Haque Rehnuma, Islam Md Shariful, Hanson Molly, Rahaman Md Zamiur, Afrin Sadia, Shome Sristi, Rahman Mahbubur, Rahman Syed Moshfiqur, Saif-Ur-Rahman K M, Raqib Rubhana
Environmental Health and WASH, Health Systems and Population Studies Division, icddr,b, Dhaka, 1212, Bangladesh.
Global Health and Migration Unit, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Public Health Pract (Oxf). 2025 Jun 25;10:100631. doi: 10.1016/j.puhip.2025.100631. eCollection 2025 Dec.
The objective of this review is to identify which environmental toxicants are linked to infectious diseases in low- and middle-income countries (LMICs) by synthesizing available evidence. It aims to summarize key findings, identify research gaps and provide policy recommendations based on the associations between specific toxicants and disease outcomes.
Systematic review.
We conducted a comprehensive search in PubMed, Scopus, Web of Science (core collection), and CENTRAL (the Cochrane Library) to identify studies on bacterial, viral, and parasitic pathogenic activity.
This search yielded 11,468 studies, of which 55 met inclusion criteria after screening following the standard methods. A consistent association is found between particulate matter (PM2.5 and PM10) exposure and increased respiratory infection risk, with PM2.5 particularly linked to increased incidence and mortality in diseases like COVID-19 and tuberculosis. Heavy metals, including lead, cadmium, and mercury worsen chronic infections such as HIV/AIDS and hepatitis by increasing body burden and inflammation. The review highlights air pollutants' substantial impact on infectious disease spread and severity while noting a research gap on other pollutants including persistent organic pollutants (POPs) and polycyclic aromatic hydrocarbons (PAHs). Bias assessment indicates around half the studies show low risk of bias; however, potential biases were noted in confounding variables and blinding of outcome assessment.
The systematic review emphasizes the need for research on biological mechanisms underlying these associations and the impacts of other pollutants. Findings advocate for reducing environmental pollution exposure in LMICs to mitigate infectious disease risk.
本综述的目的是通过综合现有证据，确定在低收入和中等收入国家（LMICs）中，哪些环境毒物与传染病有关。其旨在总结主要发现，识别研究空白，并基于特定毒物与疾病结局之间的关联提供政策建议。
系统综述。
我们在PubMed、Scopus、科学网（核心合集）和CENTRAL（考克兰图书馆）进行了全面检索，以确定关于细菌、病毒和寄生虫致病活性的研究。
本次检索得到11468项研究，其中55项在按照标准方法筛选后符合纳入标准。研究发现，接触颗粒物（PM2.5和PM10）与呼吸道感染风险增加之间存在一致关联，PM2.5尤其与COVID-19和结核病等疾病的发病率和死亡率增加有关。包括铅、镉和汞在内的重金属会增加身体负担和炎症，从而加重HIV/AIDS和肝炎等慢性感染。该综述强调了空气污染物对传染病传播和严重程度的重大影响，同时指出在包括持久性有机污染物（POPs）和多环芳烃（PAHs）在内的其他污染物方面存在研究空白。偏倚评估表明，约一半的研究显示偏倚风险较低；然而，在混杂变量和结局评估的盲法方面发现了潜在偏倚。
该系统综述强调需要对这些关联背后的生物学机制以及其他污染物的影响进行研究。研究结果主张在低收入和中等收入国家减少环境污染暴露，以降低传染病风险。
