Sasha Khomenko|Marta Cirach|Evelise Pereira Barboza|Natalie Mueller|Jose Barrera?Gómez|David Rojas-Rueda|Kees de Hoogh|Gerard Hoek|Mark Nieuwenhuijsen
Premature mortality due to air pollution in European cities: a health impact assessment
Pompeu Fabra University|Barcelona Institute for Global Health|Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública|Pompeu Fabra University|Barcelona Institute for Global Health|Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública|Pompeu Fabra University|Barcelona Institute for Global Health|Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública|Pompeu Fabra University|Barcelona Institute for Global Health|Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública|Pompeu Fabra University|Barcelona Institute for Global Health|Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública|Colorado State University|University of Basel|Swiss Tropical and Public Health Institute|Utrecht University|Pompeu Fabra University|Barcelona Institute for Global Health|Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
backgroundambient air pollution major environmental cause morbidity mortality worldwide cities generally hotspots air pollution disease however exact extent health effects air pollution city level still largely unknown aimed estimate proportion annual preventable deaths due air pollution almost 1000 cities europemethodswe quantitative health impact assessment year 2015 estimate effect air pollution exposure pm25 no2 naturalcause mortality adult residents aged 20 years 969 cities 47 greater cities europe retrieved cities greater cities urban audit 2018 dataset analysis 250 grid cell level 2015 data based global human settlement layer residential population estimated annual premature mortality burden preventable recommended values ie 10 gm3 pm25 40 gm3 no2 achieved air pollution concentrations reduced lowest values measured 2015 european cities ie 37 gm3 pm25 35 gm3 no2 clustered ranked cities basis population agestandardised mortality burden associated air pollution exposure addition several uncertainty sensitivity analyses test robustness estimatesfindingscompliance air pollution guidelines could prevent 51 213 95 ci 34 03668 682 deaths per year pm25 exposure 900 02476 deaths per year no2 exposure reduction air pollution lowest measured concentrations could prevent 124 729 83 332166 535 deaths per year pm25 exposure 79 435 0215 165 deaths per year no2 exposure great variability preventable mortality burden observed city ranging 0 202 deaths per 100 000 population pm25 0 73 deaths no2 per 100 000 population lowest measured concentrations considered highest pm25 mortality burden estimated cities po valley northern italy poland czech republic highest no2 mortality burden estimated large cities capital cities western southern europe sensitivity analyses showed results particularly sensitive choice exposure response function less choice baseline mortality values exposure assessment methodinterpretationa considerable proportion premature deaths european cities could avoided annually lowering air pollution concentrations particularly guidelines mortality burden varied considerably european cities indicating policy actions urgently needed reduce air pollution achieve sustainable liveable healthy communities current guidelines revised air pollution concentrations reduced achieve greater protection health citiesfundingspanish ministry science innovation internal isglobal fund