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Chest. 2019 Feb;155(2):409-416. doi: 10.1016/j.chest.2018.10.042. Epub 2018 Nov 9.

Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 1: The Damaging Effects of Air Pollution.

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Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL. Electronic address:
Department of Medicine, University of California, San Francisco, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA.
Divisions of Preventive, Occupational, and Aerospace Medicine, and Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
National Heart & Lung Institute, Imperial College London, London, United Kingdom.
Department of Pathology, Wonju Colleage of Medicine Yonsei University, Seoul, South Korea.
Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
National Institute of Respiratory Diseases, Mexico City, Mexico.
Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
National Institute of Public Health, Cuernavaca Morelos, Mexico.
Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Departments of Environmental Medicine and Population Health, New York University School of Medicine, New York, NY.
The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Department of Paediatrics and Child Health & MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
School of Earth, Society, and Environment, Department of Atmospheric Sciences, University of Illinois, Urbana, IL.


Air pollution poses a great environmental risk to health. Outdoor fine particulate matter (particulate matter with an aerodynamic diameter < 2.5 μm) exposure is the fifth leading risk factor for death in the world, accounting for 4.2 million deaths and > 103 million disability-adjusted life years lost according to the Global Burden of Disease Report. The World Health Organization attributes 3.8 million additional deaths to indoor air pollution. Air pollution can harm acutely, usually manifested by respiratory or cardiac symptoms, as well as chronically, potentially affecting every organ in the body. It can cause, complicate, or exacerbate many adverse health conditions. Tissue damage may result directly from pollutant toxicity because fine and ultrafine particles can gain access to organs, or indirectly through systemic inflammatory processes. Susceptibility is partly under genetic and epigenetic regulation. Although air pollution affects people of all regions, ages, and social groups, it is likely to cause greater illness in those with heavy exposure and greater susceptibility. Persons are more vulnerable to air pollution if they have other illnesses or less social support. Harmful effects occur on a continuum of dosage and even at levels below air quality standards previously considered to be safe.


air pollution; mechanism of damage; noncommunicable diseases

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