Health impact assessment of air pollution in Valladolid, Spain

Abstract

ObjectiveTo estimate the attributable and targeted avoidable deaths (ADs; TADs) of outdoor air pollution by ambient particulate matter (PM10), PM2.5 and O3 according to specific WHO methodology.DesignHealth impact assessment.SettingCity of Valladolid, Spain (around 300 000 residents).Data sourcesDemographics; mortality; pollutant concentrations collected 1999–2008.Main outcome measuresAttributable fractions; ADs and TADs per year for 1999–2008.ResultsHigher 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.ConclusionsOur 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.