PM2.5-associated burden of disease and its cost in 429 Iranian counties from 2016 to 2018

Abstract

BACKGROUND AND AIM: Ambient fine particulate matter (PM2.5: particles with an aerodynamic diameter of ≤ 2.5 μm) causes a globally considerable disease burden. Little is known about the impacts of PM2.5 in all counties of Iran. We estimated the PM2.5-health burden, years of life lost (YLL) and economic impacts (based on the value of statistical life (VSL) and value of life year (VOLY)) of 429 Iranian counties during the period 2016-2018. METHODS: All-natural cause and cause-specific mortalities were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP-CE v1.5) based on the Global Exposure Mortality Model (GEMM) and integrated exposure-response (IER) functions. RESULTS:The annual mean population-weighted PM2.5 exposure concentrations across Iranian counties varied from 17.5 to 44.9, 16.8 to 58.2 and 19.4 to 66.1 μg m-3 in 2016, 2017 and 2018, respectively. The premature all-natural cause mortality attributed to long-term exposure to ambient PM2.5 in Iran was approximately 49300 (95% Confidence Interval (95% CI): 45400, 52000), 51000 (95% CI: 47000, 53500) and 49300 (95% CI: 45600, 51800) in 2016, 2017 and 2018, respectively. Furthermore, approximately 16% of all-natural cause mortality in adults (aged above 25 years) was attributed to PM2.5. The YLL attributable to PM2.5 exposures in Iran was approximately817000 (95% CI: 679000, 950000), 848000 (95% CI: 705500, 985000) and 827000 (95% CI: 687000, 961000) in 2016, 2017 and 2018. These YLL related to premature deaths were equivalent to the death of approximately 11 thousand children at birth. The economic loss in Iran due to the total estimated premature mortality attributable to ambient PM2.5 exposures was 20600 (95% CI: 19000, 21700), 21600 (95% CI: 20000, 23000) and 20300 (95% CI: 19000, 21300) million US$ from 2016 to 2018. CONCLUSIONS:Our findings provide a quantitative assessment of PM2.5 burden, assisting national evidence-based public health programs in Iran. KEYWORDS: Particulate matter, Long-term exposure, Outcomes, Mortality.