Background

Ambient air pollution has been associated with respiratory diseases in children. However, little is known about its impact on low- and middle-income countries (LMICs) in Asia. This systematic review investigates and summarises the associations between short- and long-term exposure to ambient air pollutants and childhood respiratory diseases.

Methods

We conducted a systematic search of peer-reviewed articles on PubMed, Scopus and Ovid MEDLINE. Observation study designs consisting of the cohort, cross-sectional, case-crossover, and time series study were included. The quality assessment was conducted based on the study designs, using the AXIS (Appraisal Tool for Cross-Sectional Studies), NOS (Newcastle-Ottawa scale) and the Mustafíc criteria. Each of the included studies was appraised to evaluate the risk of bias using an adapted OHAT (Office of Health Assessment and Translation) assessment tool.

Results

A total of 41 articles with high and medium quality from 2015 to 2019 were included in this review. The studies reported exposure to a high concentration of ambient air pollution (PM₁₀ n = 25, PM_2.5 n = 22, SO₂ n = 13, NO₂ n = 24, CO n = 5, O₃ n = 7) was significantly correlated with increased risk of childhood respiratory morbidity and mortality across different age groups and countries. However, the distribution of the studies did not cover all Asian LMICs. Due to the age group variation, it was impossible to identify specific groups susceptible to ambient air pollution's adverse effects.

Conclusion

Short- and long-term exposure to ambient air pollution is associated with increased childhood respiratory morbidity and mortality in Asian LMICs. There is a need for more studies focused on the relationship between ambient air pollution and childhood respiratory diseases, especially in Asian countries with poor air quality and rapid urbanisation.

中文翻译：

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亚洲中低收入国家的环境空气污染与儿童呼吸道疾病之间的关联：系统评价

背景

环境空气污染与儿童呼吸系统疾病有关。但是，对其对亚洲中低收入国家（LMIC）的影响知之甚少。这篇系统的综述调查并总结了短期和长期暴露于环境空气污染物与儿童呼吸道疾病之间的联系。

方法

我们对PubMed，Scopus和Ovid MEDLINE上经过同行评审的文章进行了系统的搜索。包括队列研究，横断面研究，病例交叉研究和时间序列研究的观察研究设计。根据研究设计，使用AXIS（跨学科研究评估工具），NOS（纽卡斯尔-渥太华量表）和Mustafíc标准进行了质量评估。使用改良的OHAT（健康评估和翻译办公室）评估工具评估了纳入的每项研究，以评估偏倚的风险。

结果

该评价纳入了2015年至2019年共41篇高质量和中等质量的文章。研究报告表明，暴露于高浓度的环境空气污染（PM ₁₀ n = 25，PM _2.5 n = 22，SO ₂ n = 13，NO ₂ n = 24，CO n = 5，O ₃ n = 7）显着与不同年龄段和国家/地区的儿童呼吸道疾病和死亡风险增加相关。但是，研究的分布并不涵盖所有亚洲中低收入国家。由于年龄组的差异，无法确定易受周围空气污染不利影响影响的特定人群。

结论

亚洲中低收入国家的短期和长期暴露于环境空气污染与儿童呼吸道发病率和死亡率增加有关。有必要进行更多的研究，重点是环境空气污染与儿童呼吸道疾病之间的关系，尤其是在空气质量差且城市化迅速的亚洲国家。