The role of burden of disease assessment in tracking progress towards achieving WHO global air quality guidelines

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ORIGINAL ARTICLE

The role of burden of disease assessment in tracking progress towards achieving WHO global air quality guidelines Dimitris Evangelopoulos1,2 • Roman Perez-Velasco3 • Heather Walton1,2 • Sophie Gumy4 Martin Williams1 • Frank J. Kelly1,2 • Nino Ku¨nzli5,6



Received: 10 May 2020 / Revised: 29 August 2020 / Accepted: 4 September 2020 / Published online: 15 October 2020  The Author(s) 2020

Abstract Objectives More than 90% of the global population live in areas exceeding the PM2.5 air quality guidelines (AQGs). We provide an overview of the ambient PM2.5-related burden of disease (BoD) studies along with scenario analysis in the framework of the WHO AQG update on the estimated reduction in the BoD if AQGs were achieved globally. Methods We reviewed the literature for large-scale studies for the BoD attributed to ambient PM2.5. Moreover, we used the latest WHO statistics to calculate the BoD at current levels and the scenarios of aligning with interim targets and AQG levels. Results The most recent BoD studies (2010 onwards) share a similar methodology, but there are differences in the input data which affect the estimates for attributable deaths (2.9–8.9 million deaths annually). Moreover, we found that if AQGs were achieved, the estimated BoD would be reduced by up to 50% in total deaths worldwide. Conclusions Understanding the BoD across countries, especially in those that do not align with the AQGs, is essential in order to inform actions to reduce air pollution globally. Keywords Air pollution  PM2.5  Burden of disease  Air quality guidelines

Introduction Air pollution is a major public health issue and a leading risk factor for mortality and morbidity worldwide (Cohen et al. 2017). It has been estimated to account for more than

two-thirds of the environmental burden worldwide (Landrigan et al. 2018). More than 90% of the global population live in areas exceeding the World Health Organization global air quality guidelines (WHO AQGs) for particulate matter with diameter of less than 2.5 micrometres (PM2.5),

1

Environmental Research Group, Imperial College, London, United Kingdom

2

National Institute for Health Research Health Protection Unit: Environmental Exposures and Health, Imperial College, London, United Kingdom

Heather Walton [email protected]

3

European Centre for Environment and Health, World Health Organization Regional Office for Europe, Bonn, Germany

Sophie Gumy [email protected]

4

World Health Organization, Geneva, Switzerland

5

Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland

6

University of Basel, Basel, Switzerland

& Dimitris Evangelopoulos [email protected] Roman Perez-Velasco [email protected]

Martin Williams [email protected] Frank J. Kelly [email protected] Nino Ku¨nzli [email protected]

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i.e. 10 lg/m3 annual average (Shaddick et al. 2020). In 2004, WHO and the World Bank initiated the first comprehensive evaluation of ambient air pollution in the global burd