Geographic Patterns of Asthma Morbidity: A Systematic Review of Sand and Dust Storm (SDS) Impacts in Asia.

OBJECTIVE

Sand and Dust Storms (SDS) are prevalent in Asia, releasing fine particulate matter (PM10 and PM2.5) that pose significant risks to respiratory health, particularly for asthmatic populations. This systematic review evaluates the impact of SDS on asthma incidence, hospital admissions, and exacerbations across Asia, providing a basis for public health interventions.

DATA SOURCES: We performed a systematic search in PubMed, EMBASE, Scopus, and Web of Science for studies published up to May 2023 using terms related to sand and dust storms, SDS, asthma, and respiratory health.

STUDY SELECTION: Thirty-three studies met the inclusion criteria, predominantly from Japan, Korea, and the Middle East. Cohort (n = 13; 39.4%) and panel designs (n = 12; 36.4%) were the frequent methodologies.

RESULTS

Findings consistently revealed a significant association between SDS and increased asthma exacerbations, hospital admissions, and emergency visits, peaking within 1-5 days post-exposure. Overall, the vast majority of the evaluated studies documented a positive association between SDS and asthma-related healthcare utilization, although the magnitude and statistical significance varied according to study designs and outcome definitions. The impact was disproportionately high among children and the elderly. Notably, studies from East Asia demonstrated more pronounced health impacts, including higher odds ratios and longer hospital stays, compared to the Middle East.

CONCLUSION

SDS are a significant burden on respiratory health in Asia. Our findings underscore the need for targeted, region-specific public health strategies and improved air quality monitoring. However, results are subject to limitations, including significant study heterogeneity and potential language bias due to the exclusion of non-English publications.