Implementing the US air quality standard for PM2.5 worldwide can prevent millions of premature deaths per year.

BACKGROUND: Air pollution by fine aerosol particles is among the leading causes of poor health and premature mortality worldwide. The growing awareness of this issue has led several countries to implement air pollution legislation. However, populations in large parts of the world are still exposed to high levels of ambient particulate pollution. The main aim of this work is to evaluate the potential impact of implementing current air quality standards for fine particulate matter (PM2.5) in the European Union (EU), United States (US) and other countries where PM2.5 levels are high. METHODS: We use a high-resolution global atmospheric chemistry model combined with epidemiological concentration response functions to investigate premature mortality attributable to PM2.5 in adults ≥30 years and children <5 years. We perform sensitivity studies to estimate the reductions in mortality that could be achieved if the PM2.5 air quality standards of the EU and US and other national standards would be implemented worldwide. RESULTS: We estimate the global premature mortality by PM2.5 at 3.15 million/year in 2010. China is the leading country with about 1.33 million, followed by India with 575 thousand and Pakistan with 105 thousand per year. For the 28 EU member states we estimate 173 thousand and for the United States 52 thousand premature deaths in 2010. Based on sensitivity analysis, applying worldwide the EU annual mean standard of 25 µg/m(3) for PM2.5 could reduce global premature mortality due to PM2.5 exposure by 17 %; while within the EU the effect is negligible. With the 2012 revised US standard of 12 µg/m(3) premature mortality by PM2.5 could drop by 46 % worldwide; 4 % in the US and 20 % in the EU, 69 % in China, 49 % in India and 36 % in Pakistan. These estimates take into consideration that about 22 % of the global PM2.5 related mortality cannot be avoided due to the contribution of natural PM2.5 sources, mainly airborne desert dust and PM2.5 from wild fires. CONCLUSIONS: Our results reflect the need to adopt stricter limits for annual mean PM2.5 levels globally, like the US standard of 12 µg/m(3) or an even lower limit to substantially reduce premature mortality in most of the world.

HBM4EU-MOM: Prenatal methylmercury-exposure control in five countries through suitable dietary advice for pregnancy - Study design and characteristics of participants.

BACKGROUND: Seafood is a major source of vital nutrients for optimal fetal growth, but at the same time is the main source of exposure to methylmercury (MeHg), an established neurodevelopmental toxicant. Pregnant women must be provided with dietary advice so as to include safely fish in their diet for nutrition and mercury control. The aim of this work is to present the design of a multicentre randomized control trial (RCT), which combines human biomonitoring (HBM) with dietary interventions using seafood consumption advice to pregnant women for MeHg control, and to collect information about other possible sources of exposure to mercury. It also presents the materials developed for the implementation of the study and the characteristics of the study participants, which were self-reported in the first trimester of pregnancy. METHODS: The "HBM4EU-MOM" RCT was performed in the frame of the European Human Biomonitoring Initiative (HBM4EU) in five coastal, high fish-consuming European countries (Cyprus, Greece, Spain, Portugal and Iceland). According to the study design, pregnant women (≥120/country, ≤20 weeks gestational age) provided a hair sample for total mercury assessment (THg) and personal information relevant to the study (e.g., lifestyle, pregnancy status, diet before and during the pregnancy, information on seafood and factors related to possible non-dietary exposures to mercury) during the first trimester of pregnancy. After sampling, participants were randomly assigned to "control" (habitual practices) or "intervention" (received the harmonized HBM4EU-MOM dietary advice for fish consumption during the pregnancy and were encouraged to follow it). Around child delivery, participants provided a second hair sample and completed another tailored questionnaire. RESULTS: A total of 654 women aged 18-45 years were recruited in 2021 in the five countries, primarily through their health-care providers. The pre-pregnancy BMI of the participants ranged from underweight to obese, but was on average within the healthy range. For 73% of the women, the pregnancy was planned. 26% of the women were active smokers before the pregnancy and 8% continued to smoke during the pregnancy, while 33% were passive smokers before pregnancy and 23% remained passively exposed during the pregnancy. 53% of the women self-reported making dietary changes for their pregnancy, with 74% of these women reporting making the changes upon learning of their pregnancy. Of the 43% who did not change their diet for the pregnancy, 74% reported that their diet was already balanced, 6% found it difficult to make changes and 2% were unsure of what changes to make. Seafood consumption did not change significantly before and during the first trimester of pregnancy (overall average ∼8 times per month), with the highest frequency reported in Portugal (≥15 times per month), followed by Spain (≥7 times per month). During the first-trimester of pregnancy, 89% of the Portuguese women, 85% of the Spanish women and <50% of Greek, Cypriot and Icelandic women reported that they had consumed big oily fish. Relevant to non-dietary exposure sources, most participants (>90%) were unaware of safe procedures for handling spillage from broken thermometers and energy-saving lamps, though >22% experienced such an incident (>1 year ago). 26% of the women had dental amalgams. ∼1% had amalgams placed and ∼2% had amalgams removed during peri-pregnancy. 28% had their hair dyed in the past 3 months and 40% had body tattoos. 8% engaged with gardening involving fertilizers/pesticides and 19% with hobbies involving paints/pigments/dyes. CONCLUSIONS: The study design materials were fit for the purposes of harmonization and quality-assurance. The harmonized information collected from pregnant women suggests that it is important to raise the awareness of women of reproductive age and pregnant women about how to safely include fish in their diet and to empower them to make proper decisions for nutrition and control of MeHg, as well as other chemical exposures.

Exploring the economy-wide effects of agriculture on air quality and health: Evidence from Europe.

Agricultural emissions strongly contribute to fine particulate matter pollution (PM2.5) and associated effects on human health. Environmentally-extended input-output models and a regional atmospheric chemistry model (WRF-Chem) were combined to conduct an economy-wide assessment of air pollution and pre-mature mortality in the European Union (EU), associated with a 20% increase in the final demand for the output of the agricultural sector. Model results revealed significant differences in air pollution originating from agricultural growth across the 28 EU countries (EU-28). The highest impact of agricultural growth on PM2.5 concentrations occur over the Northern Balkan countries (Bulgaria and Romania) and northern Italy. However, the highest excess mortality rates in the EU-28 due to changes in emissions and enhanced PM2.5 concentrations are observed in Malta, Greece, Spain and Cyprus. The least affected countries are mostly located in the northern part of Europe, with the exception of the Scandinavian Countries, which have relatively good air quality under current conditions. Our integrated modelling framework results highlight the importance of capturing both the direct and indirect air pollution emissions of economic sectors via upstream supply chains and underscore the non-linear response of surface PM2.5 levels and their health impacts to emission fluxes.

Estimating health and economic benefits of reductions in air pollution from agriculture.

Agricultural ammonia emissions strongly contribute to fine particulate air pollution (PM2.5) with significant impacts on human health, contributing to mortality. We used model calculated emission scenarios to examine the health and economic benefits accrued by reducing agricultural emissions. We applied the "value of statistical life" metric to monetize the associated health outcomes. Our analysis indicates that a 50% reduction in agricultural emissions could prevent >200 thousand deaths per year in the 59 countries included in our study, notably in Europe, Russia, Turkey, the US, Canada and China, accompanied with economic benefits of many billions US$. In the European Union (EU) mortality could be reduced by 18% with an annual economic benefit of 89 billion US$. A theoretical complete phase-out of agricultural emissions could lead to a reduction in PM2.5 related mortality of >50% plus associated economic costs in 42 out of the 59 countries studied. Within the EU, 140 thousand deaths could be prevented per year with an associated economic benefit of about 407billionUS$/year. A cost-benefit assessment of ammonia emission abatement options for the EU indicates that the reduction of agricultural emissions generates net financial and social benefits. The monetization of the health benefits of air pollution abatement policies and the costs of implementation can help devise cost-effective air quality management strategies.