Health benefits of decreases in on-road transportation emissions in the United States from 2008 to 2017.

Decades of air pollution regulation have yielded enormous benefits in the United States, but vehicle emissions remain a climate and public health issue. Studies have quantified the vehicle-related fine particulate matter (PM2.5)-attributable mortality but lack the combination of proper counterfactual scenarios, latest epidemiological evidence, and detailed spatial resolution; all needed to assess the benefits of recent emission reductions. We use this combination to assess PM2.5-attributable health benefits and also assess the climate benefits of on-road emission reductions between 2008 and 2017. We estimate total benefits of $270 (190 to 480) billion in 2017. Vehicle-related PM2.5-attributable deaths decreased from 27,700 in 2008 to 19,800 in 2017; however, had per-mile emission factors remained at 2008 levels, 48,200 deaths would have occurred in 2017. The 74% increase from 27,700 to 48,200 PM2.5-attributable deaths with the same emission factors is due to lower baseline PM2.5 concentrations (+26%), more vehicle miles and fleet composition changes (+22%), higher baseline mortality (+13%), and interactions among these (+12%). Climate benefits were small (3 to 19% of the total). The percent reductions in emissions and PM2.5-attributable deaths were similar despite an opportunity to achieve disproportionately large health benefits by reducing high-impact emissions of passenger light-duty vehicles in urban areas. Increasingly large vehicles and an aging population, increasing mortality, suggest large health benefits in urban areas require more stringent policies. Local policies can be effective because high-impact primary PM2.5 and NH3 emissions disperse little outside metropolitan areas. Complementary national-level policies for NOx are merited because of its substantial impacts-with little spatial variability-and dispersion across states and metropolitan areas.

Impacts and mitigation of excess diesel-related NOx emissions in 11 major vehicle markets.

Vehicle emissions contribute to fine particulate matter (PM2.5) and tropospheric ozone air pollution, affecting human health, crop yields and climate worldwide. On-road diesel vehicles produce approximately 20 per cent of global anthropogenic emissions of nitrogen oxides (NOx), which are key PM2.5 and ozone precursors. Regulated NOx emission limits in leading markets have been progressively tightened, but current diesel vehicles emit far more NOx under real-world operating conditions than during laboratory certification testing. Here we show that across 11 markets, representing approximately 80 per cent of global diesel vehicle sales, nearly one-third of on-road heavy-duty diesel vehicle emissions and over half of on-road light-duty diesel vehicle emissions are in excess of certification limits. These excess emissions (totalling 4.6 million tons) are associated with about 38,000 PM2.5- and ozone-related premature deaths globally in 2015, including about 10 per cent of all ozone-related premature deaths in the 28 European Union member states. Heavy-duty vehicles are the dominant contributor to excess diesel NOx emissions and associated health impacts in almost all regions. Adopting and enforcing next-generation standards (more stringent than Euro 6/VI) could nearly eliminate real-world diesel-related NOx emissions in these markets, avoiding approximately 174,000 global PM2.5- and ozone-related premature deaths in 2040. Most of these benefits can be achieved by implementing Euro VI standards where they have not yet been adopted for heavy-duty vehicles.

Fine particulate matter damages and value added in the US economy.

Emissions of most pollutants that result in fine particulate matter (PM2.5) formation have been decreasing in the United States. However, this trend has not been uniform across all sectors or regions of the economy. We use integrated assessment models (IAMs) to compute marginal damages for PM2.5-related emissions for each county in the contiguous United States and match location-specific emissions with these marginal damages to compute economy-wide gross external damage (GED) due to premature mortality. We note 4 key findings: First, economy-wide, GED has decreased by more than 20% from 2008 to 2014. Second, while much of the air pollution policies have focused to date on the electricity sector, damages from farms are now larger than those from utilities. Indeed, farms have become the largest contributor to air pollution damages from PM2.5-related emissions. Third, 4 sectors, comprising less than 20% of the national gross domestic product (GDP), are responsible for ∼75% of GED attributable to economic activities. Fourth, uncertainty in GED estimates tends to be high for sectors with predominantly ground-level emissions because these emissions are usually estimated and not measured. These findings suggest that policymakers should target further emissions reductions from such sectors, particularly in transportation and agriculture.

Annual dementia incidence and monetary burden attributable to fine particulate matter (PM2.5) exposure in Sweden.

BACKGROUND: Alzheimer's disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM2.5) air pollution and resulting monetary estimates are lacking. METHODS: We used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM2.5 exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives. RESULTS: The annual number of dementia cases attributable to PM2.5 exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM2.5 by 1 µg/m3 was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019. CONCLUSION: This study estimated that 5% of annual dementia cases could be attributed to PM2.5 exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions.

[Economic evaluation on the health hazards of residents caused by PM_(2.5) in Beijing, Tianjin and Hebei from 2013 to 2018].

OBJECTIVE: To learn the health hazards and health economic losses caused by PM_(2.5) pollution in Beijing, Tianjin and Hebei to the resident population. METHODS: Fine particular matter concentration and the basic demographic data of Beijing, Tianjin and Hebei from 2013 to 2018 were collected. Circulatory system disease hospitalization and other indexes were chosen as the end point of health effects, appropriate exposure-response relationship were selected, and the economic loss of health effect caused by PM_(2.5) was assessed by the combination of the cost of illness approach and human capital method. RESULTS: From 2013 to 2018, the economic loss of Beijing, Tianjin and Hebei caused by fine particular matter pollution showed a decreasing trend year by year. The health economic losses of Beijing from 2013 to 2018 were 3.815, 4.177, 4.090, 3.818, 2.567 and 2.031 billion yuan; The health economic losses of Tianjin were 3.046, 2.625, 1.882, 1.914, 1.448 and 1.000 billion yuan; The health economic losses of Hebei were 13.719, 11.850, 7.423, 7.216, 6.499 and 4.124 billion yuan, Hebei Province had the highest economic loss in 2013, accounting for 13.719 billion yuan, accounting for 0.51% of GDP in that year. Tianjin had the lowest economic loss in 2018, accounting for 10.0 billion yuan, accounting for 0.05% of GDP in that year. CONCLUSION: The health loss caused by PM_(2.5) pollution in Beijing, Tianjin and Hebei region shows a decreasing trend year by year, but the number is still very considerable, and the monitoring and control of PM_(2.5) pollution need to be further strengthened.

What is the health cost of haze pollution? Evidence from China.

INTRODUCTION: Haze pollution has become a serious threat to the health of residents and has brought about considerable economic costs. The objectives of this study are to examine the relationship between haze pollution and residents' health and to estimate the health cost of haze pollution. METHODS: Using macro data on 74 major Chinese cities, this study employs a static panel data model and a dynamic panel generalized method of moments model to investigate the impact of haze pollution on the mortality of residents. On the basis of the estimation results, the value of a statistical life (VOSL) method is used to evaluate the economic cost of haze pollution on residents' health. RESULTS: In 74 major cities of China, an increase in concentration of PM2.5 pollutants by 1 µg/m3 may cause the mortality rate to rise by 25 per million people. The VOSL of haze pollution in China is about 1.53 million yuan. The health cost of residents from haze in 74 major cities of China in 2016 was about 888 billion yuan, equivalent to about 2% of the these cities' GDP. CONCLUSIONS: Haze pollution has serious damage to the health of urban residents and therefore brings about considerable economic losses.

Air Pollution, Disease Burden, and Health Economic Loss in China.

As the largest developing country in the world, China is now facing one of the severest air pollution problems. The objective of this section is to evaluate the disease burden and corresponding economic loss attributable to ambient air pollution in China. We reviewed a series of studies by Chinese or foreign investigators focusing on the disease burden and economic loss in China. These studies showed both the general air pollution and haze episodes have resulted in substantial disease burden in terms of excess number of premature deaths, disability-adjusted life-year loss, and years of life lost. The corresponding economic loss has accounted for an appreciable proportion of China's national economy. Overall, the disease burden and health economic loss due to ambient air pollution in China is greater than in the remaining parts of the world, for one of the highest levels of air pollution and the largest size of exposed population. Consideration of both health and economic impacts of air pollution can facilitate the Chinese government to develop environmental policies to reduce the emissions of various air pollutants and protect the public health.

A self-consistent method to assess air quality co-benefits from U.S. climate policies.

Air quality co-benefits can potentially reduce the costs of greenhouse gas mitigation. However, whereas many studies of the cost of greenhouse gas mitigation model the macroeconomic welfare impacts of mitigation, most studies of air quality co-benefits do not. We employ a U.S. computable general equilibrium economic model previously linked to an air quality modeling system and enhance it to represent the economy-wide welfare impacts of fine particulate matter. We present a first application of this method to explore the efficiency and distributional implications of a Clean Energy Standard (CES) and a Cap and Trade (CAT) program that both reduce CO2emissions by 10% in 2030 relative to 2006. We find that co-benefits from fine particulate matter reduction (median $6; $2 to $10/tCO2) completely offset policy costs by 110% (40% to 190%), transforming the net welfare impact of the CAT into a gain of $1 (-$5 to $7) billion 2005$. For the CES, the corresponding co-benefit (median $8; $3 to $14/tCO2) is a smaller fraction (median 5%; 2% to 9%) of its higher policy cost. The eastern United States garners 78% and 71% of co-benefits for the CES and CAT, respectively. By representing the effects of pollution-related morbidities and mortalities as an impact to labor and the demand for health services, we find that the welfare impact per unit of reduced pollution varies by region. These interregional differences can enhance the preference of some regions, such as Texas, for a CAT over a CES, or switch the calculation of which policy yields higher co-benefits, compared with an approach that uses one valuation for all regions. This framework could be applied to quantify consistent air quality impacts of other pricing instruments, subnational trading programs, or green tax swaps.

Will joint regional air pollution control be more cost-effective? An empirical study of China's Beijing-Tianjin-Hebei region.

By following an empirical approach, this study proves that joint regional air pollution control (JRAPC) in the Beijing-Tianjin-Hebei region will save the expense on air pollution control compared with a locally-based pollution control strategy. The evidences below were found. (A) Local pollutant concentration in some of the cities is significantly affected by emissions from their surrounding areas. (B) There is heterogeneity in the marginal pollutant concentration reduction cost among various districts as a result of the cities' varying contribution of unit emission reduction to the pollutant concentration reduction, and their diverse unit cost of emission reduction brought about by their different industry composition. The results imply that the cost-efficiency of air pollution control will be improved in China if the conventional locally based regime of air pollution control can shift to a regionally based one.

Siting is a constraint to realize environmental benefits from carbon capture and storage.

Carbon capture and storage (CCS) for coal power plants reduces onsite carbon dioxide emissions, but affects other air emissions on and offsite. This research assesses the net societal benefits and costs of Monoethanolamine (MEA) CCS, valuing changes in emissions of CO2, SO2, NOX, NH3 and particulate matter (PM), including those in the supply chain. Geographical variability and stochastic uncertainty for 407 coal power plant locations in the U.S. are analyzed. The results show that the net environmental benefits and costs of MEA CCS depend critically on location. For a few favorable sites of both power plant and upstream processes, CCS realizes a net benefit (benefit-cost ratio >1) if the social cost of carbon exceeds $51/ton. For much of the U.S. however, the social cost of carbon must be much higher to realize net benefits from CCS, up to a maximum of $910/ton. While the social costs of carbon are uncertain, typical estimates are in the range of $32-220 per ton, much lower than the breakeven value for many potential CCS locations. Increased impacts upstream from the power plant can dramatically change the social acceptability of CCS and needs further consideration and analysis.

Health and Economic Benefits of Complying With the World Health Organization Air Quality Guidelines for Particulate Matter in Nine Major Latin American Cities.

Objectives: This study aims to estimate the short-term preventable mortality and associated economic costs of complying with the World Health Organization (WHO) air quality guidelines (AQGs) limit values for PM10 and PM2.5 in nine major Latin American cities. Methods: We estimated city-specific PM-mortality associations using time-series regression models and calculated the attributable mortality fraction. Next, we used the value of statistical life to calculate the economic benefits of complying with the WHO AQGs limit values. Results: In most cities, PM concentrations exceeded the WHO AQGs limit values more than 90% of the days. PM10 was found to be associated with an average excess mortality of 1.88% with concentrations above WHO AQGs limit values, while for PM2.5 it was 1.05%. The associated annual economic costs varied widely, between US$ 19.5 million to 3,386.9 million for PM10, and US$ 196.3 million to 2,209.6 million for PM2.5. Conclusion: Our findings suggest that there is an urgent need for policymakers to develop interventions to achieve sustainable air quality improvements in Latin America. Complying with the WHO AQGs limit values for PM10 and PM2.5 in Latin American cities would substantially benefits for urban populations.

State and national household concentrations of PM2.5 from solid cookfuel use: results from measurements and modeling in India for estimation of the global burden of disease.

BACKGROUND: Previous global burden of disease (GBD) estimates for household air pollution (HAP) from solid cookfuel use were based on categorical indicators of exposure. Recent progress in GBD methodologies that use integrated-exposure-response (IER) curves for combustion particles required the development of models to quantitatively estimate average HAP levels experienced by large populations. Such models can also serve to inform public health intervention efforts. Thus, we developed a model to estimate national household concentrations of PM2.5 from solid cookfuel use in India, together with estimates for 29 states. METHODS: We monitored 24-hr household concentrations of PM2.5, in 617 rural households from 4 states in India on a cross-sectional basis between November 2004 and March 2005. We then, developed log-linear regression models that predict household concentrations as a function of multiple, independent household level variables available in national household surveys and generated national / state estimates using The Indian National Family and Health Survey (NFHS 2005). RESULTS: The measured mean 24-hr concentration of PM2.5 in solid cookfuel using households ranged from 163 µg/m3 (95% CI: 143,183; median 106; IQR: 191) in the living area to 609 µg/m3 (95% CI: 547,671; median: 472; IQR: 734) in the kitchen area. Fuel type, kitchen type, ventilation, geographical location and cooking duration were found to be significant predictors of PM2.5 concentrations in the household model. k-fold cross validation showed a fair degree of correlation (r = 0.56) between modeled and measured values. Extrapolation of the household results by state to all solid cookfuel-using households in India, covered by NFHS 2005, resulted in a modeled estimate of 450 µg/m3 (95% CI: 318,640) and 113 µg/m3 (95% CI: 102,127) , for national average 24-hr PM2.5 concentrations in the kitchen and living areas respectively. CONCLUSIONS: The model affords substantial improvement over commonly used exposure indicators such as "percent solid cookfuel use" in HAP disease burden assessments, by providing some of the first estimates of national average HAP levels experienced in India. Model estimates also add considerable strength of evidence for framing and implementation of intervention efforts at the state and national levels.

Particulate air pollution and health inequalities: a Europe-wide ecological analysis.

BACKGROUND: Environmental disparities may underlie the unequal distribution of health across socioeconomic groups. However, this assertion has not been tested across a range of countries: an important knowledge gap for a transboundary health issue such as air pollution. We consider whether populations of low-income European regions were a) exposed to disproportionately high levels of particulate air pollution (PM10) and/or b) disproportionately susceptible to pollution-related mortality effects. METHODS: Europe-wide gridded PM10 and population distribution data were used to calculate population-weighted average PM10 concentrations for 268 sub-national regions (NUTS level 2 regions) for the period 2004-2008. The data were mapped, and patterning by mean household income was assessed statistically. Ordinary least squares regression was used to model the association between PM10 and cause-specific mortality, after adjusting for regional-level household income and smoking rates. RESULTS: Air quality improved for most regions between 2004 and 2008, although large differences between Eastern and Western regions persisted. Across Europe, PM10 was correlated with low household income but this association primarily reflected East-West inequalities and was not found when Eastern or Western Europe regions were considered separately. Notably, some of the most polluted regions in Western Europe were also among the richest. PM10 was more strongly associated with plausibly-related mortality outcomes in Eastern than Western Europe, presumably because of higher ambient concentrations. Populations of lower-income regions appeared more susceptible to the effects of PM10, but only for circulatory disease mortality in Eastern Europe and male respiratory mortality in Western Europe. CONCLUSIONS: Income-related inequalities in exposure to ambient PM10 may contribute to Europe-wide mortality inequalities, and to those in Eastern but not Western European regions. We found some evidence that lower-income regions were more susceptible to the health effects of PM10.

Public health, climate, and economic impacts of desulfurizing jet fuel.

In jurisdictions including the US and the EU ground transportation and marine fuels have recently been required to contain lower concentrations of sulfur, which has resulted in reduced atmospheric SO(x) emissions. In contrast, the maximum sulfur content of aviation fuel has remained unchanged at 3000 ppm (although sulfur levels average 600 ppm in practice). We assess the costs and benefits of a potential ultra-low sulfur (15 ppm) jet fuel standard ("ULSJ"). We estimate that global implementation of ULSJ will cost US$1-4bn per year and prevent 900-4000 air quality-related premature mortalities per year. Radiative forcing associated with reduction in atmospheric sulfate, nitrate, and ammonium loading is estimated at +3.4 mW/m(2) (equivalent to about 1/10th of the warming due to CO(2) emissions from aviation) and ULSJ increases life cycle CO(2) emissions by approximately 2%. The public health benefits are dominated by the reduction in cruise SO(x) emissions, so a key uncertainty is the atmospheric modeling of vertical transport of pollution from cruise altitudes to the ground. Comparisons of modeled and measured vertical profiles of CO, PAN, O(3), and (7)Be indicate that this uncertainty is low relative to uncertainties regarding the value of statistical life and the toxicity of fine particulate matter.

Ecosystem services altered by human changes in the nitrogen cycle: a new perspective for US decision making.

Human alteration of the nitrogen (N) cycle has produced benefits for health and well-being, but excess N has altered many ecosystems and degraded air and water quality. US regulations mandate protection of the environment in terms that directly connect to ecosystem services. Here, we review the science quantifying effects of N on key ecosystem services, and compare the costs of N-related impacts or mitigation using the metric of cost per unit of N. Damage costs to the provision of clean air, reflected by impaired human respiratory health, are well characterized and fairly high (e.g. costs of ozone and particulate damages of $28 per kg NO(x)-N). Damage to services associated with productivity, biodiversity, recreation and clean water are less certain and although generally lower, these costs are quite variable (<$2.2-56 per kg N). In the current Chesapeake Bay restoration effort, for example, the collection of available damage costs clearly exceeds the projected abatement costs to reduce N loads to the Bay ($8-15 per kg N). Explicit consideration and accounting of effects on multiple ecosystem services provides decision-makers an integrated view of N sources, damages and abatement costs to address the significant challenges associated with reducing N pollution.

Monetary burden of health impacts of air pollution in Mumbai, India: implications for public health policy.

OBJECTIVES: Mumbai, a mega city with a population of more than 12 million, is experiencing acute air pollution due to commercial activity, a boom in construction and vehicular traffic. This study was undertaken to investigate the link between air pollution and health impacts for Mumbai, and estimate the monetary burden of these impacts. STUDY DESIGN: Cross-sectional data were subjected to logistic regression to analyse the link between air pollution and health impacts, and the cost of illness approach was used to measure the monetary burden of these impacts. METHODS: Data collected by the Environmental Pollution Research Centre at King Edward Memorial Hospital in Mumbai were analysed using logistic regression to investigate the link between air pollution and morbidity impacts. The monetary burden of morbidity was estimated through the cost of illness approach. For this purpose, information on treatment costs and foregone earnings due to illness was obtained through the household survey and interviews with medical practitioners. RESULTS: Particulate matter (PM(10)) and nitrogen dioxide (NO(2)) emerged as the critical pollutants for a range of health impacts, including symptoms such as cough, breathlessness, wheezing and cold, and illnesses such as allergic rhinitis and chronic obstructive pulmonary disease (COPD). This study developed the concentration-response coefficients for these health impacts. The total monetary burden of these impacts, including personal burden, government expenditure and societal cost, is estimated at 4522.96 million Indian Rupees (INR) or US$ 113.08 million for a 50-µg/m(3) increase in PM(10), and INR 8723.59 million or US$ 218.10 million for a similar increase in NO(2). CONCLUSIONS: The estimated monetary burden of health impacts associated with air pollution in Mumbai mainly comprises out-of-pocket expenses of city residents. These expenses form a sizable proportion of the annual income of individuals, particularly those belonging to poor households. These findings have implications for public health policy, particularly accessibility and affordability of health care for poor households in Mumbai. The study provides a rationale for strengthening the public health services in the city to make them more accessible to poor households, especially those living in the slums of Mumbai.

Health and economic impact of air pollution in the states of India: the Global Burden of Disease Study 2019.

BACKGROUND: The association of air pollution with multiple adverse health outcomes is becoming well established, but its negative economic impact is less well appreciated. It is important to elucidate this impact for the states of India. METHODS: We estimated exposure to ambient particulate matter pollution, household air pollution, and ambient ozone pollution, and their attributable deaths and disability-adjusted life-years in every state of India as part of the Global Burden of Disease Study (GBD) 2019. We estimated the economic impact of air pollution as the cost of lost output due to premature deaths and morbidity attributable to air pollution for every state of India, using the cost-of-illness method. FINDINGS: 1·67 million (95% uncertainty interval 1·42-1·92) deaths were attributable to air pollution in India in 2019, accounting for 17·8% (15·8-19·5) of the total deaths in the country. The majority of these deaths were from ambient particulate matter pollution (0·98 million [0·77-1·19]) and household air pollution (0·61 million [0·39-0·86]). The death rate due to household air pollution decreased by 64·2% (52·2-74·2) from 1990 to 2019, while that due to ambient particulate matter pollution increased by 115·3% (28·3-344·4) and that due to ambient ozone pollution increased by 139·2% (96·5-195·8). Lost output from premature deaths and morbidity attributable to air pollution accounted for economic losses of US$28·8 billion (21·4-37·4) and $8·0 billion (5·9-10·3), respectively, in India in 2019. This total loss of $36·8 billion (27·4-47·7) was 1·36% of India's gross domestic product (GDP). The economic loss as a proportion of the state GDP varied 3·2 times between the states, ranging from 0·67% (0·47-0·91) to 2·15% (1·60-2·77), and was highest in the low per-capita GDP states of Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, and Chhattisgarh. Delhi had the highest per-capita economic loss due to air pollution, followed by Haryana in 2019, with 5·4 times variation across all states. INTERPRETATION: The high burden of death and disease due to air pollution and its associated substantial adverse economic impact from loss of output could impede India's aspiration to be a $5 trillion economy by 2024. Successful reduction of air pollution in India through state-specific strategies would lead to substantial benefits for both the health of the population and the economy. FUNDING: UN Environment Programme; Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.

Effect of PM2.5 pollution on perinatal mortality in China.

Using ArcGIS to analyze satellite derived PM2.5 estimates, this paper obtains the average concentration and maximum concentration of fine particulate matter (PM2.5) in China's 31 provinces from 2002 to 2015. We adopt fixed effects model and spatial Durbin model to investigate the association between PM2.5 and perinatal mortality rates. The results indicate that PM2.5 has a significantly positive association with perinatal mortality rates. A 1% increase of log-transformed average concentration and maximum concentrations of PM2.5 is associated with 1.76‰ and 2.31‰ increase of perinatal mortality rates, respectively. In spatial econometrics analysis, we find PM2.5 has significant spatial autocorrelation characteristics. The concentrations of log-transformed average and maximum PM2.5 increase 1% is associated with a 2.49% increase in a 2.49‰ and 2.19‰ increase of perinatal mortality rates, respectively. The potential mechanism is that air pollution has an impact on infant weight to impact perinatal mortality rates.

The role of burden of disease assessment in tracking progress towards achieving WHO global air quality guidelines.

OBJECTIVES: More than 90% of the global population live in areas exceeding the PM2.5 air quality guidelines (AQGs). We provide an overview of the ambient PM2.5-related burden of disease (BoD) studies along with scenario analysis in the framework of the WHO AQG update on the estimated reduction in the BoD if AQGs were achieved globally. METHODS: We reviewed the literature for large-scale studies for the BoD attributed to ambient PM2.5. Moreover, we used the latest WHO statistics to calculate the BoD at current levels and the scenarios of aligning with interim targets and AQG levels. RESULTS: The most recent BoD studies (2010 onwards) share a similar methodology, but there are differences in the input data which affect the estimates for attributable deaths (2.9-8.9 million deaths annually). Moreover, we found that if AQGs were achieved, the estimated BoD would be reduced by up to 50% in total deaths worldwide. CONCLUSIONS: Understanding the BoD across countries, especially in those that do not align with the AQGs, is essential in order to inform actions to reduce air pollution globally.

Spatial-Temporal Effects of PM2.5 on Health Burden: Evidence from China.

By collecting the panel data of 29 regions in China from 2008 to 2017, this study used the spatial Durbin model (SDM) to explore the spatial effect of PM2.5 exposure on the health burden of residents. The most obvious findings to emerge from this study are that: health burden and PM2.5 exposure are not randomly distributed over different regions in China, but have obvious spatial correlation and spatial clustering characteristics. The maximum PM2.5 concentrations have a significant positive effect on outpatient expense and outpatient visits of residents in the current period, and the impact of PM2.5 pollution has a significant temporal lag effect on residents' health burden. PM2.5 exposure has a spatial spillover effect on the health burden of residents, and the PM2.5 concentrations in the surrounding regions or geographically close regions have a positive influence on the health burden in the particular region. The impact of PM2.5 exposure is divided into the direct effect and the indirect effect (the spatial spillover effect), and the spatial spillover effect is greater than that of the direct effect. Therefore, we conclude that PM2.5 exposure has a spatial spillover effect and temporal lag effect on the health burden of residents, and strict regulatory policies are needed to mitigate the health burden caused by air pollution.