Abstract
Air-pollution and weather exposure beyond certain thresholds have serious effects on public health. Yet, there is lack of information on wider aspects including the role of some effect modifiers and the interaction between air-pollution and weather. This article aims at a comprehensive review and narrative summary of literature on the association of air-pollution and weather with mortality and hospital admissions; and to highlight literature gaps that require further research. We conducted a scoping literature review. The search on two databases (PubMed and Web-of-Science) from 2012 to 2020 using three conceptual categories of "environmental factors", "health outcomes", and "Geographical region" revealed a total of 951 records. The narrative synthesis included all original studies with time-series, cohort, or case cross-over design; with ambient air-pollution and/or weather exposure; and mortality and/or hospital admission outcomes. The final review included 112 articles from which 70 involved mortality, 30 hospital admission, and 12 studies included both outcomes. Air-pollution was shown to act consistently as risk factor for all-causes, cardiovascular, respiratory, cerebrovascular and cancer mortality and hospital admissions. Hot and cold temperature was a risk factor for wide range of cardiovascular, respiratory, and psychiatric illness; yet, in few studies, the increase in temperature reduced the risk of hospital admissions for pulmonary embolism, angina pectoris, chest, and ischemic heart diseases. The role of effect modification in the included studies was investigated in terms of gender, age, and season but not in terms of ethnicity. Air-pollution and weather exposure beyond certain thresholds affect human health negatively. Effect modification of important socio-demographics such as ethnicity and the interaction between air-pollution and weather is often missed in the literature. Our findings highlight the need of further research in the area of health behaviour and mortality in relation to air-pollution and weather, to guide effective environmental health precautionary measures planning.
Highlights
Air-pollution and weather exposure beyond region-specific thresholds have serious effects on the public health [1, 2]
Hot and cold temperature was a risk factor for wide range of cardiovascular, respiratory, and psychiatric illness; yet, in few studies, the increase in temperature reduced the risk of hospital admissions for pulmonary embolism, angina pectoris, chest, and ischemic heart diseases
Ambient air-pollution consists of a range of pollutants including particulate matters with diameters of less than 10 μm (PM10) and less than 2.5 μm (PM2.5), nitrogen oxides (NOx) including nitrogen dioxide (NO2), Sulphur dioxide (SO2), Carbon monoxide (CO), and Ozone (O3) that have been associated with a range of different acute and chronic health conditions [5, 6]
Summary
Air-pollution and weather exposure beyond region-specific thresholds have serious effects on the public health [1, 2]. Population growth, increased urbanization, economic and industrial growth, intense energy consumption, high usage of transportation vehicles, improved living standards, and changing lifestyles and consumption patterns for at least the last 100 years have resulted in increased emissions of air pollutants including greenhouse gases; and fluctuations in ambient temperature and other weather variables [3, 4]. Research has shown that hospital admissions and mortality increase when weather exposure exceed certain thresholds with lags up to 20 days [11,12,13,14]. Air-pollution and weather exposure beyond certain thresholds have serious effects on public health. This article aims at a comprehensive review and narrative summary of literature on the association of air-pollution and weather with mortality and hospital admissions; and to highlight literature gaps that require further research
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