Low Levels of Air Pollution and Health: Effect Estimates, Methodological Challenges, and Future Directions.

PURPOSE OF REVIEW: Fine particle (PM2.5 ) levels have been decreasing in the USA over the past decades. Our goal was to assess the current literature to characterize the association between PM2.5 and adverse health at low exposure levels.

RECENT FINDINGS: We reviewed 26 papers that examined the association between short- and long-term exposure to PM2.5 and cardio-respiratory morbidity and mortality. There is evidence suggesting that these associations are stronger at lower levels. However, there are certain methodological and interpretational limitations specific to studies of low PM2.5 levels, and further methodological development is warranted. There is strong agreement across studies that air pollution effects on adverse health are still observable at low concentrations, even well below current US standards. These findings suggest that US standards need to be reevaluated, given that further improving air quality has the potential of benefiting public health.