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This research project examines the health effects of air pollution exposure, specifically fine particles, PM2.5 (particulate matter with equal to or less than 2.5 µm in diameter), on the health of diplomats, expatriates, migrants, and other long term travellers who live in multiple countries throughout their lifespan. A systematic review of the published literature describing the health effects of air pollution with at least one change in exposure level will be conducted. The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 estimates that 4.2 million deaths, or roughly 1 in 3 deaths globally, were due to air pollution exposure (A. J. Cohen et al., 2017). The most common cause of death among persons with death attributable to ambient air pollution include stroke, ischemic heart disease, (IHD), lung cancer, and chronic obstructive pulmonary disease (C. Liu et al, 2019; A. J. Cohen et al., 2017). Studies in the United States have shown that people who live in more polluted cities have a shorter lifespan than people who live in cities with a lower pollution level (Dockery et al., 1993; Pope, Ezzati, & Dockery, 2009). The United Kingdom’s Committee on the Medical Effects of Air Pollution (COMEAP) is a group of air quality scientists and clinicians that advise the UK government on the health effects of air pollution and the need for further research in the area. COMEAP has reported that both short and long term exposure to PM2.5 can lead to or exacerbate cardiovascular disease and a shorter life expectancy (Committee on the Medical Effects of Air Pollutants, 2009; Committee on the Medical Effects of Air Pollution, 2006). The United States’ American Heart Association (AHA) conducted an extensive review of air pollution and cardiovascular disease and concluded that PM2.5 exposure can lead to increased levels of IHD, ischemic stroke, cardiovascular hospitalizations and mortality (Benjamin et al., 2019; Brook et al., 2010). USGEs and family members work and live in countries all over the world, including locations with air pollution more than 10 times the level found in American cities including Washington, DC (World Health Organization, 2017b). AHA and WHO reports suggest that people who live in multiple locations with raised air pollution levels may be at increased risk of health impacts due to air pollution. This project seeks to identify if there are any additional risks of morbidity or mortality associated with PM2.5 exposure due to a career spent working internationally for USGEs. Evidence on the health effects of air pollution on long-term travellers, migrants, and other groups of people who have moved from one area to another area more than once, is limited. While there are numerous publications examining the health effects of air pollution, studies generally focus on a population with a static ambient air pollution level. |
