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A Framework for Examining Social Stress and Susceptibility to Air Pollution in Respiratory Health
Journal article   Open access   Peer reviewed

A Framework for Examining Social Stress and Susceptibility to Air Pollution in Respiratory Health

Jane E. Clougherty and Laura D. Kubzansky
Environmental health perspectives, v 117(9), pp 1351-1358
01 Sep 2009
PMID: 19750097
url
https://doi.org/10.1289/ehp.0900612View
Published, Version of Record (VoR) Open

Abstract

Environmental Sciences Environmental Sciences & Ecology Life Sciences & Biomedicine Public, Environmental & Occupational Health Science & Technology Toxicology
OBJECTIVE: There is growing interest in disentangling the health effects of spatially clustered social and physical environmental exposures and in exploring potential synergies among them, with particular attention directed to the combined effects of psychosocial stress and air pollution. Both exposures may be elevated in lower-income urban communities, and it has been hypothesized a stress, which can influence immune function and susceptibility, may potentiate the effects of air pollution in respiratory disease onset and exacerbation. In this paper, we attempt to synthesize the relevant research from social and environmental epidemiology, toxicology, immunology, and exposure assessment to provide a useful framework for environmental health researchers aiming to investigate the health effects of environmental pollution in combination with social or psychological factors. DATA SYNTHESIS: We review the existing epidemiologic and toxicologic evidence on synergistic effects of stress and pollution, and then describe the physiologic effects of stress and key issues related to measuring and evaluating stress as it relates to physical environmental exposures and susceptibility. Finally, we identify some of the major methodologic challenges ahead as we work toward disentangling the health effects of clustered social and physical exposures and accurately describing the interplay among these exposures. CONCLUSIONS: There is still tremendous work to be done toward understanding the combined and potentially synergistic health effects of stress and pollution. As this research proceeds, we recommend careful attention to the relative temporalities of stress and pollution exposures, to non-linearities in their independent and combined effects, to physiologic pathways not elucidated by epidemiologic methods, and to the relative spatial distributions of social and physical exposures at multiple geographic scales.

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Web of Science research areas
Environmental Sciences
Public, Environmental & Occupational Health
Toxicology
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