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Association of Long-Term Exposure to Fine Particulate Matter and Cardio-Metabolic Diseases in Low- and Middle-Income Countries: A Systematic Review

Author

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  • Suganthi Jaganathan

    (Centre for Chronic Disease Control, New Delhi 110016, India)

  • Lindsay M. Jaacks

    (Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA)

  • Melina Magsumbol

    (Public Health Foundation of India, Gurgaon 122002, India)

  • Gagandeep K. Walia

    (Public Health Foundation of India, Gurgaon 122002, India)

  • Nancy L. Sieber

    (Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA)

  • Roopa Shivasankar

    (Centre for Chronic Disease Control, New Delhi 110016, India)

  • Preet K. Dhillon

    (Public Health Foundation of India, Gurgaon 122002, India)

  • Safraj Shahul Hameed

    (Centre for Chronic Disease Control, New Delhi 110016, India)

  • Joel Schwartz

    (Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA)

  • Dorairaj Prabhakaran

    (Centre for Chronic Disease Control, New Delhi 110016, India
    Public Health Foundation of India, Gurgaon 122002, India
    London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK)

Abstract

Background: Numerous epidemiological studies indicated high levels of particulate matter less than2.5 μm diameter (PM 2.5 ) as a major cardiovascular risk factor. Most of the studies have been conducted in high-income countries (HICs), where average levels of PM 2.5 are far less compared to low- and middle- income countries (LMICs), and their socio-economic profile, disease burden, and PM speciation/composition are very different. We systematically reviewed the association of long-term exposure to PM 2.5 and cardio-metabolic diseases (CMDs) in LMICs. Methods: Multiple databases were searched for English articles with date limits until March 2018. We included studies investigating the association of long-term exposure to PM 2.5 (defined as an annual average/average measure for 3 more days of PM 2.5 exposure) and CMDs, such as hospital admissions, prevalence, and deaths due to CMDs, conducted in LMICs as defined by World Bank. We excluded studies which employed exposure proxy measures, studies among specific occupational groups, and specific episodes of air pollution. Results: A total of 5567 unique articles were identified, of which only 17 articles were included for final review, and these studies were from Brazil, Bulgaria, China, India, and Mexico. Outcome assessed were hypertension, type 2 diabetes mellitus and insulin resistance, and cardiovascular disease (CVD)-related emergency room visits/admissions, death, and mortality. Largely a positive association between exposure to PM 2.5 and CMDs was found, and CVD mortality with effect estimates ranging from 0.24% to 6.11% increased per 10 μg/m 3 in PM 2.5 . CVD-related hospitalizations and emergency room visits increased by 0.3% to 19.6%. Risk factors like hypertension had an odds ratio of 1.14, and type 2 diabetes mellitus had an odds ratio ranging from 1.14–1.32. Diversity of exposure assessment and health outcomes limited the ability to perform a meta-analysis. Conclusion: Limited evidence on the association of long-term exposure to PM 2.5 and CMDs in the LMICs context warrants cohort studies to establish the association.

Suggested Citation

  • Suganthi Jaganathan & Lindsay M. Jaacks & Melina Magsumbol & Gagandeep K. Walia & Nancy L. Sieber & Roopa Shivasankar & Preet K. Dhillon & Safraj Shahul Hameed & Joel Schwartz & Dorairaj Prabhakaran, 2019. "Association of Long-Term Exposure to Fine Particulate Matter and Cardio-Metabolic Diseases in Low- and Middle-Income Countries: A Systematic Review," IJERPH, MDPI, vol. 16(14), pages 1-18, July.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:14:p:2541-:d:248959
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    References listed on IDEAS

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    1. Kai Luo & Wenjing Li & Ruiming Zhang & Runkui Li & Qun Xu & Yang Cao, 2016. "Ambient Fine Particulate Matter Exposure and Risk of Cardiovascular Mortality: Adjustment of the Meteorological Factors," IJERPH, MDPI, vol. 13(11), pages 1-17, November.
    2. Tatiane Morais Ferreira & Maria Cristina Forti & Clarice Umbelino De Freitas & Felipe Parra Nascimento & Washington Leite Junger & Nelson Gouveia, 2016. "Effects of Particulate Matter and Its Chemical Constituents on Elderly Hospital Admissions Due to Circulatory and Respiratory Diseases," IJERPH, MDPI, vol. 13(10), pages 1-11, September.
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    1. Michał Święczkowski & Sławomir Dobrzycki & Łukasz Kuźma, 2023. "Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study)," IJERPH, MDPI, vol. 20(8), pages 1-17, April.
    2. Nandi S. Mwase & Alicia Ekström & Jan Eiof Jonson & Erik Svensson & Jukka-Pekka Jalkanen & Janine Wichmann & Peter Molnár & Leo Stockfelt, 2020. "Health Impact of Air Pollution from Shipping in the Baltic Sea: Effects of Different Spatial Resolutions in Sweden," IJERPH, MDPI, vol. 17(21), pages 1-16, October.
    3. Barouch Giechaskiel & Pierre Bonnel & Adolfo Perujo & Panagiota Dilara, 2019. "Solid Particle Number (SPN) Portable Emissions Measurement Systems (PEMS) in the European Legislation: A Review," IJERPH, MDPI, vol. 16(23), pages 1-23, November.
    4. Gyeyoung Choi & Yujeong Kim & Gyeongseon Shin & SeungJin Bae, 2022. "Projecting Lifetime Health Outcomes and Costs Associated with the Ambient Fine Particulate Matter Exposure among Adult Women in Korea," IJERPH, MDPI, vol. 19(5), pages 1-14, February.
    5. Zhiming Yang & Qianhao Song & Jing Li & Yunquan Zhang, 2019. "Air Pollution as a Cause of Obesity: Micro-Level Evidence from Chinese Cities," IJERPH, MDPI, vol. 16(21), pages 1-16, November.

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    Keywords

    air pollution; cardio-metabolic diseases;

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