air pollution
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Introduction
Consist of exposures to:
- carbon monoxide
- sulfur dioxide
- nitrogen dioxide
- ozone (smog)
- particulate matter (PM2.5 & PM10, largest component)
- smoke, including smoke from wild fires
Adverse effects
air pollution increases risk of mortality
- fine particulate matter & ozone exposure associated with higher risk of all-cause mortality in elderly at levels below current air quality standards[10]
- 7 million deaths/year due to air pollution[6]
- current concentrations of particulate matter pollution although within legal limits (12 ug/m3) associated with diminished life expectancy, especially in lower income counties[11]
- short-term exposure to extreme heat & air pollution alone individually associated with increased risk of mortality; coexposure with synergistic effects[24]
air pollution increases risk of cardiovascular disease & mortality
- increased risk of sudden cardiac death with increased fine particulate matter & ozone levels[1]
- exposure to gaseous air pollution or particulate matter increases risk for hospitalization or death due to heart failure[3]
- increased atherosclerotic cardiovascular disease mortality
- long-term PM2.5 exposure at moderate concentrations (10-12 ug/m3) is associated with increased risks of incident myocardial infarction, ischemic heart disease, & cardiovascular mortality[26] (legal limit is 12 ug/m3)
- increased risk of stroke[23]
- increases in each air pollutants including particulate matter, carbon dioxide, nitrogen dioxide, sulfur dioxide, & ozone increase risk of stroke & stroke mortality[8]
air pollution increases risk of respiratory complications
- increased cardiorespiratory mortality due to air pollution from burning coal
- 55% increase in particulate matter associated with 5.5 year shorter life expectancy[4]
- air pollution promotes lung cancer[32]
- particulate matter increases risk of lung cancer
- association strongest for lung adenocarcinoma[2]
- also increased risk of bladder cancer[5]
- a leading environmental cause of cancer death, especially in countries undergoing rapid industrialization[5]
- with shifting tobacco policies & escalating air pollution levels, risk factors for lung Cancer have changed[41]
- particulate matter associated lung cancer has increased 25% from 1990-2019
- increased risk for adverse respiratory outcomes in smokers[12]
air pollution increases risk of neuropsychiatric disorders
- outdoor air pollution is associated poorer cognitive function, especially semantic fluency & executive function with exposure to black carbon & NO2[29]
- exposure to PM2.5 mainly affects semantic fluency[29]
- air pollution affects cognition via inflammation & oxidative stress[31]
- increased exposure to ambient fine particulate matter (PM2.5) is associated with lower brain white matter volume in older women[9]
- no change in brain gray matter or hippocampal volume
- air pollution associated with increased risk of amyloid plaques in brain[16]
- elevated long-term exposure to fine particulate matter is associated with an increased risk of dementia[18][19][35]
- association of PM2.5 with dementia not mediated or modified by hypertension or stroke[34]
- higher residential PM2.5 levels, especially from wildfires & agriculture, are associated with increased risk of dementia[35]
- increased exposure to air pollution including air particulate matter may increase risk of anxiety & depression (noise pollution may contribute)[8][25]
- long-term exposure to air pollution is associated with increased risk of depression in the elderly[28]
- highest quartile of PM2.5 exposure associated with increased risk of Parkinson's disease[27]
- higher levels of PM2.5 & NO2 exposure are associated with increased risk of Parkinson's disease[37]
- higher levels of PM2.5 exposure are associated with increased risk of akinetic rigid Parkinson's disease & dyskinesia vs exposure to lower levels[37]
air pollution associated with other disorders
- air pollution increases risk of osteoporosis[20]
- air pollution increases risk of rheumatoid arthritis flares[21]
- air pollution increases risk of psoriasis flares[22]
- air pollution, especially particulate matter 2.5 & nitrates, associated with stroke incidence & severity, headaches, risk of dementia, Parkinson's disease, & exacerbation of multiple sclerosis[23]
- 6-8 weeks in Beijing during summer resulted in a 50% increase in plasma fibrinogen & 2-fold increase in serum CRP in healthy Los Angeles residents[13]
- among Chinese[14]
- cardiovascular disease, increase of 0.26%
- ischemic heart disease, increase of 0.31%
- heart failure, increase of 0.27%
- arrhythmia, increase of 0.29%
- ischemic stroke, increase of 0.29%[14]
- long-term exposure to air pollution impedes cognitive performance in verbal & math tests
- effect of air pollution on verbal tests becomes more pronounced as people age, especially for men & the less educated.
- long-term exposure to air pollutants (PM2.5, PM10, NO2, & NOx) may increase the risk of developing systemic lupus erythematosus (RR=1.1-1.3)[36]
Complications
- disease interaction(s) of air pollution with depression
- disease interaction(s) of air pollution with anxiety
Management
- check air quality index[36]
- air quality improvement is associated with better development of pulmonary function between ages 11-15 years[7]
- improved air quality associated with lower risk of dementia & slower cognitive decline in women[17]
- omega-3 fatty acids may protect brain from air pollution[15]
- avoid vigorous physical activity in high particulate matter air pollution
- vigorous physical activity in air pollution with high particulate matter < 10 um in diameter is associated with increased mortality in elderly[33]
- moderate physical activity may still be beneficial[33]
More specific terms
Additional terms
References
- ↑ Jump up to: 1.0 1.1 Ensor KB et al. A case-crossover analysis of out-of-hospital cardiac arrest and air pollution. Circulation 2013 Mar 19; 127:1192. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23406673
- ↑ Jump up to: 2.0 2.1 Raaschou-Nielsen O et al Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). The Lancet Oncology, Early Online Publication, 10 July 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23849838 <Internet> http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(13)70279-1/abstract
- ↑ Jump up to: 3.0 3.1 Shah AS et al Global association of air pollution and heart failure: a systematic review and meta-analysis. The Lancet, Early Online Publication, 10 July 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23849322 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60898-3/abstract
- ↑ Jump up to: 4.0 4.1 Chen Y, Ebenstein A, Greenstone M and Li H Evidence on the impact of sustained exposure to air pollution on life expectancy from China's Huai River Policy PNAS July 8, 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23836630 <Internet> http://www.pnas.org/content/early/2013/07/03/1300018110.full.pdf+html
- ↑ Jump up to: 5.0 5.1 5.2 IARC: Outdoor air pollution a leading environmental cause of cancer deaths. International Agency for Research on Cancer World Health Organization http://www.iarc.fr/en/media-centre/iarcnews/pdf/pr221_E.pdf
- ↑ Jump up to: 6.0 6.1 WHO News Release. March 25, 2014 7 million premature deaths annually linked to air pollution. http://www.who.int/mediacentre/news/releases/2014/air-pollution/en/
- ↑ Jump up to: 7.0 7.1 Gauderman WJ et al. Association of improved air quality with lung development in children. N Engl J Med 2015 Mar 5; 372:905 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25738666 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1414123
- ↑ Jump up to: 8.0 8.1 8.2 Shah ASV et al Short term exposure to air pollution and stroke: systematic review and meta-analysis. BMJ 2015;350:h1295 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25810496 <Internet> http://www.bmj.com/content/350/bmj.h1295
Power MC et al The relation between past exposure to fine particulate air pollution and prevalent anxiety: observational cohort study. BMJ 2015;350:h1111 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25810495 <Internet> http://www.bmj.com/content/350/bmj.h1111 - ↑ Jump up to: 9.0 9.1 Chen JC, Wang X, Wellenius GA et al Ambient air pollution and neurotoxicity on brain structure: Evidence from Women's Health Initiative Memory Study. Ann Neurol 2015 Jun 15 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26075655 <Internet> http://onlinelibrary.wiley.com/doi/10.1002/ana.24460/abstract
- ↑ Jump up to: 10.0 10.1 Di Q, Dai L, Wang Yet al Association of Short-term Exposure to Air Pollution With Mortality in Older Adults. JAMA. 2017;318(24):2446-2456 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29279932 https://jamanetwork.com/journals/jama/article-abstract/2667069
- ↑ Jump up to: 11.0 11.1 Boyles S. Air Pollution at Legal Levels Kills Thousands: Study Current air quality standards may be lacking, EPA-funded research suggests. MedPage Today. July 23, 2019 https://www.medpagetoday.com/publichealthpolicy/environmentalhealth/81179
Bennett JE, Tamura-Wicks H, Parks RM et al Particulate matter air pollution and national and county life expectancy loss in the USA: a spatiotemporal analysis. PLOS Med 2019; 16(7): e1002856. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31335874 Free PMC Article https://doi.org/10.1371/journal.pmed.1002856 - ↑ Jump up to: 12.0 12.1 Paulin LM, Gassett AJ, Alexis NE et al Association of Long-term Ambient Ozone Exposure With Respiratory Morbidity in Smokers. JAMA Intern Med. Published online December 9, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31816012 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2757312
Limaye VS, Knowlton K. Shining New Light on Long-term Ozone Harms. JAMA Intern Med. Published online December 9, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31816008 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2757308 - ↑ Jump up to: 13.0 13.1 Joseph S Brief Visit to Severely Polluted City Can Up Biomarkers of Heart Disease. Medscape - Dec 09, 2019. https://www.medscape.com/viewarticle/922337
- ↑ Jump up to: 14.0 14.1 14.2 Tian Y et al. Association between ambient fine particulate pollution and hospital admissions for cause specific cardiovascular disease: Time series study in 184 major Chinese cities. BMJ 2019 Dec 30; 367:l6572. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31888884
- ↑ Jump up to: 15.0 15.1 George J Omega-3s May Protect Brain From Air Pollution - Women in polluted areas with highest omega-3 levels had less brain shrinkage. MedPage Today July 16, 2020 https://www.medpagetoday.com/neurology/generalneurology/87598
Chen C, Xun P, Kaufman JD et al Erythrocyte omega-3 index, ambient fine particle exposure and brain aging. Neurology 2020 July 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32669395 https://n.neurology.org/content/early/2020/07/15/WNL.0000000000010074 - ↑ Jump up to: 16.0 16.1 Iaccarino L, La Joie R, Lesman-Segev OH et al Association Between Ambient Air Pollution and Amyloid Positron Emission Tomography Positivity in Older Adults With Cognitive Impairment. JAMA Neurol. Published online November 30, 2020. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33252608 https://jamanetwork.com/journals/jamaneurology/article-abstract/2773645
- ↑ Jump up to: 17.0 17.1 George J Better Air, Better Brains. Reducing air pollution tied to lower dementia risk, slower cognitive decline. MedPage Today July 26, 2021 https://www.medpagetoday.com/meetingcoverage/aaic/93755
Anderson P Reducing Air Pollution Linked to Slowed Brain Aging, Lower Dementia Risk. Medscape. July 26, 2021 https://www.medscape.com/viewarticle/955363
Younan D et al Association of air quality improvement with slower decline of cognitive function in older women. Alzheimer's Association International Conference (AAIC) 2021; Abstract 56162
Wang X et al Association of lower dementia risk with improved air quality in older women. Alzheimer's Association International Conference (AAIC) 2021; Abstract 56626
Alzheimer's Association International Conference (AAIC) 2021: Abstracts 56162, 56585. Presented July 26, 2021 - ↑ Jump up to: 18.0 18.1 Shaffer RM, Blanco MN, Li G et al Fine Particulate Matter and Dementia Incidence in the Adult Changes in Thought Study. Environmental Health Perspectives. 2021 129(8): August 4. https://ehp.niehs.nih.gov/doi/10.1289/EHP9018
Ritz B, Yu Y Invited Perspective: Air Pollution and Dementia: Challenges and Opportunities. Environmental Health Perspectives. 2021 129(8): August 4. https://ehp.niehs.nih.gov/doi/10.1289/EHP9605 - ↑ Jump up to: 19.0 19.1 Sullivan KJ, Ran X, Wu F et al Ambient fine particulate matter exposure and incident mild cognitive impairment and dementia. J Am Geriatr Soc 2021 69(8):2185-2194 August 2021. ePub April 26 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33904156 PMCID: PMC8373708 (available on 2022-08-01) https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.17188
- ↑ Jump up to: 20.0 20.1 Evans J Osteoporosis Risk Rises With Air Pollution Levels. Medscape. June 21, 2022 https://www.medscape.com/viewarticle/975959
- ↑ Jump up to: 21.0 21.1 Bosworth T Novel Study Links Air Pollution to Increased Risk for RA Flares. Medscape. June 9, 2022 https://www.medscape.com/viewarticle/952763
- ↑ Jump up to: 22.0 22.1 Melville NA Study Links Air Pollution to Psoriasis Flares Medscape. Feb 24, 2022 https://www.medscape.com/viewarticle/969146
Bellinato F, Adami G, Vaienti S et al Association Between Short-term Exposure to Environmental Air Pollution and Psoriasis Flare. JAMA Dermatol. 2022;158(4):375-381. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35171203 PMCID: PMC8851365 (available on 2023-02-16) https://jamanetwork.com/journals/jamadermatology/article-abstract/2788833 - ↑ Jump up to: 23.0 23.1 23.2 Louis S, Carlson AK, Suresh A et al Impacts of Climate Change and Air Pollution on Neurologic Health, Disease, and Practice: A Scoping Review. Neurology. 2022. Nov 16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36384657 https://n.neurology.org/content/early/2022/11/16/WNL.0000000000201630
- ↑ Jump up to: 24.0 24.1 Kinney PL, Pinkerton KE Heatwaves and Air Pollution: a Deadly Combination. Am J Respir Crit Care Med. 2022 Nov 1;206(9):1060-1062 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35877995 PMCID: PMC9704824 Free PMC article. No abstract available.
Rahman MM, McConnell R, Schlaerth H et al The Effects of Coexposure to Extremes of Heat and Particulate Air Pollution on Mortality in California: Implications for Climate Change. Am J Respir Crit Care Med. 2022 Nov 1;206(9):1117-1127. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35727303 PMCID: PMC9704834 Free PMC article. - ↑ Jump up to: 25.0 25.1 Yang T, Wang J, Huang J et al Long-term Exposure to Multiple Ambient Air Pollutants and Association With Incident Depression and Anxiety. JAMA Psychiatry. Published online February 1, 2023 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36723924 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2801116
- ↑ Jump up to: 26.0 26.1 Alexeeff SE, Deosaransingh K, Van Den Eeden S et al Association of Long-term Exposure to Particulate Air Pollution With Cardiovascular Events in California. JAMA Netw Open. 2023;6(2):e230561. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36826819 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801820
- ↑ Jump up to: 27.0 27.1 George J Nationwide Study Links Parkinson's Disease to Air Pollution. Researchers identify a hot spot in the Mississippi-Ohio River Valley. MedPage Today February 23, 2023 https://www.medpagetoday.com/meetingcoverage/aan/103245
- ↑ Jump up to: 28.0 28.1 Qiu X, Shi L, Kubzansky LD et al Association of Long-term Exposure to Air Pollution With Late-Life Depression in Older Adults in the US. JAMA Netw Open. 2023;6(2):e2253668 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36763364 PMCID: PMC9918878 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801241
- ↑ Jump up to: 29.0 29.1 29.2 Zare Sakhvidi MJ, Yang J, Lequy E et al Outdoor air pollution exposure and cognitive performance: findings from the enrolment phase of the CONSTANCES cohort. Lancet Planet Health. 2022 Mar;6(3):e219-e229 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35278388 Free article.
- ↑ Zhang X, Chen X, Zhang X. The impact of exposure to air pollution on cognitive performance. Proc Natl Acad Sci U S A. 2018 Sep 11;115(37):9193-9197 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30150383 PMCID: PMC6140474 Free PMC article
Chen X. Smog, cognition and real-world decision-making. Int J Health Policy Manag. 2019 Feb 1;8(2):76-80 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30980620 PMCID: PMC6462201 Free PMC article - ↑ Jump up to: 31.0 31.1 Hahad O, Lelieveld J, Birklein F, Lieb K, Daiber A, Munzel T. Ambient Air Pollution Increases the Risk of Cerebrovascular and Neuropsychiatric Disorders through Induction of Inflammation and Oxidative Stress. Int J Mol Sci. 2020 Jun 17;21(12):4306. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32560306 PMCID: PMC7352229 Free PMC article
- ↑ Jump up to: 32.0 32.1 Harris E Research Shows Air Pollution Promotes Lung Cancer. JAMA. 2023;329(18):1543. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37075236 https://jamanetwork.com/journals/jama/fullarticle/2804240
- ↑ Jump up to: 33.0 33.1 33.2 Park H, Yang PS, Sung JH et al Association Between the Combined Effects of Physical Activity Intensity and Particulate Matter and All-Cause Mortality in Older Adults. Mayo Clinic Proceedings. 2023. 98(8):_1153-1163. July 7. https://www.mayoclinicproceedings.org/article/S0025-6196(23)00191-X/fulltext
- ↑ Jump up to: 34.0 34.1 Zhang B, Langa KM, Weuve J et al Hypertension and Stroke as Mediators of Air Pollution Exposure and Incident Dementia. JAMA Netw Open. 2023;6(9):e2333470 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37728927 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809726
- ↑ Jump up to: 35.0 35.1 35.2 Zhang B, Weuve J, Langa KM et al Comparison of Particulate Air Pollution From Different Emission Sources and Incident Dementia in the US. JAMA Intern Med. 2023;183(10):1080-1089 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37578757 PMCID: PMC10425875 (available on 2024-08-14) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2808088
- ↑ Jump up to: 36.0 36.1 36.2 Xing M, Ma Y, Cui F et al Air Pollution, Genetic Susceptibility, and Risk of Incident Systemic Lupus Erythematosus: A Prospective Cohort Study. Arthritis Rheumatol. 2024 Jul 10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38982844 https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.42929
- ↑ Jump up to: 37.0 37.1 37.2 Krzyzanowski B, Mullan AF, Turcano P et al Air Pollution and Parkinson Disease in a Population-Based Study. JAMA Netw Open. 2024 Sep 3;7(9):e2433602. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39283636 PMCID: PMC11406396 Free PMC article. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823518
- ↑ Lou N ASCVD Mortality Linked to Specific Air Pollution Sources. Pollution-mortality relationship evidenced at the level of PM2.5 source type. MedPage Today November 27, 2024 https://www.medpagetoday.com/publichealthpolicy/environmentalhealth/113154
Ma T, Knobel P, Hadley M et al Source-Specific PM2.5 and Atherosclerotic Cardiovascular Disease Mortality. NEJM Evid. 2024 Dec;3(12):EVIDoa2400182. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39589192 https://evidence.nejm.org/doi/full/10.1056/EVIDoa2400182 - ↑ Drew L Air pollution and brain damage: what the science says. Epidemiological studies have linked dirty air to dementia and other brain disorders. Now researchers are trying to determine how pollutants do their damage, and how much harm they cause. Nature News. Jan 14, 2025 https://www.nature.com/articles/d41586-025-00053-y
- ↑ Drew L. Air pollution and brain damage: what the science says. Nature. 2025 Jan;637(8046):536-538. doi:http://dx.doi.org/ 10.1038/d41586-025-00053-y. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39809913
- ↑ Jump up to: 41.0 41.1 Jani CT et al Evolving trends in lung cancer risk factors in the ten most populous countries: an analysis of data from the 2019 Global Burden of Disease Study. eClinicalMedicine. 2025 79:103033 Jan https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00612-6/fulltext Not yet indexed in PubMed
- ↑ Air Quality Index (AQI) Basics https://www.airnow.gov/aqi/aqi-basics/
- ↑ National Institute of Environmental Health Sciences Air Pollution and Your Health https://www.niehs.nih.gov/health/topics/agents/air-pollution/