Interactive effects of allergens and air pollution on respiratory health: A systematic review,Science of the Total Environment

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Interactive effects of allergens and air pollution on respiratory health: A systematic review
Science of the Total Environment ( IF 8.2 ) Pub Date : 2020-12-04 , DOI: 10.1016/j.scitotenv.2020.143924
Holly C Y Lam ₁ , Deborah Jarvis ₁ , Elaine Fuertes ₂

Affiliation

Background

Studies have demonstrated an adverse role of outdoor allergens on respiratory symptoms. It is unknown whether this effect is independent or synergistic of outdoor air pollutants.

Methods

We systematically reviewed all epidemiological studies that examined interaction effects between counts of outdoor airborne allergens (pollen, fungal spores) and air pollutants, on any respiratory health outcome in children and adults. We searched the MEDLINE, EMBASE and Scopus databases. Each study was summarized qualitatively and assessed for quality and risk of bias (International Prospective Register for Systematic Reviews, registration number CRD42020162571).

Results

Thirty-five studies were identified (15 timeseries, eight case-crossovers, 11 panels and one cohort study), of which 12 reported a significant statistical interaction between an allergen and air pollutant. Eight interactions were related to asthma outcomes, including one on lung function measures and wheeze, three to medical consultations for pollinosis and one to allergic symptoms (nasal, ocular or bronchial). There was no consensus as to which allergen or air pollutant is more likely to interact. No study investigated whether interactions are stronger in atopic individuals.

Conclusion

Despite strong evidence from small experimental studies in humans, only a third of studies identified significant allergen-pollutant interactions using common epidemiological study designs. Exposure misclassification, failure to examine subgroups at risk, inadequate statistical power or absence of population-level effects are possible explanations.

中文翻译：

过敏原和空气污染对呼吸系统健康的交互影响：系统评价

背景

研究表明户外过敏原对呼吸道症状有不利影响。目前尚不清楚这种影响是独立于室外空气污染物还是协同作用。

方法

我们系统地回顾了所有流行病学研究，这些研究检查了室外空气传播的过敏原（花粉、真菌孢子）和空气污染物之间的相互作用对儿童和成人呼吸系统健康结果的影响。我们检索了 MEDLINE、EMBASE 和 Scopus 数据库。每项研究都进行了定性总结并评估了质量和偏倚风险（国际系统评价前瞻性登记册，注册号 CRD42020162571）。

结果

确定了 35 项研究（15 项时间序列、8 项病例交叉研究、11 项小组研究和一项队列研究），其中 12 项报告了过敏原和空气污染物之间的显着统计相互作用。八种相互作用与哮喘结果有关，包括一种与肺功能测量和喘息有关，三种与花粉病的医疗咨询有关，一种与过敏症状（鼻、眼或支气管）有关。对于哪种过敏原或空气污染物更有可能相互作用，尚无共识。没有研究调查特应性个体的相互作用是否更强。