A joint ERS/ATS policy statement: what constitutes an adverse health effect of air pollution? An analytical framework

TLDR

Air‑pollution health effects have been studied since the 1985 and 2000 ATS/ERS statements, with recent evidence expanding beyond respiratory disease to cardiovascular, CNS impacts and new biomarkers. The report aims to update and broaden earlier ATS/ERS statements by integrating recent science into a general framework that uses considerations rather than a fixed catalogue to judge the adversity of current and future air‑pollution health effects. The authors propose a set of considerations, illustrated with examples of various health effects, to guide judgments of adversity for both documented and emerging air‑pollution impacts.

Abstract

The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies. This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution.