Health Effects of Long-Term Exposure to Ambient PM2.5 in Asia-Pacific: a Systematic Review of Cohort Studies

Purpose of Review Health effects of long-term exposure to ambient PM2.5 vary with regions, and 75% of the deaths attributable to PM2.5 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 PM2.5 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 PM2.5 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 PM2.5-health associations. To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM2.5 exposure in understudied regions, the health effects of long-term PM2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM2.5-health associations. Study design, especially exposure assessment methods, should be improved.

Automated summary

This systematic review summarizes the existing evidence from cohort studies on the health effects of long-term exposure to ambient PM2.5 in the Asia-Pacific region. The review found consistent associations between long-term PM2.5 exposure and increased all-cause/non-accidental and cardiovascular mortality, as well as the incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Limited evidence was found for other health effects. Inequalities were identified in the associations between PM2.5 and health. Further studies are needed to assess the health effects of long-term PM2.5 exposure in understudied regions and on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia, and lung cancer, as well as to investigate the inequalities in PM2.5-health associations. Study design, particularly exposure assessment methods, should be improved.