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Review Open Access

Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review)

  • Authors:
    • Yu-Chen Zhang
    • Lei Zhang
    • Ping-Ting Zhou
    • Zi-Hui Xie
    • Wen-Jie Zhang
    • Min Fan
    • Yan-Xun Han
    • Ye-Hai Liu
    • Yu-Chen Liu
  • View Affiliations / Copyright

    Affiliations: Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
    Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 55
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    Published online on: December 31, 2025
       https://doi.org/10.3892/ijmm.2025.5726
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Abstract

Air pollution, an emerging global environmental issue, alongside extreme meteorological conditions exacerbated by climate change, threaten the sustainability of modern society and contribute to the onset and progression of various ear and nose diseases. Nonetheless, the impact of these environmental factors on ear and nose diseases and related dysfunctions remain inadequately explored. The present review involved a comprehensive search of PubMed, Web of Science, the Cochrane Library and Embase for relevant epidemiological and experimental data. How environmental factors contribute to olfactory and auditory system dysfunctions as well as the potential underlying mechanisms from the perspectives of immunity and inflammation were examined in the present review. It was found that air pollution and meteorological factors significantly influence the prevalence of major ear and nose diseases, including allergic rhinitis, otitis media and sudden sensorineural hearing loss. Of note, the present review also provides an examination of the interaction between severe acute respiratory syndrome coronavirus 2 and environmental factors in ear and nose diseases, highlighting how environmental stressors may worsen disease progression. In conclusion, the present review underscores the burden of multimorbidity caused by air pollution and extreme weather and emphasizes the need for more targeted prevention and management strategies for ear and nose diseases.
View Figures

Figure 1

Impact of air pollution and
meteorological factors on olfactory function and AR. PM induces
Th1/Th2 immune imbalance, enhances systemic oxidative stress and
inflammatory responses, thereby leading to olfactory dysfunction
and the onset of AR. High temperatures exacerbate the airborne
transmission of pollen, further intensifying Th1/Th2 imbalance and
allergic reactions. Weather conditions and air humidity affect
fungal proliferation, promoting B cell activation and triggering
allergic reactions. Furthermore, weather changes influence UVB
radiation, thus regulating the Th1/Th2 immune balance. Viruses
induce systemic inflammation, further exacerbating olfactory
dysfunction and AR. Additionally, viruses can bind to the ACE2
receptors on nasal epithelial cells, leading to olfactory damage,
while PM exacerbates this damage by promoting ACE2 expression.
25[OH]D3, 25-hydroxyvitamin D; ACE2,
angiotensin-converting enzyme 2; AR, allergic rhinitis; DCs,
dendritic cells; MUC5AC, mucin 5AC; NETs, neutrophil extracellular
traps; NQO1, quinone oxidoreductase 1; PAHs, polycyclic aromatic
hydrocarbons; PM, particulate matter; ROS, reactive oxygen species;
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; Th,
T-helper; UVB, ultraviolet B; GATA3, GATA binding protein 3; RORγ,
retinoic acid receptor-related orphan receptor γ; BAFF, B-cell
activating factor.

Figure 2

Impact of air pollution and
meteorological factors on auditory function and ear diseases. PM
can exacerbate middle ear effusion, thereby impairing hearing
function. Additionally, viral infections can elevate oxidative
stress levels in the ear and induce immune microenvironment
dysregulation, further promoting hearing damage and the onset of
ear diseases. Air humidity, temperature and viral infections can
damage ear structures, thereby intensifying the effects of viruses
on hearing function. Strong winds and high temperatures can
accelerate the spread of PM and viruses, further aggravating
hearing damage. Chemical pollution and noise exacerbate hearing
function impairment and the occurrence of ear diseases by
increasing oxidative stress levels. COX-2, cyclooxygenase-2; GSH,
glutathione; MUC5AC, mucin 5AC; PAF, platelet activating factor;
PM, particulate matter; ROS, reactive oxygen species; SARS-CoV-2,
severe acute respiratory syndrome coronavirus 2; SSNHL, sudden
sensorineural hearing loss; Th, T-helper; ENaC, epithelial sodium
channel; DEP, diesel exhaust particle; SSNHL, sudden sensorineural
hearing loss; JP-8, Jet Propellant 8.
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Copy and paste a formatted citation
Spandidos Publications style
Zhang Y, Zhang L, Zhou P, Xie Z, Zhang W, Fan M, Han Y, Liu Y and Liu Y: Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review). Int J Mol Med 57: 55, 2026.
APA
Zhang, Y., Zhang, L., Zhou, P., Xie, Z., Zhang, W., Fan, M. ... Liu, Y. (2026). Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review). International Journal of Molecular Medicine, 57, 55. https://doi.org/10.3892/ijmm.2025.5726
MLA
Zhang, Y., Zhang, L., Zhou, P., Xie, Z., Zhang, W., Fan, M., Han, Y., Liu, Y., Liu, Y."Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review)". International Journal of Molecular Medicine 57.3 (2026): 55.
Chicago
Zhang, Y., Zhang, L., Zhou, P., Xie, Z., Zhang, W., Fan, M., Han, Y., Liu, Y., Liu, Y."Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review)". International Journal of Molecular Medicine 57, no. 3 (2026): 55. https://doi.org/10.3892/ijmm.2025.5726
Copy and paste a formatted citation
x
Spandidos Publications style
Zhang Y, Zhang L, Zhou P, Xie Z, Zhang W, Fan M, Han Y, Liu Y and Liu Y: Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review). Int J Mol Med 57: 55, 2026.
APA
Zhang, Y., Zhang, L., Zhou, P., Xie, Z., Zhang, W., Fan, M. ... Liu, Y. (2026). Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review). International Journal of Molecular Medicine, 57, 55. https://doi.org/10.3892/ijmm.2025.5726
MLA
Zhang, Y., Zhang, L., Zhou, P., Xie, Z., Zhang, W., Fan, M., Han, Y., Liu, Y., Liu, Y."Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review)". International Journal of Molecular Medicine 57.3 (2026): 55.
Chicago
Zhang, Y., Zhang, L., Zhou, P., Xie, Z., Zhang, W., Fan, M., Han, Y., Liu, Y., Liu, Y."Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review)". International Journal of Molecular Medicine 57, no. 3 (2026): 55. https://doi.org/10.3892/ijmm.2025.5726
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