European Commission, Joint Research Centre

Susceptibility and vulnerability to health effects of air pollution: The case of nitrogen dioxide

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Abstract: Epidemiological and toxicological studies have reported adverse health effects in response to exposure to air pollution including nitrogen dioxide (NO2). Some of these studies have indicated that specific populations may be at different risk of NO2 related health effects that others. Adverse health effects from air pollution are not equally distributed among populations and individuals. Differences in vulnerability and susceptibility may affect the risk of developing a health effect and its severity. A description and characterization of factors associated with vulnerability and susceptibility to health effects of ambient air pollution with a focus on NO2 exposure, a common air pollutant which has been associated with human morbidity and mortality, is presented based on a scoping review for the period 2011-2015. We identified epidemiological studies of factors that may play the role of effect modifiers of the association between exposure to NO2 and related health effects. Studies that may influence risk were critically reviewed. Population groups and characteristics were identified and health effects described and put into the context of risk assessment of air pollution. Population characteristics that can modify the health effects related to NO2 and confer susceptibility are predominantly age, underlying disease, and potentially genetics and gender. These population characteristics don’t differ from those identified for other air pollutants. Understanding about the latter two characteristics has been limited also in association with other air pollutants. Differential vulnerability has been shown due to socioeconomic factors. Insufficient attention in terms of exploration has been paid to the effects of other vulnerability factors. Understanding how NO2 may differently affect individuals or population subgroups is of major relevance for evidence-based policy making in emission reduction strategies and in health protection of those populations most vulnerable and susceptible

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