Indoor air pollution and airway health

Abstract

Because of the disproportionate amount of time that people spend indoors and the complexities of air pollutant exposures found there, indoor air pollution is a growing concern for airway health. Both infiltration of outdoor air pollution into the indoor space and indoor sources (such as smoke from tobacco products, cooking or heating practices and combustion of associated fuels, and household materials) contribute to unique exposure mixtures. Although there is substantial literature on the chemistry of indoor air pollution, research focused on health effects is only beginning to emerge and remains an important area of need to protect public health. We provide a review of emerging literature spanning the past 3 years and relating indoor air exposures to airway health, with a specific focus on the impact of either individual pollutant exposures or common combustion sources on the lower airways. Factors defining susceptibility and/or vulnerability are reviewed with consideration for priority populations and modifiable risk factors that may be targeted to advance health equity.

Keywords: COPD; Indoor air pollution; airway; asthma.

FIG 1.

Considerations for susceptibility and/or vulnerability to IAP. Schematic representing many of the factors linked to susceptibility and/or vulnerability to indoor air, organized within 3 domains: within-individual (blue oval); individual-level environment (green oval; and local, regional, and national environment (orange oval). Within-individual factors include intrinsic biologic factors (purple circles indicate sex, genetics, health conditions, and age) and personal factors linked strongly with behaviors and socioeconomic status (blue circles indicate body mass index and/or adiposity, and diet, race, and/or ethnicity income and/or socioeconomic status). Factors that influence the biologic response determine susceptibility, whereas factors that influence the degree of exposure determine vulnerability.