Article open access publication

A joint ERS/ATS policy statement: what constitutes an adverse health effect of air pollution? An analytical framework

European Respiratory Journal, European Respiratory Society (ERS), ISSN 0903-1936

Volume 49, 1, 2017

DOI:10.1183/13993003.00419-2016, Dimensions: pub.1013116525, PMC: PMC5751718, PMID: 28077473,



  1. (1) New York University, grid.137628.9
  2. (2) Environmental and Occupational Health Sciences Institute, grid.414514.1
  3. (3) French Institute of Health and Medical Research, grid.7429.8
  4. (4) University of California, Berkeley, grid.47840.3f
  5. (5) University of California, San Francisco, grid.266102.1
  6. (6) University of Michigan, grid.214458.e
  7. (7) Imperial College London, grid.7445.2
  8. (8) Dept of Epidemiology, Lazio Regional Health Service, Rome, Italy
  9. (9) Umeå University, grid.12650.30
  10. (10) University of Rochester Medical Center, grid.412750.5
  11. (11) Queen Mary University of London, grid.4868.2
  12. (12) Utrecht University, grid.5477.1
  13. (13) King's College London, grid.13097.3c
  14. (14) Swiss Tropical and Public Health Institute, grid.416786.a
  15. (15) University of Basel, grid.6612.3
  16. (16) Helmholtz Zentrum München, grid.4567.0
  17. (17) University of Maryland, Baltimore, grid.411024.2
  18. (18) University of California, Los Angeles, grid.19006.3e
  19. (19) University of Southern California, grid.42505.36
  20. (20) Aarhus University, grid.7048.b, AU
  21. (21) Pompeu Fabra University, grid.5612.0
  22. (22) University Medical Center Utrecht, grid.7692.a


The American Thoracic Society has previously published statements on what constitutes an adverse effect on health of air pollution in 1985 and 2000. We set out to update and broaden these past statements that focused primarily on effects on the respiratory system. Since then, many studies have documented effects of air pollution on other organ systems, such as on the cardiovascular and central nervous systems. In addition, many new biomarkers of effects have been developed and applied in air pollution studies.This current report seeks to integrate the latest science into a general framework for interpreting the adversity of the human health effects of air pollution. Rather than trying to provide a catalogue of what is and what is not an adverse effect of air pollution, we propose a set of considerations that can be applied in forming judgments of the adversity of not only currently documented, but also emerging and future effects of air pollution on human health. These considerations are illustrated by the inclusion of examples for different types of health effects of air pollution.


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Times Cited: 128

Field Citation Ratio (FCR): 54.24

Relative Citation ratio (RCR): 12.61

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