Health Effects of Long-Term Exposure to Ambient PM2.5 in Asia-Pacific: a Systematic Review of Cohort Studies
Zhengyu Yang, Rahini Mahendran, Pei Yu, Rongbin Xu, Wenhua Yu, Sugeesha Godellawattage, Shanshan Li, Yuming Guo
Abstract
Abstract Purpose of Review Health effects of long-term exposure to ambient PM 2.5 vary with regions, and 75% of the deaths attributable to PM 2.5 were estimated in Asia-Pacific in 2017. This systematic review aims to summarize the existing evidence from cohort studies on health effects of long-term exposure to ambient PM 2.5 in Asia-Pacific. Recent Findings In Asia-Pacific, 60 cohort studies were conducted in Australia, Mainland China, Hong Kong, Taiwan, and South Korea. They consistently supported associations of long-term exposure to PM 2.5 with increased all-cause/non-accidental and cardiovascular mortality as well as with incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Evidence for other health effects was limited. Inequalities were identified in PM 2.5 -health associations. Summary To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM 2.5 exposure in understudied regions, the health effects of long-term PM 2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM 2.5 -health associations. Study design, especially exposure assessment methods, should be improved.