333: The association between ambient air pollution and chronic pain: a scoping review

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Neuroimmunology, Epidemiology, Pain in Special Populations

Background and Aims: Air pollution is strongly linked to respiratory and cardiovascular diseases, but its role in pain is comparatively unexplored. Chronic pain conditions are a leading cause of disability worldwide, shaped by biological, psychological, and social factors. Evidence suggests that air pollution may increase inflammatory processes and psychological distress, both of which can contribute to pain sensitivity and persistence. Although research has examined associations between air pollution and chronic pain conditions, no review has mapped the evidence for the air pollution-chronic pain relationship. This review aims to investigate the scope, consistency, and gaps in this literature.

Methods: We searched MEDLINE, Embase, Web of Science, Scopus, PsycINFO, ProQuest One Sustainability, GreenFILE, Global Index Medicus, and Google Scholar for published literature, and conference proceedings, dissertations, preprints, and government/non-government organization reports and websites for grey literature. We included all studies with primary quantitative, qualitative, or mixed data, on the relationship between human-caused ambient air pollution and one or more health conditions where persistent or recurring pain is a defining symptom. We excluded experimental studies and studies focusing on indoor air pollution or occupational exposure. Study selection and data extraction was conducted in duplicate. Pre-registration: https://osf.io/rf8sh/overview.

Results: From 4962 non-duplicate records, 470 were selected for full-text review and we plan to have completed data extraction by August 2026. Of the 22 studies that we have included thus far, the most common chronic pain conditions are arthritis (n=7), migraine/headache (n=7), inflammatory bowel disease (n=3), and systemic lupus erythematosus (n=3). We will descriptively summarize study characteristics by chronic pain condition (e.g., rheumatoid arthritis, migraine), pollutant type (e.g., PM2.5, NO2), geographical region, exposure time period, study design (e.g., qualitative, quantitative), and outcome measure (e.g., self-reported pain, emergency room visits).

Conclusions: By summarizing findings spanning a range of pain conditions, pollutants, geographic regions, and timeframes, this review will highlight the overall contribution of human-caused air pollution to persistent or recurrent, and often debilitating pain. These findings can inform future research (including feasibility of a future meta-analysis), help integrate environmental factors into the clinical understanding of chronic pain, and provide evidence for future policies addressing air pollution as an important factor in public health.

References: A scoping review by the IASP Presidential Task Force on Environmental Sustainability: https://www.iasp-pain.org/group/environmental-sustainability-presidential-task-force/

Presenting Author: Tim F. Oberlander
Submitting Author: Tim Oberlander

Senior Author: Tim F. Oberlander

IASP 2026 Global Year theme of Neuropathic Pain: No

• Colleen Pawliuk: MLIS - BC Children’s Hospital Research Institute
• Eveliina Glogan: PhD - KU Leuven
• Benjamin Huang: BSc - BC Children’s Hospital Research Institute
• Denise Pauline Bernardo: BSc - KU Leuven
• Mariana Arias Avila: PhD - Federal University of São Carlos
• Ursula Wesselmann: MD, PhD, DTM&H (Lond.) - University of Alabama at Birmingham (UAB)
• Anupa Pathak: PhD - University of Syndey
• Andrew Rice: MD - Imperial College London
• Johan Vlaeyen: PhD - Maastricht University; KU Leuven
• Tim Oberlander: MD - BC Children’s Hospital Research Institute