The role of imaging in the diagnosis of potential air pollution related illness: a narrative review

Introduction
The World Health Organization (WHO) emphasizes the global issue of poor air quality, largely attributed to the release of pollutants by human activity. In a significant development, air pollution was officially recorded as a cause of death in the UK for the first time in 2021, prompting the creation of the Clean Air Bill and campaigns to reduce emissions. In light of these developments, this paper aims to map available literature on air pollution-related illnesses, with a specific focus on the role of radiographic imaging in their diagnosis.

Method
A scoping review was conducted using the Scopus, Trip Medical Database, and CINAHL databases. Key terms such as “air pollution" and “imaging" and inclusion and exclusion criteria were applied. A critiquing framework assessed the quality, rigor, and transparency of research. Data from each study was extracted and extrapolated into a thematic matrix to display the results.

Results
A review of ten papers comprising four systematic reviews, four cohort studies, and two longitudinal studies found nine different pollutants implicated in various diseases. Seven papers focused on brain pathological changes, two on lung function, and one on cardiovascular changes. Eight studies used Magnetic Resonance Imaging (MRI), and two used Computed Tomography (CT) scans.

Conclusion
The findings revealed nine different air pollutants were mentioned across a range of CT and MRI imaging modalities in the studies. Dementia was the most referenced illness. The results suggest that air pollution-related illnesses will continue to pose a significant health risk, impacting the general population and the clinical work of the radiography profession.

Implications for practice
Given the diverse effects of air pollutants on health, it is important radiographers are educated on how patient's history may influence imaging findings.