Air pollution exposure in active versus passive travel modes across five continents: A Bayesian random-effects meta-analysis.

Epidemiological studies on health effects of air pollution usually estimate exposure at the residential address. However, ignoring daily mobility patterns may lead to biased exposure estimates, as documented in previous exposure studies. To improve the reliable integration of exposure related to mobility patterns into epidemiological studies, we conducted a systematic review of studies across all continents that measured air pollution concentrations in various modes of transport using portable sensors. To compare personal exposure across different transport modes, specifically active versus motorized modes, we estimated pairwise exposure ratios using a Bayesian random-effects meta-analysis. Overall, we included measurements of six air pollutants (black carbon (BC), carbon monoxide (CO), nitrogen dioxide (NO), particulate matter (PM, PM) and ultrafine particles (UFP)) for seven modes of transport (i.e., walking, cycling, bus, car, motorcycle, overground, underground) from 52 published studies. Compared to active modes, users of motorized modes were consistently the most exposed to gaseous pollutants (CO and NO). Cycling and walking were the most exposed to UFP compared to other modes. Active vs passive mode contrasts were mostly inconsistent for other particle metrics. Compared to active modes, bus users were consistently more exposed to PM and PM, while car users, on average, were less exposed than pedestrians. Rail modes experienced both some lower exposures (compared to cyclists for PM and pedestrians for UFP) and higher exposures (compared to cyclist for PM and BC). Ratios calculated for motorcycles should be considered carefully due to the small number of studies, mostly conducted in Asia. Computing exposure ratios overcomes the heterogeneity in pollutant levels that may exist between continents and countries. However, formulating ratios on a global scale remains challenging owing to the disparities in available data between countries.