Air pollution and mortality among infant and children underfive years: Asystematic review and meta-analysis

Özet

The main environmental cause of childhood mortality and morbidity around the world is related to air pollution.This meta-analysis aimed to examine the association between the mortality of infant and children under age offive and exposure to air pollution. PubMed/Medline, Web of Science, and EMBASE databases were searched torecognize studies published from 1992 to 2018. Twenty-seven studies met the inclusion criteria, of which eightstudies were conducted in North America, eight in Europe, six in Asia, four in Latin-American and one in Africa.We used the OHAT method (Office of Health Assessment and Translation) for evaluation of the risk of bias. Thepooled relative risks of the infant and child under-five mortality were estimated by Random andfixed-effectmodels. Increases in particulate matter (PM) concentration was related to infant and child under-five mortality(PM2.53.4%, per 10μg/m3(95% CI: 1.7%–5.4%); PM102.5%, per 10μg/m3(95% CI: 1.6%–4.3%)). The percentchange in the infant and child under-five mortality due to CO, NO2,SO2and O3exposure were 3.1% per 1 partper million (95% CI: 1.9–3.9%); 1.7% per 1 parts per billion (95% CI: 0.9–4.8%); 2.0% per 1 parts per billion(95% CI: 1.0–5.0%); and−1.1% per 1 parts per billion (95% CI:−2.6–0.3%), respectively. Conclusively, PM2.5,PM10, CO, NO2,and SO2were positively and significantly associated with both infant and child under-fivemortality. We obtained clear evidence of an association between exposure to particulate and gaseous air pol-lutants with the infant and child mortality. Registration number in PROSPERO: CRD42019120816