The effect of air-pollution and weather exposure on mortality and hospital admission and implications for further research: A systematic scoping review

Abstract

Background Air-pollution and weather exposure beyond certain thresholds have serious effects on public health. Yet, there is lack of information on wider aspects including the role of some effect modifiers and the interaction between air-pollution and weather. This article aims at a comprehensive review and narrative summary of literature on the association of air-pollution and weather with mortality and hospital admissions; and to highlight literature gaps that require further research. Methods We conducted a scoping literature review. The search on two databases (PubMed and Web-of-Science) from 2012 to 2020 using three conceptual categories of “environmental factors”, “health outcomes”, and “Geographical region” revealed a total of 951 records. The narrative synthesis included all original studies with time-series, cohort, or case cross-over design; with ambient air-pollution and/or weather exposure; and mortality and/or hospital admission outcomes. Results The final review included 112 articles from which 70 involved mortality, 30 hospital admission, and 12 studies included both outcomes. Air-pollution was shown to act consistently as risk factor for all-causes, cardiovascular, respiratory, cerebrovascular and cancer mortality and hospital admissions. Hot and cold temperature was a risk factor for wide range of cardiovascular, respiratory, and psychiatric illness; yet, in few studies, the increase in temperature reduced the risk of hospital admissions for pulmonary embolism, angina pectoris, chest, and ischemic heart diseases. The role of effect modification in the included studies was investigated in terms of gender, age, and season but not in terms of ethnicity. Conclusion Air-pollution and weather exposure beyond certain thresholds affect human health negatively. Effect modification of important socio-demographics such as ethnicity and the interaction between air-pollution and weather is often missed in the literature. Our findings highlight the need of further research in the area of health behaviour and mortality in relation to air-pollution and weather, to guide effective environmental health precautionary measures planning.

Short-Term Joint Effects of PM10, NO2 and SO2 on Cardio-Respiratory Disease Hospital Admissions in Cape Town, South Africa

“…An Italian study reported a linear correlation between high levels of NO 2 and PM 10 concentrations and the lack of possession of a home, low level of education, and population density [ 59 ]. Numerous studies have investigated the influence of SES on adverse health effects of air pollution, and there have been conflicting reports of effect modification [ 60 , 61 ]. This makes it difficult to draw a definitive conclusion on whether the short-term effects of air pollution on health are modified by SES.…”

Air pollution and individuals’ mental well-being in the adult population in United Kingdom: A spatial-temporal longitudinal study and the moderating effect of ethnicity

“…The third explanation is related to experiential anxiety and worrying feelings about one’s physical health and future [ 27 ]. Through substantive research, people are made aware of the negative impact of air pollution on human’s physical health and the higher risk for acute and chronic diseases such as cardiovascular, respiratory, cancer and immune system diseases [ 8 , 9 , 28 ]. People living in highly polluted areas might experience stress and anxiety about physical illness, which is reflected in poorer mental well-being.…”

“…Ambient air pollution is a mixture of particles (e.g., black carbon and particulate matter with diameters less than or equal to 10 μm: PM10 and to 2.5 μm: PM2.5) and gaseous chemicals (e.g., sulphur dioxide: SO 2 , nitrogen dioxide: NO 2 , carbon monoxide: CO, and ozone) that are released to the atmosphere from natural processes (e.g., windblown soil, volcano ashes, pollen, dust) or from man-made activities including energy production, livestock farming, traffic exhaust, and industrial and mining processes [ 8 , 9 ]. Inhalation of air pollutants can have major consequences on the human central nervous system and neuro-behavioural mechanisms [ 1 , 5 , 9 , 10 ].…”

“…Air pollution has been also linked to stress and experiential anxiety emerging from worrying feelings about one’s physical health and future [ 27 ]. Due to the more conclusive research about the effect of air pollution on physical health including cardiopulmonary, immune system and cancer diseases [ 8 , 9 , 28 ], people living in highly polluted areas might experience stress and worrisome feelings of getting physical illness, which impairs their mental well-being.…”

Suicide and Associations with Air Pollution and Ambient Temperature: A Systematic Review and Meta-Analysis

“…Air pollution and temperature can be highly correlated [ 20 ] and are simultaneously exacerbated by climate change ( Figure 1 ) [ 21 ], although the correlation differs by pollutant. Air pollution may be a confounding factor for impacts of temperature on suicide and vice versa as both are associated with neuroinflammation in the brain and serotonin neurotransmission.…”