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Effect of outdoor particulate air pollution on FEV1 in healthy adults: a systematic review and meta-analysis
  1. Stefan Edginton1,
  2. Dylan E O’Sullivan2,
  3. Will King2,
  4. M Diane Lougheed1,2,3
  1. 1 Asthma Research Unit, Kingston General Hospital, Kingston, Ontario, Canada
  2. 2 Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
  3. 3 Division of Respirology, Department of Medicine, Queen’s University, Kingston, Ontario, Canada
  1. Correspondence to Dr M Diane Lougheed, Division of Respirology, Department of Medicine, Queen’s University, 102 Stuart Street, Kingston, Ontario K7L 2V6, Canada; mdl{at}


The effect of acute and long-term exposures to outdoor particulate air pollution on lung function in healthy adults is not well established. The objective of this study was to conduct a systematic literature review and meta-analysis of studies that assessed the relationship of outdoor particulate air pollution and lung function in healthy adults. Studies that contained data on outdoor air particulate matter levels (PM10 or PM2.5) and forced expiratory volume in 1 s (FEV1) in healthy adults were eligible for inclusion. Effect estimates, in relation to long-term and acute exposures, were quantified separately using random effects models. A total of 27 effect estimates from 23 studies were included in this review. Acute exposures were typically assessed with PM2.5, while long-term exposures were predominantly represented by PM10. A 10 µg/m3 increase in short-term PM2.5 exposure (days) was associated with a −7.02 mL (95% CI −11.75 to –2.29) change in FEV1. A 10 µg/m3 difference in long-term PM10 exposure was associated with a −8.72 mL (95% CI −15.39 to –2.07) annual change in FEV1 and an absolute difference in FEV1 of −71.36 mL (95% CI −134.47 to –8.24). This study provides evidence that acute and long-term exposure to outdoor particulate air pollution are associated with decreased FEV1 in healthy adults. Residual confounding from other risk factors, such as smoking, may explain some of the effect for long-term exposures. More studies are required to determine the relationship of long-term exposure to PM2.5 and short-term exposure to PM10, which may have different biologic mechanisms.

  • outdoor air pollution
  • healthy adults
  • spirometry
  • lung function
  • fev1
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  • Contributors SE, DEO and DL contributed to the study design; SE conducted the literature search and abstract screening; SE and DEO carried out the full-text review; DEO conducted the statistical analyses; WK provided guidance of the statistical analyses and revised the manuscript; SE, DEO and DL wrote and revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests DL reports personal fees from Public Service Occupational Health Program Regions and Programs Bureau Health Canada/Government of Canada, and honoraria from the Astra Zeneca PRECISION Program during the conduct of the study; other (all paid directly to Queen’s University) from: grant from Astra Zeneca, grant from GlaxoSmithKlein, grant from Hoffman LaRoche Ltd., grant from Novartis, grant and other from Ontario Lung Association, grant from Government of Ontario’s Innovation Fund, grant from Allergen NCE, grant from Janssen, grant from Canadian Institutes of Health Research, outside the submitted work

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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