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

Multidisciplinary Respiratory Medicine volume 13, Article number:fifteen (2018) Cite this commodity

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Abstruse

Background

Outdoor air pollution is a major threat to global public health that needs responsible participation of researchers at all levels. Assessing enquiry output is an important step 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 health.

Method

Outdoor air pollution documents related to respiratory health were retrieved from Scopus database. The written report menstruum was upwards to 2017. Mapping of author keywords was carried out using VOSviewer 1.half-dozen.half-dozen.

Results

Search query yielded 3635 documents with an h-index of 137. In that location was a dramatic increment in the number of publications in the last decade of the written report period. The almost often encountered author keywords were: air pollution (835 occurrences), asthma (502 occurrences), particulate matter (198 occurrences), and children (203 occurrences). The United States of America ranked commencement (1082; 29.8%) followed by the Britain (279; 7.7%) and Italy (198; five.4%). Almanac inquiry productivity stratified past income and population size indicated that China ranked start (22.2) followed past the Usa (18.8). Analysis of regional distribution of publications indicated that the Mediterranean, African, and South-East Asia regions had the least contribution. Harvard University (92; ii.five%) was the nearly active establishment/organization followed the US Ecology Protection Agency (89; 2.4%). International collaboration was restricted to three regions: Northern America, Europe, and Asia. The superlative ten preferred journals were in the field of ecology health and respiratory health. Environmental Wellness Perspective was the nigh preferred journal for publishing documents in outdoor pollution in relation to respiratory health.

Determination

Research on the impact of outdoor air pollution on respiratory health had accelerated lately and is receiving a lot of interest. Global enquiry networks that include countries with high level of pollution and express resource are highly needed to create public opinion in favor of minimizing outdoor air pollution and investing in dark-green technologies.

Background

Outdoor air pollution is defined as the presence of ane or more substances in the atmospheric air at concentrations and elapsing above the natural limits [1]. Such substances include ozone [O3], airborne lead [Pb], carbon monoxide [CO], sulphur oxides [SOx] and nitrogen oxides [NOx] [2]. Recently, air pollution with particulate matters (PM), especially those with less than 2.5 μm, has been the focus of most outdoor air pollution studies due to its ability to penetrate the lung tissue and induce local and systemic effects [2].

Air pollution has been described every bit one of the "great killers of our historic period" and as "major threat to wellness" due to its tremendous and various wellness effects on humans of all ages and in both genders [3, four]. In 2014, the World 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 3 million deaths worldwide and half-dozen.five one thousand thousand 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,7,8,ix,10,eleven,12,thirteen]. Nearly 90% of air-pollution-related deaths occur in low- and eye-income countries, with nearly 2 out of 3 occurring in South-Eastern asia and Western Pacific regions. The problem of outdoor pollution is not a new one, only the rapid urbanization, particularly in Asia, fabricated the problem of air pollution more visible and its health burden more than tangible [fourteen,xv,sixteen,17].

Bibliometric analysis is the application of statistical methods on published literature to analyze publication trends with fourth dimension and to shed light on influential researchers, countries, and institutions in the field. In the past decade, at least 7 bibliometric studies on air pollution were published [eighteen,xix,20,21,22,23,24]. However, none of the published bibliometric studies take shed light on the air pollution - related respiratory health. Therefore, in the current report, we aim to analyze literature pertaining to outdoor air pollution and respiratory health. The size of the literature and research productivity in this field is a good indicator of national and international efforts to ameliorate air quality and to decrease the health and economic burden of air pollution. Furthermore, the quality of the air we breathe is the responsibility of everyone including researchers and academics. This study comes in line with perceived personal responsibility toward better air quality.

Method

Search strategy

This study aimed to analyze the documents nearly outdoor air pollution – related respiratory health. Scopus database was used to retrieve relevant documents because of its advantages over other databases [25,26,27,28]. The search strategy developed for this report consisted of nine steps (Additional file i). 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, 13, 29, 30]. The combined consequence of search queries underwent a filtration process by adding exclusion and limitation components (steps seven – 9).

Faux positive results were minimized by using title search. Therefore, all retrieved documents accept the keywords of involvement. Despite that, fake positive results need to be searched by reviewing the retrieved documents. The review procedure was carried out on a sample of 200 documents called based on the number of citation. The review procedure was carried out by the authors (W.S and A.J) and approved by a third author (A.S). Keywords of the irrelevant documents (faux positive results) were used in the exclusion step. A complete listing of irrelevant keywords is written in Additional file 1. The exclusion of faux positive results is not enough to ostend the validity of the search strategy. Therefore, the authors compared two dissimilar methods of data collection. In the first one, we collected data regarding research output for each of the most agile authors as obtained through the search strategy, whilst in the second 1, the enquiry output of each of the almost active authors was extracted and reviewed by exploring the author profile as presented past Scopus. The extent of agreement between the two methods is measured by interclass correlation coefficient using SPSS [31,32,33,34,35]. An splendid understanding between the two methods with an interclass correlation above 95% and a p less than v% is indicative of high validity of the search strategy. In the current study, the interclass correlation was 0.98.7% and p was 0.001.

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

Bibliometric assay versus systematic reviews

It should be emphasized that the bibliometric analysis is not the same every bit systematic reviews. In contrast to systematic reviews, bibliometric assay focuses on quantitative and qualitative aspects of all documents retrieved from one electronic big 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 affect of literature in a particular subject. Withal, in systematic reviews, a complete and exhaustive summary of current literature obtained from several electronic databases and relevant to a inquiry question is provided.

In bibliometric assay, only one big and well – known database, such as Scopus, is used. Therefore, the retrieved documents volition non include whatsoever duplicates. On the other mitt, duplicate documents might appear in systematic reviews considering several databases are used to retrieve the required documents.

Data analysis and visualization

In this written report, Hirsch-alphabetize (h-index) was used as a measure of impact of publications [36]. Graphs were created using Statistical Package for Social Sciences (SPSS). Hirsch - index is divers every bit the number of articles (n) that have received at least north citations [36]. VOSviewer software was used to create visualization maps while ArcMap ten.1 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 cut-off signal for inclusion of the keyword in mapping analysis. Analysis likewise included distribution of publications based on Earth Health System (WHO) regions.

Results

Types and growth of publications

The search strategy yielded 3635 documents. The earliest certificate in this field was published in 1943 in American Journal of Epidemiology [40]. The analysis of the types of documents showed that enquiry articles (2935, 80.seven%) were the well-nigh mutual blazon followed by review articles (359; ix.nine%). The remaining documents (341; nine.4%) were conference papers, letters, editorials, short surveys, and notes. English (2923, 80.4%) was the primary language of documents followed by French (156; four.3%) and German language (124; three.four%). The discipline areas of the documents were medicine (2772; 76.iii%) followed by ecology science (1038; 28.6%) and biochemistry/ genetics/ molecular biology (317; 8.7%) with the possibility of overlap among different subject areas. The growth of publications showed a dramatic increase in the past decade. Figure 1 shows the annual growth of publications. At that place 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 health (1900 – 2017)

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Author keywords

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

Fig. 2
figure 2

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

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Active journals

Tabular array one shows the top ten journals that were involved in publishing the retrieved documents. Ecology Health Perspective was the most active journal (153; 4.2%) followed by Environmental Enquiry (112; 3.1%) and American Journal of Respiratory and Critical Care Medicine (100; 2.8%). The elevation 10 active journals included four in the field of ecology wellness, four in the field of respiratory health, one in allergy/immunology, and the last one in toxicology field.

Tabular array 1 Elevation active journals in publishing documents in air pollution – related respiratory wellness (1900 – 2017)

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Authorship analysis

The number of different author names who participated in publishing documents was 11,014; giving an average of iii.0 authors per document. Table 2 lists the pinnacle ten active authors with their affiliations. The tiptop active authors were mainly from Western and Northern Europe, particularly from the netherlands, Italy, and the United kingdom [21]. Prof. Brunekreef, B. from the Netherlands was the virtually agile researcher in this field with 77 (ii.2%) documents. Authors with a minimum productivity of xx publications were also visualized using network visualization map that showed research networking among active authors (Fig. iii). The map showed that active authors with minimum productivity of 20 publications existed in four clusters. The largest cluster consisted of viii authors (nighttime cherry-red color). The 2d cluster consisted of 7 authors (greenish). The third cluster consisted of six authors (blue). The fourth cluster consisted of four researchers (dark yellow). Authors with minimum productivity of 20 publications who are non shown in the map are unremarkably those who did not exist within a research network that has prominent productivity.

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

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Fig. 3
figure 3

Network visualization map of authors with minimum productivity of 20 publications in the studied field and be inside a collaborative inquiry group

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Active countries

Researchers from 92 dissimilar countries contributed to the retrieved documents. Tabular array iii lists the top ten countries actively involved in air pollution – related respiratory wellness. Researchers from the U.s.a. 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.three%) 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 S-Eastern asia regions had the least contribution (Fig. 5).

Tabular array 3 Top 10 active countries in publishing documents in air pollution – related respiratory wellness (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. 5
figure 5

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

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International collaboration

International collaboration in air pollution – related respiratory wellness showed that in that location were three clusters. There was relatively adequate collaboration among countries within each cluster and there was adequate collaboration between countries in the two unlike clusters (Fig. 6). The commencement cluster consisted of ix European countries shown in light-green color while the second cluster consisted of 9 countries in different regions in the globe especially those in Northern and Southern America, South Eastern asia, and Western Pacific regions. The tertiary cluster consisted of one item, India with enquiry connections with countries in both cluster number 1 and 2. International collaboration amid countries in the Mediterranean region, Africa, or Eastern Europe and those in Northern America, Europe, or Asia did non show upwardly in the map.

Fig. 6
figure 6

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

Total size image

Tabular array 3 shows the extent and the percentage of intra and inter (international) state collaboration for the pinnacle active countries. In terms of quantity, the United states of america had the largest number of documents (276; 25.5%) with international authors. However, this quantity represents only 25.5% of total research productivity from the U.s.a. which means that approximately 75% of USA research product in this field was produced past 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 Academy ranked starting time in research output (92; 2.five%) and in the impact of publications (h-index = 44). The US Environmental Protection Agency (EPA) ranked second in research output (89; ii.4%) and in the impact of publications (h-index = 36). Tabular array 4 shows the top ten agile institutions/organizations. The listing included 7 academic institutions and three research centers. Six of the top agile institutions were American institutions, three were European, and one was Canadian.

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

Full size tabular array

Citation analysis

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-alphabetize of the retrieved documents was 137. Table 5 shows the elevation ten highly cited articles. The article that received the highest number of citations (4294) was published in 2002 in Periodical of American Medical Association (JAMA) and discussed the relation between lung cancer, cardiopulmonary mortality and air pollution [xl].

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

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Give-and-take

Growth of publications

In this study, we analyzed global research 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 menses. This indicates that the level of air pollution and its health consequences reached serious levels. In 2012, air pollution was responsible for iii 1000000 deaths, representing 5.4% of the total global deaths. In the same yr, well-nigh 25% were due to lung cancer deaths, 8% were due to chronic obstructive pulmonary affliction (COPD) deaths, and most 17% of respiratory infection deaths were caused past outdoor air pollution [41]. A written report indicated that the contribution of outdoor air pollution to global premature mortality could double by 2050 [42]. Another study concluded that outdoor air pollution contributes to the increase in global brunt of COPD and that an increase of x μg/m(iii) in PM10 produced significant increment in COPD deaths and exacerbations that tin can exist essentially reduced by controlling air pollution [43]. A accomplice Chinese written report ended 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 environment, respiratory health, public wellness, and even molecular biology/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 loftier 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 [50, 51].

Active countries and institutions

Our results showed that Mainland china had the highest enquiry productivity in terms of GDP per capita per year. In China, air pollution was previously estimated to contribute to i.2 to ii million deaths annually [52]. In its list of the world's deadliest countries for air pollution, the WHO ranked Communist china outset followed by India, Russia, Indonesia, Pakistan, Ukraine, Nigeria, Egypt, U.s., and Bangladesh [53]. Out of the top 10 countries that accept high full annual number of deaths from PM2.5 and PM10, only China and The states were amid the top ten active countries in enquiry output. The deadliest effects of air pollution in People's republic of china led to the adoption of the Ambient Air Quality Standard in China in 2012 [54]. This system started a national Air Reporting System that now includes 945 sites in 190 cities.

The presence of active institutions and many high impact journals in the field of environmental health and respiratory medicine issued from the The states contributed to the leadership of Us in this field. Enquiry output in any field is a function of money allocated to inquiry as well every bit public health agendas of the land. The leadership of the The states was seen in several other scientific subjects [55,56,57,58]. The fact that English language was the primary language of literature published in journals indexed in Scopus might have created some sort of bias toward English-speaking countries.

International collaboration

Outdoor air pollution is a global wellness business organisation and international collaboration in this field is necessary. In our report, the extent of international collaboration in research was relatively high, particularly within European countries and betwixt United states of america and Asian countries. The WHO Collaborating Eye for Air Quality Management and Air Pollution Control (WHO CC) is working with 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 relationship between outdoor air pollution and lung cancer; and received a large number of citations suggestive of great importance. The International Agency for Research on Cancer [60], which is part of the WHO, has classified outdoor air pollution, every bit a whole, as a cancer-causing agent (carcinogen) [60]. The International Bureau 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, especially in cities with high levels of outdoor air pollution [61, 62].

Strength and limitations

Information technology is the starting time to assess inquiry action in the field of outdoor air pollution – related respiratory wellness. Our study documented the accelerated increase in publications and the part of international collaboration. However, our study has a number of limitations. The Scopus database is a comprehensive and big database that includes different disciplines, but some peer – reviewed journals are non indexed in Scopus. This is particularly truthful for journals published from India, Communist china, Republic of 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 reverberate the search strategy implemented which is comprehensive in the subject area but the presence of simulated positive and simulated negative results cannot be ruled out. This is truthful in all bibliometric studies [63,64,65,66,67]. Thirdly, when listing active authors and institutions, the authors depended on the outcome obtained from the Scopus. Yet, some authors might have more than i Scopus profile or might accept their proper name written in different articles in different ways which will affect their research output and therefore their rank every bit well. Aforementioned applies to agile institutions where the name of the institution might be written in different articles in different means which will affect their research output and rank as well. Furthermore, the authors used the keyword "surroundings" in the search strategy in a strict way to avert faux positive results since not all environmental pollution could fit the scope of the current 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 keep the research question focused on outdoor air pollution, especially those produced by industry. Finally, it should be emphasized that the list of highly cited articles does not mean that these articles are the just influential ones in the field. The commendation process is dynamic and sometimes high citation reflects self-citation rather than impact. In that location were many influential and highly cited manufactures in the field that were not listed in the highly cited commodity [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 equally the Middle East, Africa, and Due south-East Asia. International multidisciplinary research network, involving countries with loftier levels of air pollution and limited resources, are needed. Research in atmospheric pollution should also exist directed toward prevention of air pollution issues by investing more in green technology.

The results presented in this report are indicative of how research activity is interacting with the urgent acceleration of the air pollution crisis at the global level. Furthermore, the research activeness is indicative of the response rate adopted by certain countries to face up this global problem in a responsible way. Force per unit area groups tin use the research action to enforce certain environmental and industrial agendas on politicians and political campaigns. Countries with loftier levels of outdoor air pollution, and therefore, poor air quality, need to go engaged in research pertaining to this field to provide health policymakers with baseline information for future action. Establishing research center for monitoring national air quality and level of air pollution is a step forward that needs to be adopted by all countries. Such centers could include scientists from unlike disciplines who can interact to convert enquiry findings into national agendas and policies. At the national levels, different world countries need to prefer 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 research networking between developed countries and developing countries with loftier levels of air pollution should be prioritized. The Chinese model in controlling air pollution and minimizing its health consequences could exist of a global do good. Finally, since the respiratory effects of air pollution are affecting children, in that location is a need to educate and increase the awareness of parents regarding this effect.

Abbreviations

IARC:

International Agency for Inquiry on Cancer

IRB:

Institutional Review Lath

WHO:

World Wellness Organization

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Acknowledgments

The authors would like to give thanks An-Najah National University for giving the opportunities to this study.

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Affiliations

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

    Waleed M. Sweileh & Ansam F. Sawalha

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

    Samah W. Al-Jabi & Sa'ed H. Zyoud

Contributions

As conceptualized and designed the study, coordinated the study and information analysis, interpreted the data, and did the final write-up of the manuscript. WS, SZ, SA; designed the method, data extraction, data analysis, information interpretation, and writing the manuscript. All authors read and approved the terminal manuscript.

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Correspondence to Ansam F. Sawalha.

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Sweileh, Due west.M., Al-Jabi, Southward.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 13, 15 (2018). https://doi.org/x.1186/s40248-018-0128-5

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Keywords

  • Outdoor air pollution
  • Respiratory wellness
  • Bibliometric analysis

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