title: Adverse respiratory effects of outdoor air pollution in the elderly.
abstract: Compared to the rest of the population, the elderly are potentially highly susceptible to the effects of outdoor air pollution due to normal and pathological ageing. The purpose of the present review was to gather data on the effects on respiratory health of outdoor air pollution in  the elderly, on whom data are scarce. These show statistically significant short-term and chronic adverse effects of various outdoor air pollutants on cardiopulmonary morbidity and mortality in the elderly. When exposed to air pollution, the elderly experience more hospital admissions for  asthma and chronic obstructive pulmonary disease (COPD) and higher COPD mortality than others. Previous studies also indicate that research on the health effects of air pollution in the elderly has been affected by methodological problems in terms of exposure and health effect assessments.  Few pollutants have been considered, and exposure assessment has been based mostly on background air pollution and more rarely on objective measurements and modelling. Significant progress needs to be made through the development of 'hybrid' models utilising the strengths of information  on exposure in various environments to several air pollutants, coupled with daily activity exposure patterns. Investigations of chronic effects of air pollution and of multi-pollutant mixtures are needed to better understand the role of air pollution in the elderly. Lastly, smoking, occupation,  comorbidities, treatment and the neighbourhood context should be considered as confounders or modifiers of such a role. In this context, the underlying biological, physiological and toxicological mechanisms need to be explored to better understand the phenomenon through a multidisciplinary  approach.
authors.affiliation: Epidémiologie des Maladies Allergiques et Respiratoires, Unité Mixte de Recherche S 707, Institut National de la Santé et de la Recherche Médicale, Paris, France. bentayeb@u707.jussieu.fr
authors.forename: M
authors.initials: M
authors.lastname: Bentayeb
authors.forename: M
authors.initials: M
authors.lastname: Simoni
authors.forename: N
authors.initials: N
authors.lastname: Baiz
authors.forename: D
authors.initials: D
authors.lastname: Norback
authors.forename: S
authors.initials: S
authors.lastname: Baldacci
authors.forename: S
authors.initials: S
authors.lastname: Maio
authors.forename: G
authors.initials: G
authors.lastname: Viegi
authors.forename: I
authors.initials: I
authors.lastname: Annesi-Maesano
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000393:Air Pollutants / Q000009:adverse effects*; D015897:Comorbidity; D004781:Environmental Exposure / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011379:Prognosis; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors
chemical_list: D000393:Air Pollutants