Journal Article

Ambient air pollution and non-communicable respiratory illness in sub-Saharan Africa: a systematic review of the literature

Larson, Peter S., Glenn, Bailey E., Espira, Leon M., Larson, Miles C.

2022

Overview

Introduction Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growth raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide. Methods We searched three major databases (PubMed, Web of Science, and Scopus) using the key words “asthma”, “chronic bronchitis”, “allergic rhinitis”, and “COPD” with “carbon monoxide (CO)”, “sulfuric oxide (SO)”, “ozone (O3)”, “nitrogen dioxide (NO2)”, and “particulate matter (PM)”, restricting the search to the 46 countries that comprise SSA. Only papers published in scholarly journals with a defined health outcome in individuals and which tested associations with explicitly measured or modelled air exposures were considered for inclusion. All candidate papers were entered into a database for review. Results We found a total of 362 unique research papers in the initial search of the three databases. Among these, 14 met the inclusion criteria. These papers comprised studies from just five countries. Nine papers were from South Africa; two from Malawi; and one each from Ghana, Namibia, and Nigeria. Most studies were cross-sectional. Exposures to ambient air pollutants were measured using spectrometry and chromatography. Some studies created composite measures of air pollution using a range of data layers. NCRD outcomes were measured by self-reported health status and measures of lung function (spirometry). Populations of interest were primarily schoolchildren, though a few studies focused on secondary school students and adults. Conclusions The paucity of research on NCRDs and ambient air pollutant exposures is pronounced within the African continent. While capacity to measure air quality in SSA is high, studies targeting NCRDs should work to draw attention to questions of outdoor air pollution and health. As the climate changes and SSA economies expand and countries urbanize, these questions will become increasingly important.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aerosols / Air Pollutants - adverse effects / Air Pollutants - analysis / Air pollution / Air Pollution - adverse effects / Air Pollution - analysis / Air pollution measurements / Air quality / Air quality measurements / Airborne particulates / Allergic rhinitis / Asthma / Bronchitis / Bronchitis, Chronic / Carbon monoxide / Child / Chronic illnesses / Chronic obstructive pulmonary disease / Climate change / Earth and Environmental Science / Environment / Environmental Epidemiology / Environmental Health / Exposure / Health aspects / Human subjects / Humans / Literature reviews / Lung diseases / Nitrogen dioxide / Nitrogen Dioxide - analysis / Noncommunicable respiratory disease / Obstructive lung disease / Occupational Medicine/Industrial Medicine / Outdoor air quality / Ozone / Ozone - analysis / Particulate emissions / Particulate matter / Particulate Matter - adverse effects / Particulate Matter - analysis / Pollutants / Pollution studies / Population / Population growth / Public Health / Pulmonary Disease, Chronic Obstructive - epidemiology / Questions / Respiratory / Respiratory diseases / Respiratory function / Respiratory tract diseases / Review / Rhinitis / Rhinitis, Allergic / Risk factors / Scientific papers / Spectrometry / Sulfuric oxide / Systematic review / Urbanization