Randall V. Martin

BackgroundExposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels.MethodsWe estimated global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2·5 μm (PM2·5) and ozone at an approximate 11 km × 11 km resolution with satellite-based estimates, chemical transport models, and ground-level measurements. Using integrated exposure–response functions for each cause of death, we estimated the relative risk of mortality from ischaemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, and lower respiratory infections from epidemiological studies using non-linear exposure–response functions spanning the global range of exposure.FindingsAmbient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015.InterpretationAmbient air pollution contributed substantially to the global burden of disease in 2015, which increased over the past 25 years, due to population ageing, changes in non-communicable disease rates, and increasing air pollution in low-income and middle-income countries. Modest reductions in burden will occur in the most polluted countries unless PM2·5 values are decreased substantially, but there is potential for substantial health benefits from exposure reduction.FundingBill & Melinda Gates Foundation and Health Effects Institute.

Exposure to ambient fine particulate matter (PM 2.5 ) is a major global health concern. Quantitative estimates of attributable mortality are based on disease-specific hazard ratio models that incorporate risk information from multiple PM 2.5 sources (outdoor and indoor air pollution from use of solid fuels and secondhand and active smoking), requiring assumptions about equivalent exposure and toxicity. We relax these contentious assumptions by constructing a PM 2.5 -mortality hazard ratio function based only on cohort studies of outdoor air pollution that covers the global exposure range. We modeled the shape of the association between PM 2.5 and nonaccidental mortality using data from 41 cohorts from 16 countries—the Global Exposure Mortality Model (GEMM). We then constructed GEMMs for five specific causes of death examined by the global burden of disease (GBD). The GEMM predicts 8.9 million [95% confidence interval (CI): 7.5–10.3] deaths in 2015, a figure 30% larger than that predicted by the sum of deaths among the five specific causes (6.9; 95% CI: 4.9–8.5) and 120% larger than the risk function used in the GBD (4.0; 95% CI: 3.3–4.8). Differences between the GEMM and GBD risk functions are larger for a 20% reduction in concentrations, with the GEMM predicting 220% higher excess deaths. These results suggest that PM 2.5 exposure may be related to additional causes of death than the five considered by the GBD and that incorporation of risk information from other, nonoutdoor, particle sources leads to underestimation of disease burden, especially at higher concentrations.

The Georgia Institute of Technology–Goddard Global Ozone Chemistry Aerosol Radiation and Transport (GOCART) model is used to simulate the aerosol optical thickness � for major types of tropospheric aerosols including sulfate, dust, organic carbon (OC), black carbon (BC), and sea salt. The GOCART model uses a dust emission algorithm that quantifies the dust source as a function of the degree of topographic depression, and a biomass burning emission source that includes seasonal and interannual variability based on satellite observations. Results presented here show that on global average, dust aerosol has the highest � at 500 nm (0.051), followed by sulfate (0.040), sea salt (0.027), OC (0.017), and BC (0.007). There are large geographical and seasonal variations of �, controlled mainly by emission, transport, and hygroscopic properties of aerosols. The model calculated total �s at 500 nm have been compared with the satellite retrieval products from the Total Ozone Mapping Spectrometer (TOMS) over both land and ocean and from the Advanced Very High Resolution Radiometer (AVHRR) over the ocean. The model reproduces most of the prominent features in the satellite data, with an overall agreement within a factor of 2 over the aerosol source areas and outflow regions. While there are clear differences among the satellite products, a major discrepancy between the model and the satellite data is that the model shows a stronger variation of � from source to remote regions. Quantitative comparison of

BACKGROUND: Epidemiologic and health impact studies of fine particulate matter with diameter < 2.5 microm (PM2.5) are limited by the lack of monitoring data, especially in developing countries. Satellite observations offer valuable global information about PM2.5 concentrations. OBJECTIVE: In this study, we developed a technique for estimating surface PM2.5 concentrations from satellite observations. METHODS: We mapped global ground-level PM2.5 concentrations using total column aerosol optical depth (AOD) from the MODIS (Moderate Resolution Imaging Spectroradiometer) and MISR (Multiangle Imaging Spectroradiometer) satellite instruments and coincident aerosol vertical profiles from the GEOS-Chem global chemical transport model. RESULTS: We determined that global estimates of long-term average (1 January 2001 to 31 December 2006) PM2.5 concentrations at approximately 10 km x 10 km resolution indicate a global population-weighted geometric mean PM2.5 concentration of 20 microg/m3. The World Health Organization Air Quality PM2.5 Interim Target-1 (35 microg/m3 annual average) is exceeded over central and eastern Asia for 38% and for 50% of the population, respectively. Annual mean PM2.5 concentrations exceed 80 microg/m3 over eastern China. Our evaluation of the satellite-derived estimate with ground-based in situ measurements indicates significant spatial agreement with North American measurements (r = 0.77; slope = 1.07; n = 1057) and with noncoincident measurements elsewhere (r = 0.83; slope = 0.86; n = 244). The 1 SD of uncertainty in the satellite-derived PM2.5 is 25%, which is inferred from the AOD retrieval and from aerosol vertical profile errors and sampling. The global population-weighted mean uncertainty is 6.7 microg/m3. CONCLUSIONS: Satellite-derived total-column AOD, when combined with a chemical transport model, provides estimates of global long-term average PM2.5 concentrations.

Exposure to ambient air pollution is a major risk factor for global disease. Assessment of the impacts of air pollution on population health and evaluation of trends relative to other major risk factors requires regularly updated, accurate, spatially resolved exposure estimates. We combined satellite-based estimates, chemical transport model simulations, and ground measurements from 79 different countries to produce global estimates of annual average fine particle (PM2.5) and ozone concentrations at 0.1° × 0.1° spatial resolution for five-year intervals from 1990 to 2010 and the year 2013. These estimates were applied to assess population-weighted mean concentrations for 1990-2013 for each of 188 countries. In 2013, 87% of the world's population lived in areas exceeding the World Health Organization Air Quality Guideline of 10 μg/m(3) PM2.5 (annual average). Between 1990 and 2013, global population-weighted PM2.5 increased by 20.4% driven by trends in South Asia, Southeast Asia, and China. Decreases in population-weighted mean concentrations of PM2.5 were evident in most high income countries. Population-weighted mean concentrations of ozone increased globally by 8.9% from 1990-2013 with increases in most countries-except for modest decreases in North America, parts of Europe, and several countries in Southeast Asia.