Evidence on Vulnerability and Susceptibility to Health Risks Associated With Short-Term Exposure to Particulate Matter: A Systematic Review and Meta-Analysis

Abstract

Although there is strong evidence that short-term exposure to particulate matter is associated with health risks, less is known about whether some subpopulations face higher risks. We identified 108 papers published after 1995 and summarized the scientific evidence regarding effect modification of associations between short-term exposure to particulate matter and the risk of death or hospitalization. We performed a meta-analysis of estimated mortality associations by age and sex. We found strong, consistent evidence that the elderly experience higher risk of particular matter--associated hospitalization and death, weak evidence that women have higher risks of hospitalization and death, and suggestive evidence that those with lower education, income, or employment status have higher risk of death. Meta-analysis showed a statistically higher risk of death of 0.64% (95% confidence interval (CI): 0.50, 0.78) for older populations compared with 0.34% (95% CI: 0.25, 0.42) for younger populations per 10 μg/m3 increase of particulate matter with aerodynamic diameter ≤10 μm. Women had a slightly higher risk of death of 0.55% (95% CI: 0.41, 0.70) compared with 0.50% (95% CI: 0.34, 0.54) for men, but these 2 risks were not statistically different. Our synthesis on modifiers for risks associated with particulate matter can aid the design of air quality policies and suggest directions for future research. Studies of biological mechanisms could be informed by evidence of differential risks by population, such as by sex and preexisting conditions.

Respiratory medication sales and urban air pollution in Brussels (2005 to 2011)

“…We observed increased sales of respiratory medication in relation to high PM 10 or NO 2 concentrations from birth to young elderly ages. For both pollutants, estimates were stronger for younger ages and no association was observed among the ≥85 y age group (Bell et al, 2013). Older patients with established respiratory conditions may be more likely to be hospitalized compared with younger populations or may live in institutions and not buy the medication themselves.…”

“…In contrast, COPD is rare below the age of 40 (Viegi et al, 2007;Mannino and Buist, 2007). Moreover, age is an effect modifier of the association between air pollution and health, with higher vulnerability among older individuals (Bell et al, 2013). Thanks to the large number of individuals included in our study we were able to investigate the association between daily concentrations of air pollutants and daily medication sales over many different stages in the life course.…”

Coarse particulate matter and emergency ambulance dispatches in Fukuoka, Japan: a time-stratified case-crossover study

“…A positive association with respiratory-related emergency visits was observed in children under 15 years of age who lived in Santiago, Chile [23], and associations with asthma and chronic obstructive pulmonary disease emergency room visits were found not only among adults aged 65 years or older but also among those aged 15-64 years old in Helsinki, Finland [18]. Adverse health effects of particulate matter on older adults are not surprising, because recent metaanalysis shows that older populations are more vulnerable to particulate matter than younger populations [24]. In our model including PM 2.5 , exposure to coarse particulate matter was not statistically significantly associated with respiratory disease-related ambulance dispatches; however, the OR point estimate was still above unity, and there was an overlap between 95 % CI with and without adjustment for PM 2.5 .…”

Health Effects of Metals in Particulate Matter

“…Particulate Suspended matter (PM) exposure raises the risk of developing cardiovascular diseases, both in the short and long term [19,20]. The proposed mechanisms include inflam-mation and the induction of hypercoagulability, oxidative stress and endothelial dysfunction [20,21].…”