Impact of air pollution on respiratory diseases in urban areas: a systematic review

Air pollution has many negative effects on the public health, especially children, elderly and those affected by pre-existing respiratory diseases. The aim of this study was to evaluate the correlation between urbanization and high levels of vehicle emissions and increased frequency of respiratory diseases, in people living in urban areas compared to those living in rural areas. Methods This review was conducted in PubMed and Cochrane library databases using a search string. We included articles related to Italian territory, published between 1971 and 2017, analyzing the effects of air pollution on frequency of respiratory diseases (asthmatic and chronic obstructive pulmonary disease, COPD, symptoms wheezing and cough), on hospital admissions for respiratory diseases and lung functioning. This review was carried out with the PRISMA Statement methodology. Results We obtained a total of 262 articles, after selection we included 19 articles in the review. The results confirm the association between the effect of air pollution exposure (PM10, PM2.5, NO2, SO2, CO2, O3) and respiratory diseases. Increased concentrations of all atmospheric pollutants, in particular of aerial particles, have been associated in 70% of the studies to cough and phlegm, in 35% to asthma symptoms, in 30% to reduction of volumes and respiratory flows, in 30% to increase of hospital stay days during hospitalization for exacerbation of pre-existing respiratory disease. Conclusions Urbanization, elevated levels of traffic and consequent vehicle emissions, and industrial lifestyle are correlated to an increase in the frequency of asthma exacerbations and respiratory infections, especially in people who live in urban areas compared with those who live in rural areas, As well as an increase in sensitivity to pollen-induced allergies. Findings suggest that environmental control may be crucial for prevention of COPD and other acute and chronic respiratory diseases. Key messages: It is necessary to put in place measures to prevention effects on population health, such as plans and interventions to disincentive use of vehicles and regulation about domestic heating systems use. National policies to reduce air pollution are needed for having clean air and no longer significant adverse effects on public health.