Abstract
Asthma is a chronic respiratory disease characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Evidence suggests that air pollution has a negative impact on asthma outcomes in both adult and pediatric populations. The aim of this review is to summarize the current knowledge on the effect of various outdoor and indoor pollutants on asthma outcomes, their burden on its management, as well as to highlight the measures that could result in improved asthma outcomes. Traffic-related air pollution, nitrogen dioxide and second-hand smoking (SHS) exposures represent significant risk factors for asthma development in children. Nevertheless, a causal relation between air pollution and development of adult asthma is not clearly established. Exposure to outdoor pollutants can induce asthma symptoms, exacerbations and decreases in lung function. Active tobacco smoking is associated with poorer asthma control, while exposure to SHS increases the risk of asthma exacerbations, respiratory symptoms and healthcare utilization. Other indoor pollutants such as heating sources and molds can also negatively impact the course of asthma. Global measures, that aim to reduce exposure to air pollutants, are highly needed in order to improve the outcomes and management of adult and pediatric asthma in addition to the existing guidelines.
Highlights
Air pollution can be defined as the presence in the air of substances harmful to humans and is associated with a high risk for premature deaths due to cardio-vascular diseases, chronic obstructive pulmonary disease, asthma, lower respiratory infections and lung cancer [1,2]
The aim of this review is to summarize the recent data about the effects of various outdoor and indoor pollutants on asthma development, symptoms, exacerbations/hospitalisations, severity, lung function and medication use, as well as to highlight the possible measures that could reduce their impact on asthma outcomes
If the use of air cleaners, low-polluting sources for cooking and heating, or personal devices to monitor indoor air pollution are less accessible for people who live in developing countries, government measures promoting health, such as smoking cessation programs and avoidance of second-hand smoking (SHS), education of people to improve household ventilation by opening windows or doors and mold removal, are cost-effective methods that could reduce the negative impact of indoor air pollution on asthma, and are feasible worldwide, independent of socioeconomic status
Summary
Air pollution can be defined as the presence in the air of substances harmful to humans and is associated with a high risk for premature deaths due to cardio-vascular diseases (e.g., ischaemic heart disease and strokes), chronic obstructive pulmonary disease, asthma, lower respiratory infections and lung cancer [1,2]. The aim of this review is to summarize the recent data about the effects of various outdoor and indoor pollutants on asthma development, symptoms, exacerbations/hospitalisations, severity, lung function and medication use, as well as to highlight the possible measures that could reduce their impact on asthma outcomes. A better knowledge of the negative impact of air pollution on asthma outcomes could help physicians (e.g., general practitioners, pulmonologists, allergologists, pediatrics, gynecologists, and emergency doctors) to improve their daily practice by adding in the interrogatory specific questions on a possible recent exposure worsening the respiratory symptoms, to educate the patients about how they could minimise the exposure and manage their asthma by an action plan. The global awareness of air pollution effects on asthma should stimulate public health authorities and governments to take more efficient measures to limit the exposure to air pollutants.
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