Environmental Science and Pollution Research

, Volume 23, Issue 1, pp 843–850 | Cite as

The impact of PM2.5 on asthma emergency department visits: a systematic review and meta-analysis

  • Jingchun Fan
  • Shulan Li
  • Chunling Fan
  • Zhenggang Bai
  • Kehu YangEmail author
Research Article


Although the relationship between asthma and exposure to fine particulate matter (PM2.5) has been frequently measured, reported conclusions have not been consistent. As emergency department (ED) visits are an effective way to estimate health outcomes for people with asthma and short-term exposure to PM2.5, this review systematically searched five databases without language or geographical restrictions from inception to January 13, 2015 to study the impact of PM2.5 on asthma ED visits. A random-effects model was used to calculate the pooled risk ratio (RR) and 95 % confidence intervals (CI). With respect to short-term effects, asthma ED visits increased at higher PM2.5 concentrations (RR 1.5 % per 10 μg/m3; 95 % CI 1.2–1.7 %), and children were more susceptible (3.6 % per 10 μg/m3; 95 % CI 1.8, 5.3 %) than adults (1.7, 95 % CI 0.7 %, 2.8 %) to increased PM2.5; the ED visits increased during the warm season by 3.7 % (95 % CI 0.5, 6.9 %) per 10 μg/m3 increase in PM2.5, which was higher than the corresponding increase during the cold season (2.6, 95 % CI 0.7–4.6 %). This demonstrates that ambient PM2.5 has an adverse impact on asthma ED visits after short-term exposure and that children are a high-risk population when PM2.5 concentrations are high, particularly in warm seasons, during which measures should be taken to prevent PM2.5.


Fine particulate matter (PM2.5) Asthma Emergency department (ED) Short-term exposure Systematic review Meta-analysis 



Jinhui Tian from Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, is acknowledged for his valuable comments on the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

11356_2015_5321_MOESM1_ESM.pdf (121 kb)
Appendix S1 Flowchart of literature research and review process. (PDF 120 kb)
11356_2015_5321_MOESM2_ESM.pdf (172 kb)
Appendix S2 Contextual details of studies included in the meta-analysis by publication year (PDF 172 kb)
11356_2015_5321_MOESM3_ESM.pdf (17 kb)
Appendix S3 References list. (PDF 16 kb)
11356_2015_5321_MOESM4_ESM.pdf (117 kb)
Appendix S4 Quality assessment of selected studies. (PDF 116 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Jingchun Fan
    • 1
    • 2
    • 3
  • Shulan Li
    • 4
  • Chunling Fan
    • 5
  • Zhenggang Bai
    • 1
    • 2
  • Kehu Yang
    • 1
    • 2
    Email author
  1. 1.Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu ProvinceLanzhouChina
  2. 2.Evidence-Based Medicine Center, School of Basic Medical SciencesLanzhou UniversityLanzhouChina
  3. 3.First Clinical Medical CollegeLanzhou UniversityLanzhouChina
  4. 4.Department of UltrasoundPeople’s Hospital of Gansu ProvinceLanzhouChina
  5. 5.Department of Clinical PharmacyGansu Provincial Cancer HospitalLanzhouChina

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