Cited by 337Air Quality and Health ImpactsAsthma and respiratory diseasesIndoor Air Quality and Microbial Exposure

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Estimates of the Global Burden of Ambient PM2.5, Ozone, and NO2 on Asthma Incidence and Emergency Room Visits

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Anenberg, Susan C., Henze, Daven K., Tinney, Veronica, Kinney, Patrick L., Raich, William, Fann, Neal, Malley, Chris S., Roman, Henry, Lamsal, Lok, Duncan, Bryan, Martin, Randall V., van Donkelaar, Aaron, Brauer, Michael, Doherty, Ruth, Jonson, Jan Eiof, Davila, Yanko, Sudo, Kengo, Kuylenstierna, Johan C.I.·2018·Environmental Health Perspectives

DOI 10.1289/ehp3766PMC PMC6371661

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Abstract

Background: Asthma is the most prevalent chronic respiratory disease worldwide, affecting 358 million people in 2015. Ambient air pollution exacerbates asthma among populations around the world and may also contribute to new-onset asthma. Objectives: We aimed to estimate the number of asthma emergency room visits and new onset asthma cases globally attributable to fine particulate matter (PM2.5), ozone, and nitrogen dioxide (NO2) concentrations. Methods: We used epidemiological health impact functions combined with data describing population, baseline asthma incidence and prevalence, and pollutant concentrations. We constructed a new dataset of national and regional emergency room visit rates among people with asthma using published survey data. Results: We estimated that 9–23 million and 5–10 million annual asthma emergency room visits globally in 2015 could be attributable to ozone and PM2.5, respectively, representing 8–20% and 4–9% of the annual number of global visits, respectively. The range reflects the application of central risk estimates from different epidemiological meta-analyses. Anthropogenic emissions were responsible for ∼37% and 73% of ozone and PM2.5 impacts, respectively. Remaining impacts were attributable to naturally occurring ozone precursor emissions (e.g., from vegetation, lightning) and PM2.5 (e.g., dust, sea salt), though several of these sources are also influenced by humans. The largest impacts were estimated in China and India. Conclusions: These findings estimate the magnitude of the global asthma burden that could be avoided by reducing ambient air pollution. We also identified key uncertainties and data limitations to be addressed to enable refined estimation. https://doi.org/10.1289/EHP3766

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Authors: Anenberg, S. C., Henze, D. K., Tinney, V., Kinney, P. L., Raich, W., Fann, N., Malley, C. S., Roman, H., Lamsal, L., Duncan, B., Martin, R. V., van Donkelaar, A., Brauer, M., Doherty, R., Jonson, J. E., Davila, Y., Sudo, K., & Kuylenstierna, J. C. I.
Affiliations: George Washington University (US)
University of Colorado Boulder (US)
Boston University (US)
Industrial Economics, Inc. , Cambridge, Massachusetts,
Environmental Protection Agency (US)
Stockholm Environment Institute , York,
Goddard Space Flight Center (US)
Dalhousie University (CA)
Dalhousie University , Halifax, Nova Scotia,
University of British Columbia (CA)
University of Edinburgh (GB)
Norwegian Meteorological Institute (NO)
Japan Agency for Marine-Earth Science and Technology (JP)
Stockholm Environment Institute (GB)
Corresponding author: Anenberg, Susan C.
ORCID: Anenberg, Susan C.
Henze, Daven K.
Kinney, Patrick L.
Raich, William
Fann, Neal
Roman, Henry
Lamsal, Lok
Duncan, Bryan
Martin, Randall V.
Brauer, Michael
Doherty, Ruth
Davila, Yanko
Sudo, Kengo
Venue: Environmental Health Perspectives
Publisher: American Chemical Society (ACS)
Published: 2018-10-01
Volume: 126
Issue: 10
Pages: 107004-107004
ISSN: 0091-6765 (ISSN-L)
1552-9924
DOI: 10.1289/ehp3766
PMC: PMC6371661
OpenAlex: W2898247900
Cited by: 337
References: 71
Citations by year: 2026: 19 · 2025: 45 · 2024: 51 · 2023: 38 · 2022: 48 · 2021: 55 · 2020: 47 · 2019: 34
FWCI: 16.80
Type: journal article
Language: en
Open access: gold
doi.org
Licence: public-domain
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Environmental Health Perspectives (publishedVersion, public-domain)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
CU Scholar (University of Colorado Boulder) (submittedVersion)
Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
Funders: National Aeronautics and Space Administration
Stockholm Environment Institute
Institute for Health Metrics and Evaluation
Topics: Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
Keywords: asthma, ambient air pollution, PM2.5, ozone, nitrogen dioxide, emergency department visits, new-onset asthma, attributable burden, anthropogenic emissions, respiratory disease burden, China, India
MeSH terms: Air Pollution, Asthma, Emergency Service, Hospital, Environmental Exposure, Humans, Nitrogen Dioxide, Ozone, Particle Size, Risk Factors, Incidence, Particulate Matter

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Estimates of the Global Burden of Ambient PM2.5, Ozone, and NO2 on Asthma Incidence and Emergency Room Visits

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