Health effects of Asian dust events: a review of the literature.

Asian dust, called 'kosa' in Japan, is the long-range transport of atmospheric pollutants originating from the desert areas of China and Mongolia. Although Asian dust has a long history of appearing in Japan, it is only quite recently that there is increasing concern for its possible adverse health effects. We reviewed the epidemiologic evidence of potential health effects of Asian dust events. PubMed was used to search for the following keywords: Asian dust, yellow sand, desert dust, dust storm, sandstorm, mortality, death, morbidity, hospitalization, hospital admission, health, pulmonary and respiratory. The search was limited to the epidemiologic studies published between January 1980 and May 2009. JMEDPlus was used to search for Japanese literature. Seventeen studies were retrieved from PubMed and one study from JMEDPlus. In addition, one study was identified for reviewing from the references of another study. In total, we identified 19 epidemiologic studies (3 for mortality, 13 for hospital visits or admissions and 3 for respiratory functions or symptoms) mainly from Taiwan and Korea. There were many combinations of outcomes and lagged exposures examined, and some suggested possible associations of dust exposure with an increase in mortality and hospital visits and admissions due to cardiovascular and respiratory diseases, whereas the rest of the studies did not show statistically significant associations. The evidence from these studies was limited because exposure assessments were inadequately described and potential confounders were insufficiently controlled. Well-designed epidemiological studies are required to clarify any potential health effects of Asian dust events in Japan.