Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala lumpur, Malaysia.
Center of Toxicology and Health Risk Studies (CORE), Universiti Kebangsaan Malaysia Fakulti Sains Kesihatan, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
BMJ Open. 2024 May 7;14(5):e079826. doi: 10.1136/bmjopen-2023-079826.
Climate change is a major global issue with significant consequences, including effects on air quality and human well-being. This review investigated the projection of non-communicable diseases (NCDs) attributable to air pollution under different climate change scenarios.
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. A population-exposure-outcome framework was established. Population referred to the general global population of all ages, the exposure of interest was air pollution and its projection, and the outcome was the occurrence of NCDs attributable to air pollution and burden of disease (BoD) based on the health indices of mortality, morbidity, disability-adjusted life years, years of life lost and years lived with disability.
The Web of Science, Ovid MEDLINE and EBSCOhost databases were searched for articles published from 2005 to 2023.
The eligible articles were evaluated using the modified scale of a checklist for assessing the quality of ecological studies.
Two reviewers searched, screened and selected the included studies independently using standardised methods. The risk of bias was assessed using the modified scale of a checklist for ecological studies. The results were summarised based on the projection of the BoD of NCDs attributable to air pollution.
This review included 11 studies from various countries. Most studies specifically investigated various air pollutants, specifically particulate matter <2.5 µm (PM), nitrogen oxides and ozone. The studies used coupled-air quality and climate modelling approaches, and mainly projected health effects using the concentration-response function model. The NCDs attributable to air pollution included cardiovascular disease (CVD), respiratory disease, stroke, ischaemic heart disease, coronary heart disease and lower respiratory infections. Notably, the BoD of NCDs attributable to air pollution was projected to decrease in a scenario that promotes reduced air pollution, carbon emissions and land use and sustainable socioeconomics. Contrastingly, the BoD of NCDs was projected to increase in a scenario involving increasing population numbers, social deprivation and an ageing population.
The included studies widely reported increased premature mortality, CVD and respiratory disease attributable to PM. Future NCD projection studies should consider emission and population changes in projecting the BoD of NCDs attributable to air pollution in the climate change era.
CRD42023435288.
气候变化是一个重大的全球性问题，具有重大影响，包括对空气质量和人类福祉的影响。本综述调查了在不同气候变化情景下，空气污染导致的非传染性疾病（NCDs）的预测。
本系统评价按照 2020 年系统评价和荟萃分析首选报告项目的清单进行。建立了一个人群-暴露-结局框架。人群指的是所有年龄段的全球总人口，感兴趣的暴露是空气污染及其预测，结局是归因于空气污染的 NCDs 的发生和疾病负担（BoD），基于死亡率、发病率、残疾调整生命年、生命损失年和残疾生存年等健康指标。
从 2005 年至 2023 年，在 Web of Science、Ovid MEDLINE 和 EBSCOhost 数据库中搜索了发表的文章。
使用评估生态研究质量检查表的修改版对合格文章进行评估。
两名审查员使用标准化方法独立搜索、筛选和选择纳入的研究。使用生态研究检查表的修改版评估偏倚风险。根据归因于空气污染的 NCDs 的 BoD 预测，对结果进行了总结。
本综述包括来自不同国家的 11 项研究。大多数研究专门研究了各种空气污染物，特别是细颗粒物<2.5 µm（PM）、氮氧化物和臭氧。这些研究使用耦合空气质量和气候建模方法，主要使用浓度-反应函数模型预测健康影响。归因于空气污染的 NCDs 包括心血管疾病（CVD）、呼吸道疾病、中风、缺血性心脏病、冠心病和下呼吸道感染。值得注意的是，在促进减少空气污染、碳排放和土地利用以及可持续社会经济的情景下，归因于空气污染的 NCDs 的 BoD 预计会减少。相比之下，在人口增加、社会贫困和人口老龄化的情景下，归因于空气污染的 NCDs 的 BoD 预计会增加。
纳入的研究广泛报告了归因于 PM 的过早死亡、CVD 和呼吸道疾病的增加。在气候变化时代，未来的 NCD 预测研究应考虑排放和人口变化，预测归因于空气污染的 NCDs 的 BoD。
PROSPERO 注册号：CRD42023435288。
