The Health Effects Institute PAPA-SAN
Public Health and Air Pollution in Asia:
Science Access on the Net
Results
The current version of PAPA-SAN, updated in May 2008, presents key data from 421 peer-reviewed research reports published since 1980 that provide original estimates of the health effects of air pollution in 11 Asian countries. It includes, for the first time, reports from Bangladesh, Pakistan, and Sri Lanka, as well as reports on biomarkers of exposure to benzene and lead.
In general, the reports assessed, or in some cases projected, ambient exposure to various combinations of particulate matter and gaseous pollutants and estimated the effects of exposure on human health by analyzing such measures as daily mortality, hospital admissions, and adverse reproductive outcomes.
The large majority of the reports were published in the past 10 years—a trend in keeping with the growth in similar reports in the West (Figure 2). A majority of the reports (266) were from either cross-sectional prevalence studies of chronic respiratory symptoms or lung function or time-series studies of various short-term effects of pollution.
Figure 2. Reports according to year of publication. Data for 2007 include only reports published through September.
Overview of Reports in PAPA-SAN Study design Number of reportsa Case–control 10 Case–crossover 20 Cohortb 27 Cross sectionalb 168 Descriptiveb 2 Ecologic 23 Health impact 43 Panelb 28 Time-seriesb 99 Unspecified 1 Pollutantc TSP, SPM, RSP 118 PM10 147 PM2.5 27 NOx, NO2 197 SO2 207 CO 86 O3 104 Nonspecific (ambient air pollution, etc.) 34 Other (benzene, BaP, lead, etc.) 30 Health outcome Biomarker 47 Birth outcomes 23 Economic assessment 22 Hospital admissions, visits, and discharges 46 Lung cancer 18 Mortality 99 Respiratory disease, symptoms, lung function, asthma 173 Other 44 a In some reports, more than one pollutant or health outcome was described.
b Cross-sectional, cohort, descriptive, panel, and time-series studies include episode studies.
c See Abbreviations.
Summaries
View short summaries of results by country or region.
The reports listed in PAPA-SAN were compiled into a master table of all studies; 26 subsidiary tables organized according to country or region, study design, pollutant, and health outcome; and a table of reports identified in the 2007 literature search. Click on the links below to view or download any or all of the 28 tables as PDF files.
In each table, the reports are listed by first author, and key data are provided for each report, including the citation, study design, country or region, study period, study sample, pollutants, and health outcomes. Each table also contains a brief summary of findings for each report and (if available) a link to its abstract.
Table of all 421 studies Table 1. All studies Reports listed by country or region
China Table 2. Research in China Mainland (110 reports) Hong Kong (25 reports) Taipei,China (80 reports) Japan (60 reports) Table 3. Research in Japan South Korea (51 reports) Table 4. Research in South Korea 
Southeast Asia Indonesia (9 reports) Table 5. Research in Indonesia Malaysia (3 reports) Table 6. Research in Malaysia Singapore (10 reports) Table 7. Research in Singapore Thailand (26 reports) Table 8. Research in Thailand Bangladesh (2 reports) Table 9. Research in Bangladesh India (44 reports) Table 10. Research in India Pakistan (3 reports) Table 11. Research in Pakistan Sri Lanka (3 reports) Table 12. Research in Sri Lanka
Tables for research in China, Japan, and South Korea include reports that compared results in more than one country. As a result, the numbers of studies listed for all the countries total more than 421. No information was available for the following countries: Bhutan, Burma, Cambodia, Nepal, Philippines, and Vietnam. If you have information on studies of the health effects of air pollution in Asian countries not included here, please send it to PAPA@healtheffects.org and we will update our records. Additional information on studies in Sri Lanka has become available. Please see the Summaries page.Reports listed by study design
Case–control (10 reports) Table 13. Case–Control Studies Case–crossover (20 reports) Table 14. Case–Crossover Studies Cohort (27 reports) Table 15. Cohort Studies Cross sectional (168 reports) Table 16. Cross-Sectional Studies Ecologic (23 reports) Table 17. Ecologic Studies Health impact (43 reports) Table 18. Health-Impact Panel (28 reports) Table 19. Panel Studies Time series (99 reports) Table 20. Time-Series Studies Reports listed by pollutant
Particulate matter and
gaseous pollutants(216 reports)
Table 21. Studies of Particulate Matter and Gaseous Pollutants Particulate matter only (49 reports) Table 22. Studies of Particulate Matter Only Gaseous pollutants only (29 reports) Table 23. Studies of Gaseous Pollutants Only Reports listed by health outcome
Birth outcomes (23 reports) Table 24. Studies of Birth Outcomes Hospital admissions, visits, and discharges (46 reports) Table 25. Studies of Hospital Admissions, Visits, and Discharges Mortality (99 reports) Table 26. Studies of Mortality Respiratory disease, symptoms, and function (173 reports) Table 27. Studies of Respiratory Disease, Symptoms, and Function Reports identified in 2007
The final table is a compilation of the 116 reports that are new to the PAPA-SAN database, listed by first author; these reports were identified in our most recent literature searches, conducted in 2007. Most of the new reports were from studies of respiratory and cardiovascular outcomes; 27 estimated impacts from air pollution. The table also includes the new groups of reports mentioned earlier—those from Bangladesh, Pakistan, and Sri Lanka, and studies of benzene and lead. Table 28. Reports Identified in 2007
Read more about study designs, pollutants, and abbreviations commonly found in air pollution reports.
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