The deterioration of ambient air quality worldwide has intensified the need to examine the environmental factors associated with the growing burden of respiratory disease. This study aimed to identify broad patterns in the adverse effects of environmental exposures on the respiratory system, while accounting for regional variation and population-specific vulnerability. A systematic literature review was conducted between April and December 2024 using four international databases: PubMed, Web of Science, Scopus, and Google Scholar. Seventy-one relevant publications were included in the final analysis. The findings indicate that, in India, concentrations of particulate matter with aerodynamic diameters of up to 10 μm (PM₁₀) and 2.5 μm (PM₂.₅) exceed recommended limits by a factor of 2.56. In Northern Thailand, reductions of 5.3%–34.3% in particulate matter concentrations were associated with significant declines in hospitalization rates. In China and South Africa, pollutant levels substantially exceed the World Health Organization guideline of 5 μg/m³, while national standards in some settings permit concentrations of up to 40 μg/m³, thereby increasing the risk of chronic inflammatory respiratory conditions. In Bogotá, Colombia, heavy traffic contributes to increased morbidity and mortality from respiratory complications. In Kyrgyzstan, seasonal variation and changes in vegetation patterns have been linked to a rise in allergic reactions, whereas in Slovakia, prolonged pollen seasons are associated with a higher prevalence of bronchial asthma. Children, particularly those under 5 years of age, older adults, and industrial workers were identified as the most vulnerable groups. Climate change further aggravates these risks by intensifying exposure to fine particulate matter and gaseous pollutants. The findings underscore the need for integrated policies focused on emission reduction, environmental monitoring, public awareness, and the harmonization of air-quality standards. The study provides evidence that may support cross-sectoral planning and the development of preventive strategies aimed at reducing the burden of acute and chronic respiratory disease.
Indoor air quality (IAQ) is a critical determinant of clinical safety and infection control in healthcare facilities, where vulnerable populations exhibit greater susceptibility to indoor environmental conditions. This review synthesises global evidence from 215 peer-reviewed publications identified through PRISMA screening between 2015 and 2025, comprising 26 review papers and 189 primary studies. Evaluating publication trends, setting distribution, monitored parameters and regulatory frameworks, the findings reveal a sharp post-pandemic surge in research that is heavily skewed toward operating rooms (44%) and intensive care units (35%), while high-density patient waiting areas (< 2%) remain severely understudied. Although microbial contaminants and particulate matter are consistently prioritised to track infection risks, critical ventilation performance indicators like carbon dioxide concentrations (15%) and airflow (6%) are rarely monitored. Furthermore, using Malaysia as a representative case study with year-round tropical climates highlight a significant regulatory gap, as Malaysia relies primarily on general IAQ guidelines rather than comprehensive healthcare-specific IAQ threshold standards. Findings suggested that international IAQ thresholds may not be directly transferable to tropical healthcare facilities without adaptation. By connecting global evidence with local practices, this review identified key research gaps and highlighted the need for region-specific IAQ frameworks to support patient safety, staff well-being, and infection control in tropical healthcare settings.
The findings demonstrated a consistent association between NO₂ exposure and an increased risk of hypertension, particularly in poorly ventilated work environments, and underscore the importance of improving workplace air quality management, strengthening exposure monitoring, and implementing preventive occupational health strategies.
Ayudhia Rachmawati, Morrin Choirunnisa Thohira, M. Fitrah et al.· International Journal of Pub...· 0 citations
Background: Ambient particulate matter ≤2.5 μm (PM2.5) is a major environmental health risk contributing to global morbidity and mortality. Although its link with cardiovascular diseases is well established, evidence on the stroke burden attributable to PM2.5 exposure remains limited in Indonesia. Methods: This ecological study used Global Burden of Disease (GBD) 2021 data to analyze the association between PM2.5 exposure and stroke burden, including incidence, prevalence, and mortality, across 34 Indonesian provinces from 2011 to 2020. Age-standardized rates (ASRs) were assessed using a linear mixed model, with year as a repeated measure and province as a random effect to account for spatial and temporal variations. Findings: Mean PM2.5 concentrations ranged from 16.96 to 20.10 µg/m³, exceeding WHO and national air quality standards. Despite minor annual fluctuations in PM2.5, stroke mortality attributable to air pollution showed an increasing trend. Higher PM2.5 levels were significantly associated with ischemic stroke (IS) incidence (β = -0.117, p <0.001) and mortality (β = 0.152, p <0.001), as well as intracerebral hemorrhage (ICH) incidence (β = 0.017, p = 0.015), prevalence (β = 1.641, p <0.001), and mortality (β = 0.773, p = 0.004). The effect of PM2.5 exposure was greater for ICH than for IS. Conclusion: Long-term exposure to PM2.5 is significantly associated with stroke burden in Indonesia, particularly for ICH. Strengthening air quality management and stroke prevention policies is crucial, especially in high-risk regions. Novelty/Originality of this article: This study is the first to comprehensively assess the long-term association between PM2.5 and stroke subtypes using national-level GBD data across all Indonesian provinces, providing spatially and temporally robust evidence for public health policy in low- and middle-income tropical settings.
Salma Dhiya Rachmadani· Public Health Risk Assesment...· 0 citations
INTRODUCTION
Respiratory infections and tuberculosis are leading causes of global morbidity and mortality; yet comprehensive research on their associated risk factors remains limited, hindering the development of effective preventive strategies.
METHODOLOGY
The 2021 Global Burden of Disease data from 204 countries (1990-2021) was used to measure deaths, disability-adjusted life years (DALYs), and their age-standardized rates (ASMR and ASDR) tied to 9 risk factors. The trends were analyzed by age, gender, and socio-demographic index (SDI) regions, with annual and average annual percentage changes (APC, AAPC) used to track changes over time.
RESULTS
Globally, mortality rates (ASMR) for respiratory infections and tuberculosis linked to traditional risks-malnutrition, air pollution, and alcohol use-declined significantly; annual decreases of 4.46%, 3.18%, and 3.35%, respectively. Deaths attributed to metabolic risks like high BMI and blood sugar increased, despite falling ASMR. Geographic disparities were notable: Lesotho saw the sharpest rise in BMI-related mortality (3.92%), while Hungary had the steepest decline (-7.4%). Men faced a higher burden from behavioral risks, with tobacco-related mortality 3.6 times higher than in women. Children under 5 years were especially vulnerable to environmental risks, with unsafe water and sanitation contributing to a 4.55% annual decline in mortality rates.
CONCLUSIONS
This study highlights the need for targeted actions, such as tobacco control in high-middle SDI regions, air quality improvements in South Asia, and nutrition programs in Sub-Saharan Africa. It offers a precise public health framework to reduce respiratory infections and tuberculosis, and promote global health equity by analyzing sociodemographic and time trends.
Shareli Caikai, Jing Jiang, Yi Shi et al.· Journal of Infection in Deve...· 0 citations
This review synthesised evidence on associations between air pollution and respiratory morbidity in Africa. Following PRISMA guidelines, we systematically searched PubMed, ScienceDirect and Elicit for case-control studies published between 2015 and 2025. Thirteen studies from ten African countries reported pollutant levels far exceeding WHO guidelines. Indoor PM₂.₅ in biomass-using homes ranged from 96 to 177 µg/m³, and ambient PM₂.₅ reached 259 µg/m³. Nitrogen oxides were consistently associated with reduced lung function in children, while household air pollution increased risks of under-five mortality and low birthweight. Associations with acute respiratory infections varied across settings. Vulnerability was greatest among young children, those with airway hyperresponsiveness, and households with poor ventilation. Only three studies included temperature, and none examined heat–respiratory interactions. Across African case-control studies, particulate matter and household air pollution remain consistently linked to adverse respiratory outcomes, highlighting urgent needs for cleaner fuels, improved ventilation, and stronger evidence on combined pollution and heat exposures.
Caradee Y. Wright, T. Kapwata, Viwe Dikoko et al.· Current Environmental Health...· 0 citations
The findings indicate that long-term exposure to PM2.5 is associated with a significant increase in the risk of chronic respiratory conditions, cardiovascular diseases, and premature mortality, and integrated prevention strategies-combining policy measures, planning solutions, and technological innovations have proven effective in reducing ambient pollutant levels and associated health burdens.
Dragana Kerkez, S. Nešović, Kristina Filipović et al.· Zbornik radova· 0 citations
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