{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:54:11Z","timestamp":1789829651578,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, observational studies have demonstrated an association between high levels of air pollution and asthma attacks in children. It remains unclear whether and to what extent exposure may be associated with increased near\u2010fatal\/fatal attacks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review the evidence for an\u202fassociation between ambient outdoor air pollution and fatal and\/or near\u2010fatal asthma (NFA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Following Cochrane methodology, we searched MEDLINE, EMBASE, Web of Science, Scopus, and Open Grey electronic databases for studies reporting the association of fatal\/NFA and air pollution (particulate matter [PM], sulfur dioxide, nitrogen dioxide, black carbon and ozone [O\n                      <jats:sub>3<\/jats:sub>\n                      ]) in children. NFA was defined as requiring intensive care unit\u00a0(ICU) management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two reviewers independently screened 1358 papers. A total of 276 studies identified asthma attacks related to air pollution, 272 did not meet inclusion criteria after full\u2010text review. Four observational studies described fatal\/NFA, of which three addressed NFA. PM2.5 (per 12.5\u2009\u00b5g\/m\n                      <jats:sup>3<\/jats:sup>\n                      increase) and O\n                      <jats:sub>3<\/jats:sub>\n                      (per 22\u2009ppb increase) were associated with NFA in one study (PM2.5,\u00a0relative risk: 1.26, confidence interval [CI] [1.10\u20131.44]), O\n                      <jats:sub>3\u00a0<\/jats:sub>\n                      (1.19 [1.01\u20131.40]). PM10 was associated with ICU admission in the context of thunderstorm asthma. Elemental carbon was associated equally with NFA that did not require an ICU admission (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.67). Studies of fatal asthma including children did not demarcate age within the analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ozone and PM2.5 have been associated with NFA in children but synthesis is limited by the paucity of studies and methodological heterogeneity. Poor reporting of severities of asthma attacks hinders the assessment of whether outdoor air pollution is associated with an increased number of NFA\/fatal attacks in children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.26932","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T09:32:20Z","timestamp":1710322340000},"page":"1196-1206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Outdoor air pollution and near\u2010fatal\/fatal asthma attacks in children: A systematic review"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2177-590X","authenticated-orcid":false,"given":"Deepa","family":"Varghese","sequence":"first","affiliation":[{"name":"Department of Child Life and Health University of Edinburgh Edinburgh UK"},{"name":"Asthma UK Centre for Applied Research, Usher Institute University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Ferris","sequence":"additional","affiliation":[{"name":"Asthma UK Centre for Applied Research, Usher Institute University of Edinburgh Edinburgh UK"},{"name":"Wellcome\u2010Wolfson Institute For Experimental Medicine Queen's University Belfast Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohee","family":"Lee","sequence":"additional","affiliation":[{"name":"Asthma UK Centre for Applied Research, Usher Institute University of Edinburgh Edinburgh UK"},{"name":"National Heart and Lung Institute Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Grigg","sequence":"additional","affiliation":[{"name":"The Blizard Institute Queen Mary's University London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary","family":"Pinnock","sequence":"additional","affiliation":[{"name":"Asthma UK Centre for Applied Research, Usher Institute University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Child Life and Health University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"issue":"60","key":"e_1_2_10_2_1","article-title":"Asthma mortality in the UK and member nations between 2001 and 2011","volume":"48","author":"Mukherjee M","year":"2023","journal-title":"Eur Respir J"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1306770"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12561"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2016.11.012"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17176212"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60617-6"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.01.056"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/15287390701598234"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-14-31"},{"key":"e_1_2_10_11_1","volume-title":"Air Pollution","author":"World Health Organisation","year":"2024"},{"key":"e_1_2_10_12_1","volume-title":"Ambient (Outdoor) Air Pollution","author":"World Health Organisation","year":"2022"},{"key":"e_1_2_10_13_1","unstructured":"GOV.UK. 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