Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis
- Autores
- Zheng, Xue Yan; Orellano, Pablo Wenceslao; Lin, Hua Liang; Jiang, Mei; Guan, Wei Jie
- Año de publicación
- 2021
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Background: Air pollution is a major environmental hazard to human health and a leading cause of morbidity for asthma worldwide. Objectives: To assess the current evidence on short-term effects (from several hours to 7 days) of exposure to ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2) on asthma exacerbations, defined as emergency room visits (ERVs) and hospital admissions (HAs). Methods: We searched PubMed/MEDLINE, EMBASE and other electronic databases to retrieve studies that investigated the risk of asthma-related ERVs and HAs associated with short-term exposure to O3, NO2, or SO2. We evaluated the risks of bias (RoB) for individual studies and the certainty of evidence for each pollutant in the overall analysis. A subgroup analysis was performed, stratified by sex, age, and type of asthma exacerbation. We conducted sensitivity analysis by excluding the studies with high RoB and based on the E-value. Publication bias was examined with the Egger's test and with funnel plots. Results: Our literature search retrieved 9,059 articles, and finally 67 studies were included, from which 48 studies included the data on children, 21 on adults, 14 on the elderly, and 31 on the general population. Forty-three studies included data on asthma ERVs, and 25 on asthma HAs. The pooled relative risk (RR) per 10 µg/m3 increase of ambient concentrations was 1.008 (95%CI: 1.005, 1.011) for maximum 8-hour daily or average 24-hour O3, 1.014 (95%CI: 1.008, 1.020) for average 24-hour NO2, 1.010 (95%CI: 1.001, 1.020) for 24-hour SO2, 1.017 (95%CI: 0.973, 1.063) for maximum 1-hour daily O3, 0.999 (95%CI: 0.966, 1.033) for 1-hour NO2, and 1.003 (95%CI: 0.992, 1.014) for 1-hour SO2. Heterogeneity was observed in all pollutants except for 8-hour or 24-hour O3 and 24-hour NO2. In general, we found no significant differences between subgroups that can explain this heterogeneity. Sensitivity analysis based on the RoB showed certain differences in NO2 and SO2 when considering the outcome or confounding domains, but the analysis using the E-value showed that no unmeasured confounders were expected. There was no major evidence of publication bias. Based on the adaptation of the Grading of Recommendations Assessment, Development and Evaluation, the certainty of evidence was high for 8-hour or 24-hour O3 and 24-hour NO2, moderate for 24-hour SO2, 1-hour O3, and 1-hour SO2, and low for 1-hour NO2. Conclusion: Short-term exposure to daily O3, NO2, and SO2 was associated with an increased risk of asthma exacerbation in terms of asthma-associated ERVs and HAs.
Fil: Zheng, Xue Yan. Institute of Non-communicable Disease Control and Prevention; China
Fil: Orellano, Pablo Wenceslao. Universidad Tecnológica Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Lin, Hua Liang. Sun Yat-sen University; China
Fil: Jiang, Mei. Guangzhou Medical Universit; China
Fil: Guan, Wei Jie. Guangzhou Medical Universit; China - Materia
-
AIR POLLUTANTS
ASTHMA
META-ANALYSIS
OBSERVATIONAL STUDY
SYSTEMATIC REVIEW
TIME SERIES STUDIES - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/165588
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CONICET Digital (CONICET) |
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Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysisZheng, Xue YanOrellano, Pablo WenceslaoLin, Hua LiangJiang, MeiGuan, Wei JieAIR POLLUTANTSASTHMAMETA-ANALYSISOBSERVATIONAL STUDYSYSTEMATIC REVIEWTIME SERIES STUDIEShttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: Air pollution is a major environmental hazard to human health and a leading cause of morbidity for asthma worldwide. Objectives: To assess the current evidence on short-term effects (from several hours to 7 days) of exposure to ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2) on asthma exacerbations, defined as emergency room visits (ERVs) and hospital admissions (HAs). Methods: We searched PubMed/MEDLINE, EMBASE and other electronic databases to retrieve studies that investigated the risk of asthma-related ERVs and HAs associated with short-term exposure to O3, NO2, or SO2. We evaluated the risks of bias (RoB) for individual studies and the certainty of evidence for each pollutant in the overall analysis. A subgroup analysis was performed, stratified by sex, age, and type of asthma exacerbation. We conducted sensitivity analysis by excluding the studies with high RoB and based on the E-value. Publication bias was examined with the Egger's test and with funnel plots. Results: Our literature search retrieved 9,059 articles, and finally 67 studies were included, from which 48 studies included the data on children, 21 on adults, 14 on the elderly, and 31 on the general population. Forty-three studies included data on asthma ERVs, and 25 on asthma HAs. The pooled relative risk (RR) per 10 µg/m3 increase of ambient concentrations was 1.008 (95%CI: 1.005, 1.011) for maximum 8-hour daily or average 24-hour O3, 1.014 (95%CI: 1.008, 1.020) for average 24-hour NO2, 1.010 (95%CI: 1.001, 1.020) for 24-hour SO2, 1.017 (95%CI: 0.973, 1.063) for maximum 1-hour daily O3, 0.999 (95%CI: 0.966, 1.033) for 1-hour NO2, and 1.003 (95%CI: 0.992, 1.014) for 1-hour SO2. Heterogeneity was observed in all pollutants except for 8-hour or 24-hour O3 and 24-hour NO2. In general, we found no significant differences between subgroups that can explain this heterogeneity. Sensitivity analysis based on the RoB showed certain differences in NO2 and SO2 when considering the outcome or confounding domains, but the analysis using the E-value showed that no unmeasured confounders were expected. There was no major evidence of publication bias. Based on the adaptation of the Grading of Recommendations Assessment, Development and Evaluation, the certainty of evidence was high for 8-hour or 24-hour O3 and 24-hour NO2, moderate for 24-hour SO2, 1-hour O3, and 1-hour SO2, and low for 1-hour NO2. Conclusion: Short-term exposure to daily O3, NO2, and SO2 was associated with an increased risk of asthma exacerbation in terms of asthma-associated ERVs and HAs.Fil: Zheng, Xue Yan. Institute of Non-communicable Disease Control and Prevention; ChinaFil: Orellano, Pablo Wenceslao. Universidad Tecnológica Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lin, Hua Liang. Sun Yat-sen University; ChinaFil: Jiang, Mei. Guangzhou Medical Universit; ChinaFil: Guan, Wei Jie. Guangzhou Medical Universit; ChinaPergamon-Elsevier Science Ltd2021-05info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/165588Zheng, Xue Yan; Orellano, Pablo Wenceslao; Lin, Hua Liang; Jiang, Mei; Guan, Wei Jie; Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis; Pergamon-Elsevier Science Ltd; Environment International; 150; 5-2021; 1-110160-4120CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1016/j.envint.2021.106435info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S016041202100060info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:21:37Zoai:ri.conicet.gov.ar:11336/165588instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:21:37.469CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis |
title |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis |
spellingShingle |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis Zheng, Xue Yan AIR POLLUTANTS ASTHMA META-ANALYSIS OBSERVATIONAL STUDY SYSTEMATIC REVIEW TIME SERIES STUDIES |
title_short |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis |
title_full |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis |
title_fullStr |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis |
title_full_unstemmed |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis |
title_sort |
Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis |
dc.creator.none.fl_str_mv |
Zheng, Xue Yan Orellano, Pablo Wenceslao Lin, Hua Liang Jiang, Mei Guan, Wei Jie |
author |
Zheng, Xue Yan |
author_facet |
Zheng, Xue Yan Orellano, Pablo Wenceslao Lin, Hua Liang Jiang, Mei Guan, Wei Jie |
author_role |
author |
author2 |
Orellano, Pablo Wenceslao Lin, Hua Liang Jiang, Mei Guan, Wei Jie |
author2_role |
author author author author |
dc.subject.none.fl_str_mv |
AIR POLLUTANTS ASTHMA META-ANALYSIS OBSERVATIONAL STUDY SYSTEMATIC REVIEW TIME SERIES STUDIES |
topic |
AIR POLLUTANTS ASTHMA META-ANALYSIS OBSERVATIONAL STUDY SYSTEMATIC REVIEW TIME SERIES STUDIES |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.3 https://purl.org/becyt/ford/3 |
dc.description.none.fl_txt_mv |
Background: Air pollution is a major environmental hazard to human health and a leading cause of morbidity for asthma worldwide. Objectives: To assess the current evidence on short-term effects (from several hours to 7 days) of exposure to ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2) on asthma exacerbations, defined as emergency room visits (ERVs) and hospital admissions (HAs). Methods: We searched PubMed/MEDLINE, EMBASE and other electronic databases to retrieve studies that investigated the risk of asthma-related ERVs and HAs associated with short-term exposure to O3, NO2, or SO2. We evaluated the risks of bias (RoB) for individual studies and the certainty of evidence for each pollutant in the overall analysis. A subgroup analysis was performed, stratified by sex, age, and type of asthma exacerbation. We conducted sensitivity analysis by excluding the studies with high RoB and based on the E-value. Publication bias was examined with the Egger's test and with funnel plots. Results: Our literature search retrieved 9,059 articles, and finally 67 studies were included, from which 48 studies included the data on children, 21 on adults, 14 on the elderly, and 31 on the general population. Forty-three studies included data on asthma ERVs, and 25 on asthma HAs. The pooled relative risk (RR) per 10 µg/m3 increase of ambient concentrations was 1.008 (95%CI: 1.005, 1.011) for maximum 8-hour daily or average 24-hour O3, 1.014 (95%CI: 1.008, 1.020) for average 24-hour NO2, 1.010 (95%CI: 1.001, 1.020) for 24-hour SO2, 1.017 (95%CI: 0.973, 1.063) for maximum 1-hour daily O3, 0.999 (95%CI: 0.966, 1.033) for 1-hour NO2, and 1.003 (95%CI: 0.992, 1.014) for 1-hour SO2. Heterogeneity was observed in all pollutants except for 8-hour or 24-hour O3 and 24-hour NO2. In general, we found no significant differences between subgroups that can explain this heterogeneity. Sensitivity analysis based on the RoB showed certain differences in NO2 and SO2 when considering the outcome or confounding domains, but the analysis using the E-value showed that no unmeasured confounders were expected. There was no major evidence of publication bias. Based on the adaptation of the Grading of Recommendations Assessment, Development and Evaluation, the certainty of evidence was high for 8-hour or 24-hour O3 and 24-hour NO2, moderate for 24-hour SO2, 1-hour O3, and 1-hour SO2, and low for 1-hour NO2. Conclusion: Short-term exposure to daily O3, NO2, and SO2 was associated with an increased risk of asthma exacerbation in terms of asthma-associated ERVs and HAs. Fil: Zheng, Xue Yan. Institute of Non-communicable Disease Control and Prevention; China Fil: Orellano, Pablo Wenceslao. Universidad Tecnológica Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Lin, Hua Liang. Sun Yat-sen University; China Fil: Jiang, Mei. Guangzhou Medical Universit; China Fil: Guan, Wei Jie. Guangzhou Medical Universit; China |
description |
Background: Air pollution is a major environmental hazard to human health and a leading cause of morbidity for asthma worldwide. Objectives: To assess the current evidence on short-term effects (from several hours to 7 days) of exposure to ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2) on asthma exacerbations, defined as emergency room visits (ERVs) and hospital admissions (HAs). Methods: We searched PubMed/MEDLINE, EMBASE and other electronic databases to retrieve studies that investigated the risk of asthma-related ERVs and HAs associated with short-term exposure to O3, NO2, or SO2. We evaluated the risks of bias (RoB) for individual studies and the certainty of evidence for each pollutant in the overall analysis. A subgroup analysis was performed, stratified by sex, age, and type of asthma exacerbation. We conducted sensitivity analysis by excluding the studies with high RoB and based on the E-value. Publication bias was examined with the Egger's test and with funnel plots. Results: Our literature search retrieved 9,059 articles, and finally 67 studies were included, from which 48 studies included the data on children, 21 on adults, 14 on the elderly, and 31 on the general population. Forty-three studies included data on asthma ERVs, and 25 on asthma HAs. The pooled relative risk (RR) per 10 µg/m3 increase of ambient concentrations was 1.008 (95%CI: 1.005, 1.011) for maximum 8-hour daily or average 24-hour O3, 1.014 (95%CI: 1.008, 1.020) for average 24-hour NO2, 1.010 (95%CI: 1.001, 1.020) for 24-hour SO2, 1.017 (95%CI: 0.973, 1.063) for maximum 1-hour daily O3, 0.999 (95%CI: 0.966, 1.033) for 1-hour NO2, and 1.003 (95%CI: 0.992, 1.014) for 1-hour SO2. Heterogeneity was observed in all pollutants except for 8-hour or 24-hour O3 and 24-hour NO2. In general, we found no significant differences between subgroups that can explain this heterogeneity. Sensitivity analysis based on the RoB showed certain differences in NO2 and SO2 when considering the outcome or confounding domains, but the analysis using the E-value showed that no unmeasured confounders were expected. There was no major evidence of publication bias. Based on the adaptation of the Grading of Recommendations Assessment, Development and Evaluation, the certainty of evidence was high for 8-hour or 24-hour O3 and 24-hour NO2, moderate for 24-hour SO2, 1-hour O3, and 1-hour SO2, and low for 1-hour NO2. Conclusion: Short-term exposure to daily O3, NO2, and SO2 was associated with an increased risk of asthma exacerbation in terms of asthma-associated ERVs and HAs. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-05 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/165588 Zheng, Xue Yan; Orellano, Pablo Wenceslao; Lin, Hua Liang; Jiang, Mei; Guan, Wei Jie; Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis; Pergamon-Elsevier Science Ltd; Environment International; 150; 5-2021; 1-11 0160-4120 CONICET Digital CONICET |
url |
http://hdl.handle.net/11336/165588 |
identifier_str_mv |
Zheng, Xue Yan; Orellano, Pablo Wenceslao; Lin, Hua Liang; Jiang, Mei; Guan, Wei Jie; Short-term exposure to ozone, nitrogen dioxide, and sulphur dioxide and emergency department visits and hospital admissions due to asthma: A systematic review and meta-analysis; Pergamon-Elsevier Science Ltd; Environment International; 150; 5-2021; 1-11 0160-4120 CONICET Digital CONICET |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.envint.2021.106435 info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S016041202100060 |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-nd/2.5/ar/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/ |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Pergamon-Elsevier Science Ltd |
publisher.none.fl_str_mv |
Pergamon-Elsevier Science Ltd |
dc.source.none.fl_str_mv |
reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
reponame_str |
CONICET Digital (CONICET) |
collection |
CONICET Digital (CONICET) |
instname_str |
Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.name.fl_str_mv |
CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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1844614205147185152 |
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13.070432 |