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Cardiovascular Disease Burden From Ambient Air Pollution in Europe
Study Questions:
What is the excess cardiovascular mortality attributed to air pollution in Europe?
Methods:
The investigators combined the new hazard ratio functions from the Global Exposure Mortality Model (GEMM) with ambient air pollution exposure data to estimate the impacts in Europe and the 28 countries of the European Union (EU-28).
Results:
The annual excess mortality rate from ambient air pollution in Europe is 790,000 [95% confidence interval (95% CI) 645,000–934,000], and 659,000 (95% CI, 537,000–775,000) in the EU-28. Between 40% and 80% are due to cardiovascular events, which dominate health outcomes. The upper limit includes events attributed to other noncommunicable diseases, which are currently not specified. These estimates exceed recent analyses, such as the Global Burden of Disease for 2015, by more than a factor of two. The investigators estimated that air pollution reduces the mean life expectancy in Europe by about 2.2 years with an annual, attributable per capita mortality rate in Europe of 133/100,000 per year.
Conclusions:
The authors concluded that the health impacts attributable to ambient air pollution in Europe are substantially higher than previously assumed.
Perspective:
This study reports that the relatively high attributable to air pollution per capita mortality rate in Europe of about 133/year (and 129/year in the EU-28) per 100,000 is explained by the combination of poor air quality and dense population, leading to exposure that is among the highest in the world. The attributable excess mortality rate is about 8.79 million per year with an overall uncertainty of about ±50%. It appears that improving European air quality would be a highly effective and therefore pressing health promotion intervention. Replacing fossil energy sources with clean, renewable fuels could reduce the attributable mortality rate in Europe by 55%. Additional reductions are possible by controlling other industrial and agricultural pollution sources, and may further reduce mortality attributable to air pollution.
Clinical Topics: Acute Coronary Syndromes, Prevention
Keywords: Acute Coronary Syndrome, Air Pollution, Cardiovascular Diseases, Energy-Generating Resources, Health Promotion, Life Expectancy, Myocardial Ischemia, Primary Prevention, Vascular Diseases
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