The association between short-term exposure to ambient air pollution and fractional exhaled nitric oxide level: A systematic review and meta-analysis of panel studies
2020
Chen, Xiaolu | Liu, Feifei | Niu, Zhiping | Mao, Shuyuan | Tang, Hong | Li, Na | Chen, Gongbo | Liu, Suyang | Lu, Yuanan | Xiang, Hao
Several epidemiological studies have evaluated the fractional exhaled nitric oxide (FeNO) of ambient air pollution but the results were controversial. We therefore conducted a systematic review and meta-analysis to investigate the associations between short-term exposure to air pollutants and FeNO level. We searched PubMed and Web of Science and included a total of 27 articles which focused on associations between ambient air pollutants (PM₁₀, PM₂.₅, black carbon (BC), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃)) exposure and the change of FeNO. Random effect model was used to calculate the percent change of FeNO in association with a 10 or 1 μg/m³ increase in air pollutants exposure concentrations. A 10 μg/m³ increase in short-term PM₁₀, PM₂.₅, NO₂, and SO₂ exposure was associated with a 3.20% (95% confidence interval (95%CI): 1.11%, 5.29%), 2.25% (95%CI: 1.51%, 2.99%),4.90% (95%CI: 1.98%, 7.81%), and 8.28% (95%CI: 3.61%, 12.59%) change in FeNO, respectively. A 1 μg/m³ increase in short-term exposure to BC was associated with 3.42% (95%CI: 1.34%, 5.50%) change in FeNO. The association between short-term exposure to O₃ and FeNO level was insignificant (P＞0.05). Future studies are warranted to investigate the effect of multiple pollutants, different sources and composition of air pollutants on airway inflammation.
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