Individual-level interventions to reduce personal exposure to outdoor air pollution and their effects on people with long-term respiratory conditions.
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ABSTRACT:
SUBMITTER: Janjua S
PROVIDER: S-EPMC8407478 | biostudies-literature | 2021 Aug
REPOSITORIES: biostudies-literature
Publications
Individual-level interventions to reduce personal exposure to outdoor air pollution and their effects on people with long-term respiratory conditions.
Janjua Sadia S Powell Pippa P Atkinson Richard R Stovold Elizabeth E Fortescue Rebecca R
The Cochrane database of systematic reviews 20210809
<h4>Background</h4>More than 90% of the global population lives in areas exceeding World Health Organization air quality limits. More than four million people each year are thought to die early due to air pollution, and poor air quality is thought to reduce an average European's life expectancy by one year. Individuals may be able to reduce health risks through interventions such as masks, behavioural changes and use of air quality alerts. To date, evidence is lacking about the efficacy and safe ...[more]
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Project description:BackgroundExposure to air pollution can cause adverse health effects in people living with chronic lung disease. In people with asthma, it is not clear whether strategies to reduce outdoor air pollution can affect clinical symptoms and lung function.ObjectivesTo determine strategies to reduce air pollution exposure for people with asthma, and to describe the effect of reduced air pollution on asthma outcome.MethodsA systematic review was conducted of six databases for English literature. Any study published between April 2012 and March 2022 that mentioned air pollution exposure reduction and asthma was reviewed. Two reviewers (STH and RMp) screened and extracted the data separately, using a standardised form based on the Cochrane data extraction tool. Risk of bias was assessed using the risk-of bias 2 tool. Outcome measures were the Asthma Control Test (ACT), the Childhood Asthma Control Test, exacerbations, and the forced expiratory volume in the 1st second (FEV1 ), forced vital capacity (FVC) and FEV1 /FVC ratio. The study was registered with PROSPERO (reg. no. CRD42022341648).ResultsOf the 11 116 identified studies, eight met the inclusion criteria, with a total of 11 395 043 participants. Clean air policy implementation modestly improved lung function, as shown by an increase in FVC and FEV1 of 0.02 L/year and 0.01 L/year, respectively. Reduction of exposure to outdoor smoke pollution with use of mobile application alerts resulted in behavioural change and improved ACT scores over 8 weeks (mean (standard deviation (SD)) 21.5 (2.3) compared with baseline (20.0 (2.4); p<0.001). Asthma control improved during low levels of pollution related to COVID-19 lockdown, as shown by mean (SD) ACT scores (17.3 (4.7) v. 19.7 (4.5); p<0.001) and associated declines in mean daily hospital admissions (4.5 (3.4) days v. 2.8 (2.5) days; p<0.001).ConclusionAir pollution is a major hazard, and strategies to reduce exposure have a positive outcome in terms of the asthma morbidity. This field would benefit from further high-quality randomised clinical trial evidence to inform policy and decision-making.Study synopsisWhat the study adds. The prevalence and burden of asthma are increasing globally. Air pollution exposure is a major cause of worse asthma symptoms. Strategies to reduce air pollution or exposure to it may contribute towards improved quality of life. This study highlights potential strategies and their effect on asthma outcome.Implications of the findings. A combination of individual activities and actions by governments to reduce air pollution can improve asthma outcome. A focus on education together with behavioural changes can reduce exposure at the individual level. Implementation of clean air policies reduces air pollution exposure and improves lung health.
| S-EPMC11633239 | biostudies-literature
Project description: Not available
| S-EPMC6600837 | biostudies-literature
Project description:BackgroundLittle is known about how individuals are exposed to air pollution in various daily activity spaces due to a lack of data collected in the full range of spatial contexts in which they spend their time. The limited understanding makes it difficult for people to act in informed ways to reduce their exposure both indoors and outdoors.ObjectiveThis study aimed to (1) assess whether personalized air quality data collected using GPS-enabled portable monitors (GeoAir2), coupled with travel-activity diaries, promote people's awareness and behavioral changes regarding indoor and outdoor air pollution and (2) demonstrate the effect of places and activities on personal exposure by analyzing individual exposure profiles.Methods44 participants carried GeoAir2 to collect geo-referenced air pollution data and completed travel-activity diaries for three days. These data were then combined for spatial data analysis and visualization. Participants also completed pre- and post-session surveys about awareness and behaviors regarding air pollution. Paired-sample t-tests were performed to evaluate changes in knowledge, attitudes/perceptions, and behavioral intentions/practices, respectively. Lastly, follow-up interviews were conducted with a subset of participants.ResultsMost participants experienced PM2.5 peaks indoors, especially when cooking at home, and had the lowest exposure in transit. Participants reported becoming more aware of air quality in their surroundings and more concerned about its health effects (t = 3.92, p = 0.000) and took more action or were more motivated to alter their behaviors to mitigate their exposure (t = 3.40, p = 0.000) after the intervention than before. However, there was no significant improvement in knowledge (t = 0.897; p = 0.187).SignificancePersonal exposure monitoring, combined with travel-activity diaries, leads to positive changes in attitudes, perceptions, and behaviors related to air pollution. This study highlights the importance of citizen engagement in air monitoring for effective risk communication and air pollution management.
| S-EPMC10238623 | biostudies-literature
Project description:BackgroundThere are a few epidemiological studies that (1) link increased ambient air pollution (AP) with an increase in lung cancer incidence rates and (2) investigate whether residing in green spaces could be protective against cancer. However, it is completely unclear whether other forms of cancer are also affected by AP and if residential green spaces could lower cancer incidence rates in general. Therefore, the objective was to estimate whether AP and green space are associated with several cancer types.MethodsThe analysis was based on routine health care data from around 1.9 million people from Saxony who were free of cancer in 2008 and 2009. Incident cancer cases (2010-2014) of mouth and throat, skin (non-melanoma skin cancer - NMSC), prostate, breast, and colorectum were defined as: (1) one inpatient diagnosis, or (2) two outpatient diagnoses in two different quarters within one year and a specific treatment or death within two quarters after the diagnosis. Exposures, derived from freely available 3rd party data, included particulate matter with aerodynamic diameter of less than 10 μm (PM10) and nitrogen dioxide (N02) as well as green space (Normalized Difference Vegetation Index - NDVI). Associations between air pollutants, green space, and cancer incidence were assessed by multilevel Poisson models. Age, sex, physician contacts, short- and long-term unemployment, population density, and having an alcohol-related disorder were considered as potential confounders.ResultsThree thousand one hundred seven people developed mouth and throat cancer, 33,178 NMSC, 9611 prostate cancer, 9577 breast cancer, and 11,975 colorectal cancer during the follow-up period (2010-2014). An increase in PM10 of 10 μg/m3 was associated with a 53% increase in relative risk (RR) of mouth and throat cancer and a 52% increase in RR of NMSC. Prostate and breast cancer were modestly associated with PM10 with an increase in RR of 23 and 19%, respectively. The associations with N02 were in the same direction as PM10 but the effect estimates were much lower (7-24%). A 10% increase in NDVI was most protective of mouth and throat cancer (- 11% RR) and of NMSC (- 16% RR). Colorectal cancer was not affected by any of the exposures.ConclusionsIn addition to the studies carried out so far, this study was able to provide evidence that higher ambient AP levels increase the risk of mouth and throat cancer as well as of NMSC and that a higher residential green space level might have a protective effect for NMSC in areas with low to moderate UV intensity. Nevertheless, we cannot rule out residual confounding by socioeconomic or smoking status.
| S-EPMC5994126 | biostudies-literature
Project description:BackgroundThe effects of outdoor air pollution on lung function in adults are still controversial.ObjectiveEvaluate the effects of exposure to different levels of traffic-generated PM2.5 on workers' lung functions in São Paulo, Brazil.MethodsTo cover a wide range of exposures, 101 non-smoking workers from three occupations (taxi drivers, traffic controllers, and forest rangers) were selected for the study. After clinical evaluation, the participants were scheduled to attend four consecutive weekly visits in which they received a 24-hour personal PM2.5 sampler and had lung function tests measured on the following day. The association between the spirometric variables and the averaged PM2.5 levels was assessed using robust regression models adjusted for age, waist circumference, time at the job, daily work hours, diabetes or hypertension and former smoking habits.ResultsRelative to workers in the lowest exposed group (all measures < 25 μg/m3), those with the highest level of exposure (all measures > 39.6 μg/m3) showed a reduction of predicted FVC (-12.2%; CI 95%: [-20.0% to -4.4%]), a marginal reduction of predicted FEV1 (-9.1%; CI 95%: [-19.1% to 0.9%]) and an increase of predicted FEF25-75%/FVC (14.9%; CI 95%: [2.9% to 26.8%]) without changes of FEV1/FVC.ConclusionsExposure to vehicular traffic air pollution is associated with a small but significant reduction of FVC without a reduction of FEV1/FVC.
| S-EPMC5053536 | biostudies-literature
Project description:BackgroundConcentrations of ambient air pollution and pollutants in China have changed considerably during the last decade. However, few studies have evaluated the effects of current ambient air pollution on the health of kindergarten children.MethodsWe studied 6730 Chinese children (age, 3-7 years) from 50 kindergartens in 7 cities of Northeast China in 2009. Parents or guardians completed questionnaires that asked about the children's histories of respiratory symptoms and risk factors. Three-year concentrations of particles with an aerodynamic diameter ≤10 µm (PM10), sulfur dioxide (SO2), and nitrogen dioxides (NO2) were calculated at monitoring stations in 25 study districts. A 2-stage regression approach was used in data analyses.ResultsThe prevalence of respiratory symptoms was higher among children living near a busy road, those living near chimneys or a factory, those having a coal-burning device, those living with smokers, and those living in a home that had been recently renovated. Among girls, PM10 was associated with persistent cough (odds ratio [OR]PM10 = 1.44; 95% CI, 1.18-1.77), persistent phlegm (ORPM10 = 1.36; 95% CI, 1.02-1.81), and wheezing (ORPM10 = 1.31; 95% CI, 1.04-1.65). NO2 concentration was associated with increased prevalence of allergic rhinitis (OR = 1.96; 95% CI, 1.27-3.02) among girls. In contrast, associations of respiratory symptoms with concentrations of PM10, SO2, and NO2 were not statistically significant among boys.ConclusionsAir pollution is particularly important in the development of respiratory morbidity among children. Girls may be more susceptible than boys to air pollution.
| S-EPMC3709542 | biostudies-literature
Project description:In communities with household solid fuel use, transitioning to clean stoves/fuels often results in only moderate reductions in fine particulate matter (PM2.5) exposures; the chemical composition of those exposures may help explain why. We collected personal exposure (men and women) and outdoor PM2.5 samples in villages in three Chinese provinces (Shanxi, Beijing, and Guangxi) and measured chemical components, including water-soluble organic carbon (WSOC), ions, elements, and organic tracers. Source contributions from chemical mass balance modeling (biomass burning, coal combustion, vehicles, dust, and secondary inorganic aerosol) were similar between outdoor and personal PM2.5 samples. Principal component analysis of organic and inorganic components identified analogous sources, including a regional ambient source. Chemical components of PM2.5 exposures did not differ significantly by gender. Participants using coal had higher personal/outdoor (P/O) ratios of coal combustion tracers (picene, sulfate, As, and Pb) than those not using coal, but no such trend was observed for biomass burning tracers (levoglucosan, K+, WSOC). Picene and most levoglucosan P/O ratios exceeded 1 even among participants not using coal and biomass, respectively, indicating substantial indirect exposure to solid fuel emissions from other homes. Contributions of community-level emissions to exposures suggest that meaningful exposure reductions will likely require extensive fuel use changes within communities.
| S-EPMC8655976 | biostudies-literature
Project description:IntroductionWhile associations between ambient air pollution and respiratory health in chronic obstructive pulmonary disease (COPD) patients are well studied, little is known about individuals' personal exposure to pollution and associated health effects by source.AimTo separate measured total personal exposure into indoor-generated and outdoor-generated pollution and use these improved metrics in health models for establishing more reliable associations with exacerbations and respiratory symptoms.MethodsWe enrolled a panel of 76 patients with COPD and continuously measured their personal exposure to particles and gaseous pollutants and location with portable monitors for 134 days on average. We collected daily health information related to respiratory symptoms through diary cards and peak expiratory flow (PEF). Mixed-effects models were applied to quantify the relationship between total, indoor-generated and outdoor-generated personal exposures to pollutants with exacerbation and symptoms occurrence and PEF.ResultsExposure to nitrogen dioxide from both indoor and outdoor sources was associated with exacerbations and respiratory symptoms. We observed an increase of 33% (22%-45%), 19% (12%-18%) and 12% (5%-20%) in the odds of exacerbation for an IQR increase in total, indoor-generated and outdoor-generated exposures. For carbon monoxide, health effects were mainly attributed to indoor-generated pollution. While no associations were observed for particulate matter2.5 with COPD exacerbations, indoor-generated particles were associated with a significant decrease in PEF.ConclusionsIndoor-generated and outdoor-generated pollution can deteriorate COPD patients' health. Policy-makers, physicians and patients with COPD should note the importance of decreasing exposure equally to both source types to decrease risk of exacerbation.
| S-EPMC11671933 | biostudies-literature
Project description:BackgroundOutdoor air pollution is a major threat to global public health that needs responsible participation of researchers at all levels. Assessing research output is an important step in highlighting national and international contribution and collaboration in a certain field. Therefore, the aim of this study was to analyze globally-published literature in outdoor air pollution - related respiratory health.MethodOutdoor air pollution documents related to respiratory health were retrieved from Scopus database. The study period was up to 2017. Mapping of author keywords was carried out using VOSviewer 1.6.6.ResultsSearch query yielded 3635 documents with an h-index of 137. There was a dramatic increase in the number of publications in the last decade of the study period. The most frequently encountered author keywords were: air pollution (835 occurrences), asthma (502 occurrences), particulate matter (198 occurrences), and children (203 occurrences). The United States of America ranked first (1082; 29.8%) followed by the United Kingdom (279; 7.7%) and Italy (198; 5.4%). Annual research productivity stratified by income and population size indicated that China ranked first (22.2) followed by the USA (18.8). Analysis of regional distribution of publications indicated that the Mediterranean, African, and South-East Asia regions had the least contribution. Harvard University (92; 2.5%) was the most active institution/organization followed the US Environmental Protection Agency (89; 2.4%). International collaboration was restricted to three regions: Northern America, Europe, and Asia. The top ten preferred journals were in the field of environmental health and respiratory health. Environmental Health Perspective was the most preferred journal for publishing documents in outdoor pollution in relation to respiratory health.ConclusionResearch on the impact of outdoor air pollution on respiratory health had accelerated lately and is receiving a lot of interest. Global research networks that include countries with high level of pollution and limited resources are highly needed to create public opinion in favor of minimizing outdoor air pollution and investing in green technologies.
| S-EPMC5984296 | biostudies-literature
Project description:BackgroundClean cooking interventions to reduce air pollution exposure from burning biomass for daily cooking and heating needs have the potential to reduce a large burden of disease globally.ObjectiveThe objective of this study is to evaluate the air pollution exposure impacts of a fan-assisted efficient biomass-burning cookstove and a liquefied petroleum gas (LPG) stove intervention in rural Ghana.MethodsWe randomized 1414 households in rural Ghana with pregnant mothers into a control arm (N = 526) or one of two clean cooking intervention arms: a fan-assisted efficient biomass-burning cookstove (N = 527) or an LPG stove and cylinder refills as needed (N = 361). We monitored personal maternal carbon monoxide (CO) at baseline and six times after intervention and fine particulate matter (PM2.5) exposure twice after intervention. Children received three CO exposure monitoring sessions.ResultsWe obtained 5655 48-h maternal CO exposure estimates and 1903 for children, as well as 1379 maternal PM2.5 exposure estimates. Median baseline CO exposures in the control, improved biomass, and LPG arms were 1.17, 1.17, and 1.30 ppm, respectively. Based on a differences-in-differences approach, the LPG arm showed a 47% reduction (95% confidence interval: 34-57%) in mean 48-h CO exposure compared to the control arm. Mean maternal PM2.5 exposure in the LPG arm was 32% lower than the control arm during the post-intervention period (52 ± 29 vs. 77 ± 44 μg/m3). The biomass stove did not meaningfully reduce CO or PM2.5 exposure.ConclusionsWe show that LPG interventions lowered air pollution exposure significantly compared to three-stone fires. However, post-intervention exposures still exceeded health-relevant targets.SignificanceIn a large controlled trial of cleaner cooking interventions, an LPG stove and fuel intervention reduced air pollution exposure in a vulnerable population in a low-resource setting.
| S-EPMC8273075 | biostudies-literature