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Int. J. Environ. Res. Public Health 2017, 14(6), 646; doi:10.3390/ijerph14060646

Systematic Review and Meta-Analysis of the Association between Ambient Nitrogen Dioxide and Respiratory Disease in China

1
School of Health Care Management, Shandong University, Key Laboratory of Health Economics and Policy Research, National Health and Family Planning Commission of People’s Republic of China (NHFPC), Shandong University, 44 West Wenhua Road, Jinan 250012, China
2
Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, 830 E Main St., Richmond, VA 23219, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 6 May 2017 / Revised: 7 June 2017 / Accepted: 14 June 2017 / Published: 16 June 2017
(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)
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Abstract

Objective: This study aimed to assess the quantitative effects of short-term exposure of ambient nitrogen dioxide (NO2) on respiratory disease (RD) mortality and RD hospital admission in China through systematic review and meta-analysis. Methods: A total of 29 publications were finally selected from searches in PubMed, Web of Science, CNKI and Wanfang databases. Generic inverse variance method was used to pool effect estimates. Pooled estimates were used to represent the increased risk of RD mortality and RD hospital admission per 10 μg/m3 increase in NO2 concentration. Results: Positive correlations were found between short-term NO2 exposure and RD in China. RD mortality and RD hospital admission respectively increased by 1.4% (95% CI: 1.1%, 1.7%) and 1.0% (95% CI: 0.5%, 1.5%) per 10 μg/m3 increase in NO2 concentration. Differences were observed across geographic regions of China. The risk of RD mortality due to NO2 was higher in the southern region (1.7%) than in the north (0.7%). Conclusions: Evidence was found that short-term exposure to NO2 was associated with an increased risk of RD mortality and RD hospital admission in China and these risks were more pronounced in the southern regions of the country, due in part to a larger proportion of elderly persons with increased susceptibility to NO2 in the population compared with the north. View Full-Text
Keywords: nitrogen dioxide; respiratory disease; hospital admission; China nitrogen dioxide; respiratory disease; hospital admission; China
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Sun, J.; Barnes, A.J.; He, D.; Wang, M.; Wang, J. Systematic Review and Meta-Analysis of the Association between Ambient Nitrogen Dioxide and Respiratory Disease in China. Int. J. Environ. Res. Public Health 2017, 14, 646.

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