Abstract
Background: Exposure to 2.5-micron diameter air pollutants (PM 2.5) has been associated with an increased risk of illness and death worldwide; however, in Latin American health impacts assessment of this risk factor is scarce. Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk. Methods: A descriptive study of the disease burden was carried out using the city as the unit of observation. Health events were selected based on epidemiologic evidence and the availability of the population attributable fraction associated with PM 2.5. The mortality records were taken from the module of deceased of the Single Registry of Affiliates of the Health System; the morbidity records were taken from the Individual Health Services Registries. For the estimation of the burden of disease, the current Global Burden of Disease guidelines were followed. Results: Attributable disability-adjusted life years to exposure to ambient PM 2.5 pollution (DALYs PM2.5) constituted 13.8% of total burden of the city. Males showed the greatest loss of DALYs PM2.5 due to acute events, while in women the greatest loss was due to chronic events. Ischemic heart disease, chronic diseases of the lower respiratory tract, and influenza and pneumonia were the events that contributed the most to DALYs PM2.5. 71.4% of the DALYs PM2.5 corresponded to mortality, mainly in the population over 65 years of age. Regarding attributable morbidity, acute events were more prevalent in both sexes, especially due to respiratory diseases Conclusion: Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM 2.5 pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender.
Highlights
Air pollution is one of the main concerns surrounding public health worldwide due to its impacts on human health and ecosystem (Dominici et al, 2006)
Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM2.5 pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender
The attributable disease burden to ambient air pollution at a global, regional, and local level has been widely documented, this involves the measurement of disability-adjusted life years (DALYs), an aggregate value of years of life lost (YLLs) due to premature death and years lived with disability (YLDs) (HEI, 2019)
Summary
Air pollution is one of the main concerns surrounding public health worldwide due to its impacts on human health and ecosystem (Dominici et al, 2006). The Institute for Health Metrics and Evaluation (IHME) has identified to air pollution as the fifth main health risk factor for the population, and it is estimated that the exposure to PM2.5 contributes to 4.9 million deaths (8.7% of all deaths worldwide), and the loss of 147 million of healthy life years (5.9% of all DALYs). The World Health Organization (WHO) considers air pollution to be the main environmental health risk factor for the population in the Americas (Prüss-Ustün et al, 2016) due to its impact in susceptible populations, such as children younger than 5 years old, pregnant women, and elderly people (Piñeros-Jiménez et al, 2018). Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk
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