Systematic review and meta-analysis on the health effects of long-term exposure to ultrafine particles

  • Background Ultrafine particles (≤100 nm diameter) may have a higher toxicity than larger particles but are still not regulated nor part of routine air pollution monitoring. So far, health effects of long-term exposure to ambient ultrafine particles are not well understood, owing to a lack of exposure data and epidemiological studies. Methods We conducted a systematic review and meta-analysis on the health effects of long-term exposure to ultrafine particles, including studies published until December 2024. A meta-analysis was conducted for outcomes with at least four available effect estimates. Confidence in the body of evidence was evaluated using the Office of Health Assessment and Translation method. Results We identified 85 studies investigating various mortality, morbidity and subclinical outcomes. In meta-analyses of single-pollutant models, we found positive associations with natural mortality (hazard ratio 1.06, 95% CI 1.04–1.08) and C-reactive protein (10.14% increaseBackground Ultrafine particles (≤100 nm diameter) may have a higher toxicity than larger particles but are still not regulated nor part of routine air pollution monitoring. So far, health effects of long-term exposure to ambient ultrafine particles are not well understood, owing to a lack of exposure data and epidemiological studies. Methods We conducted a systematic review and meta-analysis on the health effects of long-term exposure to ultrafine particles, including studies published until December 2024. A meta-analysis was conducted for outcomes with at least four available effect estimates. Confidence in the body of evidence was evaluated using the Office of Health Assessment and Translation method. Results We identified 85 studies investigating various mortality, morbidity and subclinical outcomes. In meta-analyses of single-pollutant models, we found positive associations with natural mortality (hazard ratio 1.06, 95% CI 1.04–1.08) and C-reactive protein (10.14% increase (95% CI −0.51–21.99%) per 10 000 pt·cm−3 increase in long-term exposure to ultrafine particles, with low and inadequate levels of evidence, respectively. The remaining studies revealed overall limited evidence for adverse effects on a wide range of outcomes. Less than half of the studies adjusted for co-pollutants. Conclusion The evidence base on long-term health effects of ultrafine particles has increased substantially in the past decade, while the overall evidence for independent effects of long-term ultrafine particle exposure remains inadequate to low. More studies are needed to draw firm conclusions about the independent adverse effects of long-term ultrafine particles on various health end-points, with a special focus on the influence of co-pollutant adjustment.show moreshow less

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Author:Marie BergmannORCiD, Pascale Haddad-Thoelke, Haeran Jeong, Ron Kappeler, Hicran Altug, Lukas OberwinsterORCiD, Hanna Boogaard, Tobias Pohl, Vanessa Soppa, Katherine Ogurtsova, Meltem Kutlar Joss, Zorana Jovanovic AndersenORCiD, Barbara Hoffmann
Qualitätssicherung:peer reviewed
open access:Gold - Erstveröffentlichung mit Lizenzhinweis
Research fields:Leben und Wohlergehen / Prävention von Krankheiten
Fachbereich/Einrichtung:Hochschule Düsseldorf / Fachbereich - Maschinenbau und Verfahrenstechnik
Document Type:Article
Year of Completion:2026
Language of Publication:English
Publisher:European Respiratory Society
Parent Title (English):European Respiratory Review
Volume:35
Issue:179
Article Number:250156
Page Number:39
URN:urn:nbn:de:hbz:due62-opus-60272
DOI:https://doi.org/10.1183/16000617.0156-2025
ISSN:1600-0617
Tag:Luftreinhaltung
GND Keyword:SchadstoffbelastungGND; Luftverunreinigender StoffGND; FeinstaubGND; AuswirkungGND
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):Creative Commons - CC BY-NC - Namensnennung - Nicht kommerziell 4.0 International
Release Date:2026/02/11
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