Mega-Events, Air Pollution and Health Outcomes: A Systematic Review
Abstract
Mega-events can create changes in air quality, offering quasi-experimental settings to synthesise evidence on pollutant shifts and the associated short‑term health effects. We systematically reviewed 31 studies (PROSPERO CRD420251032553) from four databases up to 7 April 2025. Fourteen studies assessed mortality/hospitalisation outcomes. A 10 μg/m3 decrease in PM10 during emission-control periods was associated with 8.4-9.6% lower all-cause mortality and 8.8% lower cardiovascular mortality. Whereas each 10 μg/m3 increase in NO2 and O3 increased total mortality by 1.89 % (95% C.I. 1.49-2.29) and 0.60 % (95% C.I.: 0.47- 0.74), and increases raised cardiovascular mortality by 4.42 % (95% C.I.: 3.16-5.69). Seventeen studies assessed early biological responses via human biomonitoring. Reduction in PM2.5, NO2 and O3 during emission control-measures were consistently associated with reduced circulating levels of ICAM-1, VCAM-1 and IL-1β, reduced in pulmonary-inflammatory and oxidative stress markers (FeNO, 8-isoprostane), systemic-inflammation/oxidative-stress markers (von-Willebrand-factor “vWf”, urinary-8-OHdG, Malondialdehyde), as well as haemostasis/platelet-activation markers (sCD40L, sCD62P) and improvement in cardiovascular measures (heart-rate, systolic BP), which increased again after controls ended, and similar decreases and rebounds were seen for fibrinogen, vWF, sCD62P, sCD40L when pollutants decreased by 13-60% and later returned to pre‑Olympic levels. Mega‑events show that emission-control lower mortality and improve inflammatory and oxidative stress responses suggesting the need for increasingly spread urban planning and event‑management policies to protect Public Health.
Key messages: • Mega-events affect air pollution levels, which in turn may cause a higher mortality rate and hospitalisations in local population. This may be prevented by emission controls policies.
• Early biological responses like oxidative stress and inflammation can be modulated by air pollution fluctuations related to mega-events. Human biomonitoring can support prevention in Public Health.
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BibTeX
@article{khattaby2026megaevents,
title = {{Mega-Events, Air Pollution and Health Outcomes: A Systematic Review}},
author = {H El Khattaby and M Panizzolo and F Ghelli and S El Sherbiny and V Bellisario and N Colombi and R Bono and G Squillacioti},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1253},
url = {https://doi.org/10.1093/eurpub/ckag169.1253},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Mega-Events, Air Pollution and Health Outcomes: A Systematic Review
AU - H El Khattaby
AU - M Panizzolo
AU - F Ghelli
AU - S El Sherbiny
AU - V Bellisario
AU - N Colombi
AU - R Bono
AU - G Squillacioti
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1253
UR - https://doi.org/10.1093/eurpub/ckag169.1253
AB - Mega-events can create changes in air quality, offering quasi-experimental settings to synthesise evidence on pollutant shifts and the associated short‑term health effects. We systematically reviewed 31 studies (PROSPERO CRD420251032553) from four databases up to 7 April 2025. Fourteen studies assessed mortality/hospitalisation outcomes. A 10 μg/m3 decrease in PM10 during emission-control periods was associated with 8.4-9.6% lower all-cause mortality and 8.8% lower cardiovascular mortality. Whereas each 10 μg/m3 increase in NO2 and O3 increased total mortality by 1.89 % (95% C.I. 1.49-2.29) and 0.60 % (95% C.I.: 0.47- 0.74), and increases raised cardiovascular mortality by 4.42 % (95% C.I.: 3.16-5.69). Seventeen studies assessed early biological responses via human biomonitoring. Reduction in PM2.5, NO2 and O3 during emission control-measures were consistently associated with reduced circulating levels of ICAM-1, VCAM-1 and IL-1β, reduced in pulmonary-inflammatory and oxidative stress markers (FeNO, 8-isoprostane), systemic-inflammation/oxidative-stress markers (von-Willebrand-factor “vWf”, urinary-8-OHdG, Malondialdehyde), as well as haemostasis/platelet-activation markers (sCD40L, sCD62P) and improvement in cardiovascular measures (heart-rate, systolic BP), which increased again after controls ended, and similar decreases and rebounds were seen for fibrinogen, vWF, sCD62P, sCD40L when pollutants decreased by 13-60% and later returned to pre‑Olympic levels. Mega‑events show that emission-control lower mortality and improve inflammatory and oxidative stress responses suggesting the need for increasingly spread urban planning and event‑management policies to protect Public Health. Key messages: • Mega-events affect air pollution levels, which in turn may cause a higher mortality rate and hospitalisations in local population. This may be prevented by emission controls policies. • Early biological responses like oxidative stress and inflammation can be modulated by air pollution fluctuations related to mega-events. Human biomonitoring can support prevention in Public Health.
SN - 1101-1262
SN - 1464-360X
ER -