Respiratory health outcomes and air pollution in the Eastern Mediterranean Region: a systematic review

Nour Abdo, Yousef S. Khader, Mostafa Abdelrahman, Ashley Graboski-Bauer, Mazen Malkawi, Munjed Al-Sharif and Ahmad M. Elbetieha
  • Department of Applied Biological Sciences, Jordan University of Science and Technology
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Exposure to air pollution can cause detrimental health and be an economic burden. With newly developed equipment, monitoring of different air pollutants, identifying the sources, types of air pollutants and their corresponding concentrations, and applying mitigation intervention techniques became a crucial step in public health protection. Countries in the Eastern Mediterranean Region (EMR) are highly exposed to dust storms, have high levels of particulate matter (PM) concentrations, and have a unique climatic as well as topographic and socio-economic structure. This is the first study conducted to systemically and qualitatively assess the health impacts of air pollution in the EMR, identify susceptible populations, and ascertain research and knowledge gaps in the literature to better inform decisions by policy makers. We screened relevant papers and reports published between 2000 and 2014 in research databases. A total of 36 published studies met the inclusion criteria. A variety of indoor and outdoor exposures associated with various acute and chronic respiratory health outcomes were included. Respiratory health outcomes ranged in severity, from allergies and general respiratory complaints to lung cancer and mortality. Several adverse health outcomes were positively associated with various indoor/outdoor air pollutants throughout the EMR. However, epidemiological literature concerning the EMR is limited to a few studies in a few countries. More research is needed to elucidate the health outcomes of air pollution. Standardized reliable assessments on the national level for various air pollutants in different regions should be implemented and made publically available for researchers to utilize in their research. Moreover, advancing and utilizing more sound epidemiological designs and studies on the effect of air pollution on the respiratory health outcomes is needed to portray the actual situation in the region.

  • 1.

    Chen Z, Salam MT, Eckel SP, Breton CV, Gilliland FD. Chronic effects of air pollution on respiratory health in Southern California children: findings from the Southern California Children’s Health Study. J Thorac Dis 2015;7(1):46–58.

  • 2.

    Simoni M, Baldacci S, Maio S, Cerrai S, Sarno G, et al. Adverse effects of outdoor pollution in the elderly. J Thorac Dis 2015;7(1):34–45.

  • 3.

    World Health Organization. 2014. Ambient (outdoor) air quality and health. Fact sheet retrieved on March 19th 2015. Available at:

  • 4.

    World Health Organization. Household air pollution data by country. Retrieved January 31, 2016, Available at:

  • 5.

    Zhang JJ, Smith KR. Indoor air pollution: a global health concern. Br Med Bull 2003;68:209–25.

  • 6.

    Desai MA, Mehta S, Smith KR. Indoor smoke from solid fuels: assessing the environmental burden of disease at national and local levels. Geneva: World Health Organization, 2004 (WHO Environmental Burden of Disease Series, No. 4).

  • 7.

    Goudarzi G, Shirmardi M, Khodarahmi F, Hashemi-Shahraki A, Alavi N, et al. Particulate matter and bacteria characteristics of the Middle East Dust (MED) storms over Ahvaz, Iran. Aerobiologia 2014;30:345–56.

  • 8.

    Hospodsky D, Qian J, Nazaroff WW, Yamamoto N, Bibby K, et al. Human occupancy as a source of indoor airborne bacteria. PLoS One 2012;7(4):e34867.

  • 9.

    CDC. 2013. Air pollution and respiratory health. Retrieved on March 19th 2015. Available at:

  • 10.

    Hasnain S, Al-Frayh A, Subiza J, Fernández-Caldas E, Casanovas M, et al. Sensitization to indigenous pollen and molds and other outdoor and indoor allergens in allergic patients from Saudi Arabia, United Arab Emirates, and Sudan. World Allergy Organ J 2012;5(6):59–65.

  • 11.

    International Agency for Research on Cancer IARC. 2013. WHO. IARC: Outdoor air pollution a leading environmental cause of cancer deaths. PRESS RELEASE N° 221.

  • 12.

    World Health Organization. 2012 Mortality from household air pollution. Retrieved January 31, 2016. Available at:

  • 13.

    El Raey M. 2006. Air quality and atmospheric pollution in the Arab region. United National Environment Programme, Regional Office for West Asia. Available at:

  • 14.

    Kumar M. Air quality in the Middle East and Indian Sub-continent. 2015 retrieved on March 17th 2015. Available at:

  • 15.

    Croitoru L, Sarraf M. The cost of environmental degradation case studies from the Middle East and North Africa. The World Bank.

  • 16.

    World Bank. 2013. World Development Indicators database. Available online at:

  • 17.

    Engelbrecht JP, McDonald EV, Gillies JA, Jayanty RK, Casuccio G, et al. Characterizing mineral dusts and other aerosols from the Middle East – Part 1: ambient sampling. Inhal Toxicol 2009;21(4):297–326.

  • 18.

    World Health Organization. Ambient (outdoor) air pollution in cities database 2014. Retrieved January 31, 2016. Available at:

  • 19.

    WHO’s ten worst countries for air pollution. Retrieved from:

  • 20.

    World Health Organization. Household air pollution and health. Fact Sheet No. 292. 2016. Retrieved January 31, 2016. Available at:

  • 21.

    Khattab A, Javaid A, Iraqi G, Alzaabi A, Ben Kheder A, et al. Smoking habits in the Middle East and North Africa: results of the BREATHE study. Respir Med 2012;106(Suppl 2): s16–24.

  • 22.

    El-Ghitany EM, Abd El-Salam MM. Environmental intervention for house dust mite control in childhood bronchial asthma. Environ Health Prev Med 2012;17(5):377–84.

  • 23.

    Shiva F, Nasiri M, Sadeghi B, Padyab M. Effects of passive smoking on common respiratory symptoms in young children. Acta Paediatr 2003;92(12):1394–7.

  • 24.

    Abdul Wahab A, Mostafa OA. Arabian incense exposure among Qatari asthmatic children. A possible risk factor. Saudi Med J 2007;28(3):476–8.

  • 25.

    Al-Mousawi MS, Lovel H, Behbehani N, Arifhodzic N, Woodcock A, et al. Asthma and sensitization in a community with low indoor allergen levels and low pet-keeping frequency. J Allergy Clin Immunol 2004;114(6):1389–94.

  • 26.

    Al-Rawas OA, Al-Maniri AA, Al-Riyami BM. Home exposure to Arabian incense (bakhour) and asthma symptoms in children: a community survey in two regions in Oman. BMC Pulm Med 2009;9:23.

  • 27.

    Houssaini AS, Messaouri H, Nasri I, Roth MP, Nejjari C, et al. Air pollution as a determinant of asthma among schoolchildren in Mohammedia, Morocco. Int J Environ Health Res 2007;17(4):243–57.

  • 28.

    Fahim AE, El-Prince M. Pulmonary function impairment and airway allergy among workers in traditional bakeries. Int J Occup Med Environ Health 2013;26(2):214–9.

  • 29.

    Masjedi MR, Jamaati HR, Dokouhaki P, Ahmadzadeh Z, Taheri SA, et al. The effects of air pollution on acute respiratory conditions. Respirology 2003;8(2):213–30.

  • 30.

    Yeatts KB, El-Sadig M, Leith D, Kalsbeek W, Al-Maskari F, et al. Indoor air pollutants and health in the United Arab Emirates. Environ Health Perspect 2012;120(5):687–94.

  • 31.

    Maziak W, Ward KD, Rastam S, Mzayek F, Eissenberg T. Extent of exposure to environmental tobacco smoke (ETS) and its dose-response relation to respiratory health among adults. Respir Res 2005;6:13.

  • 32.

    Thalib L, Al-Taiar A. Dust storms and the risk of asthma admissions to hospitals in Kuwait. Sci Total Environ 2012;433:347–51.

  • 33.

    Mahboub B, Al-Hammadi S, Prakash VP, Sulaiman N, Blaiss MS, et al. Prevalence and triggers of allergic rhinitis in the United Arab Emirates. World Allergy Organ J 2014;7(1):19.

  • 34.

    Elshabrawy WO, Ismail HA, Hassanein KM. The impact of environmental and agricultural pollutants on the prevalence of allergic diseases in people from Qassim, KSA. Int J Health Sci (Qassim) 2014;8(1):21–31.

  • 35.

    Qasem JA, Nasrallah H, Al-Khalaf BN, Al-Sharifi F, Al-Sherayfee A, et al. Meteorological factors, aeroallergens and asthma-related visits in Kuwait: a 12-month retrospective study. Ann Saudi Med 2008;28(6):435–41.

  • 36.

    Kelishadi R, Hashemi M, Javanmard SH, Mansourian M, Afshani M, et al. Effect of particulate air pollution and passive smoking on surrogate biomarkers of endothelial dysfunction in healthy children. Paediatr Int Child Health 2014;34(3):165–9.

  • 37.

    Meo SA, Al-Kheraiji MF, Alfaraj ZF, Alwehaibi NA, Aldereihim AA. Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia. Pak J Med Sci 2013;29(2):642–6.

  • 38.

    Kobrossi R, Nuwayhid I, Sibai AM, El-Fadel M, Khogali M. Respiratory health effects of industrial air pollution on children in North Lebanon. Int J Environ Health Res 2002;12(3):205–20.

  • 39.

    Zeidan RK, Rachidi S, Awada S, El Hajje A, El Bawab W, et al. Carbon monoxide and respiratory symptoms in young adult passive smokers: a pilot study comparing waterpipe to cigarette. Int J Occup Med Environ Health 2014;27(4):571–82.

  • 40.

    Merghani TH, Saeed AM. The relationship between regular second-hand smoke exposure at home and indictors of lung function in healthy school boys in Khartoum. Tob Control 2013;22(5):315–8.

  • 41.

    Hammad M, Atta K, Manzoor M, Tariq M, Saeed Z, et al. Association of passive smoking with respiratory symptoms and clinical correlates, among married women, in a rural community in Islamabad. J Pak Med Assoc 2010;60(7):601–4.

  • 42.

    Abu Sham’a F, Skogstad M, Nijem K, Bjertness E, Kristensen P. Lung function and respiratory symptoms in male Palestinian farmers. Arch Environ Occup Health 2010;65(4):191–200.

  • 43.

    Mansourian M, Javanmard SH, Poursafa P, Kelishadi R. Air pollution and hospitalization for respiratory diseases among children in Isfahan, Iran. Ghana Med J 2010;44(4):138–43.

  • 44.

    Awadalla NJ, Hegazy A, Elmetwally RA, Wahby I. Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Egypt: a multicenter case-control study. Int J Occup Environ Med 2012;3(3):107–16.

  • 45.

    Qorbani M, Yunesian M, Baradaran HR. Indoor smoke exposure and risk of anthracosis. Iran J Med Sci 2014;39(6):571–6.

  • 46.

    Waked M, Salame J, Khayat G, Salameh P. Correlates of COPD and chronic bronchitis in non-smokers: data from a cross-sectional study. Int J Chron Obstruct Pulmon Dis 2012;7:577–85.

  • 47.

    Mohammad Y, Shaaban R, Hassan M, Yassine F, Mohammad S, et al. Respiratory effects in children from passive smoking of cigarettes and narghile: ISAAC phase three in Syria. Int J Tuberc Lung Dis 2014;18(11):1279–84.

  • 48.

    Akhtar T, Ullah Z, Khan MH, Nazli R. Chronic bronchitis in women using solid biomass fuel in rural Peshawar, Pakistan. Chest 2007;132(5):1472–5.

  • 49.

    Ghozikali MG, Mosaferi M, Safari GH, Jaafari J. Effect of exposure to O3, NO2, and SO2 on chronic obstructive pulmonary disease hospitalizations in Tabriz, Iran. Environ Sci Pollut Res Int 2015;22(4):2817–23.

  • 50.

    Hamadeh RR, Al-Roomi KA. Air quality and seasonal variations in consultations for respiratory, allergic, dermatological and gastrointestinal diseases in Bahrain, 2007. East Mediterr Health J 2014;20(5):309–16.

  • 51.

    Sasco AJ, Merrill RM, Dari I, Benhaïm-Luzon V, Carriot F, et al. A case-control study of lung cancer in Casablanca, Morocco. Cancer Causes Control 2002;13(7):609–16.

  • 52.

    Aoun J, Saleh N, Waked M, Salamé J, Salameh P. Lung cancer correlates in Lebanese adults: a pilot case – control study. J Epidemiol Glob Health 2013;3(4):235–44.

  • 53.

    Luqman M, Javed MM, Daud S, Raheem N, Ahmad J, et al. Risk factors for lung cancer in the Pakistani population. Asian Pac J Cancer Prev 2014;15(7):3035–9.

  • 54.

    Gholampour A, Nabizadeh R, Naseri S, Yunesian M, Taghipour H, et al. Exposure and health impacts of outdoor particulate matter in two urban and industrialized area of Tabriz, Iran. J Environ Health Sci Eng 2014;12(1):27.

  • 55.

    Li Y, Gibson JM, Jat P, Puggioni G, Hasan M, et al. Burden of disease attributed to anthropogenic air pollution in the United Arab Emirates: estimates based on observed air quality data. Sci Total Environ 2010;408(23):5784–93.

  • 56.

    Al-Taiar A, Thalib L. Short-term effect of dust storms on the risk of mortality due to respiratory, cardiovascular and all-causes in Kuwait. Int J Biometeorol 2014;58(1):69–77.

  • 57.

    Leski TA, Malanoski AP, Gregory MJ, Lin B, Stenger DA. Application of a broad-range resequencing array for detection of pathogens in desert dust samples from Kuwait and Iraq. Appl Environ Microbiol 2011;77(13):4285–92.

  • 58.

    Hasnain SM, Akhter T, Waqar MA. Airborne and allergenic fungal spores of the Karachi environment and their correlation with meteorological factors. J Environ Monit 2012;14(3):1006–13.

  • 59.

    Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012;380(9859):2095–128.

  • 60.

    World Health Organization. The global burden of disease: 2004 Update.Geneva, Switzerland: World Health Organization 2008.

  • 61.

    Emanuel MB. Hay fever, a post industrial revolution epidemic: a history of its growth during the 19th century. Clin Allergy 1988;18:295–304.

  • 62.

    Bascom R, Bromberg PA, Costa DA, Devlin R, Dockery DW, et al. State of the art: health effects of outdoor air pollution (parts 1 and 2). Am J Respir Crit Care Med 1996;153:3–50 and 477–98.

  • 63.

    Delfino RJ. Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community air pollution research. Environ Health Perspect 2002;110(Suppl 4):573–89.

  • 64.

    Abbey DE, Burchette RJ, Knutsen SF, McDonnell WF, Lebowitz MD, et al. Long-term particulate and other air pollutants and lung function in non-smokers. Am J Respir Crit Care Med 1998;158:289–98.

  • 65.

    Berglund DJ, Abbey DE, Lebowitz MD, Knutsen SF, McDonnell WF. Respiratory symptoms and pulmonary function in an elderly nonsmoking population. Chest 1999;115:49–59.

  • 66.

    Frischer T, Studnicka M, Gartner C, Tauber E, Horak F, et al. Lung function growth and ambient ozone: a three-year population study in school children. Am J Respir Crit Care Med 1999;160:390–6.

  • 67.

    Jedrychowski W, Flak E, Mróz E. The adverse effect of low levels of ambient air pollutants on lung function growth in preadolescent children. Environ Health Perspect 1999;107:669–74.

  • 68.

    Gauderman WJ, McConnell R, Gilliland F, London S, Thomas D, et al. Association between air pollution and lung function growth in southern California children. Am J Respir Crit Care Med 2000;162:1383–90.

  • 69.

    Abbey DE, Mills PK, Petersen FF, Beeson WL. Long-term ambient concentrations of total suspended particulates and oxidants as related to incidence of chronic disease in California seventh-day adventists. Environ Health Perspect 1991;94:43–50.

  • 70.

    Abbey DE, Petersen FF, Mills PK, Kittle L. Chronic respiratory disease associated with long-term ambient concentrations of sulfates and other air pollutants. J Expos Anal Environ Epidemiol 1993:3(Suppl 1):99–115.

  • 71.

    McDonnell WF, Abbey DE, Nishino N, Lebowitz MD. Longterm ambient ozone concentration and the incidence of asthma in nonsmoking adults: the AHSMOG Study. Environ Res 1999;80:110–21.

  • 72.

    Gauderman WJ, Avol E, Lurmann F, Kuenzli N, Gilliland F, et al. Childhood asthma and exposure to traffic and nitrogen dioxide. Epidemiology 2005;16:737–43.

  • 73.

    Jerrett M, Shankardass K, Berhane K, Gauderman WJ, Künzli N, et al. Traffic-related air pollution and asthma onset in children: a prospective cohort study with individual exposure measurement. Environ Health Perspect 2008;116:1433–8.

  • 74.

    McConnell R, Islam T, Shankardass K, Jerrett M, Lurmann F, et al. Childhood incident asthma and traffic-related air pollution at home and school. Environ Health Perspect 2010;118:1021–6.

  • 75.

    McConnell R, Berhane K, Gilliland F, London SJ, Islam T, et al. Asthma in exercising children exposed to ozone: a cohort study. Lancet 2002;359:386–91.

  • 76.

    Al-Riyami BM, Al-Rawas OA, Al-Riyami AA, Jasim LG, Mohammed AJ. Prevalence of asthma symptoms in Omani school children. SQU J Sci Res – Med Sci 2001;3:21–7.

  • 77.

    Al-Rawas OA, Al-Riyami BM, Al-Kindi HA, Al-Maniri AA, Al-Riyami AA. Regional variation in the prevalence of asthma symptoms among Omani school children: Comparisons from two nationwide cross-sectional surveys six years apart. SQU Med J 2008;8:157–64.

  • 78.

    Al-Riyami BM, Al-Rawas OA, Al-Riyami AA, Jasim LG, Mohammed AJ. A relatively high prevalence and severity of asthma, allergic rhinitis and atopic eczema in schoolchildren in the Sultanate of Oman. Respirology 2003;8:69–76.

  • 79.

    Asher MI, Anderson HR, Stewart AW, Crane J. Worldwide variations in the prevalence of asthma symptoms. The International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998;12:315–35.

  • 80.

    El-Hefny AM, Nassar SI, El-Heneidy FM, Said M, El-Beleidy AS, et al. Epidemiology of childhood asthma in Cairo. Med J Cairo Univ 1994;62:505–18.

  • 81.

    Strachan DP, Cook DG. Health effects of passive smoking. Parental smoking and childhood asthma: longitudinal and case-control studies. Thorax 1998;53:204–12.

  • 82.

    Tseng RY, Li CK. Low level atmospheric sulfur dioxide pollution and childhood asthma. Ann Allergy 1990;65(5):379–83.

  • 83.

    Hua J, Yin Y, Peng L, Du L, Geng F, et al. Acute effects of black carbon and PM2.5 on children asthma admissions: a time-series study in a Chinese city. Sci Total Environ 2014;481:433–8.

  • 84.

    Leikauf GD, Kline S, Albert RE, Baxter CS, Bernstein DI, et al. Evaluation of a possible association of urban air toxics and asthma. Environ Health Perspect 1995;103:253–71.

  • 85.

    Oryszczyn MP, Annesi-Maesano I, Charpin D, Paty E, Maccario J, et al. Relationships of active and passive smoking to total IgE in adults of the Epidemiological Study of the Genetics and Environment of Asthma, Bronchial Hyperresponsiveness, and Atopy (EGEA). Am J Respir Crit Care Med 2000;161:1241–6.

  • 86.

    Jindal SK. Effects of smoking on asthma. J Assoc Physicians India 2014;62(3 Suppl):32–7.

  • 87.

    Welte T, Groneberg DA. Asthma and COPD. Exp Toxicol Pathol 2006;57:35–40.

  • 88.

    Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease – Revised November 2011. Available from: Accessed January 10, 2012.

  • 89.

    Montes de Oca M, Halbert RJ, Lopez Varela MV, Perez-Padilla R, Tálamo C, et al. The chronic bronchitis phenotype in subjects with and without COPD: the PLATINO study. Eur Respir J 2012;40:28–36.

  • 90.

    Burgel PR, Paillasseur JL, Caillaud D, Tillie-Leblond I, Chanez P, et al. Clinical COPD phenotypes: a novel approach using principal components and cluster analysis. Eur Respir J 2010;36:531–9.

  • 91.

    World Health Organization. Chronic Obstructive Pulmonary Disease (COPD). Available online: Accessed on 17 Feb 2015.

  • 92.

    Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease. Lancet 2012;379:1341–51.

  • 93.

    Eisner MD, Anthonisen N, Coultas D, Kuenzli N, Perez-Padilla R, et al. An official American Thoracic Society public policy statement: novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2010;182:693–718.

  • 94.

    Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS, GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med 2001;163(5):1256–76.

  • 95.

    Ezzati M, Kammen DM. The health impacts of exposure to indoor air pollution from solid fuels in developing countries: knowledge, gaps, and data needs. Environ Health Perspect 2002;110:1057–68.

  • 96.

    Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Selected major risk factors and global and regional burden of disease. Lancet 2002;360:1347–60.

  • 97.

    World Health Organization. The world health report 2002 – reducing risks, promoting healthy life. Geneva: WHO, 2002. Available online:

  • 98.

    Zhou Y, Zou Y, Li X, Chen S, Zhao Z, et al. Lung function and incidence of chronic obstructive pulmonary disease after improved cooking fuels and kitchen ventilation: a 9-year prospective cohort study. PLoS Med 2014;11:e1001621.

  • 99.

    Hu G, Zhou Y, Tian J, Yao W, Li J, et al. Risk of COPD from exposure to biomass smoke: a metaanalysis. Chest 2010;138:20–31.

  • 100.

    Malekafzali H, Masjedi MR, Ahmadzadeh Z, Salmanmanesh H, Abadi A. Report of Air Pollutants Survey in Tehran. Library of Ministry of Health and Medical Education of IR, Iran, 1993.

  • 101.

    Figueroa MCG, Carrillo G, Pèrez-Padilla R, Fernández-Plata MR, Buendía-Roldán I, et al. Risk factors for idiopathic pulmonary fibrosis in a Mexican population. A case-control study. Respir Med 2010;104:305–9.

  • 102.

    Ramage JE, Roggli VL, Bell DY. Interstitial lung disease and domestic wood burning. Am Rev Respir Dis 1988;137:1229–32.

  • 103.

    Scott J, Johnston I, Britton J. What causes cryptogenic fibrosing alveolitis? A case-control study of environmental exposure to dust. Br Med J 1990;301:1015–7.

  • 104.

    Hubbard R, Lewis S, Richards K. Occupational exposure to metal or wood dust and aetiology of crytogenic fibrosing alveolitis. Lancet 1996;347:284–9.

  • 105.

    Chung MP, Lee KS, Han J, Kim H, Rhee CH, et al. Bronchial stenosis due to anthracofibrosis. Chest 1998;113:344–50.

  • 106.

    IARC. 2015. WHO. Global cancer incidence. Accessed on March 29, 2015. Available at:

  • 107.

    Jemal A, Bray F, Center MM, Ferlay J, Ward E, et al. Global cancer statistics. CA Cancer J Clin 2011;61:69–90.

  • 108.

    Lissowska J, Bardin-Mikolajczak A, Fletcher T, Zaridze D, Szeszenia-Dabrowska N, et al. Lung cancer and indoor pollution from heating and cooking with solid fuels: the IARC international multicentre case-control study in Eastern/Central Europe and the United Kingdom. Am J Epidemiol 2005;162:326–33.

  • 109.

    Cohen AJ, Pope III CA. Lung cancer and air pollution. Environ Health Perspect 1995;103(Suppl.):219–24.

  • 110.

    Olsson AC, Gustavsson P, Zaridze D, Mukeriya A, Szeszenia-Dabrowska N, et al. Lung cancer risk attributable to occupational exposures in a multicenter case-control study in Central and Eastern Europe. J Occup Environ Med 2011;53:1262–7.

  • 111.

    Man Lai K, Emberlin J, Colbeck I. Outdoor environments and human pathogens in air. Environ Health 2009;8(Suppl 1):S15.

  • 112.

    Thurston G, Lippmann M. Ambient particulate matter air pollution and cardiopulmonary diseases. Semin Respir Crit Care Med 2015;36(3):422–32.

  • 113.

    Brook RD, Rajagopalan S, Pope CA, Brook JR, Bhatnagar A, et al. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 2010;121:2331–78.

  • 114.

    Sacks JD, Stanek LW, Luben TJ, Johns DO, Buckley BJ, et al. Particulate matter-induced health effects: who is susceptible? Environ Health Perspect 2011;119:446–54.

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