Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis

Background The association between long-term ambient air pollution and adult lung function has been inconsistently reported. This systematic review and meta-analysis aimed to quantify the impact of long-term (≥1 year) ambient air pollution on adult lung function. Methods Original articles published...

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Main Authors: Albina Gross, Rachel Tham, Shyamali C. Dharmage, Martin Röösli, Urs Frey, Olga Gorlanova
Format: Article
Language:English
Published: European Respiratory Society 2025-06-01
Series:European Respiratory Review
Online Access:http://err.ersjournals.com/content/34/176/240264.full
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author Albina Gross
Rachel Tham
Shyamali C. Dharmage
Martin Röösli
Urs Frey
Olga Gorlanova
author_facet Albina Gross
Rachel Tham
Shyamali C. Dharmage
Martin Röösli
Urs Frey
Olga Gorlanova
author_sort Albina Gross
collection DOAJ
description Background The association between long-term ambient air pollution and adult lung function has been inconsistently reported. This systematic review and meta-analysis aimed to quantify the impact of long-term (≥1 year) ambient air pollution on adult lung function. Methods Original articles published between 1 January 2006 and 26 July 2024 were searched in PubMed, Embase and Web of Science. Random-effects models were used to assess the strength of associations of gaseous (nitrogen dioxide and ozone) and particulate matter (PM) pollutants with diameters ≤2.5 and 10 µg, with lung function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio). Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) approach. Results Of 25 064 potential papers, 27 were included, of which 12 were meta-analysed. There was low-certainty evidence that a 10 µg·m−3 increase in long-term NO2 exposure was associated with lower FEV1 (−15.6 mL, 95% CI −25.0– −6.2; I2=86%; p<0.01) and high-certainty evidence for FVC (−25.3 mL, 95% CI −36.7– −14.0; I2=70%, p<0.01). Similar associations were observed for PM2.5, while long-term exposure to O3 and PM10 were associated with lower FEV1 with high- and moderate-certainty evidence, respectively. Exposure to O3 was associated with lower FEV1/FVC (high-certainty evidence). Interpretation Long-term exposure to ambient air pollution adversely impacts adult lung function. This emphasises the importance of ongoing commitments to mitigating air pollution levels to preserve optimum lung health and prevent premature lung function decline that can lead to earlier and avoidable respiratory diseases.
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spelling doaj-art-c697a81b75ce490dac4ee50cc43bd8ed2025-08-20T03:14:49ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172025-06-013417610.1183/16000617.0264-20240264-2024Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysisAlbina Gross0Rachel Tham1Shyamali C. Dharmage2Martin Röösli3Urs Frey4Olga Gorlanova5 University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health and Department of Medicine, The University of Melbourne, Melbourne, Australia Allergy and Lung Health Unit, Centre of Epidemiology and Biostatistics, Melbourne School of Population and Global Health and Department of Medicine, The University of Melbourne, Melbourne, Australia Swiss Tropical and Public Health Institute Basel, Allschwil, Switzerland University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland University Children's Hospital Basel UKBB, University of Basel, Basel, Switzerland Background The association between long-term ambient air pollution and adult lung function has been inconsistently reported. This systematic review and meta-analysis aimed to quantify the impact of long-term (≥1 year) ambient air pollution on adult lung function. Methods Original articles published between 1 January 2006 and 26 July 2024 were searched in PubMed, Embase and Web of Science. Random-effects models were used to assess the strength of associations of gaseous (nitrogen dioxide and ozone) and particulate matter (PM) pollutants with diameters ≤2.5 and 10 µg, with lung function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio). Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) approach. Results Of 25 064 potential papers, 27 were included, of which 12 were meta-analysed. There was low-certainty evidence that a 10 µg·m−3 increase in long-term NO2 exposure was associated with lower FEV1 (−15.6 mL, 95% CI −25.0– −6.2; I2=86%; p<0.01) and high-certainty evidence for FVC (−25.3 mL, 95% CI −36.7– −14.0; I2=70%, p<0.01). Similar associations were observed for PM2.5, while long-term exposure to O3 and PM10 were associated with lower FEV1 with high- and moderate-certainty evidence, respectively. Exposure to O3 was associated with lower FEV1/FVC (high-certainty evidence). Interpretation Long-term exposure to ambient air pollution adversely impacts adult lung function. This emphasises the importance of ongoing commitments to mitigating air pollution levels to preserve optimum lung health and prevent premature lung function decline that can lead to earlier and avoidable respiratory diseases.http://err.ersjournals.com/content/34/176/240264.full
spellingShingle Albina Gross
Rachel Tham
Shyamali C. Dharmage
Martin Röösli
Urs Frey
Olga Gorlanova
Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis
European Respiratory Review
title Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis
title_full Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis
title_fullStr Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis
title_full_unstemmed Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis
title_short Exposure to long-term ambient air pollution and lung function in adults: a systematic review and meta-analysis
title_sort exposure to long term ambient air pollution and lung function in adults a systematic review and meta analysis
url http://err.ersjournals.com/content/34/176/240264.full
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