Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015

Abstract

SummaryBackgroundExposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels.MethodsWe estimated global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2·5 μm (PM2·5) and ozone at an approximate 11 km × 11 km resolution with satellite-based estimates, chemical transport models, and ground-level measurements. Using integrated exposure–response functions for each cause of death, we estimated the relative risk of mortality from ischaemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, and lower respiratory infections from epidemiological studies using non-linear exposure–response functions spanning the global range of exposure.FindingsAmbient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015.InterpretationAmbient air pollution contributed substantially to the global burden of disease in 2015, which increased over the past 25 years, due to population ageing, changes in non-communicable disease rates, and increasing air pollution in low-income and middle-income countries. Modest reductions in burden will occur in the most polluted countries unless PM2·5 values are decreased substantially, but there is potential for substantial health benefits from exposure reduction.FundingBill & Melinda Gates Foundation and Health Effects Institute.

Cardiovascular and Cerebrovascular Emergency Department Visits Associated With Wildfire Smoke Exposure in California in 2015

“…Wildfire smoke contains numerous air pollutants, including particulate matter, ozone, carbon monoxide, polycyclic aromatic compounds, and nitrogen dioxide, all of which have previously been associated with respiratory and cardiovascular outcomes in health studies of air pollution 6, 7, 8, 9, 10. Fine particulate matter (<2.5 μm in diameter [PM 2.5 ]) is a known respiratory irritant and causally related to cardiovascular morbidity 11, 12, 13.…”

“…This has been linked to cardiovascular health impacts such as ischemic heart disease and cerebrovascular events such as ischemic stroke in the ambient air pollutant PM 2.5 literature 11, 15, 16, 17, 18. Other air pollutants in wildfire smoke have also been linked to cardiovascular and respiratory outcomes in urban and ambient air pollution studies, including nitrogen oxides, carbon monoxide, and ozone 7, 8, 9, 10…”

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“…In 2015, it was estimated that exposure to air pollution, in terms of fine particulate matter, was responsible for 4.2 million deaths, representing 7.6% of total global deaths, with a majority of them caused by cardio‐ and cerebrovascular disease 11. Exposure to outdoor air pollution is an established risk factor for CVD morbidity and mortality, including MI 12, 13, 14.…”

Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling

“…Non-exhaust traffic emissions that contribute to total road traffic emission, are estimated to equal about 22% of the exhaust emissions of primary PM2.5, but there are large variations across Europe [10]. Transport-related air pollution increases not only mortality, but also the risk of different health outcomes such as cardiovascular and respiratory diseases, cancer, and adverse birth outcomes [11], and ambient PM2.5 accounts for about 4.2 million deaths and 103.1 million disability-adjusted life-years (DALYs) in 2015 [12]. Lack of physical activity, high BMI, and ambient particulate matter pollution were included among the leading risk factors of the global burden of disease in 2015 [13].…”