Abstract
Globally, the issue of air pollution keep being one of most serious challenges that affecting environment and human health, coming from emissions of industries, transport, agriculture and also from the fuel people use in homes, in addition to natural events that make the situation worse. This review try to bring together the available evidences about the sources, types, and the health impacts of the main air pollutants, including the gaseous ones like SO₂, O₃, NO₂, and CO, and the particulate matter (PM₁₀, PM₂.₅). Exposure for short or long time to these pollutants is linked with many harmful outcomes, such as cardiovascular and respiratory problems, issues related to pregnancy, lowering life expectancy, and rising mortality levels. The risks become even higher for vulnerable groups like infants, children, old adults, pregnant women, and people who already have chronic conditions. Mechanistic studies show that Pollutants are one of the factors that may lead to oxidative stress, inflammation, problems in immune functions, and harm in different organs, which all together push the development of chronic diseases. Moreover growing evidence suggesting that air pollution connected more predisposition and worse of COVID-19 infection. In many regions, PM₂.₅ exposure still represent the most important factor predicting health burden, particularly in nations with poor and medium incomes where impacts on cardiovascular mortality and on life expectancy are more noticeable. Altogether, these results point to how urgent it is to apply strict air quality regulations and to design interventions that focus on the groups most at risk, and also to build integrated policies that take care of both environmental and public health priorities at the same time.
Recommended Citation
Al-Mansoori, Mohammed Obaid
(2026)
"Air Pollution and Public Health: Global Evidence and Implications,"
Al-Bahir: Vol. 9:
Iss.
1, Article 9.
Available at: https://doi.org/10.55810/2313-0083.1140
References
1. Haryanto B, editor. Air pollution: a comprehensive perspective. Norderstedt: BoD–Books on Demand; 2012.
2. World Health Organization. Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide: global update 2005. Geneva: WHO; 2006.
3. Firket J. Fog along the Meuse valley. Trans Faraday Soc. 1936;32:1192–6.
4. Marchwinska-Wyrwal E, Dziubanek G, Hajok I, Rusin M, Oleksiuk K, Kubasiak M. Impact of air pollution on public health. In: The impact of air pollution on health, economy, environment and agricultural sources. 2011. p. 1.
5. Chen F, Zhang W, Mfarrej MF, Saleem MH, Khan KA, Ma J, et al. Breathing in danger: understanding the multifaceted impact of air pollution on health. Ecotoxicol Environ Saf. 2024;280:116532.
6. World Health Organization. Health impacts of air pollution [Internet]. Geneva: WHO; 2024 [cited 2025 Apr 12]. Available from: https://www.who.int/teams/environment-climate-change-and-health/air-quality-energy-and-health/health-impacts
7. International Agency for Research on Cancer. Outdoor air pollution. IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 109. Lyon: IARC; 2016. Available from: https://www.ncbi.nlm.nih.gov/books/NBK368024/pdf/Bookshelf_NBK368024.pdf
8. Sonwani S, Saxena P. Identifying the sources of primary air pollutants and their impact on environmental health: a review. Int J Eng Technol Res. 2016;6(2):111–30.
9. Tran VV, Park D, Lee YC. Indoor air pollution, related human diseases, and recent trends in the control and improvement of indoor air quality. Int J Environ Res Public Health. 2020;17(8):2927.
10. British Lung Foundation, Asthma + Lung UK. What is indoor air pollution? [Internet]. London: BLF; 2023 [cited 2025 Apr 12]. Available from: https://www.asthmaandlung.org.uk/living-with/indoor-air-pollution/home#what-is-indoor-airpollution
11. American Academy of Pediatrics. Outdoor air pollutants. 2024. Available from:https://www.aap.org/en/patient-care/environmental-health/promoting-healthy-environments-for-children/outdoor-air-pollutants/
12. International Agency for Research on Cancer. Outdoor air pollution. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 109. Lyon, France: IARC; 2016. Available from: https://publications.iarc.who.int/_publications/media/download/6722/1ae3970318d61c0646712d6ccb2b8bdd03f1859e.pdf
13. Pourkiaei M, Romain AC. Scoping review of indoor air quality indexes: characterization and applications. J Build Eng. 2023;75:106703.
14. Chen T, Zou C, Yuan Y, Pan J, Zhang B, Qiao L, et al. Indoor air pollution from solid fuel on children pneumonia in low- and middle-income countries: a systematic review and meta-analysis. Environ Sci Pollut Res. 2022;29(17):24574–88.
15. Maimaitiniyazi M, Maimaitiniyazi M, Maisuti M, Aihaiti A, Yisimiti T, Muyesai N. Outdoor air pollution and hospitalizations for ischemic heart disease: a systematic review and meta-analysis. Front Public Health. 2025;13:1643134.
16. ScienceDirect. Gaseous pollutant. In: Earth and Planetary Sciences. Elsevier. Available from: https://www.sciencedirect.com/topics/earth-and-planetary-sciences/gaseous-pollutant
17. U.S. Environmental Protection Agency. Particulate matter (PM) basics. 2025 May 30. Available from: https://www.epa.gov/pm-pollution/particulate-matter-pm-basics
18. Lodovici M, Bigagli E. Oxidative stress and air pollution exposure. J Toxicol. 2011;2011:487074.
19. Wu W, Jin Y, Carlsten C. Inflammatory health effects of indoor and outdoor particulate matter. J Allergy Clin Immunol. 2018;141(3):833–44
20. Bauer RN, Diaz-Sanchez D, Jaspers I. Effects of air pollutants on innate immunity: the role of Toll-like receptors and nucleotide-binding oligomerization domain–like receptors. J Allergy Clin Immunol. 2012;129(1):14–24.
21. Breton CV, Marutani AN. Air pollution and epigenetics: recent findings. Curr Environ Health Rep. 2014;1(1):35–45.
22. Duan R, Niu H, Dong F, Yu T, Li X, Wu H, et al. Short-term exposure to fine particulate matter and genome-wide DNA methylation in chronic obstructive pulmonary disease: a panel study conducted in Beijing, China. Front Public Health. 2023;10:1069685.
23. Breton CV, Song AY, Xiao J, Kim SJ, Mehta HH, Wan J, et al. Effects of air pollution on mitochondrial function, mitochondrial DNA methylation, and mitochondrial peptide expression. Mitochondrion. 2019;46:22–9.
24. Iaccarino J, Mignini I, Maresca R, Giansanti G, Esposto G, Borriello R, et al. The impact of air pollution on the lung–gut–liver axis: oxidative stress and its role in liver disease. Antioxidants (Basel). 2025;14(10):1148.
25. Nurkiewicz TR, Porter DW, Barger M, Millecchia L, Rao KM, Marvar PJ, et al. Systemic microvascular dysfunction and inflammation after pulmonary particulate matter exposure. Environ Health Perspect. 2006;114(3):412–9.
26. U.S. National Park Service. Sulfur dioxide and effects on human health [Internet]. Washington (DC): NPS; 2024 [cited 2025 May 5]. Available from: https://www.nps.gov/subjects/air/humanhealth-sulfur.htm#:~:text=Sulfur%20dioxide%20irritates%20the%20skin,people%20who%20are%20less%20active.
27. Ministry for the Environment. Sulphur dioxide and effects on health [Internet]. Wellington: Ministry for the Environment; 2021 [cited 2025 May 5]. Available from: https://environment.govt.nz/facts-and-science/air/air-pollutants/sulphur-dioxide-and-effects-on-health/
28. Finlayson-Pitts BJ, Pitts JN Jr. Tropospheric air pollution: ozone, airborne toxics, polycyclic aromatic hydrocarbons, and particles. Science. 1997;276(5315):1045–51.
29. U.S. Environmental Protection Agency. Health effects of ground-level ozone pollution [Internet]. Washington (DC): EPA; 2025 [cited 2025 Aug 10]. Available from: https://www.epa.gov/ground-level-ozone-pollution/health-effects-ozone-pollution
30. Strand V, Rak S, Svartengren M, Bylin G. Nitrogen dioxide exposure enhances asthmatic reaction to inhaled allergen in subjects with asthma. Am J Respir Crit Care Med. 1997;155(3):881–7.
31. Palmeri, R. and Gupta, V., 2020. Carboxyhemoglobin toxicity.
32. Hamanaka RB, Mutlu GM. Particulate matter air pollution: effects on the cardiovascular system. Front Endocrinol (Lausanne). 2018;9:680.
33. Ristovski ZD, Miljevic B, Surawski NC, Morawska L, Fong KM, Goh F, et al. Respiratory health effects of diesel particulate matter. Respirology. 2012;17(2):201–12.
34. Jang AS. Particulate air pollutants and respiratory diseases. In: Air Pollution – A Comprehensive Perspective. London: IntechOpen; 2012. doi:10.5772/51363.
35. Prevention P, Handbook A, WORLD BANK GROUP. Airborne Particulate Matter. World Bank Group. 1998.
36. Ayres JG, Borm P, Cassee FR, Castranova V, Donaldson K, Ghio A, et al. Evaluating the toxicity of airborne particulate matter and nanoparticles by measuring oxidative stress potential: a workshop report and consensus statement. Inhal Toxicol. 2008;20(1):75–99.
37. Schwartz J, Slater D, Larson TV, Pierson WE, Koenig JQ. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis. 1993;147(4):826–31.
38. Han F, Yang X, Xu D, Wang Q, Xu D. Association between outdoor PM2.5 and prevalence of COPD: a systematic review and meta-analysis. Postgrad Med J. 2019;95(1129):612–8
39 Prüss-Üstün A, Corvalán C. Preventing disease through healthy environments: towards an estimate of the environmental burden of disease. Geneva: World Health Organization; 2006.
40 Zumla A, Niederman MS. The explosive epidemic outbreak of novel coronavirus disease 2019 (COVID-19) and the persistent threat of respiratory tract infectious diseases to global health security. Curr Opin Pulm Med. 2020;26(3):193–6.
41. World Health Organization. Coronavirus disease (COVID-19) pandemic—emergency use listing procedure (EUL) open for in vitro diagnostics [Internet]. Geneva: WHO; 2020 [cited 2025 Sep 24]. Available from: https://extranet.who.int/pqweb/vitro-diagnostics/coronavirus-disease-covid-19-pandemic-%E2%80%94-emergency-use-listing-procedure-eul-open.
42. Wang B, Chen H, Chan YL, Oliver BG. Is there an association between the level of ambient air pollution and COVID-19? Am J Physiol Lung Cell Mol Physiol. 2020;319(3):L416–21.
43. Yu K, Zhang Q, Wei Y, Chen R, Kan H. Global association between air pollution and COVID-19 mortality: a systematic review and meta-analysis. Sci Total Environ. 2024;906:167542
44. Urrutia-Pereira M, Mello-da-Silva CA, Solé D. COVID-19 and air pollution: a dangerous association? Allergol Immunopathol (Madr). 2020;48(5):496–9.
45. Albano GD, Montalbano AM, Gagliardo R, Anzalone G, Profita M. Impact of air pollution in airway diseases: role of the epithelial cells (cell models and biomarkers). Int J Mol Sci. 2022;23(5):2799.
46. van der Valk JP, CCM J. The interplay between air pollution and coronavirus disease (COVID-19). J Occup Environ Med. 2021;63(3):e163–7.
47. Ciencewicki J, Jaspers I. Air pollution and respiratory viral infection. Inhal Toxicol. 2007;19(14):1135–46.
48. Huff RD, Carlsten C, Hirota JA. An update on immunologic mechanisms in the respiratory mucosa in response to air pollutants. J Allergy Clin Immunol. 2019;143(6):1989–2001.
49. Musonye HA, He YS, Bekele MB, Jiang LQ, Cao F, Xu YQ, Gao ZX, Ge M, He T, Zhang P, Zhao CN. Exploring the association between ambient air pollution and COVID-19 risk: A comprehensive meta-analysis with meta-regression modelling. Heliyon. 2024 Jun 30;10(12).
50 Setti L, Passarini F, De Gennaro G, Barbieri P, Perrone MG, Borelli M, et al. SARS-CoV-2 RNA found on particulate matter of Bergamo in Northern Italy: first evidence. Environ Res. 2020;188:109754.
51. Jiang Y, Xu J. The association between COVID-19 deaths and short-term ambient air pollution and meteorological condition exposure: a retrospective study from Wuhan, China. Air Qual Atmos Health. 2021;14(1):1–5.
52. Yao Y, Pan J, Liu Z, Meng X, Wang W, Kan H, Wang W. Ambient nitrogen dioxide pollution and spreadability of COVID-19 in Chinese cities. Ecotoxicol Environ Saf. 2021;208:111421.
53. Travaglio M, Yu Y, Popovic R, Selley L, Leal NS, Martins LM. Links between air pollution and COVID-19 in England. Environ Pollut. 2021;268:115859.
54. Accarino G, Lorenzetti S, Aloisio G. Assessing correlations between short-term exposure to atmospheric pollutants and COVID-19 spread in all Italian territorial areas. Environ Pollut. 2021;268:115714.
55. Bowe B, Xie Y, Gibson AK, Cai M, van Donkelaar A, Martin RV, et al. Ambient fine particulate matter air pollution and the risk of hospitalization among COVID-19-positive individuals: a cohort study. Environ Int. 2021;154:106564.
56. Wu X, Nethery RC, Sabath MB, Braun D, Dominici F. Air pollution and COVID-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. Science Advances. 2020;6(45):eabd4049. doi:10.1126/sciadv.abd4049.
57. Aithal SS, Sachdeva I, Kurmi OP. Air quality and respiratory health in children. Breathe (Sheff). 2023;19(2):220180.
58. Rzymski P, Poniedziałek B, Rosińska J, Ciechanowski P, Peregrym M, Pokorska-Śpiewak M, et al. Air pollution might affect the clinical course of COVID-19 in pediatric patients. Ecotoxicol Environ Saf. 2022;239:113651.
59. Brown L, Barnes J, Hayes E. Traffic-related air pollution reduction at UK schools during the COVID-19 lockdown. Sci Total Environ. 2021;780:146651.
60. Abdel-Salam MM. Assessment of children’s exposure to air pollutants in urban residences during the COVID-19 pandemic. Front Environ Sci. 2022;10:1050623.
61. Woolf AD, Pingali H, Hauptman M. The COVID-19 pandemic and children's environmental health. Pediatr Ann. 2020;49(12):e537–42.
62. Saha J, Chouhan P. Indoor air pollution (IAP) and pre-existing morbidities among under-5 children in India: are risk factors of coronavirus disease (COVID-19)? Environ Pollut. 2020;266:115250.
63. World Health Organization. Cardiovascular diseases (CVDs) [Internet]. Geneva: WHO; 2025 [cited 2025 Nov 5]. Available from: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
64. European Heart Network. Annual report 2009: fighting heart disease and stroke [Internet]. Brussels: EHN; 2009 [cited 2025 Jun 11] .Available from: http://www.ehnheart.org/publications/annual-reports.html
65. Brook RD, Rajagopalan S, Pope CA III, Brook JR, Bhatnagar A, Diez-Roux AV, et al. Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation. 2010;121(21):2331–78.
66. Liu C, Chen R, Sera F, Vicedo-Cabrera AM, Guo Y, Tong S, et al. Ambient particulate air pollution and daily mortality in 652 cities. N Engl J Med. 2019;381(8):705–15.
67. Brook RD, Brook JR, Urch B, Vincent R, Rajagopalan S, Silverman F. Inhalation of fine particulate air pollution and ozone causes acute arterial vasoconstriction in healthy adults. Circulation. 2002;105(13):1534–6.
68. Simkhovich BZ, Kleinman MT, Kloner RA. Air pollution and cardiovascular injury: epidemiology, toxicology, and mechanisms. J Am Coll Cardiol. 2008;52(9):719–26.
69. Apte JS, Brauer M, Cohen AJ, Ezzati M, Pope CA III. Ambient PM2.5 reduces global and regional life expectancy. Environ Sci Technol Lett. 2018;5(9):546–51.
70. Liao NS, Sidney S, Deosaransingh K, Van Den Eeden SK, Schwartz J, Alexeeff SE. Particulate air pollution and risk of cardiovascular events among adults with a history of stroke or acute myocardial infarction. J Am Heart Assoc. 2021;10(10):e019758.
71. Pope CA III, Burnett RT, Thurston GD, Thun MJ, Calle EE, Krewski D, et al. Cardiovascular mortality and long-term exposure to particulate air pollution: epidemiological evidence of general pathophysiological pathways of disease. Circulation. 2004;109(1):71–7.
72. Maji KJ, Ye WF, Arora M, Nagendra SS. Ozone pollution in Chinese cities: assessment of seasonal variation, health effects and economic burden. Environ Pollut. 2019;247:792–801.
73. Zhang J, Wei Y, Fang Z. Ozone pollution: a major health hazard worldwide. Front Immunol. 2019;10:2518.
74. Niu Y, Zhou Y, Chen R, Yin P, Meng X, Wang W, et al. Long-term exposure to ozone and cardiovascular mortality in China: a nationwide cohort study. Lancet Planet Health. 2022;6(6):e496–503.
75. Health Effects Institute. State of global air: life expectancy [Internet]. Boston: HEI; 2024 [cited 2025 Oct 3]. Available from: https://www.stateofglobalair.org/sites/default/files/2024-08/soga-life-expectancy_0.pdf
76. Health Effects Institute. State of global air: life expectancy [Internet]. Boston: HEI; 2024 [cited 2025 Oct 3]. Available from: https://www.stateofglobalair.org/hap/life-expectancy
77. Health Effects Institute. State of global air 2024 [Internet]. Boston: HEI; 2024 [cited 2025 Oct 3]. Available from: https://www.stateofglobalair.org/sites/default/files/documents/2024-06/soga-2024-report_0.pdf
78. UNICEF. Air pollution accounted for 8.1 million deaths globally in 2021, becoming the second-leading risk factor for death, including for children under five years [Internet]. New York: UNICEF; 2024 [cited 2025 Oct 3]. Available from: https://www.unicef.org/press-releases/air-pollution-accounted-81-million-deaths-globally-2021-becoming-second-leading-risk
79. Girardi G, Bremer AA. Effects of climate and environmental changes on women's reproductive health. J Womens Health (Larchmt). 2022;31(6):755–7.
80. Aguilera J, Konvinse K, Lee A, Maecker H, Prunicki M, Mahalingaiah S, et al. Air pollution and pregnancy. Semin Perinatol. 2023;47(8):151838.
81. World Health Organization. Billions of people still breathe unhealthy air: new WHO data [Internet]. Geneva: WHO; 2023 [cited 2025 Aug 17]
82. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89–94.
83. Bongaerts E, Lecante LL, Bové H, Roeffaers MB, Ameloot M, Fowler PA, Nawrot TS. Maternal exposure to ambient black carbon particles and their presence in maternal and fetal circulation and organs: an analysis of two independent population-based observational studies. Lancet Planet Health. 2022;6(10):e804–11.
84 Salvi S. Health effects of ambient air pollution in children. Paediatr Respir Rev. 2007;8(4):275–80.
85. Vijayasekaran S. Pediatric airway pathology. Front Pediatr. 2020;8:246.
86. Trachsel D, Erb TO, Hammer J, von Ungern-Sternberg BS. Developmental respiratory physiology. Pediatr Anesth. 2022;32(2):108–17.
87. Pedersen M, Stayner L, Slama R, Sørensen M, Figueras F, Nieuwenhuijsen MJ, et al. Ambient air pollution and pregnancy-induced hypertensive disorders: a systematic review and meta-analysis. Hypertension. 2014;64(3):494–500.
88. Sarizadeh R, Dastoorpoor M, Goudarzi G, Simbar M. The association between air pollution and low birth weight and preterm labor in Ahvaz, Iran. Int J Womens Health. 2020;12:313–25.
89. Niu Z, Habre R, Chavez TA, Yang T, Grubbs BH, Eckel SP, et al. Association between ambient air pollution and birth weight by maternal individual- and neighborhood-level stressors. JAMA Netw Open. 2022;5(10):e2238174.
90. Daba C, Asmare L, Demeke Bayou F, Arefaynie M, Mohammed A, Tareke AA, et al. Exposure to indoor air pollution and adverse pregnancy outcomes in low- and middle-income countries: a systematic review and meta-analysis. Front Public Health. 2024;12:1356830.
91. Nazarpour S, Poursani AS, Simbar M, Yarandi RB. The relationship between air pollution and infant mortality rate. Iran J Public Health. 2023;52(6):1278.
92. UNICEF. 1 in 5 infant deaths in Europe and Central Asia linked to air pollution [Internet]. 2024 [cited 2025 Dec 30]. Available from: https://www.unicef.org/turkiye/en/press-releases/1-5-infant-deaths-europe-and-central-asia-linked-air-pollution-unicef.
93. Rich DQ, Kipen HM, Huang W, Wang G, Wang Y, Zhu P, et al. Association between changes in air pollution levels during the Beijing Olympics and biomarkers of inflammation and thrombosis in healthy young adults. JAMA. 2012;307(19):2068–78.
94. Wang Y, Hao J, McElroy MB, Munger JW, Ma H, Chen D, Nielsen CP. Ozone air quality during the 2008 Beijing Olympics: effectiveness of emission restrictions. Atmos Chem Phys. 2009;9(14):5237–51.
95. Hajmohammadi H, Heydecker B. Evaluation of air quality effects of the London ultra-low emission zone by state-space modelling. Atmos Pollut Res. 2022;13(8):101514.
96. Mudway IS, Dundas I, Wood HE, Marlin N, Jamaludin JB, Bremner SA, et al. Impact of London's low emission zone on air quality and children's respiratory health: a sequential annual cross-sectional study. Lancet Public Health. 2019;4(1):e28–40.





Indexed in: