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Air pollution interventions and respiratory health: a systematic review.

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Saleh, Sepeedeh, Shepherd, Wendi, Jewell, C, Lam, N L, Balmes, J, Bates, M N, Lai, P S, Ochieng, C A, Chinouya, Martha and Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871 (2020) 'Air pollution interventions and respiratory health: a systematic review.'. International Journal of Tuberculosis and Lung Disease, Vol 24, Issue 2, pp. 150-164.

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Abstract

Indoor and ambient air pollution exposure is a major risk to respiratory health worldwide, particularly in low- and middle-income countries (LMICs). Interventional trials have mainly focused on alternatives to cooking stoves, with mixed results. Beyond cooking, additional sources of particulate matter also contribute to the burden of air pollution exposure. This review explores evidence from current randomised controlled trials (RCTs) on the clinical effectiveness of interventions to reduce particulate matter in LMICs. Twelve databases and the grey literature (e.g., Government reports and policy papers) were searched. Eligible studies were RCTs conducted in LMICs aiming to reduce particulate exposure from any source and reporting on at least one clinical respiratory outcome (respiratory symptoms, lung function or clinical diagnoses). Data from relevant studies were systematically extracted, the risk of bias assessed and narrative synthesis provided. Of the 14 included studies, 12 tested 'improved' cookstoves, most using biomass, but solar and bioethanol cookers were also included. One trial used solar lamps and another was an integrated intervention incorporating behavioural and environmental components for the treatment and prevention of chronic obstructive pulmonary disease. Of the six studies reporting child pneumonia outcomes, none demonstrated significant benefit in intention-to-treat analysis. Ten studies reported respiratory symptom outcomes with some improvements seen, but self-reporting made these outcomes highly vulnerable to bias. Substantial inter-study clinical and methodological heterogeneity precluded calculation of pooled effect estimates. Evidence from the RCTs performed to date suggests that individual household-level interventions for air pollution exposure reduction have limited benefits for respiratory health. More comprehensive approaches to air pollution exposure reduction must be developed so their potential health benefits can be assessed.

Item Type: Article
Subjects: QS Anatomy > QS 4 General works. Classify here works on regional anatomy
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Air pollution > WA 750 Air sanitation and hygiene
WA Public Health > Air pollution > WA 754 Pollution and pollutants (incl. tobacco pollution; passive smoking)
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 202 Pneumonia (General or not elsewhere classified)
WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Education
Digital Object Identifer (DOI): https://doi.org/10.5588/ijtld.19.0417
Depositing User: Julie Franco
Date Deposited: 09 Mar 2020 12:16
Last Modified: 01 Aug 2020 01:02
URI: https://archive.lstmed.ac.uk/id/eprint/13920

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