title: The contribution of outdoor air pollution sources to premature mortality on a global scale.
abstract: Assessment of the global burden of disease is based on epidemiological cohort studies that connect premature mortality to a wide range of causes, including the long-term health impacts of ozone and fine particulate matter with a diameter smaller than 2.5 micrometres (PM2.5). It has proved difficult to quantify premature mortality related to air pollution, notably in regions where air quality is not monitored, and also because the toxicity of particles from various sources may vary. Here we use a global atmospheric chemistry model to investigate the link between premature mortality and seven emission source categories in urban and rural environments. In accord with the global burden of disease for 2010 (ref. 5), we calculate that outdoor air pollution, mostly by PM2.5, leads to 3.3 (95 per cent confidence interval 1.61-4.81) million premature deaths per year worldwide, predominantly in Asia. We primarily assume that all particles are equally toxic, but also include a sensitivity study that accounts for differential toxicity. We find that emissions from residential energy use such as heating and cooking, prevalent in India and China, have the largest impact on premature mortality globally, being even more dominant if carbonaceous particles are assumed to be most toxic. Whereas in much of the USA and in a few other countries emissions from traffic and power generation are important, in eastern USA, Europe, Russia and East Asia agricultural emissions make the largest relative contribution to PM2.5, with the estimate of overall health impact depending on assumptions regarding particle toxicity. Model projections based on a business-as-usual emission scenario indicate that the contribution of outdoor air pollution to premature mortality could double by 2050.
authors.affiliation: Max Planck Institute for Chemistry, Atmospheric Chemistry Department, 55128 Mainz, Germany.|The Cyprus Institute, Energy, Environment and Water Research Center, 1645 Nicosia, Cyprus.
authors.forename: J
authors.initials: J
authors.lastname: Lelieveld
authors.affiliation: Harvard School of Public Health, Boston, Massachusetts 02215, USA.|Cyprus International Institute for Environment and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus.
authors.forename: J S
authors.initials: JS
authors.lastname: Evans
authors.affiliation: King Saud University, College of Science, Riyadh 11451, Saudi Arabia.
authors.forename: M
authors.initials: M
authors.lastname: Fnais
authors.affiliation: The Cyprus Institute, Energy, Environment and Water Research Center, 1645 Nicosia, Cyprus.
authors.forename: D
authors.initials: D
authors.lastname: Giannadaki
authors.affiliation: Max Planck Institute for Chemistry, Atmospheric Chemistry Department, 55128 Mainz, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Pozzer
mesh_terms: D000328:Adult; D000383:Agriculture / Q000706:statistics & numerical data; D000393:Air Pollutants / Q000009:adverse effects* / Q000506:poisoning; D000397:Air Pollution / Q000009:adverse effects*; D001272:Atmosphere / Q000737:chemistry; D018533:Biomass; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003296:Cooking / Q000706:statistics & numerical data; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D005060:Europe / Q000453:epidemiology; D005202:Asia, Eastern / Q000453:epidemiology; D005390:Fires / Q000706:statistics & numerical data; D006361:Heating / Q000706:statistics & numerical data; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D038622:Internationality; D008875:Middle Aged; D061213:Mortality, Premature / Q000639:trends; D010126:Ozone / Q000009:adverse effects / Q000032:analysis / Q000506:poisoning; D052638:Particulate Matter / Q000009:adverse effects* / Q000506:poisoning; D011210:Power Plants / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data; D012426:Russia / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data; D001335:Vehicle Emissions / Q000506:poisoning
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D001335:Vehicle Emissions; D010126:Ozone