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
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/165588

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repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling 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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