Tracking biochemical indicators of air pollution exposure in acute cardiorespiratory emergencies: a scoping review

Abstract

Background Short-term ambient air pollution is a known trigger for acute cardiovascular and respiratory events. Biochemical markers help reveal pollution-induced physiological changes during emergency presentations, though evidence remains fragmented. Objectives This scoping review mapped existing literature on short-term biochemical responses to air pollution in patients presenting acutely with cardiorespiratory conditions. Eligibility criteria Eligible studies were human studies assessing at least one biochemical marker in people presenting to emergency departments after short-term exposure to outdoor air pollution. Sources of evidence Five databases (PubMed, Scopus, Web of Science, Embase, CINAHL) were searched from 2000 to 2025. Charting methods Data were extracted using the PCC framework and summarized in structured tables. Results Twelve studies met criteria. PM2.5, PM10, and NO2 were most frequently linked to inflammatory and coagulative markers such as CRP, IL-6, D-dimer, and troponins, often with effects seen within hours to days. Conclusions The mapped evidence suggests that short-term air pollution exposure is associated with acute biochemical alterations. Standardized exposure windows, harmonized biomarker panels, and more detailed subgroup analyses are needed before these markers can support emergency-care pathways and environmental health policy.