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Health effects of ultrafine particles: a systematic literature review update of epidemiological evidence

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International Journal of Public Health



Due to their small size, ultrafine particles (UFP) are believed to exert higher toxicity than larger particles. As numerous studies on health effects of UFP have been published since the last systematic review in 2013, we aim to systematically review the new literature.


We searched MEDLINE and the specialized LUDOK database for studies published between 01.01.2011 and 11.05.2017 investigating health effects of ambient air pollution-related UFP. We included epidemiologic studies containing UFP measures and quantifiable measures of associations. Relevant data were extracted on the basis of previously developed evaluation criteria.


We identified 85 original studies, conducting short-term (n = 75) and long-term (n = 10) investigations. Panel (n = 32), scripted exposure with predefined settings (n = 16) or time series studies (n = 11) were most frequent. Thirty-four studies adjusted for at least one other pollutant. Most consistent associations were identified for short-term effects on pulmonary/systemic inflammation, heart rate variability and blood pressure.


The evidence suggests adverse short-term associations with inflammatory and cardiovascular changes, which may be at least partly independent of other pollutants. For the other studied health outcomes, the evidence on independent health effects of UFP remains inconclusive or insufficient.

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The study was supported by the German Environmental Agency (Project Number: Grant 00377 7205-2 UKAGEP) and the Swiss Federal Office for the Environment (Contracts No 110001982/8T20/13.0077.PJ/0003/M461-2794 and 00.5082.PZ 1-0389. Financial support was provided by the Swiss Federal Ministry of Education and Research.

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Correspondence to Simone Ohlwein.

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Ohlwein, S., Kappeler, R., Kutlar Joss, M. et al. Health effects of ultrafine particles: a systematic literature review update of epidemiological evidence. Int J Public Health 64, 547–559 (2019).

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