Environmental exposure to air pollution and pollen and the risk of perioperative respiratory adverse events in paediatric anaesthesia: A narrative review.

This narrative review article summarises the current evidence on environmental exposures before surgery. There is emerging evidence suggesting that environmental exposures before surgery, namely exposure to air pollution and allergenic pollen, may significantly influence the risk of these events occurring. Understanding the impact of air pollution and pollen exposure on the risk for perioperative respiratory adverse events, one of the leading causes of morbidity and mortality in children undergoing anaesthesia, could enhance current preoperative risk stratification practices. This review explores the mechanistic pathways by which these exposures exacerbate respiratory vulnerability and evaluates existing evidence linking environmental factors to perioperative outcomes. By raising awareness of these (mainly) modifiable risk factors, anaesthesiologists may better anticipate and manage perioperative respiratory adverse events in paediatric populations, optimising resource utilisation.