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      Fine particulate matter (PM 2.5): The culprit for chronic lung diseases in China

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          Abstract

          Air pollution is a world public health problem. Particulate matter (PM), a mix of solid and liquid particles in the air, becomes an increasing concern in the social and economic development of China. For decades, epidemiological studies have confirmed the association between fine particle pollutants and respiratory diseases. It has been reported in different populations that increased Fine particulate matter (PM 2.5) concentrations cause elevated susceptibility to respiratory diseases, including acute respiratory distress, asthma, chronic obstructive pulmonary disease, and lung cancer. This review will discuss the pathophysiology of PM 2.5 in respiratory diseases, which are helpful for the prevention of air pollution and treatment of respiratory tract inflammatory diseases.

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          Most cited references75

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          Epidemiological time series studies of PM2.5 and daily mortality and hospital admissions: a systematic review and meta-analysis

          Background Short-term exposure to outdoor fine particulate matter (particles with a median aerodynamic diameter <2.5 μm (PM2.5)) air pollution has been associated with adverse health effects. Existing literature reviews have been limited in size and scope. Methods We conducted a comprehensive, systematic review and meta-analysis of 110 peer-reviewed time series studies indexed in medical databases to May 2011 to assess the evidence for associations between PM2.5 and daily mortality and hospital admissions for a range of diseases and ages. We stratified our analyses by geographical region to determine the consistency of the evidence worldwide and investigated small study bias. Results Based upon 23 estimates for all-cause mortality, a 10 µg/m3 increment in PM2.5 was associated with a 1.04% (95% CI 0.52% to 1.56%) increase in the risk of death. Worldwide, there was substantial regional variation (0.25% to 2.08%). Associations for respiratory causes of death were larger than for cardiovascular causes, 1.51% (1.01% to 2.01%) vs 0.84% (0.41% to 1.28%). Positive associations with mortality for most other causes of death and for cardiovascular and respiratory hospital admissions were also observed. We found evidence for small study bias in single-city mortality studies and in multicity studies of cardiovascular disease. Conclusions The consistency of the evidence for adverse health effects of short-term exposure to PM2.5 across a range of important health outcomes and diseases supports policy measures to control PM2.5 concentrations. However, reasons for heterogeneity in effect estimates in different regions of the world require further investigation. Small study bias should also be considered in assessing and quantifying health risks from PM2.5.
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            Fine Particulate Air Pollution and Daily Mortality. A Nationwide Analysis in 272 Chinese Cities.

            Evidence concerning the acute health effects of air pollution caused by fine particulate matter (PM2.5) in developing countries is quite limited.
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              Air pollution in China: Status and spatiotemporal variations.

              In recent years, China has experienced severe and persistent air pollution associated with rapid urbanization and climate change. Three years' time series (January 2014 to December 2016) concentrations data of air pollutants including particulate matter (PM2.5 and PM10) and gaseous pollutants (SO2, NO2, CO, and O3) from over 1300 national air quality monitoring sites were studied to understand the severity of China's air pollution. In 2014 (2015, 2016), annual population-weighted-average (PWA) values in China were 65.8 (55.0, 50.7) μg m(-3) for PM2.5, 107.8 (91.1, 85.7) μg m(-3) for PM10, 54.8 (56.2, 57.2) μg m(-3) for O3_8 h, 39.6 (33.3, 33.4) μg m(-3) for NO2, 34.1 (26, 21.9) μg m(-3) for SO2, 1.2 (1.1, 1.1) mg m(-3) for CO, and 0.60 (0.59, 0.58) for PM2.5/PM10, respectively. In 2014 (2015, 2016), 7% (14%, 19%), 17% (27%, 34%), 51% (67%, 70%) and 88% (97%, 98%) of the population in China lived in areas that meet the level of annual PM2.5, PM10, NO2, and SO2 standard metrics from Chinese Ambient Air Quality Standards-Grade II. The annual PWA concentrations of PM2.5, PM10, O3_8 h, NO2, SO2, CO in the Northern China are about 40.4%, 58.9%, 5.9%, 24.6%, 96.7%, and 38.1% higher than those in Southern China, respectively. Though the air quality has been improving recent years, PM2.5 pollution in wintertime is worsening, especially in the Northern China. The complex air pollution caused by PM and O3 (the third frequent major pollutant) is an emerging problem that threatens the public health, especially in Chinese mega-city clusters. NOx controls were more beneficial than SO2 controls for improvement of annual PM air quality in the northern China, central, and southwest regions. Future epidemiologic studies are urgently required to estimate the health impacts associated with multi-pollutants exposure, and revise more scientific air quality index standards.
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                Author and article information

                Contributors
                Journal
                Chronic Dis Transl Med
                Chronic Dis Transl Med
                Chronic Diseases and Translational Medicine
                Chinese Medical Association
                2095-882X
                2589-0514
                28 August 2018
                September 2018
                28 August 2018
                : 4
                : 3
                : 176-186
                Affiliations
                [a ]Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
                [b ]Section of Allergy and Clinical Immunology, Internal Medicine and Pediatrics, Yale University School of Medicine, New Haven, CT 06511, USA
                [c ]Department of Translational Medicine, Medical College of Xiamen University, Xiamen, Fujian 361102, China
                [d ]Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45249, USA
                [e ]Institute of Integrative Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, China
                [f ]Department of Respiratory Medicine, Jiangsu Shengze Hospital, Nanjing Medical University, Suzhou, Jiangsu 215228, China
                Author notes
                []Corresponding author. lfzhou@ 123456njmu.edu.cn
                [g]

                These authors contributed equally to this article.

                Article
                S2095-882X(17)30128-7
                10.1016/j.cdtm.2018.07.002
                6160608
                30276364
                1e9fbb96-937f-4675-8331-091d6665fd24
                © 2018 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 31 December 2017
                Categories
                Perspective

                air pollution,particulate matter,lung diseases,chronic obstructive pulmonary disease

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