The Science of the total environment · 2026
Impact of traffic-related air pollution exposure on fractional exhaled nitric oxide: A systematic review and Meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Kiratipaisarl Wuttipat, Hannarong Chutharat, Chaiwarut Matina, Lehnu Naowaf, Assavanopakun Pheerasak
Аннотация
BACKGROUND: Traffic-Related Air Pollution (TRAP) is a complicated mix of gases and particulates associated with respiratory oxidative stress and immunological dysfunction. FeNO (Fractional exhaled Nitric Oxide) is emerging as an essential biomarker for inflammation. The duration, specific exposure patterns, and magnitude of associations of FeNO with TRAP remain unclear. This research synthesizes and analyzes the evidence linking specific TRAP to FeNO alteration in human population.
METHODS AND RESULTS: A systematic review across 3 databases: PubMed, Scopus and Embase, until 3 February 2026, yields a qualitative synthesis of 48 papers, with a majority reporting increase in FeNO levels with various TRAP exposure (33 out of 48, 71.1%). A network meta-analysis of 9 studies (n = 5761) across a network of 10 pollutants found black carbon (BC, 10.8, 95% CI (confidence interval): 2.1, 20.2) and polycyclic aromatic hydrocarbons (PAH, 9.5, 95% CI: 0.8, 18.9) as the pollutant associated with the highest 24-h percent FeNO difference per interquartile range (IQR) of pollutants. Heterogenous results may related to confounders and effect modifiers affecting FeNO, such as demographic differences, follow-up time inconsistencies, varying baseline FeNO levels and IQR of pollutants.
DISCUSSION AND CONCLUSION: FeNO may serve as a biomarker for adverse health effects from TRAP exposure for BC and PAH. Consistent approach for defining air pollutants components and measurement units is advocated for future research to be cohesive. Though a short term 24-h for FeNO level is the most common, future research should standardize protocol of follow-up time and confounder adjustments to ensure comparability of the statistical estimates across other time points.
METHODS AND RESULTS: A systematic review across 3 databases: PubMed, Scopus and Embase, until 3 February 2026, yields a qualitative synthesis of 48 papers, with a majority reporting increase in FeNO levels with various TRAP exposure (33 out of 48, 71.1%). A network meta-analysis of 9 studies (n = 5761) across a network of 10 pollutants found black carbon (BC, 10.8, 95% CI (confidence interval): 2.1, 20.2) and polycyclic aromatic hydrocarbons (PAH, 9.5, 95% CI: 0.8, 18.9) as the pollutant associated with the highest 24-h percent FeNO difference per interquartile range (IQR) of pollutants. Heterogenous results may related to confounders and effect modifiers affecting FeNO, such as demographic differences, follow-up time inconsistencies, varying baseline FeNO levels and IQR of pollutants.
DISCUSSION AND CONCLUSION: FeNO may serve as a biomarker for adverse health effects from TRAP exposure for BC and PAH. Consistent approach for defining air pollutants components and measurement units is advocated for future research to be cohesive. Though a short term 24-h for FeNO level is the most common, future research should standardize protocol of follow-up time and confounder adjustments to ensure comparability of the statistical estimates across other time points.