title: A multi-scale health impact assessment of air pollution over the 21st century.
abstract: BACKGROUND
  Ozone and PM₂.₅ are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales.
  
  
  METHODS
  We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM₂.₅ under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR).
  
  
  RESULTS
  Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109,000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM₂.₅ changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.
  
  
  CONCLUSIONS
  Multi-scale HIAs can illustrate the difference in direct consequences of costly mitigation policies and provide results that may help decision-makers choose between different policy alternatives at different scales.
authors: LSCE, Laboratoire des Sciences du Climat et de l'Environnement, CEN Saclay-Orme des Merisiers-Bat. 712, F-91191 Gif-sur-Yvette CEDEX, France. Electronic address: vlikhvar@gmail.com.
authors: Victoria N
authors: VN
authors: Likhvar
authors: InVS, French Institut of Public Health Surveillance (Institut de Veille Sanitaire), 12 rue du Val-d'Osne, 94415 Saint-Maurice Cédex, France. Electronic address: m.pascal@invs.sante.fr.
authors: Mathilde
authors: M
authors: Pascal
authors: LMD, Laboratoire de Météorologie Dynamique, IPSL Laboratoire CEA/CNRS/UVSQ, Ecole Polytechnique, 91128 Palaiseau Cedex, France. Electronic address: konstantinos.markakis@lmd.polytechnique.fr.
authors: Konstantinos
authors: K
authors: Markakis
authors: INERIS, Institut National de l'Environnement Industriel et des Risques, BP2 60550 Verneuil-en-Halatte, France. Electronic address: augustin.colette@ineris.fr.
authors: Augustin
authors: A
authors: Colette
authors: LSCE, Laboratoire des Sciences du Climat et de l'Environnement, CEN Saclay-Orme des Merisiers-Bat. 712, F-91191 Gif-sur-Yvette CEDEX, France. Electronic address: didier.hauglustaine@lsce.ipsl.fr.
authors: Didier
authors: D
authors: Hauglustaine
authors: LMD, Laboratoire de Météorologie Dynamique, IPSL Laboratoire CEA/CNRS/UVSQ, Ecole Polytechnique, 91128 Palaiseau Cedex, France. Electronic address: myrto.valari@lmd.polytechnique.fr.
authors: Myrto
authors: M
authors: Valari
authors: IIASA, International Institute for Applied Systems Analysis, Schlossplatz 1, 2361 Laxenburg, Austria. Electronic address: klimont@iiasa.ac.at.
authors: Zbigniew
authors: Z
authors: Klimont
authors: InVS, French Institut of Public Health Surveillance (Institut de Veille Sanitaire), 12 rue du Val-d'Osne, 94415 Saint-Maurice Cédex, France. Electronic address: s.medina@invs.sante.fr.
authors: Sylvia
authors: S
authors: Medina
authors: Columbia University in the City of New York, 722 West 168th Street, Room 1104E, New York, NY 10032, United States. Electronic address: plk3@columbia.edu.
authors: Patrick
authors: P
authors: Kinney
mesh_terms: D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000706:statistics & numerical data*; D002980:Climate; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D004784:Environmental Monitoring; D062489:Health Impact Assessment; D006801:Humans; D010126:Ozone / Q000032:analysis; D052638:Particulate Matter / Q000032:analysis; D011634:Public Health
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D010126:Ozone
keywords: Air quality modeling; Cardiovascular disease; Emissions scenarios; Health impact assessment; Particulate matter