Authors: Ioana Agache, Isabella Annesi-Maesano, Lorenzo Cecchi, Benedetta Biagioni, Kian Fan Chung, Bernard Clot, Gennaro D’Amato, Athanasios Damialis, Stefano del Giacco, Javier Dominguez-Ortega, Carmen Galàn, Stefanie Gilles, Stephen Holgate, Mohamed Jeebhay, Stelios Kazadzis, Kari Nadeau, Nikolaos Papadopoulos, Santiago Quirce, Joaquin Sastre, Fiona Tummon, Claudia Traidl-Hoffmann, Jolanta Walusiak-Skorupa, Marek Jutel, Cezmi A. Akdis 

Abstract:

The EAACI Guidelines on the impact of short-term exposure to outdoor pollutants on asthma-related outcomes provide recommendations for prevention, patient care and mitigation in a framework supporting rational decisions for healthcare professionals and patients to individualize and improve asthma management and for policymakers and regulators as an evidence-informed reference to help setting legally binding standards and goals for outdoor air quality at international, national and local levels. The Guideline was developed using the GRADE approach and evaluated outdoor pollutants referenced in the current Air Quality Guideline of the World Health Organization as single or mixed pollutants and outdoor pesticides. Short-term exposure to all pollutants evaluated increases the risk of asthma-related adverse outcomes, especially hospital admissions and emergency department visits (moderate certainty of evidence at specific lag days). There is limited evidence for the impact of traffic-related air pollution and outdoor pesticides exposure as well as for the interventions to reduce emissions. Due to the quality of evidence, conditional recommendations were formulated for all pollutants and for the interventions reducing outdoor air pollution. Asthma management counselled by the current EAACI guidelines can improve asthma-related outcomes but global measures for clean air are needed to achieve significant impact.

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