title: Effect of environmental exposure to hydrogen sulfide on central nervous system and respiratory function: a systematic review of human studies.
abstract: Assessment of the health effects of low-level exposure to hydrogen sulfide (H2S) on humans through experiments, industrial, and community studies has shown inconsistent results.
  
  
  
  To critically appraise available studies investigating the effect of H2S on the central nervous system (CNS) and on respiratory function.
  
  
  
  A search was conducted in 16 databases for articles published between January 1980 and July 2014. Two researchers independently evaluated potentially relevant papers based on a set of inclusion/exclusion criteria.
  
  
  
  Twenty-seven articles met the inclusion criteria: 6 experimental, 12 industry-based studies, and 10 community-based studies (one article included both experimental and industry-based studies). The results of the systematic review varied by study setting and quality. Several community-based studies reported associations between day-to-day variations in H2S levels and health outcomes among patients with chronic respiratory conditions. However, evidence from the largest and better-designed community-based studies did not support that chronic, ambient H2S exposure has health effects on the CNS or respiratory function. Results from industry-based studies varied, reflecting the diversity of settings and the broad range of H2S exposures. Most studies did not have individual measurements of H2S exposure.
  
  
  
  The results across studies were inconsistent, justifying the need for further research.
authors.affiliation: a Biostatistics and Quantitative Health Sciences , John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA.
authors.forename: Eunjung
authors.initials: E
authors.lastname: Lim
authors.affiliation: a Biostatistics and Quantitative Health Sciences , John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Mbowe
authors.affiliation: b Health Sciences Library , John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA.
authors.forename: Angela S W
authors.initials: AS
authors.lastname: Lee
authors.affiliation: a Biostatistics and Quantitative Health Sciences , John A. Burns School of Medicine, University of Hawaii , Honolulu , HI , USA.
authors.forename: James
authors.initials: J
authors.lastname: Davis
mesh_terms: D000393:Air Pollutants / Q000633:toxicity*; D002490:Central Nervous System / Q000187:drug effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D006862:Hydrogen Sulfide / Q000633:toxicity*; D012129:Respiratory Function Tests; D012143:Respiratory Physiological Phenomena / Q000187:drug effects*
chemical_list: D000393:Air Pollutants; D006862:Hydrogen Sulfide
keywords: Central nervous system; Geothermal; Hydrogen sulfide; Respiratory function