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Global links between air pollution and premature mortality
Globally, outdoor air pollution leads to over 3 million premature deaths per year, predominantly in Asia, suggests a study published in this week’s Nature. Outdoor air pollutants, such as ozone and tiny particles (less than 0.0025 mm in diameter, known as fine particulate matter), are associated with serious diseases with long-term health impacts. Quantifying the effects of outdoor air pollution on a global scale is challenging, in part because air quality is not monitored in some regions, and the toxicity of particles varies depending on their source.
Jos Lelieveld and colleagues combine a global atmospheric chemistry model with population data and health statistics to estimate the relative contribution of different sources of outdoor air pollution, mainly from fine particulate matter, to premature mortality. Their results show that residential energy emissions, such as those from heating and cooking, which are prevalent in India and China, have the largest impact on premature mortality worldwide. In most regions of the USA and a few other countries, emissions from traffic and power generation are found to be important, whereas in the eastern USA, Europe, Russia and East Asia, agricultural emissions are the largest relative contribution of fine particulate matter.
On the basis of model projections, the authors predict that premature mortality from outdoor air pollution could double by 2050, with 6.6 million premature deaths forecast globally per year, including large increases in Southeast Asia and the western Pacific.
Expert Reaction
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Associate Professor Adrian Barnett is a Senior Research Fellow in the School of Public Health and Social Work at the Queensland University of Technology (QUT).
This is a big data paper that combines world estimates of population with world pollution levels to provide a broad picture of deaths due to two common outdoor air pollutants. The main estimate is that 3.3 million people per year are dying prematurely because of exposure to air pollution, and that’s not all in the elderly as 230,000 children under five are dying per year. The greatest cause is fuel for cooking and heating which generates a lot of indoor pollution if it’s wood or coal. So in many parts of the world the way people heat or feed themselves is also slowly killing them. The paper predicts that by 2050 the 3.3 million deaths per year will have risen to 6.5 million deaths per year, partly due to an older population who are more vulnerable to pollution. We could avoid many of these future and current deaths if we used cleaner ways to create heat and energy. The country with the most deaths was China, with 1.3 million per year. Australia had an estimated 280 premature deaths per year, of which nearly 100 are due to biomass burning emissions. However the paper did not fully consider pollution due to traffic, which would is the main cause of air pollution exposure in Australia.
Dr Christine Cowie is a Senior Research Fellow in the Faculty of Medicine at the University of New South Wales
Joint comment with Professor Bin Jalaludin, UNSW
This study estimated that the global mortality due to both fine particles (PM2.5) and ozone air pollution in 2010 was 3.3 million, with 3.15 million attributed to fine particles alone. Much of this burden falls in Asia, predominantly China and India. China is estimated to contribute 1.36 million of these cases (about 40 per cent of the total deaths), due to its high death rate and its high population density. The main causes of deaths globally due to fine particles are stroke and heart disease. Of concern, there will be an estimated doubling of deaths due to air pollution by 2050 in a “business as usual” scenario.
The sources of fine particles include man-made sources such as biofuel use for cooking and heating, power generation, traffic, industry and agriculture, as well as natural sources such as dust storms and forest fires (biomass burning). The study showed that the sources of fine particles varied substantially by world region. Whereas residential energy use (cooking and heating) were major sources of fine particles in China and India, in the US the greatest contributing sources were power generation, agriculture and traffic.
Although separate mortality estimates were not available for Australia, the study estimated that there were 27,000 deaths due to air pollution in the Western Pacific countries of Australia, Brunei Darussalam, Japan, New Zealand and Singapore. While air pollution from natural sources and bushfires affected large areas of Australia in 2010, the increased mortality from air pollution occurred in the urban areas of Sydney and Melbourne (according to the map; Figure 1), with sources such as traffic, power generation and industry expected to predominate and contribute to natural sources.
This study is further demonstration of the need to adopt policies and legislation which help to minimise air pollution from all sources, particularly fine particles. Different approaches will be required to tackle the sources of fine particles in different regions of the world. Even in countries with good air quality such as Australia, there is still a health gain to be made by reducing fine particle pollution.
Professor Jos Lelieveld is Director of the Atmospheric Chemistry Department at the Max Planck Institute for Chemistry, Germany
In Australia air quality is typically better than other continents. Nevertheless, for Australia we calculate 280 premature deaths per year, of which nearly 100 are due to biomass burning emissions
Professor Ian Rae is an expert on chemicals in the environment from the School of Chemistry at the University of Melbourne. He was also an advisor to the United Nations Environment Programme on chemicals in the environment and is former President of the Royal Australian Chemical Institute
This is a broader study than most so the numbers are larger. However, the results are sadly predictable - illness and death (morbidity and mortality, to use the professional terms) are greater in places with filthy air.
Air pollution and its effects were covered in the United Nations Global Environment Outlook - Geo 5 - published in 2012.
A number of Australian studies over the last two decades have implicated fine particles and gaseous pollutants like ozone, sulphur oxides and nitrogen oxides as the main culprits and given estimates of morbidity (often based on hospital admissions) and mortality.