Health impact assessment of air pollution in Valladolid, Spain

Abstract

Objective: To estimate the attributable and targeted avoidable deaths (ADs; TADs) of outdoor air pollution by ambient particulate matter (PM10), PM2.5 and O3according to specific WHO methodology. Design: Health impact assessment. Setting: City of Valladolid, Spain (around 300 000 residents). Data sources: Demographics; mortality; pollutant concentrations collected 1999-2008. Main outcome measures: Attributable fractions; ADs and TADs per year for 1999-2008. Results: Higher TADs estimates (shown here) were obtained when assuming as 'target' concentrations WHO Air Quality Guidelines instead of Directive 2008/50/EC. ADs are considered relative to pollutant background levels. All-cause mortality associated to PM10 (all ages): 52 ADs (95%CI 39 to 64); 31 TADs (95%CI 24 to 39). All-cause mortality associated to PM10 (<5 years): 0 ADs (95% CI 0 to 1); 0 TADs (95% CI 0 to 1). All-cause mortality associated to PM2.5 (>30 years): 326 ADs (95% CI 217 to 422); 231 TADs (95% CI 153 to 301). Cardiopulmonary and lung cancer mortality associated to PM2.5 (>30 years): ▸ Cardiopulmonary: 186 ADs (95% CI 74 to 280); 94 TADs (95% CI 36 to 148). ▸ Lung cancer : 51 ADs (95% CI 21 to 73); 27 TADs (95% CI 10 to 41).All-cause, respiratory and cardiovascular mortality associated to O3 (all ages): ▸ All-cause: 52ADs (95% CI 25 to 77); 31 TADs (95% CI 15 to 45). ▸ Respiratory: 5ADs (95% CI -2 to 13); 3 TADs (95% CI -1 to 8). ▸ Cardiovascular: 30 ADs (95% CI 8 to 51); 17 TADs (95% CI 5 to 30). Negative estimates which should be read as zero were obtained when pollutant concentrations were below counterfactuals or assumed risk coefficients were below one. Conclusions: Our estimates suggest a not negligible negative impact on mortality of outdoor air pollution. The implementation of WHO methodology provides critical information to distinguish an improvement range in air pollution control.