Prenatal exposure to ambient air pollution and subsequent risk of lower respiratory tract infections in childhood and adolescence: A systematic review

IF 4.5 2区医学 Q1 INFECTIOUS DISEASES

International journal of hygiene and environmental health Pub Date : 2024-10-05 DOI:10.1016/j.ijheh.2024.114473

Maxine Pepper , Poliana Rebouças , Ila R. Falcão , Nuria Sanchez Clemente , Rachel Lowe , Rochelle Schneider , Julia M. Pescarini , Gervásio F. dos Santos , Roberto FS. Andrade , Taísa R. Cortes , Otavio T. Ranzani , Elizabeth B. Brickley , Mauricio L. Barreto , Enny S. Paixao

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引用次数: 0

Abstract

Background

Pregnancy represents a critical window of vulnerability to the harmful effects of air pollution on health. However, long-term consequences such as risk of having lower respiratory tract infections (LRTIs) are less explored. This systematic review aims to synthesize previous research on prenatal exposure to ambient (outdoor) air pollution and LRTIs in childhood and adolescence.

Methods

We systematically searched Embase, MEDLINE, Web of Science Core Collection, CINAHL, and Global Health up to May 17, 2024. We included peer-reviewed publications of studies which investigated the association between prenatal exposure to ambient air pollution and LRTIs up to the age of 19. We excluded conference abstracts, study protocols, review articles, and grey literature. Screening and data extraction was conducted by two reviewers independently. We used the Office of Health Assessment and Translation tool to assess risk of bias and conducted a narrative synthesis.

Results

The search yielded 6056 records, of which 16 publications describing 12 research studies were eligible for the synthesis. All studies were conducted in high- or upper-middle-income countries in Europe or Asia. Half (6) of the studies focused on LRTIs occurring within the first three years of life, and the others also included LRTIs in older children (up to age 14). Air pollutants investigated included nitrogen dioxide, sulphur dioxide, particulate matter (PM_2.5: diameter ≤2.5 μm and PM₁₀: diameter ≤10 μm), carbon monoxide, ozone, and benzene. Findings on a potential association between prenatal ambient air pollution exposure and LRTIs were inconclusive, without a clear and consistent direction. There was some suggestion of a positive association with prenatal PM_2.5 exposure. The small number of studies identified, their poor geographical representation, and their methodological limitations including concerns for risk of bias preclude more definitive conclusions.

Conclusion

The available published evidence is insufficient to establish whether prenatal exposure to ambient air pollution increases risk of LRTIs in children and adolescents. With many populations exposed to high levels of air pollution, there is an urgent need for research in more diverse settings, more transparent reporting of methods, and exploring how, when, and for whom prenatal exposure to ambient air pollution leads to the greatest health risks.

PROSPERO registration number

CRD42023407689.

查看原文本刊更多论文

产前暴露于环境空气污染与儿童和青少年随后的下呼吸道感染风险：系统综述。

背景：妊娠期是易受空气污染有害健康影响的关键时期。然而，人们对空气污染的长期影响（如患下呼吸道感染（LRTIs）的风险）的研究较少。本系统性综述旨在综合以往关于产前暴露于环境（室外）空气污染与儿童和青少年时期下呼吸道感染的研究：我们系统地检索了截至 2024 年 5 月 17 日的 Embase、MEDLINE、Web of Science Core Collection、CINAHL 和 Global Health。我们纳入了调查产前暴露于环境空气污染与 19 岁以下儿童 LRTIs 之间关系的同行评审研究出版物。我们排除了会议摘要、研究方案、综述文章和灰色文献。筛选和数据提取由两名审稿人独立完成。我们使用了健康评估与转化办公室的工具来评估偏倚风险，并进行了叙述性综合：搜索共获得 6056 条记录，其中有 16 篇描述 12 项研究的出版物符合合成条件。所有研究均在欧洲或亚洲的高收入或中上收入国家进行。半数（6 项）研究关注的是出生后三年内发生的 LRTI，其他研究也包括年龄较大儿童（14 岁以下）的 LRTI。调查的空气污染物包括二氧化氮、二氧化硫、颗粒物（PM2.5：直径≤2.5 μm，PM10：直径≤10 μm）、一氧化碳、臭氧和苯。关于产前环境空气污染暴露与 LRTIs 之间的潜在联系的研究结果尚无定论，没有明确一致的方向。有迹象表明，产前 PM2.5 暴露与 LRTIs 呈正相关。所发现的研究数量少、地域代表性差、研究方法存在局限性（包括存在偏倚风险），因此无法得出更明确的结论：现有已发表的证据不足以确定产前暴露于环境空气污染是否会增加儿童和青少年患 LRTIs 的风险。由于许多人群暴露于高浓度的空气污染中，因此迫切需要在更多样化的环境中开展研究、更透明地报告研究方法，并探索产前暴露于环境空气污染会如何、何时以及对哪些人造成最大的健康风险：CRD42023407689。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of hygiene and environmental health 医学-传染病学

CiteScore

11.50

自引率

5.00%

发文量

151

审稿时长

22 days

期刊介绍： The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.