Issue link: https://hi.iaq.net/i/670243
Every breath we take: the lifelong impact of air pollution For some time, COMEAP has also made recommendations on quantification of the effects of O 3 on mortality, and of NO 2 and SO 2 in addition to PM and O 3 on hospital admission rates. 2 These recommendations have been applied by the Interdepartmental Group on Costs and Benefits in evaluating policies that influence emissions of air pollution in the UK. However, the ensuing results are dominated by the mortality burden of fine particles. COMEAP is currently undertaking a number of activities to investigate extension of the range of effects for which quantification may be recommended for UK policy analysis. In related work, the function for PM-related mortality has been applied to generate a list of attributable deaths and life-years lost for each local authority in the UK. 10 Preliminary estimates of NO 2 impacts on mortality were published by the UK's Department for Environment Food and Rural Affairs (Defra) in September 2015. 11 These indicate that NO 2 is linked to 23,500 deaths annually in the UK (with a range of 9,500–38,000), based on pollutant levels in 2013. It is noted that this figure will include some overlap with the impact quantified against exposure to PM 2.5 . When quantifying the total impact associated with exposure to both NO 2 and PM 2.5 , it is therefore necessary to account for this overlap in the response functions. Defra estimates that the annual equivalent number of attributable deaths associated with the two pollutants combined is 44,750–52,500, with an associated annual social cost of £25.3 billion – £29.7 billion. However, a subsequent paper issued by COMEAP in December 2015 indicates that the level of overlap in estimates between pollutants may be greater than originally thought. 12 On this basis, while recognising that COMEAP's research on this issue is continuing, this report adopts a combined estimate of effect of around 40,000 deaths annually with an associated annual social cost of £22.6 billion (both with a range for a central estimate of ±25%). 6.2.3 Global burden of disease With respect to air pollution, the Global Burden of Disease (GBD) 2010 study 13 focused on quantification of mortality impacts from exposure to PM 2.5 and O 3 . Overall, results indicate that a total of 7 million deaths in 2010 across the world were attributable to indoor and outdoor air pollution, making air pollution one of the most important risk factors globally. Results for air pollutant impacts for the UK, expressed as both disability-adjusted life-years (DALYs) and deaths (GBD did not include morbidity), are shown in Table 2. 82 © Royal College of Physicians 2016 Table 2. GBD results for outdoor air pollution for the UK 13 DALYs Deaths % Ambient PM pollution Cerebrovascular disease 73,061 5,448 20% COPD 27,558 1,681 8% Ischaemic heart disease 220,643 13,907 61% Lower respiratory infections 815 9 0% Trachea, bronchus and lung cancers 38,623 2,328 11% Total (all causes) 360,700 23,373 100% Ozone Total (all COPD) 8,865 772 100%