Air pollution and respiratory health: a multinational needs assessment of physicians

Air pollution is a major threat to human health globally, but physicians' awareness of its specific health impacts and the extent they educate patients remain poorly understood.

We sought out the perceptions of general practitioners and pulmonologists regarding their role in managing impacts of air pollution on patients. We also assessed the educational and behavioural gaps, and contextual challenges relevant to respiratory health management from these professional perspectives. Computer-assisted telephone interviews were conducted across eight countries (Brazil, Canada, China, France, Germany, India, Mexico and the United States) with 600 physicians (primary care and respiratory medicine specialties).

While 95% of respondents agreed that it was their role to assess and manage air pollution exposure and proactively educate patients, fewer reported concrete demonstrations of this role in practice. Over half (55%) recommended medical treatment addressing exposure, and 20% engaged in normal monitoring but without preventive action for patients exposed to air pollution. Only 11% recommended concrete lifestyle changes for patients. In addition, 34% of respondents were unsure whether they should prioritise only acute cases for counselling. Significant country differences in awareness of air pollution health impacts and management were found. Inadequate integration of air quality indices in patient care and costly protective equipment were identified as systemic barriers.

Although general practitioners and pulmonologists recognise their role in assessing, managing and educating patients about air pollution exposure, their perception of this role and competencies within it indicate the need for educational support translating to impactful practice.