Concentrations and health effects of short- and long-term exposure to PM2.5, NO2, and O3 in ambient air of Ahvaz city, Iran (2014–2017)
Introduction
Ambient air pollution is a major cause of death and disability in the current world. According to a report by the World Health Organization (WHO), 3.7 million deaths were estimated to be attributed to urban and rural outdoor air pollution worldwide (WHO, 2014). Global Burden of Disease (GBD) and the World Bank introduced air pollution as the fifth and fourth health risk factor globally, respectively (Global Burden of Disease (GBD), 2015; World Bank, 2016). By considering the particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5), it is reported that approximately 87% of the people in the world are living in areas with PM2.5 concentrations higher than the WHO guidelines. In countries with low and middle income, about 90% of the population faces unsafe concentrations of air pollution (Brauer et al., 2016; World Bank, 2016). The health effects attributed to air pollution induce financial burden to economics as well. The global total welfare losses and the decrease in the gross domestic product (GDP) due to air pollution were 31 million USD and 2.48% in 2013, respectively (World Bank, 2016). The associations between air pollution and various adverse health outcomes have been investigated in numerous studies worldwide (Anderson et al., 2004; Brunekreef and Forsberg, 2005; Dehghani et al., 2018; Delikhoon et al., 2018; Hassanvand et al., 2017; Mohseni Bandpi et al., 2017; Motesaddi Zarandi et al., 2015). Beelen et al. (2014) performed a cohort study to investigate 22 European regarding the relationships between several air pollutants and natural mortality, and it was found that PM2.5 concentrations even lower than the European annual mean limit value of 25 μg/m3 was associated to the natural mortality. The associations were not statistically significant for nitrogen dioxide (NO2) and particulates with a diameter of 10 μm or less (PM10). Raaschou-Nielsen et al. (2013) evaluated the association between long-term exposure to outdoor air pollution and lung cancer incidence in 17 European cohorts. The meta-analyses showed that there is a significant relationship between lung cancer and exposure to PM2.5, with a hazard ratio (HR) of 1·18 (CI 95%, 0·96–1·46) per 5 μg/m3. Yang et al. (2018) reported that several air pollutants such as PM1, PM2.5, PM10, SO2, NO2, and O3 are significantly associated with metabolic syndrome. Since air pollution imposes a remarkable number of mortality and morbidity of diseases, it is critical to quantify its health effects in each society. In addition to health-related purposes, these results provide a reasonable basis for lawmakers and authorities to set new air pollution standard limits to increase the budget for strategies and actions for reducing ambient air pollution (Jo, 2014). Health impact assessment (HIA) is a method to quantify the number of deaths or hospital admissions attributed to a risk factor such as outdoor air pollution (Pascal et al., 2011). In recent years, several tools have been developed by different agencies for HIA of air pollution, including AirQ, BenMAP, Aphekom, and AirQ+. AirQ+ was developed by the WHO in 2016 for HIA of short- and long-term exposure to indoor and outdoor air pollution, and contains exposure-response functions and relative risk (RR) values reported in recent epidemiological studies (Burnett et al., 2014; Hoek et al., 2013; Naddafi et al., 2012; WHO, 2013). So far, limited studies have been conducted using AirQ+ (Faridi et al., 2018; Hadei et al., 2017a, 2017b, 2018; Hopke et al., 2018; Yarahmadi et al., 2018). For conducting an HIA study by AirQ+, some input data should be provided including air quality data, total and at-risk population of the city, baseline incidence of the health outcome per 100,000 of population, relative risk (RR) values from epidemiological studies, and cut-off value for air quality. AirQ + quantifies the health effects only for concentrations higher than that cut-off value (WHO, 2016a). Ahvaz is a megacity in the southwestern part of Iran and is located in an arid region. The annual average of PM10 concentrations in Ahvaz was 231 μg/m3 during 2016, which made this city as the third most polluted city in the world (Naimabadi et al., 2016; WHO, 2016b). In addition to petrochemical industries and traffic-related air pollution, Ahvaz is faced with the repetitive occurrence of the Middle Eastern dust storms in recent years (Farsani et al., 2018; Goudarzi et al., 2019; Marzouni et al., 2017). These dust storms originate from arid areas inside and outside of Iran, leading to high concentrations of PM, particularly PM10 and PM2.5 (Naimabadi et al., 2018; Neisi et al., 2018; Shahsavani et al., 2012). Since PM2.5 particulate penetrates into deeper parts of the lung, it can cause some more dangerous and detrimental health effects compared with PM10. Therefore, in this study, PM2.5 was selected as important ambient air pollutant to investigate its health effects. In addition, it has been reported that PM2.5, O3, and NO2 are the most consistent and rather independent predictors of health effects of ambient air pollution (Faridi et al., 2018). Therefore, we focus here on these three key indicators of ambient air pollution. The extremely polluted ambient air of Ahvaz causes adverse effects on human health. The use of AirQ + for HIA of air pollution has been limited. The results of AirQ + will be based on the new epidemiological findings. In addition, there is no comprehensive study to quantify the health effects attributed to several air pollutants in Ahvaz until now. Considering multiple pollutants such as PM2.5, NO2, and O3 for HIA can better present the health effects of ambient air pollution. Therefore, the present study was aimed to evaluate the concentrations and short- and long-term health effects attributed to PM2.5, NO2, and O3 observed in Ahvaz during the March 2014–March 2017 period using the AirQ + modeling tool.
Section snippets
The study area, period, and estimation procedure
This study focused on the excess mortality and morbidity attributed to short-term and long-term exposure to PM2.5, NO2, and O3 in Ahvaz, Iran, during March 21, 2014–March 20, 2017 period. The total population of Ahvaz in the first, second, and third period were 1170231, 1177487, and 1184788, respectively. We obtained the value of the population of the city from the Statistical Centre of Iran. The population of the first year was based on the census that is carried out every 5 years. Then, the
Results and discussion
Yearly health effects attributed to exposure to ambient PM2.5, NO2, and O3 were estimated using the WHO's AirQ + modeling software (WHO, 2016a). To interpret our results correctly, it should be noted that the health effects attributed to PM2.5 and NO2 were calculated only for the concentrations higher than WHO's guideline values. In addition, O3 health effects were estimated for the concentrations higher than 35 ppbv.
The annual averages and standard deviations of the pollutants are illustrated
Conclusion
We investigated the short- and long-term health effects attributed to exposure to PM2.5, NO2, and O3 in Ahvaz during a three-year period using AirQ + model. The pollutants' concentrations were much higher than the WHO's guideline values. The short-term health effects of PM2.5 were higher than NO2. However, the long-term effects of NO2 were greater than those of PM2.5. The attributable health effects of ozone were low and negligible. In general, a significant number of deaths were estimated to
Acknowledgments
The authors are grateful to the Department of Environment of Ahvaz city to provide us the related data as well as to the Air Pollution and Respiratory Diseases Research Center of Ahvaz Jundishapur University of Medical Sciences for funding (APRD-9602) and providing necessary facilities to perform this research.
References (40)
Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project
The Lancet
(2014)Characteristics and health effects of BTEX in a hot spot for urban pollution
Ecotoxicol. Environ. Saf.
(2018)Characteristics and health effects of formaldehyde and acetaldehyde in an urban area in Iran
Environ. Pollut.
(2018)Long-term trends and health impact of PM2.5 and O3 in Tehran, Iran, 2006–2015
Environ. Int.
(2018)Evaluation of the relationship between PM10 concentrations and heavy metals during normal and dusty days in Ahvaz, Iran
Aeolian Res.
(2018)Chemical and organic characteristics of PM2.5 particles and their in-vitro cytotoxic effects on lung cells: the Middle East dust storms in Ahvaz, Iran
Sci. Total Environ.
(2019)Short-term effects of particle size fractions on circulating biomarkers of inflammation in a panel of elderly subjects and healthy young adults
Environ. Pollut.
(2017)Physicochemical characterization of ambient PM2.5 in Tehran air and its potential cytotoxicity in human lung epithelial cells (A549)
Sci. Total Environ.
(2017)Chemical composition of PM10 and its in vitro toxicological impacts on lung cells during the Middle Eastern Dust (MED) storms in Ahvaz, Iran
Environ. Pollut.
(2016)On the chemical nature of precipitation in a populated Middle Eastern Region (Ahvaz, Iran) with diverse sources
Ecotoxicol. Environ. Saf.
(2018)
Air pollution and lung cancer incidence in 17 european cohorts: prospective analyses from the european study of cohorts for air pollution effects (ESCAPE)
Lancet Oncol.
The evaluation of PM10, PM2.5, and PM1 concentrations during the Middle Eastern Dust (MED) events in Ahvaz, Iran, from april through september 2010
J. Arid Environ.
Long-term exposure to ambient air pollution (including PM1) and metabolic syndrome: the 33 Communities Chinese Health Study (33CCHS)
Environ. Res.
Meta-analysis of Time-Series Studies and Panel Studies of Particulate Matter (PM) and Ozone (O3): Report of a WHO Task Group
Ambient air pollution exposure estimation for the global burden of disease 2013
Environ. Sci. Technol.
Epidemiological evidence of effects of coarse airborne particles on health
Eur. Respir. J.
An integrated risk function for estimating the global burden of disease attributable to ambient fine particulate matter exposure
Environ. Health Perspect.
Lag time structure of cardiovascular deaths attributed to ambient air pollutants in Ahvaz, Iran, 2008-2015
Int. J. Occup. Med. Environ. Health
Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
Lancet
Cited by (83)
Modeling Urban-Rural health disparities using a Taxi-Based mobile atmospheric monitoring system
2024, Transportation Research Part D: Transport and EnvironmentFlexible In<inf>2</inf>Se<inf>3</inf> sensor for chemiresistive NO<inf>2</inf> detection at room temperature
2023, Sensors and Actuators B: ChemicalQuantifying the potential effects of air pollution reduction on population health and health expenditure in Taiwan
2023, Environmental PollutionPredict the effect of meteorological factors on haze using BP neural network
2023, Urban Climate