Ewha Med J.  2024 Apr;47(2):e20. 10.12771/emj.2024.e20.

Exposure to air pollution and precocious puberty: a systematic review

Affiliations
  • 1Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
  • 2Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Korea
  • 3Institute of Ewha-SCL for Environmental Health (IESEH), Ewha Womans University College of Medicine, Seoul, Korea
  • 4Department of Human Systems Medicine, College of Medicine, Seoul National University, Seoul, Korea
  • 5System Health & Engineering Major in Graduate School (BK21 Plus Program), Ewha Womans University, Seoul, Korea

Abstract

The worldwide incidence of precocious puberty, which is associated with negative health outcomes, is increasing. Several studies have suggested that environmental factors contribute to the development of precocious puberty alongside genetic factors. Some epidemiological studies have provided limited evidence suggesting an association between exposure to air pollution and changes in pubertal development. This systematic review aimed to summarize existing evidence on the association between air pollution exposure and precocious puberty. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched two databases (PubMed and Web of Science) until August 2023. The included studies assessed the association between air pollutant exposure and the risk of precocious puberty, early menarche, or pubertal development. Two authors independently performed study selection and data extraction. A meta-analysis and analysis of the risk of bias were infeasible due to the limited number of studies and the heterogeneity among them. The literature search resulted in 184 studies, from which we included six studies with sample sizes ranging from 437 to 4,074 participants. The studies reported heterogeneous outcomes. Four studies found that increased exposure to air pollution was related to earlier pubertal onset. One study was inconclusive, and another suggested that air pollutant exposure may delay the onset of thelarche. Most studies suggest that exposure to air pollutants accelerates pubertal development; however, the results from the available studies are inconsistent. More extensive and well-designed longitudinal studies are required for a comprehensive understanding of the association between air pollution and precocious puberty.

Keyword

Air pollution; Endocrine disruptors; Menarche; Particulate matter; Puberty, precocious

Figure

  • Fig. 1. Flow diagram summarizing the process of literature search and selection. WoS, Web of Science.


Reference

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