Health and Economic Impact Assessment of Air Pollution: An Uncertainty Analysis of the Estimates

Abstract:

Air pollution adversely affects health, and each year millions die prematurely due to respiratory infection, cardiovascular disease, cancer, and other causes of disease. Air pollution disproportionally affects susceptible subpopulations (infants and people with underlying morbidity) and socioeconomically disadvantaged groups. In 2018, the World Health Organization (WHO) estimated that 7 million people worldwide die from exposure to fine particulate matter (PM_2.5) ambient and household air pollution, an attribution of 1 in 8 deaths due to PM_2.5. The WHO has declared air pollution as the leading and, more importantly, preventable environmental health risk. In the absence of more stringent air quality legislative policies, the projected PM_2.5 deaths could double by 2050, relative to current estimates by the Global Burden of Disease. In 41 European countries, ambient pollution (PM_2.5, ozone and nitrogen dioxide), contributed between 280 and 580 thousand premature deaths in 2016, according to the European Environment Agency. The benefit of a hypothetical analysis if the WHO air quality guideline for PM_2.5 was achieved across Europe would reduce premature mortality by one-third.

Even when air pollution doesn’t kill, exposure leads to constant degradation in the quality of life through manifestation of physical disability and loss of mental acuity, while prolonged exposure shortens life expectancy. Globally, ambient air pollution at current concentrations reduces life span at birth by 1 year. This estimate varies regionally from few months to several years, based on population susceptibility and environmental determinants. On average, each statistical death involves a loss of life of 10–15 years.

Health impacts and costs are quantified using an impact pathway analysis, which considers pollutant atmospheric transport, estimation of health burdens using relative risk (RR) factors from epi models, and economic valuation (health care expenditures, productivity losses, and willingness to avoid suffering from illness). The current global economic cost of ambient pollution range is $5–10 trillion (4–10% of world GDP). The largest contributor to the uncertainty is related to the RR choice and the valuation of premature mortality. Typically, the economic cost range is a factor of three about the mean value.