiratory infections (ALRI) account for nearly one fifth of mortality in young children worldwide and have been associated with exposures to indoor and outdoor sources of combustion-derived air pollution. A systematic review was conducted to identify relevant articles on air pollution and ALRI in children. Using a Bayesian approach to meta-analysis, a summary estimate of 1.12 (1.03, 1.30) increased risk in ALRI occurrence per 10 μg/m3 increase in annual average PM2.5 concentration was derived from the longer-term (subchronic and chronic) effects studies. This analysis strengthens the evidence for a causal relationship between exposure to PM2.5 and the occurrence of ALRI and provides a basis for estimating the global attributable burden of mortality due to ALRI that is not influenced by the wide variation in regional case fatality rates. Most studies, however, have been conducted in settings with relatively low levels of PM2.5. Extrapolating their results to other, more polluted, regions will require a model that is informed by evidence from studies of the effects on ALRI of exposure to PM2.5 from other combustion sources, such as secondhand smoke and household solid fuel use.

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Keywords

Acute lower respiratory infections
 
annual average PM2.5 concentration
 
causal relationship
 
combustion sources
 
combustion-derived air pollution
 
global attributable burden
 
household solid fuel use
 
outdoor sources
 
regional case fatality rates
 
secondhand smoke