Pulmonary Health Effects of Indoor Volatile Organic Compounds-A Meta-Analysis.

Kyle L Alford,Naresh Kumar

doi:10.3390/ijerph18041578

Abstract

Volatile organic compounds (VOCs) are commonly found in consumer products, including furniture, sealants and paints. Thus, indoor VOCs have become a public health concern, especially in high-income countries (HICs), where people spend most of their time indoors, and indoor and outdoor air exchange is minimal due to a lack of ventilation. VOCs produce high levels of reaction with the airway epithelium and mucosa membrane and is linked with pulmonary diseases. This paper takes a stock of the literature to assess the strength of association (measured by effect size) between VOCs and pulmonary diseases with the focus on asthma and its related symptoms by conducting a meta-analysis. The literature was searched using the PubMed database. A total of 49 studies that measured VOCs or VOC types and pulmonary health outcomes were included in the analysis. The results of these studies were tabulated, and standard effect size of each study was computed. Most studies were conducted in high-income countries, including France (n = 7), Japan (n = 7) and the United States (n = 6). Our analysis suggests that VOCs have a medium-sized effect on pulmonary diseases, including the onset of asthma (effect size (or Cohen’s d) ~0.37; 95% confidence interval (CI) = 0.25–0.49; n = 23) and wheezing (effective size ~0.26; 95% CI = 0.10–0.42; n = 10). The effect size also varied by country, age and disease type. Multiple stakeholders must be engaged in strategies to mitigate and manage VOC exposure and its associated pulmonary disease burden.

Highlights

Chronic pulmonary diseases, including the onset and persistence of asthma and chronic obstructive pulmonary diseases (COPD), and their associated morbidity and healthcare costs are on the rise
We used the following criteria to select studies that were included in the meta-analysis: studies which investigated the role of airborne exposure to Volatile organic compounds (VOCs) in indoor environments in asthma morbidity and/or related pulmonary diseases; studies that included empirical data and results in the form of coefficients, including odds ratios, relative risk and correlation
(87.7%) of the 49 studies were epidemiological, and the remaining 12 were clinical and cross-sectional studies. 15 studies included smokers, and the average number of smokers in these studies was 16.3%. 46 of 49 studies reported odds ratios (OR), and three of them reported a coefficient of correlations between VOC and pulmonary diseases. 42 of the studies provided sample composition by gender and 49.3% of the sample represented male population (95% confidence interval (CI) 44.8% to 53.9%)

Summary

Introduction

Chronic pulmonary diseases, including the onset and persistence of asthma and chronic obstructive pulmonary diseases (COPD), and their associated morbidity and healthcare costs are on the rise. These diseases are associated with reduced productivity and mortality worldwide [1]. In 2019 alone, 339 million new cases of asthma were reported worldwide, of which 417,918 resulted in death [1]. Common symptoms associated with asthma are coughing (with or without phlegm), bronchial inflammation and shortness of breath, and the symptom severity varies from person to person [2].

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Conclusion