Gender-differentiated impact of PM2.5 exposure on respiratory and cardiovascular mortality: a review

The association between PM_2.5 and cardiovascular and respiratory mortality from a gender perspective is scarce in the literature, despite the fifth sustainable development goal (SDG 5) related to gender equality. This study aims to assess whether gender analysis in the association of PM_2.5 on respiratory and cardiovascular mortality shows a different impact on women than men around diverse regions of the world. We conducted a scoping review of the Web of Science database citations for epidemiological studies published between June 2020 and October 2021. The articles that met our inclusion criteria were grouped into three categories based on gender-induced effects to compare the registered risks between men and women. Of 956 articles identified, 36 published were eligible. The regions with the most gender analysis studies were Asia (n = 15), North America (n = 15), and Europe (n = 6). Irrespective of the gender-induced effect category, 7 articles reported a higher risk for women than men, and 14 declared the contrary. The magnitude of the impact of PM_2.5 on cardiovascular and respiratory mortality in women is unclear. Differences in covariates, methods of analysis, and regional characteristics of each country could influence the results. All studies lacked indoor PM_2.5 measurements, which may bias mortality estimates for the female population. The use of indoor PM_2.5 measurements would more accurately reflect the air quality that women and girls typically breathe.