Health Effects of Asian Dust: A Systematic Review and Meta-Analysis

Abstract

B ACKGROUND : Potential adverse health e ff ects of Asian dust exposure have been reported, but systematic reviews and quantitative syntheses are lacking. O BJECTIVE : We reviewed epidemiologic studies that assessed the risk of mortality, hospital admissions, and symptoms/dysfunction associated with exposure to Asian dust. M ETHODS : We performed a systematic search of PubMed and Web of Science to identify studies that reported the association between Asian dust ex- posure and human health outcomes. We conducted separate meta -analyses using a random -e ff ects model for mortality and hospital admissions for a speci fi c health outcome and assessed pooled estimates for each lag when at least three studies were available for a speci fi c lag. R ESULTS : We identi fi ed 89 studies that met our inclusion criteria for the systematic review, and 21 studies were included in the meta -analysis. The pooled estimates (percentage changes) of mortality from circulatory and respiratory causes for Asian dust days vs. non -Asian dust days were 2.33% [95% con fi dence interval (CI): 0.76, 3.93] increase at lag 0 and 3.99% (95% CI: 0.08, 8.06) increase at lag 3, respectively. The increased risk for hos- pital admissions for respiratory disease, asthma, and pneumonia peaked at lag 3 by 8.85% (95% CI: 0.80, 17.55), 14.55% (95% CI: 6.74, 22.94), and 8.51% (95% CI: 2.89, 14.44), respectively. Seven of 12 studies reported reduced peak expiratory fl ow, and 16 of 21 studies reported increased respira- tory symptoms associated with Asian dust exposure. There were substantial variations between the studies in de fi nitions of Asian dust, study designs, model speci fi cations, and confounder controls. D ISCUSSION : We found evidence of increased mortality and hospital admissions for circulatory and respiratory events. However, the number of studies included in the meta -analysis was not large and further evidences are merited to strengthen our conclusions. Standardized protocols for epidemiologi- cal studies would facilitate interstudy comparisons.