International Journal of Public Health Science (IJPHS)
Vol 15, No 3: September 2026

Association between occupational NO₂ exposure and hypertension risk: a PRISMA-based systematic review with risk-of-bias assessment

Ayudhia Rachmawati (Mulawarman University)
Morrin Choirunnisa Thohira (Mulawarman University)
Muhammad Aidil Fitrah (Mulawarman University)
Vivi Filia Elvira (Mulawarman University)



Article Info

Publish Date
01 Sep 2026

Abstract

Nitrogen dioxide (NO₂) is a major air pollutant generated from fossil fuel combustion in transportation and industrial activities and is associated with adverse health effects. Prolonged exposure to NO₂ may induce chronic inflammation and endothelial dysfunction, which contribute to the development of hypertension. This study aimed to systematically review the association between NO₂ exposure and the incidence of hypertension among workers. The review was conducted in accordance with PRISMA guidelines, with literature searches performed in Google Scholar, PubMed, and ScienceDirect for publications from 2020 to 2025. Inclusion criteria comprised full-text articles in English or Indonesian employing observational study designs (cross-sectional, cohort, case-control, or ecological) and involving workers in both formal and informal sectors. Eligible studies examined NO₂ exposure as the independent variable and hypertension as the outcome. Of 2,051 records identified, five studies met the inclusion criteria, originating from China and Nigeria. Risk of bias was assessed using the office of health assessment and translation (OHAT) risk of bias tool. The findings demonstrated a consistent association between NO₂ exposure and an increased risk of hypertension, particularly in poorly ventilated work environments. These results underscore the importance of improving workplace air quality management, strengthening exposure monitoring, and implementing preventive occupational health strategies.

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Journal Info

Abbrev

IJPHS

Publisher

Subject

Health Professions

Description

International Journal of Public Health Science (IJPHS) is an interdisciplinary journal that publishes material on all aspects of public health science. This IJPHS provides the ideal platform for the discussion of more sophisticated public health research and practice for authors and readers world ...