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Outdoor air pollution and respiratory wellness: a bibliometric analysis of publications in peer-reviewed journals (1900 – 2017)

Multidisciplinary Respiratory Medicine book 13, Article number:15 (2018) Cite this commodity

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Abstract

Background

Outdoor air pollution is a major threat to global public health that needs responsible participation of researchers at all levels. Assessing research output is an important stride in highlighting national and international contribution and collaboration in a certain field. Therefore, the aim of this study was to clarify globally-published literature in outdoor air pollution – related respiratory wellness.

Method

Outdoor air pollution documents related to respiratory health were retrieved from Scopus database. The study flow was upward to 2017. Mapping of author keywords was carried out using VOSviewer 1.half-dozen.6.

Results

Search query yielded 3635 documents with an h-alphabetize of 137. There was a dramatic increment in the number of publications in the final decade of the study period. The almost often encountered author keywords were: air pollution (835 occurrences), asthma (502 occurrences), particulate matter (198 occurrences), and children (203 occurrences). The U.s.a. of America ranked commencement (1082; 29.8%) followed by the Uk (279; 7.7%) and Italy (198; 5.four%). Annual research productivity stratified by income and population size indicated that China ranked first (22.2) followed past the USA (18.viii). Assay of regional distribution of publications indicated that the Mediterranean, African, and S-East Asia regions had the to the lowest degree contribution. Harvard University (92; 2.5%) was the nearly active institution/organization followed the U.s. Ecology Protection Agency (89; 2.4%). International collaboration was restricted to 3 regions: Northern America, Europe, and Asia. The peak ten preferred journals were in the field of environmental health and respiratory wellness. Environmental Wellness Perspective was the about preferred journal for publishing documents in outdoor pollution in relation to respiratory health.

Conclusion

Inquiry on the impact of outdoor air pollution on respiratory health had accelerated lately and is receiving a lot of interest. Global research networks that include countries with high level of pollution and limited resources are highly needed to create public stance in favor of minimizing outdoor air pollution and investing in greenish technologies.

Background

Outdoor air pollution is defined as the presence of one or more substances in the atmospheric air at concentrations and duration above the natural limits [ane]. Such substances include ozone [O3], airborne atomic number 82 [Pb], carbon monoxide [CO], sulphur oxides [SOx] and nitrogen oxides [NOx] [two]. Recently, air pollution with particulate matters (PM), particularly those with less than ii.5 μm, has been the focus of most outdoor air pollution studies due to its power to penetrate the lung tissue and induce local and systemic effects [2].

Air pollution has been described every bit 1 of the "great killers of our age" and as "major threat to health" due to its tremendous and various wellness effects on humans of all ages and in both genders [three, 4]. In 2014, the Earth Health Organization (WHO) estimated that 92% of the world population was living in places with less than optimum outdoor air quality. Furthermore, WHO reported that in 2012, outdoor air pollution caused around iii 1000000 deaths worldwide and vi.5 million deaths (11.6% of all global deaths) were associated with indoor and outdoor air pollution together [5].

Air pollution was linked to cancer, respiratory diseases, negative pregnancy outcomes, infertility, cardiovascular diseases, stroke, cognitive decline, and other adverse medical weather [half dozen,7,eight,9,10,11,12,13]. Nearly 90% of air-pollution-related deaths occur in low- and centre-income countries, with nearly ii out of 3 occurring in S-East asia and Western Pacific regions. The problem of outdoor pollution is not a new one, but the rapid urbanization, peculiarly in Asia, fabricated the trouble of air pollution more visible and its health burden more tangible [14,15,16,17].

Bibliometric analysis is the awarding of statistical methods on published literature to analyze publication trends with time and to shed lite on influential researchers, countries, and institutions in the field. In the past decade, at least seven bibliometric studies on air pollution were published [18,19,xx,21,22,23,24]. However, none of the published bibliometric studies have shed calorie-free on the air pollution - related respiratory health. Therefore, in the current study, we aim to analyze literature pertaining to outdoor air pollution and respiratory health. The size of the literature and inquiry productivity in this field is a good indicator of national and international efforts to improve air quality and to decrease the health and economical burden of air pollution. Furthermore, the quality of the air we exhale is the responsibility of anybody including researchers and academics. This study comes in line with perceived personal responsibility toward better air quality.

Method

Search strategy

This study aimed to clarify the documents about outdoor air pollution – related respiratory wellness. Scopus database was used to retrieve relevant documents because of its advantages over other databases [25,26,27,28]. The search strategy adult for this study consisted of nine steps (Boosted file 1). The first six steps utilized various keywords and search queries to retrieve the maximum number of documents. Keywords included in search queries were those found in recent relevant systematic reviews [6, 12, xiii, 29, 30]. The combined consequence of search queries underwent a filtration process by calculation exclusion and limitation components (steps vii – 9).

False positive results were minimized past using championship search. Therefore, all retrieved documents have the keywords of interest. Despite that, false positive results demand to be searched past reviewing the retrieved documents. The review process was carried out on a sample of 200 documents chosen based on the number of citation. The review process was carried out by the authors (Due west.S and A.J) and canonical by a third author (A.Southward). Keywords of the irrelevant documents (imitation positive results) were used in the exclusion step. A complete list of irrelevant keywords is written in Additional file 1. The exclusion of false positive results is not enough to confirm the validity of the search strategy. Therefore, the authors compared two unlike methods of information drove. In the get-go one, we collected data regarding research output for each of the most active authors as obtained through the search strategy, whilst in the second one, the research output of each of the about active authors was extracted and reviewed by exploring the author profile every bit presented by Scopus. The extent of agreement between the 2 methods is measured past interclass correlation coefficient using SPSS [31,32,33,34,35]. An splendid agreement between the 2 methods with an interclass correlation above 95% and a p less than five% is indicative of loftier validity of the search strategy. In the current study, the interclass correlation was 0.98.7% and p was 0.001.

The retrieved information were also sorted based on the number of different country affiliations per article to summate international collaboration. Documents with authors from different countries represent international or inter-state collaboration while documents in which all authors accept 1 state affiliation stand for intra-country collaboration. Information technology should exist emphasized that Scopus has the function which can separate documents with intra or inter – country collaboration. Therefore, the calculation of international collaboration was extracted from data provided by Scopus.

Bibliometric analysis versus systematic reviews

Information technology should be emphasized that the bibliometric analysis is not the same as systematic reviews. In contrast to systematic reviews, bibliometric analysis focuses on quantitative and qualitative aspects of all documents retrieved from i electronic large database. In bibliometric analysis, the investigated research question is the volume of research published, how this volume of literature evolved with time, what major topics were of high interest, and the scientific impact of literature in a particular subject area. However, in systematic reviews, a consummate and exhaustive summary of current literature obtained from several electronic databases and relevant to a research question is provided.

In bibliometric analysis, only one large and well – known database, such as Scopus, is used. Therefore, the retrieved documents will not include any duplicates. On the other paw, duplicate documents might announced in systematic reviews because several databases are used to retrieve the required documents.

Data analysis and visualization

In this report, Hirsch-index (h-index) was used every bit a measure of impact of publications [36]. Graphs were created using Statistical Parcel for Social Sciences (SPSS). Hirsch - index is defined equally the number of articles (n) that take received at least n citations [36]. VOSviewer software was used to create visualization maps while ArcMap ten.ane was used to create geographical distribution of the retrieved documents [37,38,39]. For VOSviewer mapping of most frequent author keywords, a minimum occurrence of 10 was used as a cutting-off signal for inclusion of the keyword in mapping assay. Assay too included distribution of publications based on World Health Arrangement (WHO) regions.

Results

Types and growth of publications

The search strategy yielded 3635 documents. The earliest document in this field was published in 1943 in American Journal of Epidemiology [twoscore]. The analysis of the types of documents showed that research manufactures (2935, 80.7%) were the nearly mutual blazon followed past review manufactures (359; nine.9%). The remaining documents (341; 9.4%) were conference papers, letters, editorials, short surveys, and notes. English (2923, 80.4%) was the chief linguistic communication of documents followed by French (156; 4.3%) and German (124; iii.4%). The subject areas of the documents were medicine (2772; 76.3%) followed past environmental science (1038; 28.half-dozen%) and biochemistry/ genetics/ molecular biology (317; 8.7%) with the possibility of overlap among different bailiwick areas. The growth of publications showed a dramatic increase in the past decade. Figure 1 shows the annual growth of publications. In that location was a 72% increase in number of publications in 2017 compared to that in 2008.

Fig. 1
figure 1

Annual growth of publications in Outdoor air pollution and respiratory wellness (1900 – 2017)

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Author keywords

Analysis of writer keywords showed that the most often encountered author keywords were: air pollution (835 occurrences), asthma (502 occurrences), particulate affair (198 occurrences), and children (203 occurrences) (Fig. 2a). Farther mapping of types of pollutants almost commonly encountered in writer keywords showed that particulate thing (198 occurrences), ozone (192 occurrences), nitrogen oxide (95 occurrences), PM10 (75 occurrences), PM2.5 (57 occurrences), and Sulfur dioxide (54 occurrences), were the most frequently encountered author keywords (Fig. 2b).

Fig. ii
figure 2

Most frequent author keywords encountered in the retrieved documents (a) and most frequently encountered types of outdoor air pollutants encountered in the retrieved documents (b)

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Agile journals

Table ane shows the top ten journals that were involved in publishing the retrieved documents. Environmental Health Perspective was the most active periodical (153; 4.2%) followed by Environmental Research (112; 3.i%) and American Periodical of Respiratory and Disquisitional Care Medicine (100; ii.8%). The top ten active journals included iv in the field of environmental health, iv in the field of respiratory wellness, one in allergy/immunology, and the last i in toxicology field.

Table 1 Top active journals in publishing documents in air pollution – related respiratory health (1900 – 2017)

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Authorship analysis

The number of dissimilar author names who participated in publishing documents was 11,014; giving an average of 3.0 authors per certificate. Table 2 lists the top ten active authors with their affiliations. The peak active authors were mainly from Western and Northern Europe, particularly from kingdom of the netherlands, Italia, and the United Kingdom [21]. Prof. Brunekreef, B. from kingdom of the netherlands was the nearly active researcher in this field with 77 (2.2%) documents. Authors with a minimum productivity of 20 publications were also visualized using network visualization map that showed research networking among active authors (Fig. 3). The map showed that active authors with minimum productivity of 20 publications existed in four clusters. The largest cluster consisted of viii authors (night red colour). The second cluster consisted of vii authors (green). The third cluster consisted of 6 authors (bluish). The 4th cluster consisted of four researchers (dark yellow). Authors with minimum productivity of 20 publications who are not shown in the map are ordinarily those who did non exist within a research network that has prominent productivity.

Table 2 Most active researchers in the field of air pollution – related respiratory health (1900 – 2017)

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Fig. iii
figure 3

Network visualization map of authors with minimum productivity of twenty publications in the studied field and be within a collaborative research grouping

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Active countries

Researchers from 92 different countries contributed to the retrieved documents. Table 3 lists the top ten countries actively involved in air pollution – related respiratory health. Researchers from the USA participated in publishing 1082 (29.8%) documents. The top 10 list included countries from Northern America, Western Europe, and Asia. Researchers from these top ten countries participated in publishing 2630 (72.iii%) documents. Figure 4 shows worldwide geographical distribution of retrieved documents. Regional distribution of retrieved documents indicated that the regions of Americas, Europe, and Western pacific had the highest percentage of contribution while Mediterranean, Africa, and Due south-E Asia regions had the to the lowest degree contribution (Fig. 5).

Table 3 Acme 10 agile countries in publishing documents in air pollution – related respiratory health (1900 – 2017)

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Fig. 4
figure 4

Geographical distribution of published research in outdoor air pollution and respiratory health (1900 – 2017)

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Fig. v
figure 5

Geographical distribution of published inquiry in outdoor air pollution and respiratory wellness (1900 – 2017) based on WHO world region. WP: Western Pacific; EM: Eastern Mediterranean; E: Europe; Ocean: South Eastern Asia; AM: Americas; AF: Africa

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International collaboration

International collaboration in air pollution – related respiratory health showed that there were iii clusters. There was relatively adequate collaboration among countries within each cluster and there was adequate collaboration between countries in the 2 different clusters (Fig. six). The showtime cluster consisted of 9 European countries shown in green color while the 2nd cluster consisted of 9 countries in dissimilar regions in the world specially those in Northern and Southern America, South Eastern asia, and Western Pacific regions. The third cluster consisted of i detail, India with inquiry connections with countries in both cluster number 1 and 2. International collaboration among countries in the Mediterranean region, Africa, or Eastern Europe and those in Northern America, Europe, or Asia did non prove upwards in the map.

Fig. vi
figure 6

Network visualization map of inquiry collaboration in outdoor air pollution and respiratory health (1900 – 2017)

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Tabular array 3 shows the extent and the percentage of intra and inter (international) country collaboration for the top active countries. In terms of quantity, the United states had the largest number of documents (276; 25.5%) with international authors. Nonetheless, this quantity represents only 25.5% of full research productivity from the USA which ways that approximately 75% of USA research production in this field was produced by authors from the USA without collaboration with international researchers. Japan had the least percentage (22.2%) of international collaboration while Sweden had the largest percentage (58.0%) of documents with international collaboration.

Agile institutions

Harvard University ranked starting time in research output (92; 2.5%) and in the touch of publications (h-alphabetize = 44). The US Ecology Protection Agency (EPA) ranked 2nd in research output (89; ii.4%) and in the affect of publications (h-index = 36). Table four shows the top 10 agile institutions/organizations. The listing included vii academic institutions and iii research centers. Six of the top active institutions were American institutions, three were European, and i was Canadian.

Table 4 Top active institutions/organizations in publishing documents in air pollution – related respiratory health (1900 – 2017)

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Citation assay

The total number of citations received past documents was 101,113, with an average of 27.8 citations per document. Range of citations was [0 – 4294]. The h-index of the retrieved documents was 137. Table v shows the meridian ten highly cited manufactures. The article that received the highest number of citations (4294) was published in 2002 in Journal of American Medical Clan (JAMA) and discussed the relation between lung cancer, cardiopulmonary mortality and air pollution [xl].

Table 5 Height 10 cited documents in air pollution – related respiratory health (1900 – 2017)

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Word

Growth of publications

In this written report, we analyzed global inquiry output in outdoor air pollution – related respiratory wellness. The results showed a noticeable increase in the number of publications in the last decade of the study flow. This indicates that the level of air pollution and its health consequences reached serious levels. In 2012, air pollution was responsible for 3 million deaths, representing five.4% of the full global deaths. In the same year, about 25% were due to lung cancer deaths, 8% were due to chronic obstructive pulmonary disease (COPD) deaths, and most 17% of respiratory infection deaths were caused by outdoor air pollution [41]. A study indicated that the contribution of outdoor air pollution to global premature bloodshed could double by 2050 [42]. Another study concluded that outdoor air pollution contributes to the increment in global brunt of COPD and that an increase of 10 μg/thousand(three) in PM10 produced significant increment in COPD deaths and exacerbations that can be substantially reduced by controlling air pollution [43]. A cohort Chinese study concluded that the risks of mortality and years of life lost were elevated corresponding to an increment in electric current ambient concentrations of the air pollutants [44].

The contribution of researchers from /ifferent scientific fields led to an acceleration in the growth of publications in this field. Scientists in the fields of the surroundings, respiratory wellness, public health, and fifty-fifty molecular biological science/genetics contributed to the retrieved documents [45,46,47,48,49]. The fact that air pollution is a multidisciplinary field created a large number of readers from different scientific fields and thus leading to large number of citations, reflected in the relatively high h-alphabetize value of documents. For example, the h-index of literature in global carbapenem resistance was 102 and that for literature in resistant tuberculosis was 76 [l, 51].

Active countries and institutions

Our results showed that China had the highest research productivity in terms of Gdp per capita per twelvemonth. In Mainland china, air pollution was previously estimated to contribute to 1.2 to two meg deaths annually [52]. In its list of the world's deadliest countries for air pollution, the WHO ranked Prc first followed by Republic of india, Russia, Indonesia, Pakistan, Ukraine, Nigeria, Egypt, The states, and Bangladesh [53]. Out of the tiptop 10 countries that have loftier total annual number of deaths from PM2.5 and PM10, only China and USA were amongst the meridian x active countries in inquiry output. The deadliest effects of air pollution in Cathay led to the adoption of the Ambient Air Quality Standard in China in 2012 [54]. This system started a national Air Reporting Organization that now includes 945 sites in 190 cities.

The presence of agile institutions and many high affect journals in the field of ecology health and respiratory medicine issued from the USA contributed to the leadership of USA in this field. Research output in any field is a part of money allocated to inquiry every bit well equally public health agendas of the country. The leadership of the USA was seen in several other scientific subjects [55,56,57,58]. The fact that English was the primary language of literature published in journals indexed in Scopus might accept created some sort of bias toward English-speaking countries.

International collaboration

Outdoor air pollution is a global wellness concern and international collaboration in this field is necessary. In our written report, the extent of international collaboration in research was relatively high, particularly within European countries and between USA and Asian countries. The WHO Collaborating Center for Air Quality Management and Air Pollution Command (WHO CC) is working with fellow member states in Europe and Asia to encourage collaboration in air quality programs through interaction and networking [59].

Highly cited documents

The top cited documents in the field was about the human relationship between outdoor air pollution and lung cancer; and received a large number of citations suggestive of great importance. The International Agency for Enquiry on Cancer [60], which is part of the WHO, has classified outdoor air pollution, as a whole, equally a cancer-causing agent (carcinogen) [60]. The International Agency for Research on Cancer (IARC) ended that outdoor air pollution causes lung cancer and is associated with increased risk for bladder cancer. Urgent action to minimize level of outdoor air pollution and exposure of population to such carcinogenic pollutants is necessary, peculiarly in cities with loftier levels of outdoor air pollution [61, 62].

Force and limitations

Information technology is the commencement to appraise research activity in the field of outdoor air pollution – related respiratory health. Our written report documented the accelerated increment in publications and the role of international collaboration. Nonetheless, our written report has a number of limitations. The Scopus database is a comprehensive and large database that includes dissimilar disciplines, but some peer – reviewed journals are not indexed in Scopus. This is particularly true for journals published from India, Red china, Indonesia, and other Asian and African countries where outdoor air pollution is a real public health problem. Therefore, documents published in un-indexed journals were not retrieved. Secondly, the results presented in this study reflect the search strategy implemented which is comprehensive in the subject but the presence of fake positive and imitation negative results cannot exist ruled out. This is true in all bibliometric studies [63,64,65,66,67]. Thirdly, when list active authors and institutions, the authors depended on the result obtained from the Scopus. Nonetheless, some authors might have more than ane Scopus profile or might have their name written in different manufactures in dissimilar means which will affect their inquiry output and therefore their rank likewise. Same applies to active institutions where the name of the institution might be written in unlike articles in different means which will bear upon their research output and rank as well. Furthermore, the authors used the keyword "environment" in the search strategy in a strict way to avoid imitation positive results since not all ecology pollution could fit the scope of the electric current written report which focused on outdoor air pollution and its impact on respiratory health. In this regard, the authors also avoided the use of the keyword "climate" in the search strategy to proceed the research question focused on outdoor air pollution, particularly those produced by manufacture. Finally, it should be emphasized that the list of highly cited manufactures does not mean that these articles are the just influential ones in the field. The citation procedure is dynamic and sometimes high citation reflects self-commendation rather than impact. There were many influential and highly cited articles in the field that were non listed in the highly cited article [68,69,70,71,72,73,74,75,76,77,78,79].

Conclusions

Growth of publications in outdoor air pollution – related respirator health is rapidly increasing. However, limited enquiry output and international collaboration were seen in world regions such as the Middle East, Africa, and South-Eastward Asia. International multidisciplinary research network, involving countries with high levels of air pollution and limited resources, are needed. Research in atmospheric pollution should also exist directed toward prevention of air pollution problems by investing more in green engineering.

The results presented in this study are indicative of how research action is interacting with the urgent acceleration of the air pollution crunch at the global level. Furthermore, the research action is indicative of the response rate adopted by certain countries to face up this global problem in a responsible manner. Pressure groups tin can use the research action to enforce certain environmental and industrial agendas on politicians and political campaigns. Countries with high levels of outdoor air pollution, and therefore, poor air quality, need to become engaged in research pertaining to this field to provide health policymakers with baseline information for future activity. Establishing research center for monitoring national air quality and level of air pollution is a step forward that needs to be adopted past all countries. Such centers could include scientists from different disciplines who tin can collaborate to convert research findings into national agendas and policies. At the national levels, dissimilar world countries demand to adopt strict guidelines for air quality. Collaboration between industry and health authorities is needed to implement measures that could significantly reduce the levels of particulate matter. The outdoor air pollution is a global public health and therefore enquiry networking between developed countries and developing countries with loftier levels of air pollution should exist prioritized. The Chinese model in decision-making air pollution and minimizing its health consequences could exist of a global benefit. Finally, since the respiratory effects of air pollution are affecting children, in that location is a demand to educate and increase the sensation of parents regarding this issue.

Abbreviations

IARC:

International Agency for Inquiry on Cancer

IRB:

Institutional Review Board

WHO:

World Health System

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Acknowledgments

The authors would similar to thank An-Najah National University for giving the opportunities to this report.

Availability of data and materials

Data are available in additional file.

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Affiliations

  1. Division of Biomedical Sciences, Department of Physiology, Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine

    Waleed M. Sweileh & Ansam F. Sawalha

  2. Section of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National Academy, Nablus, Palestine

    Samah W. Al-Jabi & Sa'ed H. Zyoud

Contributions

Equally conceptualized and designed the written report, coordinated the study and data analysis, interpreted the data, and did the final write-upwards of the manuscript. WS, SZ, SA; designed the method, information extraction, data assay, data interpretation, and writing the manuscript. All authors read and approved the last manuscript.

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Correspondence to Ansam F. Sawalha.

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Sweileh, Westward.Thou., Al-Jabi, S.W., Zyoud, S.H. et al. Outdoor air pollution and respiratory health: a bibliometric assay of publications in peer-reviewed journals (1900 – 2017). Multidiscip Respir Med xiii, fifteen (2018). https://doi.org/ten.1186/s40248-018-0128-5

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Keywords

  • Outdoor air pollution
  • Respiratory health
  • Bibliometric assay

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