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

Abstract

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.

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Acknowledgments

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.

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Authors

Corresponding author

Correspondence to Kehu Yang.

Additional information

Shulan Li contributed equally to this work.

Responsible editor: Philippe Garrigues

Electronic supplementary material

Below is the link to the electronic supplementary material.

Appendix S1

Flowchart of literature research and review process. (PDF 120 kb)

Appendix S2

Contextual details of studies included in the meta-analysis by publication year (PDF 172 kb)

Appendix S3

References list. (PDF 16 kb)

Appendix S4

Quality assessment of selected studies. (PDF 116 kb)

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Cite this article

Fan, J., Li, S., Fan, C. et al. The impact of PM2.5 on asthma emergency department visits: a systematic review and meta-analysis. Environ Sci Pollut Res 23, 843–850 (2016). https://doi.org/10.1007/s11356-015-5321-x

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Keywords

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