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Comparative Study
. 2020 Sep 1;116(11):1910-1917.
doi: 10.1093/cvr/cvaa025.

Loss of life expectancy from air pollution compared to other risk factors: a worldwide perspective

Jos Lelieveld  1   2 , Andrea Pozzer  1 , Ulrich Pöschl  1 , Mohammed Fnais  3 , Andy Haines  4 , Thomas Münzel  5   6
Affiliations
Comparative Study

Loss of life expectancy from air pollution compared to other risk factors: a worldwide perspective

Jos Lelieveld et al. Cardiovasc Res. .

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Cardiovasc Res. 2020 Jun 1;116(7):1334. doi: 10.1093/cvr/cvaa073. Cardiovasc Res. 2020. PMID: 32270863 Free PMC article. No abstract available.

Abstract

Aims: Long-term exposure of humans to air pollution enhances the risk of cardiovascular and respiratory diseases. A novel Global Exposure Mortality Model (GEMM) has been derived from many cohort studies, providing much-improved coverage of the exposure to fine particulate matter (PM2.5). We applied the GEMM to assess excess mortality attributable to ambient air pollution on a global scale and compare to other risk factors.

Methods and results: We used a data-informed atmospheric model to calculate worldwide exposure to PM2.5 and ozone pollution, which was combined with the GEMM to estimate disease-specific excess mortality and loss of life expectancy (LLE) in 2015. Using this model, we investigated the effects of different pollution sources, distinguishing between natural (wildfires, aeolian dust) and anthropogenic emissions, including fossil fuel use. Global excess mortality from all ambient air pollution is estimated at 8.8 (7.11-10.41) million/year, with an LLE of 2.9 (2.3-3.5) years, being a factor of two higher than earlier estimates, and exceeding that of tobacco smoking. The global mean mortality rate of about 120 per 100 000 people/year is much exceeded in East Asia (196 per 100 000/year) and Europe (133 per 100 000/year). Without fossil fuel emissions, the global mean life expectancy would increase by 1.1 (0.9-1.2) years and 1.7 (1.4-2.0) years by removing all potentially controllable anthropogenic emissions. Because aeolian dust and wildfire emission control is impracticable, significant LLE is unavoidable.

Conclusion: Ambient air pollution is one of the main global health risks, causing significant excess mortality and LLE, especially through cardiovascular diseases. It causes an LLE that rivals that of tobacco smoking. The global mean LLE from air pollution strongly exceeds that by violence (all forms together), i.e. by an order of magnitude (LLE being 2.9 and 0.3 years, respectively).

Keywords: Air pollution; Anthropogenic emissions; Fine particulate matter; Fossil fuel emissions; Loss of life expectancy; Natural emissions; Public health risks.

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Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
Annual years of life lost from air pollution (units per 1000 km2). The global total is 233 (221–250) million per year.
Figure 2
Figure 2
Age distribution of excess mortality from ambient air pollution. Globally, about 25% of the attributable mortality occurs at an age of
Figure 3
Figure 3
Percentage of global life expectancy loss from air pollution by different disease categories. CEV, cerebrovascular disease; COPD, chronic obstructive pulmonary disease; IHD, ischaemic heart disease; LC, lung cancer; LRI, lower respiratory infections; NCD, non-communicable diseases.
Figure 4
Figure 4
Mean global and country-level loss of life expectancy from different causes of death referring to the year 2015. Household air pollution is from the indoor use of solid biofuels. Ambient residential air pollution is mostly from household sources and can include fossil and biofuel use. Parasitic and vector-borne diseases include malaria, leishmaniasis, rabies, dengue, yellow fever, and others. Violence includes interpersonal, collective conflict, and armed intervention.
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