Air pollution in the Asia‐Pacific Region

Abstract

The Asia‐Pacific (AP) region is home to over 4.5 billion people, more than half of the world's population. It is a diverse and beautiful part of the world that includes not only 7 of the world's 10 most populous countries but also some of the world's smallest island nations. The AP region celebrates many cultures and people, and over the last several decades, it has seen industrial and technological developments with major economic growth. Such extraordinary achievements in productivity have accelerated the emergence of environmental challenges and increased the prevalence of diseases that are associated with pollution in industrialized economies. This cost of economic success has increased the need for environmental preservation and sustainable, healthy living environments. Foremost among such aspirations are the universal right to breathe clean air and the collective moral obligation to provide children with the opportunity to grow and develop healthy lungs. The Asian Pacific Society of Respirology (APSR) and the American Thoracic Society (ATS) are two leading professional respiratory societies. The APSR was established in 1986 to encourage research, improve clinical practice through teaching, increase awareness of respiratory health problems and promote the exchange of knowledge among pulmonologists (i.e. respirologists) in the AP region. The 11 countries of the APSR comprise 9% of the world's population and include Australia, Cambodia, Indonesia, Japan, Kyrgyz Republic, Malaysia, New Zealand, the Philippines, Republic of Korea, Sri Lanka, Taiwan and Vietnam. Approximately 15 700 healthcare professionals have membership in the APSR. The ATS was founded in 1905 as the American Sanatorium Association with an initial mission to prevent, control and treat tuberculosis. It was renamed the American Trudeau Society in 1938 and then the American Thoracic Society in 1960; with the renaming, its core mission was broadened to improve health worldwide by advancing research, clinical care and public health in respiratory disease, critical illness and sleep disorders. The ATS has a membership of more than 16 000 physicians, research scientists, nurses and other healthcare professionals. Given the complementary mandates of the APSR and ATS, the societies formed a partnership to focus on the need for clean air, with the fundamental aim of promoting lung health. This pulmonary perspective is intended as an assertive declaration of the public health importance of clean air and the deleterious implications of environmental pollution. It is our hope that it will serve as a catalyst for additional activities in the AP region to ensure that people in all parts of the world, including the AP region, breathe clean, healthy air. Participants were identified by the leadership of the APSR and ATS on the basis of their expertise in the effects of air pollution and/or the development of professional society statements. An initial search was performed using PubMed to search MEDLINE and using Google Scholar. Synonyms were used to look for articles that address the AP region (i.e. 'Asia', 'Pacific' and 'Asia Pacific'), air pollution (i.e. 'air', 'air pollution', 'atmosphere', 'environment', 'outdoor', 'outdoor air pollution', 'particulate matter' and 'PM2.5') and potential respiratory consequences of air pollution (i.e. 'respiratory', 'asthma', 'COPD', 'hospitalizations', 'influenza', 'lower respiratory tract infection', 'lung cancer', 'lung function', 'obstructive lung disease', 'spirometry', 'tuberculosis' and 'wheeze'). An initial literature search yielded 68 000 studies, and a more specific repeat search yielded 1418 studies, including 791 studies related to sources of air pollution, 1249 studies related to the impact of air pollution, 896 studies related to the impact of air pollution on vulnerable populations and 845 studies related to the burden of air pollution. Each author was assigned a section of the manuscript. Authors selected the relevant studies that they wanted to inform their sections of the manuscript. Many authors conducted individual literature searches to identify relevant publications. The bibliographies of selected studies were also searched for additional relevant references. Completed sections were returned to the project chair (K.M.F.), who collated the sections into a single manuscript. All authors reviewed and provided feedback about the draft manuscript. Multiple cycles of review and revision ensued until there was consensus among the authors that the manuscript was ready for submission to the journal. Air pollution originates from both natural and human‐related activities that involve combustion or dissemination of dust 1, 2 (Table 1). Natural events that contribute to the pollution burden include volcanoes, forest fires and dust storms. -Abstract Truncated-