Air Pollution Exposure Research Articles

Abstract 4124226: Long-term exposure to air pollutants and incidence of cardiovascular disease events and mortality in The Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air)

Introduction: Exposure to ambient air pollution may increase the risk of cardiovascular disease events and mortality, but prior publications have primarily included administrative cohorts with outcomes that have not been individually reviewed and with air pollution estimates created without cohort-specific exposure monitoring. Multi-Ethnic Study of Atherosclerosis (MESA) is a multi-site cohort study designed specifically to prospectively collect and adjudicate cardiovascular disease (CVD) events. MESA Air recruited additional participants into sub-cohorts for enhanced air pollution variation and sample size. Research Question: The aim of this analysis was to characterize the relationship between long-term exposure to nitrogen dioxide (NO 2 ) and fine particulate matter (PM 2.5 ) and all-cause mortality and CVD events. Methods: Air pollution exposure was assessed using address history with a purpose-built exposure model incorporating cohort-specific monitoring including measurement and validation at participant homes. We used Cox models to assess the risk of rolling 2-year average exposures on all cause-mortality and on a composite CVD endpoint (definite angina, probable angina with revascularization, myocardial infarction, atherosclerosis or other CVD death, resuscitated cardiac arrest, and stroke). Models were stratified for baseline hazard by age, sub-cohort, and recruitment year and were additionally adjusted for age, sex, race/ethnicity, field center, smoking/second-hand smoke, pack-years, physical activity, education, income, neighborhood socioeconomic status, and statin use. Results: MESA Air participants were aged 44-87 years at enrollment between 2000 and 2007; follow-up averaged 14 years. 6,915 participants had follow-up for events, NO 2 exposure, and covariate information. We observed 1,442 deaths and 985 CVD events. The interquartile range over all 2-year averages was 10.5-23.1 ppb for NO 2 and 10.1-14.9 µ/m 3 for PM 2.5 . The adjusted hazard ratio (aHR) for a 10 ppb increment in NO 2 was 1.38 (95% CI: 1.17, 1.64) for all-cause mortality and 1.16 (95% CI: 0.95, 1.42) for incident CVD events. The aHR for a 5 µg/m 3 increment in PM 2.5 was 1.20 (95% CI: 0.99, 1.46) for all-cause mortality and 1.15 (95% CI: 0.95, 1.39) for incident CVD events Conclusions: These results add to growing literature demonstrating an association between air pollution exposure, mortality, and CVD in a cohort with well-characterized clinical endpoints and cohort-specific exposure assessment.

Air pollution exposure and head and neck cancer incidence

Air pollution exposure and head and neck cancer incidence

The Impact of NO2 on Epithelial Barrier Integrity of a Primary Cell‐Based Air–Liquid Interface Model of the Nasal Respiratory Epithelium

ABSTRACTNitrogen dioxide (NO2) is a pervasive gaseous air pollutant with well‐documented hazardous effects on health, necessitating precise toxicological characterization. While prior research has primarily focused on lower airway structures, the upper airways, serving as the first line of defense against airborne substances, remain understudied. This study aimed to investigate the functional effects of NO2 exposure alone or in combination with hypoxia as a secondary stimulus on nasal epithelium and elucidate its molecular mechanisms because hypoxia is considered a pathophysiological factor in the onset and persistence of chronic rhinosinusitis, a disease of the upper airways. Air–liquid interface cell cultures derived from primary nasal mucosa cells were utilized as an in vitro model, offering a high in vitro–in vivo correlation. Our findings demonstrate that NO2 exposure induces malfunction of the epithelial barrier, as evidenced by decreased transepithelial electrical resistance and increased fluorescein isothiocyanate (FITC)‐dextran permeability. mRNA expression analysis revealed a significant increase in IL‐6 and IL‐8 expressions following NO2. Reduced mRNA expression of the tight junction component occludin was identified as a structural correlate of the damaged epithelial barrier. Notably, hypoxic conditions alone did not alter epithelial barrier integrity. These findings provide information on the harmful effects of NO2 exposure on the human nasal epithelium, including compromised barrier integrity and induction of inflammatory responses. Overall, this study contributes to our understanding of pathophysiological mechanisms underlying also upper airway respiratory diseases associated with air pollution exposure and emphasizes the importance of mitigating NO2 emissions to safeguard respiratory health.

Air pollutant exposure and mortality risk of critically ill patients

Air pollutant exposure and mortality risk of critically ill patients

Abstract 4132875: Living Address Environmental Biotope Affects the Risk of Coronary Obstruction and Myocardial Ischemia Detected by Coronary Computed Tomography

Background: Several studies reported positive associations between air and noise pollution exposure and coronary artery calcification, but environmental effects on coronary obstruction and flow remain largely unknown. Hypothesis: Distance to road and airport, air pollution, and residential green space are linked to coronary artery obstruction and myocardial ischemia. Low CV-risk patients develop coronary obstruction due to environmental factors, while high-risk patients are more prone to develop myocardial ischemia. Methods: Consecutive patients screened by coronary CT angiography for stable chest pain between 01/01/2019 and 31/12/2020 were included in a registry. Distance to airport and major road, and exposure to PM2.5, NO 2 and normalized difference vegetation index (NDVI) were modelled at patients’ living address. Risk of obstructive coronary artery disease (OCAD, stenosis ≥50%) and abnormal fractional flow reserve (FFR CT <80%) was assessed using propensity score (PS)-adjusted logistic regression. Subgroup analysis was performed according to gender and Framingham CV-risk categories. Results: We enrolled 2620 patients, including 420 (16%) FFR CT analyses. OCAD was reported in 518 (20%) patients and abnormal FFR CT in 276 (11%). People with OCAD lived closer to the airport (10.841 [7.869-19.022] km vs. 12.297 [8.691-22.843] km, p<0.001). Distance to airport decreased OCAD risk (OR 0.983, 95%CI 0.974-0.992, per 1 km) in univariate analysis, with the association present in male, female, and low-risk patients. After PS-adjustment, a trend of association was present between airport distance and abnormal FFR CT risk (OR 0.986, 95%CI 0.969-1.003, per 1 km). Road distance tended to decrease OCAD risk in univariate and PS-adjusted analysis, in the general (OR 0.928, 95%CI 0.808-1.309; and OR 0.928, 95%CI 0.840-1.021, per 1 km) and high-risk population. NO 2 exposure tended to increase OCAD risk in univariate analysis (OR 1.012, 95%CI 0.997-1.027, per 1 µg/m 3 ), with the association only present in female patients, and disappearance after PS-adjustment. PM2.5 exposure showed no associations, while NDVI tended to increase OCAD risk in low-risk patients after PS-adjustment. Conclusion: Residential distance to airport is the major risk component compared to other urban exposome factors studied in this epidemiological observation. Green space tends to exert a cardioprotective effect in low-risk patients, whereas living close to major road worsens the risk in high-risk patients

Long-Term Air Pollution Exposure and Severity of Idiopathic Pulmonary Fibrosis: Data from the IPF-PRO Registry

Long-Term Air Pollution Exposure and Severity of Idiopathic Pulmonary Fibrosis: Data from the IPF-PRO Registry

Ambient air pollution exposure and incidence of cataract surgery: The prospective 3City‐Alienor study

AbstractPurposeCataract, the leading cause of blindness worldwide, is a multifactorial disease involving oxidative stress mechanisms. The aim of our study was to investigate the relationship between air pollution exposure and the incidence of cataract surgery.MethodsThe 3C‐Alienor study is a population‐based cohort of residents of Bordeaux, France, aged 65 years or more, recruited in 1999–2000 and followed every 2–3 years until 2017. Cataract surgery was self‐reported and checked at slit‐lamp by trained professionals. Average air pollution exposure (particulate matter ≤2.5 μm (PM2.5), black carbon (BC), nitrogen dioxide (NO2)) in the 10 years preceding baseline was estimated at the participants' geocoded residential address, using temporally adjusted land use regression. Associations of 10‐year average air pollution exposure with incidence of cataract were estimated using Cox proportional hazard models adjusted for confounders.ResultsThe study included 829 subjects without cataract surgery prior to inclusion; the mean age at inclusion was 72.6 years (standard deviation (SD): 4.2) and 61% were women. The median (Interquartile‐range (IQR)) follow‐up duration was 14.1 (6.4) years during which 507 participants underwent cataract surgery. Exposure to a concentration ≥40 μg/m3 of NO2 (the current regulatory limit value in Europe) was associated with incident cataract surgery (HR = 1.46, CI (1.16, 1.84), p = 0.001). No statistically significant association was found with PM2.5 and BC.ConclusionLong‐term exposure to a NO2 concentration ≥ 40 μg/m3 was associated with an increased incidence of cataract surgery. Complying with current European air pollution standards could reduce cataract surgery costs and improve population quality of life.

Indoor and ambient influences on PM2.5 exposure and well-being for a rail impacted community and implications for personal protections

Abstract Background
Higher air pollution concentrations can be observed near rail networks, local and highway automobile corridors, and shipyards. Communities adjacent to such sources are disproportionately exposed to air pollution from these stationary and mobile sources. One such community is West San Bernardino in California, where households are feet away from the Burlington Northern Santa Fe intermodal facility and are impacted by activities that are estimated to continuously emit air pollutants due to 24/7 operation.
Objective
This study aimed to (1) quantify the impact of personal mobility and housing characteristics on daily PM2.5 exposures and well-being for West San Bernardino community members, and (2) develop individualized resilience plans for community collaborators to support future PM2.5 exposure reduction. 
Methods
Personal PM2.5 exposures were measured for community collaborators for seven consecutive days during three deployment periods: October 2021, January 2022, and March 2022. Indoor and ambient PM2.5 levels were also continuously measured for five households over six months using PurpleAir Classic monitors. Demographic and well-being data were collected upon recruitment and after each week of engagement, respectively. 
Results
Personal exposures in home microenvironments were highest near the railyard and lower farthest away from the railyard. Home exposures were 40% higher on average compared to non-home microenvironments. Household PM2.5 had a higher-than-expected average infiltration factor of 0.55, and indoor 98th percentiles across the households far exceeded a healthy level at an average of 165 μg/m3. Resilience plans featured summaries of personal data and recommendations for mitigating exposures. 
Significance
Results suggest that surrounding land use and residential building characteristics compound to worsen air pollution exposures beyond what is expected for exposures in non-industrialized areas. Findings prompt a call for stronger regulation, not only for emissions, but also for indoor air quality and zoning standards that specifically protect disproportionately impacted communities.

Nepal Family Cohort study: a study protocol

IntroductionThe Nepal Family Cohort study uses a life course epidemiological approach to collect comprehensive data on children’s and their parents’ environmental, behavioural and metabolic risk factors. These factors can affect...

Current trend in air pollution exposure and stroke.

Stroke is the second leading cause of death worldwide, and exposure to particulate air pollution is now recognized as one of the major modifiable risk factors. However, air pollution can vary in terms of physicochemical composition and exposition specificities. Therefore, its relationships with stroke outcomes remain under intense investigation. This review highlights, alongside particles, that short-term and long-term exposure to nitrogen dioxide (NO2) and ozone is likely to be also linked to stroke-related morbidity and mortality. Moreover, air pollution may increase the risk of transitioning from a healthy status to incident stroke and morbimortality after stroke. Additionally, relationships may vary depending on the air pollution mixture (e.g., particle-related components, pollutant interactions), pollutant sources (e.g., traffic-related or not), stroke etiology (ischemic or hemorrhagic), or exposed individual's characteristics (e.g., age, sex, genetic predisposition, weight status). Nonlinear dose-response functions and short-term effect lags have been reported, but these features need further refinement. The relationship between stroke and air pollution is now well established. Nonetheless, future research should further consider the physicochemical properties of air pollutants, multiple exposures, and individual vulnerabilities. Moreover, advanced statistical methods should be more commonly used to better describe the relationship shapes.

Association of Respiratory Morbidities with Particulate Air Pollution in Delhi, India- A Prospective Study

Abstract Background: Elevated levels of air pollution and long-term exposure can lead to detrimental health conditions, mainly affecting cardiorespiratory systems. Materials and Methods: A prospective observational study was conducted in five sampled hospitals in Delhi. A pre-designed, pre-tested, semi-structured questionnaire was filled out for each patient with data from hospital records. The admission rates were recorded daily over the study period along with the air quality with reference to particulate matter (PM). The trends of the hospital admissions for respiratory morbidity were corroborated with PM 2.5. Descriptive statistics and correlation amongst emergency admissions and air pollutants were analysed using Microsoft Excel. The impact of air quality on the rate of hospitalisation due to respiratory conditions was projected by mathematical modelling. Results: The rate of hospitalisation due to bronchial asthma, chronic obstructive pulmonary disease, bronchitis and lower respiratory tract infections was found to be directly proportional to an increase in PM2.5. Conclusion: The healthcare system is increasingly strained and thus, the additional burden due to rising air pollution needs to be prevented by making people aware about the methods of reducing air pollution.

Ambient air pollution, urban green space and childhood overweight and obesity: A health impact assessment for Barcelona, Spain

BackgroundThe burden of childhood overweight and obesity attributable to ambient air pollution and a lack of urban green spaces (UGS) remains unknown. This study aimed to estimate the attributable cases of childhood overweight and obesity due to air pollution and insufficient UGS exposure in Barcelona, Spain. MethodsWe applied a quantitative health impact assessment approach. We collected childhood overweight and obesity prevalence levels and exposure data from 69 spatial basic health zones in Barcelona. We estimated particulate matter (PM2.5) and nitrogen dioxide (NO2) levels using land use regression models, normalized difference vegetation index (NDVI) levels using remote sensing and percentage of green area (%GA) using land use. We estimated relative risks, population attributable fractions, and preventable overweight/obesity cases in children under following scenarios: Compliance of World Health Organization (WHO) air quality guidelines (AQGs) for (1) PM2.5 and (2) NO2; achieving (3) city-target NDVI levels and (4) 25% green area (%GA) recommendations. The analyses were stratified by socioeconomic deprivation index (in quintiles). Uncertainty was quantified using Monte Carlos simulations. ResultsCompliance of WHO AQGs could prevent 0.4% [253 (95%CI, −604; 1086)] and 4.2% [3000 (95%CI, 1009; 4943)] of childhood overweight/obesity cases due to excess PM2.5 and NO2 levels in Barcelona, respectively. Compliance of NDVI and %GA targeted levels could prevent 6% [4094 (95%CI, 1698; 6379)] and 10% [6853 (95%CI, 1440; 12779)] of childhood overweight/obesity cases respectively. The preventable burdens of childhood overweight/obesity cases were slightly higher in middle-class socioeconomic areas due to the higher adverse exposure levels at baseline (high air pollution, less UGS). DiscussionCompliance with WHO AQGs and achieving UGS targets can reduce childhood overweight and obesity levels in Barcelona, and potentially in other locations as well. This underscores the need for policies that foster healthier urban environments of high environmental quality in order to protect child health.

Examining the impacts of school bus travel on students' academic performance in two major cities

AbstractSchool buses are a prevalent mode of school travel that may negatively affect students’ academic performance due to numerous factors, including longer commutes. These extended travel times can introduce or exacerbate mental and physical stressors, including air pollution exposure and bullying, while reducing opportunities for health‐promoting activities like physical activity and sleep. While a few researchers have explored the effects of school bus transportation on academic achievement, the research is limited. In this study, we used data from two major Canadian cities, Toronto and Ottawa, to investigate the relationship between the proportion of students commuting by bus to and from school and the percentage meeting standards on standardized tests. We employed beta regression models to analyze performance in reading, writing, math, and literacy across Grades 3, 6, 9, and 10 while controlling for family and income variables that may influence school travel mode and student achievement. Our findings indicate a significant inverse correlation between school bus transportation and academic achievement for Grade 10 literacy. Longer commutes appear to impair academic performance, given that Grade 10 students presumably spend more time on the bus than younger students. Notably, the negative effects on literacy outcomes are greater than on math.

Windows of susceptibility and joint effects of prenatal and postnatal ambient air pollution and temperature exposure on asthma and wheeze in Mexican children

IntroductionPrenatal and early-life exposure to air pollution and extreme temperatures are associated with childhood asthma and wheeze. However, potential windows of susceptibility and their sex-specific and interactive effects have not been fully elucidated. We aimed to identify critical windows of susceptibility and evaluate sex-specific effects in these associations, and evaluate exposure interactions. MethodsWe analyzed data from 468 mother–child pairs enrolled in the PROGRESS birth cohort in Mexico City. Daily residential levels of PM2.5, NO2, and temperature were generated from our validated spatiotemporally resolved models from conception to age 4 years. Childhood asthma and wheeze outcomes were collected at 4–6 and 7–8 years. Distributed lag nonlinear models (DLNMs) were used to identify susceptible windows for prenatal weekly-specific and postnatal monthly-specific associations of air pollution and temperature with respiratory outcomes adjusting for covariates. To evaluate sex-specific effects, DLNMs were stratified. Joint effects were assessed using relative excess risk due to interaction and attributable proportion. ResultsMid-gestation was a critical window for both PM2.5 (weeks 20–28, cumulative OR: 1.18 [95% CI: 1.01, 1.37]; weeks 19–26, cumulative OR: 1.18 [95% CI: 1.02, 1.36]) and NO2 (weeks 18–25, cumulative OR: 1.16 [95% CI: 1.02, 1.31]) exposure, associated with higher odds of wheeze. Postnatal exposure to PM2.5 and NO2 during the first year of life was also linked to higher odds of wheeze. The warmer and colder temperatures showed mixed effects on respiratory outcomes. We observed a synergistic interaction between high PM2.5 and high temperature exposure during the first year of life, associated with higher odds of current wheeze. The associations of prenatal air pollution and temperature exposure with respiratory outcomes were more pronounced in males. ConclusionsEarly-life air pollution exposure contributes to the development of childhood asthma and wheeze, while exposure to temperature showed mixed associations with respiratory outcomes.

Metabolomic profiling identifies signatures and biomarkers linking air pollution to dementia risk: a prospective cohort study

Exposure to air pollution has been associated with increased dementia. However, it remains unknown what specific metabolic mechanisms play a role in this relationship. We included 192,300 dementia-free participants from the UK Biobank cohort study. Annual concentrations of air pollution were assessed based on the residential address. Elastic net regression was performed to identify air pollution-related metabolites, and metabolic score was constructed. Cox regression models and covariate balancing generalized propensity scores (CBGPS) regression models were conducted to explore the longitudinal associations between air pollution/metabolic signatures and dementia risk. The underlying mechanisms between air pollution and dementia driven by metabolic signature or specific metabolites were also investigated. A total of 2,592 incident dementia cases were documented. We identified the metabolite profiles in response to air pollution exposure, including 87 metabolites for PM2.5, 65 metabolites for PM10, 76 metabolites for NO2, and 71 metabolites for NOx. The air pollution-related metabolic signatures were associated with increased risk of dementia, with hazard ratios (HR) of 1.17 (95% CI: 1.12, 1.22), 1.06 (95% CI: 1.02, 1.11), 1.16 (95% CI: 1.10, 1.21), and 1.17 (95% CI: 1.12, 1.22) for PM2.5, PM10, NO2 and NOx, respectively. The associations persisted using causal models. Metabolic signatures mediated the associations between air pollution exposure and dementia risk, with mediation proportions ranging from 6.57% to 12.71%. Additionally, we observed that a metabolite known as free cholesterol in medium VLDL (M-VLDL-FC) played a crucial mediating role. Our study provides novel insights into the metabolic mechanisms linking air pollution exposure to dementia risk.

Association between residential greenness exposure and semen quality: A retrospective study in China

BackgroundThe association between greenness exposure and semen quality and the underlying mechanism are unclear. ObjectivesTo assess the association between greenness exposure and semen quality and whether the association is mediated by air pollutant exposure. MethodsWe collected data from 10,273 men in Zhejiang, China, whose wives received assisted reproductive technology from 2015 to 2021. The mean exposure concentrations of air pollutants and greenness indices (normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI)) in the 300 m, 400 m, 800 m, and 1000 m buffer zones were assessed from 0–90 days prior to semen testing on the basis of the patient’s residential address. A multivariate linear mixed-effects model was used to evaluate the associations, and mediation analysis was used to investigate the influences of air pollutant exposure and body mass index (BMI) on the associations. ResultsThe average (standard deviation) age of the participants was 33.1 (5.2) years. After adjusting for confounders, progressive motility was positively associated with the NDVI400m (β (95 % CI): 1.744 (0.834, 2.655)) and SAVI400m (β (95 % CI): 1.484 (0.591, 2.377)). Furthermore, we found that NO2 and CO exposure significantly mediated part of the association between greenness exposure and progressive motility. Similar results are observed in the sensitivity analysis. ConclusionsOur results suggest that greater greenness exposure is associated with higher semen quality and can be partially mediated by lower NO2 and CO exposure levels.

Modification of asthma treatment efficacy by healthcare access: A reanalysis of AsthmaNet Step-Up Yellow Zone Inhaled Corticosteroids to Prevent Exacerbations (STICS) clinical trial

BackgroundWhile randomized controlled trials (RCTs) in asthma management are designed to balance known and unknown variables across treatment groups, including social and environmental co-exposures, it remains important to consider how these co-exposures influence disease progression and treatment outcomes. The importance of considering socio-environmental co-exposures in the context of asthma is twofold: 1) asthma disproportionately affects low-income urban communities, where air pollution and chronic stress are pervasive; and 2) despite the wide range of asthma treatments, inadequate disease control persists. MethodsIn the present ancillary study of the Step-Up Yellow Zone Inhaled Corticosteroids to Prevent Exacerbations (STICS) RCT, we investigated how socio-environmental factors, such as air pollution exposure and healthcare access, modify the effect of inhaled corticosteroid (ICS) therapy in children with asthma. The original STICS RCT evaluated the efficacy and safety of increasing the dose of inhaled glucocorticoids from a baseline daily low dose to five times the daily dose for 7 days in school-age children with mild -to-moderate persistent asthma who began to have short-term loss of asthma control (Jackson et al., 2018 Mar 8) [1]. Our study adds onto those findings by incorporating residential level particulate matter 2.5 μg/m3 (PM2.5) and geographic health provider shortage areas (HPSA) as potential modifiers. ResultsConsistent with the main trial results, we did not find a difference in the number of exacerbations between treatment arms. However, we found the effect of receiving 5xICS, as compared with 1xICS on the time to prednisone was significantly different for children living in areas a shortage of health professionals (HR: 2.09; 95 % CI: 0.74, 5.95) than for children living in no shortage areas (HR: 0.40; 95 % CI: 0.21, 0.77). ConclusionThis finding underscores the importance of considering environmental and social factors in asthma treatment. Trial registrationClinicalTrials.gov ID NCT02066129 https://clinicaltrials.gov/study/NCT02066129.

Methods for Quantifying Source-Specific Air Pollution Exposure to Serve Epidemiology, Risk Assessment, and Environmental Justice.

Identifying sources of air pollution exposure is crucial for addressing their health impacts and associated inequities. Researchers have developed modeling approaches to resolve source-specific exposure for application in exposure assessments, epidemiology, risk assessments, and environmental justice. We explore six source-specific air pollution exposure assessment approaches: Photochemical Grid Models (PGMs), Data-Driven Statistical Models, Dispersion Models, Reduced Complexity chemical transport Models (RCMs), Receptor Models, and Proximity Exposure Estimation Models. These models have been applied to estimate exposure from sources such as on-road vehicles, power plants, industrial sources, and wildfires. We categorize these models based on their approaches for assessing emissions and atmospheric processes (e.g., statistical or first principles), their exposure units (direct physical measures or indirect measures/scaled indices), and their temporal and spatial scales. While most of the studies we discuss are from the United States, the methodologies and models are applicable to other countries and regions. We recommend identifying the key physical processes that determine exposure from a given source and using a model that sufficiently accounts for these processes. For instance, PGMs use first principles parameterizations of atmospheric processes and provide source impacts exposure variability in concentration units, although approaches within PGMs for source attribution introduce uncertainties relative to the base model and are difficult to evaluate. Evaluation is important but difficult-since source-specific exposure is difficult to observe, the most direct evaluation methods involve comparisons with alternative models.

Air pollution exposure in vitrified oocyte donors and male recipient partners in relation to fertilization and embryo quality

Air pollution exposure in vitrified oocyte donors and male recipient partners in relation to fertilization and embryo quality

Understanding the Risk Factors, Burden, and Interventions for Chronic Respiratory Diseases in Low- and Middle-Income Countries: A Scoping Review

ObjectiveThis scoping review aims to identify risk factors for COPD and asthma, examine the burden and intervention measures, and clarify the findings in the context of climate change, with a particular focus on LMICs.MethodsFollowing the PRISMA-ScR guidelines, we conducted a scoping review using PubMed, Embase, and Scopus, focusing on studies published from 2011 to 2024.ResultsOur review included 52 studies that encompassed 244,004 participants. Predominantly conducted in SSA (n = 43, 83%) and Asia (n = 16, 31%), they address indoor and ambient air pollution, occupational hazards, and environmental conditions. Climate change exacerbates risks, varying regionally. SSA faces severe household and occupational exposures, while other LMICs deal with industrial and urban pollution. Stigma, social exclusion and economic burden underscore the necessity for intervention strategies (e.g., educational programs, pulmonary rehabilitation, low-emission cookstoves).ConclusionOur research shows a strong link between air pollution, occupational and environmental exposures, and the prevalence of COPD and asthma in LMICs. It suggests that targeted interventions are effective ways to mitigate these diseases and also highlights the significant impact of climate change on respiratory health.