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The association between PM2.5 exposure and neurological disorders: A systematic review and meta-analysis
Fu P, Guo X, Cheung FMH, Yung KKL.. The Science of the total environment, 2018-11-15
Topic: Risk, prevention and care in population studies
Background Recent systematic review and meta-analyses have tried to identify an association between PM 2.5 exposure and stroke, but few could find a conclusive and comprehensive evidence. Moreover, the associations between PM 2.5 , neurodegenerative diseases and neurodevelopmental disorders have never been reviewed. We aimed to assess the effects of PM 2.5 exposure on stroke, dementia, Alzheimer's disease, autism spectrum disorder (ASD), Parkinson's disease, and mild cognitive impairment (MCI). Methods We searched PubMed and CNKI databases for articles published until June 2018. Studies were eligible for analysis if they were human studies and provided risk estimates with 95% CI. We screened 1645 articles and identified 80 eligible studies covering 26 countries across all continents except Antarctica. Risks of incidence and mortality were extracted and stratified by types of neurological disorders, PM 2.5 concentration and duration of PM 2.5 exposure. Results We found significant association between PM 2.5 exposure and stroke, dementia, Alzheimer's disease, ASD, Parkinson's disease. The risks of ischemic and hemorrhagic stroke were higher than that of stroke in general, and that hemorrhagic stroke had by far the highest mortality. The risk of stroke for heavily polluted countries was significantly higher than that of lightly polluted countries. Short- and long-term PM 2.5 exposure was associated with increased risks of stroke (short-term odds ratio 1.01 [per 10 μg/m 3 increase in PM 2.5 concentrations], 95% CI 1.01-1.02; long-term 1.14, 95% CI 1.08-1.21) and mortality (short-term 1.02, 95% CI 1.01-1.04; long-term 1.15, 95% CI 1.07-1.24) of stroke. Long-term PM 2.5 exposure was associated with increased risks of dementia (1.16, 95% CI 1.07-1.26), Alzheimer's disease (3.26, 95% 0.84-12.74), ASD (1.68, 95% CI 1.20-2.34), and Parkinson's disease (1.34, 95% CI 1.04-1.73). Conclusions There is a strong association between PM 2.5 exposure and neurological disorders. National governments should exert greater efforts to improve air quality given its health implications.
Key findings
- Results We found significant association between PM 2.5 exposure and stroke, dementia, Alzheimer's disease, ASD, Parkinson's disease.
- The risk of stroke for heavily polluted countries was significantly higher than that of lightly polluted countries.
- Short- and long-term PM 2.5 exposure was associated with increased risks of stroke (short-term odds ratio 1.01 [per 10 μg/m 3 increase in PM 2.5 concentrations], 95% CI 1.01-1.02; long-term 1.14, 95% CI 1.08-1.21) and mortality (short-term 1.02, 95% CI 1.01-1.04; long-term 1.15, 95% CI 1.07-1.24) of stroke.
- Long-term PM 2.5 exposure was associated with increased risks of dementia (1.16, 95% CI 1.07-1.26), Alzheimer's disease (3.26, 95% 0.84-12.74), ASD (1.68, 95% CI 1.20-2.34), and Parkinson's disease (1.34, 95% CI 1.04-1.73).
Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 66/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 38 of the 58 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Science of the total environment) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2019 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30577116) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 38 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 38 of the 58 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Fu, P., Guo, X., Cheung, F. M. H., & Yung, K. K. L. (2019). The association between PM2.5 exposure and neurological disorders: A systematic review and meta-analysis. The Science of the total environment. https://doi.org/10.1016/j.scitotenv.2018.11.218
Vancouver
Fu P, Guo X, Cheung FMH, Yung KKL. The association between PM2.5 exposure and neurological disorders: A systematic review and meta-analysis. The Science of the total environment. 2019. doi:10.1016/j.scitotenv.2018.11.218. PMID: 30577116.
BibTeX
@article{fu2019-30577116,
author = {Fu, P. and Guo, X. and Cheung, F. M. H. and Yung, K. K. L.},
title = {{The association between PM2.5 exposure and neurological disorders: A systematic review and meta-analysis}},
journal = {The Science of the total environment},
year = {2019},
doi = {10.1016/j.scitotenv.2018.11.218},
pmid = {30577116},
url = {https://doi.org/10.1016/j.scitotenv.2018.11.218}
}
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