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Air Pollution and Health – A Science-Policy Initiative



Air pollution is a major, preventable and manageable threat to people's health, well-being and the fulfillment of sustainable development. Air pollution is estimated to contribute to at least 5 million premature deaths each year across the world. No one remains unaffected by dirty air, but the adverse impacts of air pollution fall most heavily upon vulnerable populations, such as children, women, and people living in poverty - groups to whom States have special obligations under international human rights law. The National Academies of Sciences and Medicine of South Africa, Brazil, Germany and the United States of America are calling upon government leaders, business and citizens to take urgent action on reducing air pollution throughout the world - to the benefit of human health and well-being, to the benefit of the environment and as a condition towards sustainable development. Air pollution is a cross-cutting aspect of many UN Sustainable Development Goals.
Air pollution is a major, preventable and manageable
threat to people’s health, well-being and the fulfillment
of sustainable development. Air pollution is estimated
to contribute to at least 5 million premature deaths each
year across the world. No one remains unaffected by dirty
air, but the adverse impacts of air pollution fall most heav-
ily upon vulnerable populations, such as children, women,
and people living in poverty — groups to whom States have
special obligations under international human rights law.
Poor air quality threatens human life, population health,
and the future prosperity of children. Air pollution also
threatens the sustainability of the earth’s environment, as
clean air is as vital to life on earth as clean water.
The scientific evidence is unequivocal: air pollution can
harm health across the entire lifespan. It causes disease,
disability and death, and impairs everyone’s quality of life.
It damages lungs, hearts, brains, skin and other organs; it
increases the risk of disease and disability, affecting virtu-
ally all systems in the human body.
The costs of air pollution to society and the economies
of low- and middle-income countries are enormous. These
economic losses are so significant that they can undercut
sustainable development. Economic growth that accepts
air pollution and ignores the public health and environ-
mental impacts is unsustainable and unethical.
Combustion of fossil fuels and biomass is the most sig-
nificant source of air pollution globally. These are also
significant sources of short-lived climate pollutants such
as black carbon, methane, ground-level ozone and the
main sources of CO2 emissions. Many of the solutions to
air pollution issues will also have a positive impact on cli-
mate change mitigation and can make important contri-
butions to meeting a 1.5°C climate target.
Public and private investments in tackling air pollution
are insufficient and do not match the scale of the prob-
lem. Opportunities to create synergies between air pollu-
tion control, climate change mitigation and sustainable
development are many, but have not been fully realized.
Air pollution is a preventable problem. But without
renewed action, air pollution exposure will continue to be
a significant contributor to global mortality. Coupled with
ageing, population growth and urbanization, more people
will suffer and die each year.
Air pollution can be cost-effectively controlled through
a combination of policies, legislation, regulation, stand-
ards and enforcement coupled with implementing new
technologies and increasing social awareness. Air pol-
lution control fosters economic growth and benefits
national economies by averting disease and preventing
productivity losses.
The National Academies of Sciences and Medicine of
South Africa, Brazil, Germany and the United States of
America are calling upon government leaders, business
and citizens to take urgent action on reducing air pol-
lution throughout the world — to the benefit of human
health and well-being, to the benefit of the environment
and as a condition towards sustainable development. Air
pollution is a cross-cutting aspect of many UN Sustainable
Development Goals.
Our five National Academies of Sciences and Medicine
propose the adoption of a global compact on air pollution
to make air pollution control and reduction a priority for all.
Academy of Science of South Africa, et al. Air Pollution and
Health – A Science-Policy Initiative.
Annals of Global Health
85(1):140, 1–9. DOI:
* Academy of Science of South Africa, ZA
Brazilian Academy of Sciences, BR
German National Academy of Sciences Leopoldina, DE
§ U. S. National Academy of Medicine, US
U. S. National Academy of Sciences, US
Corresponding academy: German National Academy of Sciences
Leopoldina (
Air Pollution and Health – A Science-Policy Initiative
Academy of Science of South Africa*
, Brazilian Academy of Sciences, German National
Academy of Sciences Leopoldina, U. S. National Academy of Medicine§ and U. S.
National Academy of Sciences
Air pollution is a major, preventable and manageable threat to people’s health, well-being and the fulllment
of sustainable development. Air pollution is estimated to contribute to at least 5 million premature deaths
each year across the world. No one remains unaected by dirty air, but the adverse impacts of air pollu-
tion fall most heavily upon vulnerable populations, such as children, women, and people living in poverty
— groups to whom States have special obligations under international human rights law. The National
Academies of Sciences and Medicine of South Africa, Brazil, Germany and the United States of America
are calling upon government leaders, business and citizens to take urgent action on reducing air pollution
throughout the world to the benet of human health and well-being, to the benet of the environment
and as a condition towards sustainable development. Air pollution is a cross-cutting aspect of many UN
Sustainable Development Goals.
Academy of Science of South Africa et al: Air Pollution and Health – A Science-Policy InitiativeArt. 140, page 2 of 9
Air Pollution Aects the Health of Everyone
Clean air is essential for life and health. Air pollution is the
largest environmental cause of disease and early death in
the world today. It has been associated with at least 5 million
premature deaths every year. While air pollution impacts
everyone, the burden of disease is highest among the poor
and the powerless, minorities and the marginalized.
Air pollution affects people from the beginning until
the end of life, causing a wide range of acute and chronic
diseases from the earliest stages of child development to
extreme old age. Particularly sensitive populations include
infants in the womb, children, the elderly, and people
with pre-existing chronic diseases. Almost all organs, sys-
tems and processes in the human body may be impacted:
the lungs, the heart, the brain, the vascular system, the
metabolism, and reproduction.
Air pollution is a major cause of pneumonia, bronchitis
and asthma in infants and children. It slows the growth of
the developing lungs of children and adolescents. It con-
tributes to heart disease including cardiac arrhythmias
and acute myocardial infarction, stroke, cancer, asthma,
chronic obstructive pulmonary disease, diabetes, allergies,
eczema, and skin ageing. There is emerging and growing
evidence that air pollution contributes to dementia in
adults and impacts brain development in children.
Women in low-income countries are disproportionately
affected by exposure to household air pollution from the
use of solid fuels (coal and biomass) for cooking, and they
bear the greatest burden of pollution-related disease.
Women also bear the main burden of caring for other
household members suffering from air pollution-related
ill health.
The risks of air pollution vary across societies, with vul-
nerability varying among individuals. Factors that affect
individual vulnerability include age, gender, education,
socioeconomic status, location and residence, fuels used
for cooking and heating, and occupation. Biological fac-
tors that increase individual vulnerability include genetic
susceptibility and underlying diseases, such as asthma,
heart disease or diabetes.
Diseases related to air pollution cause productivity
losses that can reduce gross domestic product, cause work
and school absenteeism, and perpetuate existing societal
inequalities. These diseases also result in health care costs
that in rapidly industrializing countries can consume as
much as 7% of national health budgets.
The global economic burden of disease caused by air
pollution (both outdoor and indoor) across 176 countries
was estimated to be USD 3.8 trillion in 2015. The health
and economic benefits of action against air pollution will
generally far outweigh the costs of action.
There is an ethical imperative to work together to pro-
tect everyone against the health risks of air pollution,
which are sustained by the population as an unpaid
adverse consequence of actions by polluters.
Combustion of Fossil Fuels and Biomass is the
Main Source of Air Pollution
The air pollutants of greatest concern for human health
are airborne particulate matter. The unfiltered emissions
of combustion contain significant concentrations of
ultrafine, fine and large particles, including black carbon,
as well as harmful gases.
Air pollution is a complex mixture of different compo-
nents. Levels of fine particles (PM2.5 mass concentration)
along with ozone serve as a robust indicator for regulatory
purposes; with black carbon as a proxy for emissions from
The main sources of combustion-related air pollution
are: A. stationary combustion facilities; B. household
heating and cooking; C. controlled biomass burning
and waste combustion; and D. mobile sources. The rela-
tive importance of these sources varies from country to
A Stationary sources include power plants, manufac-
turing facilities and mining with limited emission
controls. Facilities that burn coal or other poor qual-
ity fuels or that rely on diesel-powered generators
due to a lack of grid reliability are generally the
worst offenders.
B Households are an important source of air pollution,
especially in low-income countries that rely on bio-
mass fuels for heating and cooking. They are also a
place where people are greatly exposed.
C Controlled biomass burning sources related to agri-
cultural waste burning and to land and forest clear-
ance are important sources of air pollution in devel-
oping countries. Additional uncontrolled biomass
burning is related to residential and other waste
D Mobile sources of air pollution include petroleum-
powered cars, trucks, and buses; in both the pri-
vate and public sectors. They are the main source
of air pollution in cities. Old and poorly maintained
vehicles that burn low-grade fuels are especially
hazardous. Emissions from ships and aircraft are the
major mobile sources of air pollution near ports and
There are synergies between air pollution control and
climate change mitigation as they share common sources
and, to a large extent, solutions; while the majority of air
pollutants also impact the climate. They also aggravate
each other in multiple ways, e.g. greenhouse gases, such
as methane, contribute to the formation of ground-level-
ozone, and levels of ground-level ozone increase with
rising temperatures and rising temperatures increase the
frequency of wildfires; which in turn further elevate levels
of particulate air pollution.
Black carbon from combustion impacts health but also
regional temperatures, precipitation and extreme weather.
The Arctic and glaciated regions such as the Himalayas are
particularly vulnerable to melting as a result of deposited
black carbon which heats the surface. Changing rain pat-
terns from black carbon aerosol-cloud interactions can
have far-reaching consequences for both ecosystems and
human livelihoods, for example by disrupting monsoons,
and droughts which are critical for agriculture in large
parts of Asia and Africa.
Academy of Science of South Africa et al: Air Pollution and Health – A Science-Policy Initiative Art. 140, page 3 of 9
Call to Action
The five National Academies of Sciences and Medicine
of South Africa, Brazil, Germany and the United States of
America are issuing a call to action to government leaders,
business and citizens to reduce air pollution in all coun-
tries. This call is underpinned by unequivocal scientific
evidence on the health impacts of air pollution.
Many existing agreements, resolutions, conventions
and initiatives already address aspects of air pollu-
tion. These include the Montreal Protocol, the United
Nations Economic Commission for Europe Convention
on Long-range Transboundary Air Pollution, the WHO
Framework Convention on Tobacco Control, and the
World Health Assembly resolution on the health impact
of air pollution.
Therefore, the Academies propose adoption of a global
compact on air pollution. This would ensure sustained
engagement at the highest level and make air pollution
control and reduction a priority for all. It would also
encourage policymakers and other key partners, includ-
ing the private sector, to integrate emission control and
reduction into national and local planning, development
processes, and business and finance strategies. For such
a process to be successful, there would need to be both
political leadership and partnerships including working
together with existing multinational structures.
The Academies recognize that no perfect solution fits
all situations in all countries. Nevertheless, urgent action
is needed in the following areas:
There are many policy and technological solutions to
reduce harmful products of combustion. For stationary
sources this includes implementation of emission con-
trols for industry and power plants or changing to clean
fuels. For households this includes provision of access to
clean household fuels. For controlled biomass burning
this includes enforcement of rules to eliminate garbage
burning and new agricultural techniques to reduce crop
burning. For mobile sources this includes promoting
and investing in sustainable mass transport and urban
Effective policies and technologies need to be shared.
Where applicable, these strategies should urgently be put
into action in countries at every level of economic devel-
opment across the world. Some solutions enjoy a high
degree of consensus. Where that consensus is lacking or
where the policy choice depends importantly on context
(given the heterogeneity in legal systems, geography, eco-
nomic development stage, sources of pollution), tailoring
of policies is needed, although there are universal actions
that are needed in many parts of the world.
There is a need to collect the success stories in control-
ling air pollution from cities and countries and to extract
lessons from those stories and share those lessons with
countries now beginning to grapple with the issue.
Population exposure is directly related to population
density, pollutant concentration and duration of expo-
sure. In optimizing the costs and benefits of actions taken
to improve air quality priority should be given to the pol-
lution sources where population exposure can be reduced
cost-effectively, and to reducing exposures to the poorest
members of society, recognizing that these two metrics
may at times conflict.
Sufficient monitoring of key pollution metrics, espe-
cially PM2.5 concentrations and population exposures, is
a critical need in all countries. An additional need is for
follow-on statistical analyses that can be used to assess the
success of policy actions.
Co-benefits amongst policy instruments need to be
identified. Priority should be given to policies that maximize
synergies across multiple development goals, including
climate change mitigation and food security. Energy effi-
ciency improvements provide reductions in both CO2 and
harmful products of combustion, as do many other strate-
gies to mitigate climate change such as greater reliance on
renewable energy and electrification of transport.
Efforts need to be made to devise strategies for the
implementation of solutions. These strategies may
include building institutional capacity, improving gov-
ernance, and fostering mechanisms for cross-agency
collaborations and enforcement. Using the tools of risk
assessment and cost-benefit analysis will help in choosing
policy designs and targets. Air pollution control policies
should be designed to deliver cost-effective reductions
in exposures. Ideally, they should also deliver benefits in
other areas, such as climate, or other sectors, such as agri-
culture. Polluters could be incentivized to find the cheap-
est ways of reducing pollution and thereby exposures.
This call for action requires mobilizing finance and
substantial investment in opportunities to reduce air
pollution. Increased funding is also needed for research,
pollution monitoring, infrastructure, management and
control, and stakeholder interaction.
Finally, there needs to be advocacy for action where
citizens are informed and inspired to reduce their air
pollution footprint and advocate for bold commitments
from the public and private sectors.
This statement has first been published in June 2019. It is
available in all official UN-languages and in German and
Portuguese on
Author Information
Academies Working Group
Maria de Fatima Andrade, Professor of Meteorology and
Atmospheric Sciences, University of São Paulo, São Paulo,
Paulo Artaxo, Professor of Environmental Physics,
University of São Paulo, São Paulo, Brazil.
Simone Georges El Khouri Miraglia, Associate Professor
and Leader of the Laboratory of Economics, Health and
Environmental Pollution (LESPA), Federal University of
São Paulo, São Paulo, Brazil.
Nelson Gouveia, Associate Professor of Epidemiology,
University of São Paulo, São Paulo, Brazil.
Alan J. Krupnick, Senior Fellow, Resources for the Future,
Washington, DC, U.S.A.
Jean Krutmann, Scientific Director, IUF — Leibniz Research
Institute for Environmental Medicine, Düsseldorf,
Academy of Science of South Africa et al: Air Pollution and Health – A Science-Policy InitiativeArt. 140, page 4 of 9
Philip J. Landrigan, Professor of Biology and Director,
Program in Global Public Health and the Common Good,
Boston College, Boston, U.S.A.
Kristy Langerman, Senior Lecturer, University of
Johannesburg, Johannesburg, South Africa.
Tafadzwa Makonese, Senior Researcher and Lab Manager,
University of Johannesburg, Johannesburg, South Africa.
Angela Mathee, Director MRC Environment & Health
Research Unit, South African Medical Research Council
(SAMRC), Johannesburg, South Africa.
Stuart Piketh, Professor of Environmental Science,
North-West University, Potchefstroom, South Africa.
Beate Ritz, Professor of Epidemiology and Environmental
Health Sciences, University of California, Los Angeles,
Paulo H. N. Saldiva, Director, Institute of Advanced Studies,
University of São Paulo, São Paulo, Brazil.
Jonathan Samet, Dean, Colorado School of Public Health,
Aurora, U.S.A.
Tamara Schikowski, Head of Research Group
“Environmental epidemiology of lung, brain and skin
aging”, IUF — Leibniz Research Institute for Environmen-
tal Medicine, Düsseldorf, Germany.
Alexandra Schneider, Head of Research Group
“Environmental Risks”, Institute of Epidemiology,
Helmholtz Zentrum München — German Research Center
for Environmental Health, Neuherberg, Germany.
Kirk R. Smith, Professor of Global Environmental Health,
University of California, Berkeley, U.S.A. and Director,
Collaborative Clean Air Policy Centre, Delhi, India.
Claudia Traidl-Hoffmann, Chair and Institute of
Environmental Medicine, UNIKA-T, Technical University
of Munich and Helmholtz Zentrum München — German
Research Center for Environmental Health, Augsburg,
Alfred Wiedensohler, Head of Department for
Experimental Aerosol and Cloud Microphysics, Leibniz
Institute for Tropospheric Research, Leipzig, Germany.
Caradee Wright, Specialist Scientist, South African Medical
Research Council (SAMRC), Parktown, South Africa.
Invited External Experts
David Richard Boyd, United Nations Special Rapporteur on
Human Rights and the Environment, Office of the United
Nations High Commissioner for Human Rights (OHCHR),
Geneva, Switzerland.
Valentin Foltescu, Senior Science and Programme Officer,
Climate and Clean Air Coalition Secretariat, United
Nations Environment, New Delhi, India.
Richard Fuller, Lancet Commission on Pollution and
Health Co-Chair, Pure Earth and Global Alliance on Health
and Pollution, New York, U.S.A.
Dorota Jarosińska, Programme Manager, World Health
Organization, European Centre for Environment and
Health, Bonn, Germany.
Jacqueline Myriam McGlade Former Chief Scientist,
United Nations Environment, Nairobi, Kenya.
Drew Shindell, Duke University Durham, NC, U.S.A. and
Chair of the Scientific Advisory Panel, Climate and Clean
Air Coalition, Paris, France.
Marcos Cortesao Barnsley Scheuenstuhl, Executive
Director of International Affairs, Brazilian Academy of
Sciences (ABC), Rio de Janeiro, Brazil.
John P. Boright, Director of International Affairs, U.S.
National Academy of Sciences (NAS), Washington, DC,
Siyavuya Bulani, Senior Liaison Officer, Academy of
Science of South Africa (ASSAf), Pretoria, South Africa.
Margaret Hamburg, Foreign Secretary, U.S. National
Academy of Medicine (NAM), Washington, DC, U.S.A.
Kathrin Happe, Deputy Head of Department of Science —
Policy — Society, German National Academy of Sciences
Leopoldina, Halle (Saale), Germany.
Jan Nissen, Senior Officer, Department of International
Relations, German National Academy of Sciences Leopol-
dina, Halle (Saale), Germany.
Isabel Scheer, Assistant, Department of International Rela-
tions, German National Academy of Sciences Leopoldina,
Halle (Saale), Germany.
Funding Statement
Funding for this article was provided by the US National
Academy of Sciences and the US National Academy of
Competing Interests
The authors have no competing interests to declare.
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How to cite this article: Academy of Science of South Africa, Brazilian Academy of Sciences, German National Academy of
Sciences Leopoldina, U. S. National Academy of Medicine and U. S. National Academy of Sciences. Air Pollution and Health – A
Science-Policy Initiative.
Annals of Global Health
. 2019; 85(1):140, 1–9. DOI:
Published: 16 December 2019
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Background. Globally, a growing body of research has shown that ambient air pollution is one of the most critical environmental issues, especially in relation to human health. Exposure to ambient air pollution leads to serious health conditions such as lower respiratory infections, cancers, diabetes mellitus type 2, ischaemic heart disease, stroke and chronic obstructive pulmonary disease. Objectives. To estimate the burden of disease attributable to ambient air pollution in South Africa (SA) for the years 2000, 2006 and 2012. Methods. Comparative risk assessment method was used to determine the burden of disease due to two pollutants (particulate matter (PM2.5) and ambient ozone). Regionally optimised fully coupled climate chemistry models and surface air pollution observations were used to generate concentrations of PM2.5 and ozone for each SA Census Small Area Level, for the year 2012. For 2000 and 2006, population-weighted PM2.5 and ozone were estimated, based on the 2012 results. Following the identification of disease outcomes associated with particulate matter with aerodynamic diameter <2.5 µm (PM2.5) and ozone exposure, the attributable burden of disease was estimated for 2000, 2006 and 2012. Furthermore, for the year 2012, the burden of disease attributable to ambient air pollution exposure was computed at provincial levels. Results. In 2012, approximately 97.6% of people in SA were exposed to PM2.5 at levels above the 2005 World Health Organization guideline: 10 μg/m3 annual mean. From 2000 to 2012, population-weighted annual average PM2.5 increased from 26.6 μg/m3 to 29.7 μg/m3 , and ozone 6-month high 8-hour daily maximum increased from 64.4 parts per billion (ppb) to 72.1 ppb. At a national scale, in the year 2000, 15 619 (95% uncertainty interval (UI) 8 958 - 21 849) deaths were attributed to PM2.5 exposure, while 1 326 (95% UI 534 - 1 885) deaths were attributed to ozone. In 2006, an estimated 19 672 deaths (95% UI 11 526 - 27 086) were attributed to PM2.5, and a further 1 591 deaths (95% UI 651 - 2 236) to ozone exposure. In 2012, deaths attributed to PM2.5 were 19 507 (95% UI 11 318 - 27 111), and to ozone 1 734 (95% UI 727 - 2 399). Additionally, population-weighted provincial scale analysis showed that Gauteng Province had the highest number of attributable deaths due to both PM2.5 and ozone in 2012. Conclusion. The study showed that ambient air pollution exposure is an important health risk in SA, requiring both short- and long-term intervention. In the short term, the SA Ambient Air Quality Standards and industrial minimum emissions standards need to be enforced. In the longer term, to reduce air pollution and the associated disease burden, the combustion of fossil fuels as a source of energy for power generation and transportation, as well as industrial and domestic uses, needs to be replaced with clean renewable energy sources. In addition to local measures, when the southern African prevalent anticyclonic air dynamics that transport regionally emitted pollutants into SA (especially from biomass burning) are considered, it is also advisable to establish long-term regional co-operation in reducing air pollution.
... Este fenómeno se ha visto particularmente con el material particulado (PM), los óxidos de nitrógeno (NO 3 ) y el dióxido de azufre (SO 2 ). 5,6 Un análisis sistemático encontró que las PM 2.5 y el NO 2 están más asociados con la mortalidad por Covid-19 que las PM 10 ; además se observó una asociación significativa entre las concentraciones ambientales de PM 2.5 y el aumento en la incidencia de Covid-19, principalmente en China, Italia y Estados Unidos. 7 En contraste, en Corea se halló una asociación significativa no lineal entre la temperatura diaria y las concentraciones de NO 2 , SO 2 , y CO respecto de los casos confirmados de Covid-19. ...
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Objetivo: Analizar la asociación de la concentración de con-taminantes atmosféricos y los indicadores epidemiológicos de Covid-19 en la Zona Metropolitana del Valle de México (ZMVM). Material y métodos. Se diseñó un estudio epidemiológico ecológico. Se utilizaron modelos lineales tipo Poisson para variables de conteo y modelos lineales de efectos aleatorios en variables continuas para cuantificar la asociación entre los contaminantes atmosféricos y los indicadores de Covid-19. Los datos obtenidos fueron del 28 de febrero de 2020 al 30 de junio de 2021. La exposición a contaminantes se estratificó por estaciones climáticas. Resultados: Los contaminantes que tuvieron asociación significativa con indicadores de morbilidad y mortalidad fueron CO, NOX, O3 y PM10. En la estación seca fría el CO y el NOX tuvieron efecto sobre los casos diarios confirmados y las defunciones diarias. Las PM10 se asociaron con efecto en los indicadores de casos diarios confirmados, incidencia diaria, porcentaje de hospitalizados y la tasa de letalidad. Conclusiones: Los resultados sugieren una asociación entre el comportamiento epidemiológico de Covid-19 y la exposición a CO, NOX, O3 y PM10, en la que se encontró un mayor efecto en la estación seca-fría en la ZMVM.
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Air pollution and poor air quality is impacting human health globally and is a major cause of respiratory and cardiovascular disease and damage to human organ systems. Automated air quality monitoring stations continuously record airborne pollutant concentrations, but are restricted in number, costly to maintain and cannot document all spatial variability of airborne pollutants. Biomonitors, such as lichens, are commonly used as an inexpensive alternative to assess the degree of pollution and monitor air quality. However, only a few studies combined lichen carbon, nitrogen and sulfur contents, with their stable-isotope-ratio signatures (δ¹³C, δ¹⁵N and δ³⁴S values) to assess spatial variability of air quality and to ‘fingerprint’ potential pollution sources. In this study, a high-spatial resolution lichen biomonitoring approach (using Xanthoria parietina and Physcia spp.) was applied to the City of Manchester (UK), the centre of the urban conurbation Greater Manchester, including considerations of its urban characteristics (e.g., building heights and traffic statistics), to investigate finer spatial detail urban air quality. Lichen wt% N and δ¹⁵N signatures, combined with lichen nitrate (NO3⁻) and ammonium (NH4⁺) concentrations, suggest a complex mixture of airborne NOx and NHx compounds across Manchester. In contrast, lichen S wt%, combined with δ³⁴S strongly suggest anthropogenic sulfur sources, whereas C wt% and δ¹³C signatures were not considered reliable indicators of atmospheric carbon emissions. Manchester’s urban attributes were found to influence lichen pollutant loadings, suggesting deteriorated air quality in proximity to highly trafficked roads and densely built-up areas. Lichen elemental contents and stable-isotope-ratio signatures can be used to identify areas of poor air quality, particularly at locations not covered by automated air quality measurement stations. Therefore, lichen biomonitoring approaches provide a beneficial method to supplement automated monitoring stations and also to assess finer spatial variability of urban air quality. Graphical abstract
Pollution from fine particulate matter (PM2.5) has become a major threat to public health and has been related to lung toxicity. One of the key regulators of the Hippo signaling system, Yes-associated protein 1 (YAP1), is speculated to play a role in ferroptosis development. Here, we focused on investigating the function of YAP1 in pyroptosis and ferroptosis, aiming to explore its therapeutic potential in PM2.5-induced lung toxicity. PM2.5-induced lung toxicity was induced in Wild-type WT and conditional YAP1-knockout mice, and lung epithelial cells were stimulatd by PM2.5 in vitro. We used western blot, transmission electron microscopy, and fluorescence microscopy to investigate pyroptosis- and ferroptosis-related characteristics. We found that PM2.5 leads to lung toxicity using mechanisms involving pyroptosis and ferroptosis. YAP1 knockdown impeded pyroptosis, ferroptosis, and PM2.5-induced lung damage, as shown by increased histopathology, higher levels of proinflammatory cytokines, GSDMD protein, lipid peroxidation, and iron accumulation, as well as increased NLRP3 inflammasome activation and decreased SLC7A11 expression. YAP1 silencing consistently promoted NLRP3 inflammasome activation and reduced SLC7A11 levels, aggravating PM2.5-induced cellular damage. In contrast, YAP1-overexpressing cells inhibited NLRP3 inflammasome activation and increased SLC7A11 levels, preventing pyroptosis and ferroptosis. Overall, our data suggest that YAP1 ameliorates PM2.5-induced lung injury by inhibiting NLRP3-mediated pyroptosis and SL7A11-dependent ferroptosis.
The coronavirus disease 2019 (COVID-19) pandemic had a transformational impact on public policy as governments played a leading role, working alongside and coordinating with business/industry, healthcare, public health, education, transportation, researchers, non-governmental organizations, philanthropy, and media/communications. This paper summarizes the impact of the pandemic on different areas of public policy affecting healthy living and cardiovascular health including prevention (i.e., nutrition, physical activity, air quality, tobacco use), risk factors for chronic disease (hypertension, diabetes, obesity, substance abuse), access to health care, care delivery and payment reform, telehealth and digital health, research, and employment policy. The paper underscores where public policy is evolving and where there are needs for future evidence base to inform policy development, and the intersections between the public and private sectors across the policy continuum. There is a continued need for global multi-sector coordination to optimize population health.
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Background: Lisbon has about 500,000 inhabitants and it's the capital and the main economic hub of Portugal. Studies have demonstrated that exposure to Particulate Matter with an aerodynamic diameter<2.5μm (PM2.5) have strong association with health effects. Researchers continue to identify new harmful air pollutants effects in our health even in low levels. Objectives: This study evaluates air pollution scenarios considering a Health Impact Assessment approach in Lisbon, Portugal. Methods: We have studied abatement scenarios of PM2.5 concentrations and the health effects in the period from 2015 to 2017 using the APHEKOM tool and the associated health costs were assessed by Value of Life Year. Results: The mean concentration of PM2.5 in Lisbon was 23μg/m3±10μg/m3 (±Standard Deviation). If we consider that World Health Organization (WHO) standards of PM2.5 (10μg/m3) were reached, Lisbon would avoid more than 423 premature deaths (equivalent to 9,172 life years' gain) and save more than US$45 million annually. If Lisbon city could even diminish the mean of PM2.5 by 5μg/m3, nearly 165 deaths would be avoided, resulting in a gain of US$17 million annually. Conclusion: According to our findings, reduced levels of PM2.5 could improve the life's quality and save a significant amount of economic resources.
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We present a suite of nine scenarios of future emissions trajectories of anthropogenic sources, a key deliverable of the ScenarioMIP experiment within CMIP6. Integrated assessment model results for 14 different emissions species and 13 emissions sectors are provided for each scenario with consistent transitions from the historical data used in CMIP6 to future trajectories using automated harmonization before being downscaled to provide higher emissions source spatial detail. We find that the scenarios span a wide range of end-of-century radiative forcing values, thus making this set of scenarios ideal for exploring a variety of warming pathways. The set of scenarios is bounded on the low end by a 1.9 W m⁻² scenario, ideal for analyzing a world with end-of-century temperatures well below 2 ∘C, and on the high end by a 8.5 W m⁻² scenario, resulting in an increase in warming of nearly 5 ∘C over pre-industrial levels. Between these two extremes, scenarios are provided such that differences between forcing outcomes provide statistically significant regional temperature outcomes to maximize their usefulness for downstream experiments within CMIP6. A wide range of scenario data products are provided for the CMIP6 scientific community including global, regional, and gridded emissions datasets.
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Exposure to ambient air pollution and noise is ubiquitous globally. A strong body of evidence links air pollution, and recently noise, to cardiovascular conditions that eventually may also affect cognition in the elderly. Data that support a broader influence of these exposures on cognitive function during aging is just starting to emerge. This review summarizes current findings and discusses methodological challenges and opportunities for research. Although current evidence is still limited, especially for chronic noise exposure, high exposure has been associated with faster cognitive decline either mediated through cerebrovascular events or resulting in Alzheimer's disease. Ambient environmental exposures are chronic and affect large populations. While they may yield relatively modest-sized risks, they nevertheless result in large numbers of cases. Reducing environmental pollution is clearly feasible, though lowering levels requires collective action and long-term policies such as standard setting, often at the national level as well as at the local level.
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The current report presents an updated overview and analysis of air quality in Europe from 2000 to 2016. It reviews the progress made towards meeting the air quality standards established in the two EU Ambient Air Quality Directives and towards the World Health Organization (WHO) air quality guidelines (AQGs). It also presents the latest findings and estimates on population and ecosystem exposure to the air pollutants with the greatest impacts and effects. The evaluation of the status of air quality is based mainly on reported ambient air measurements, in conjunction with modelling data and data on anthropogenic emissions and their evolution over time.
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Background: Air pollution is a major planetary health risk, with India estimated to have some of the worst levels globally. To inform action at subnational levels in India, we estimated the exposure to air pollution and its impact on deaths, disease burden, and life expectancy in every state of India in 2017. Methods: We estimated exposure to air pollution, including ambient particulate matter pollution, defined as the annual average gridded concentration of PM2.5, and household air pollution, defined as percentage of households using solid cooking fuels and the corresponding exposure to PM2.5, across the states of India using accessible data from multiple sources as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. The states were categorised into three Socio-demographic Index (SDI) levels as calculated by GBD 2017 on the basis of lag-distributed per-capita income, mean education in people aged 15 years or older, and total fertility rate in people younger than 25 years. We estimated deaths and disability-adjusted life-years (DALYs) attributable to air pollution exposure, on the basis of exposure-response relationships from the published literature, as assessed in GBD 2017; the proportion of total global air pollution DALYs in India; and what the life expectancy would have been in each state of India if air pollution levels had been less than the minimum level causing health loss. Findings: The annual population-weighted mean exposure to ambient particulate matter PM2·5 in India was 89·9 μg/m3 (95% uncertainty interval [UI] 67·0-112·0) in 2017. Most states, and 76·8% of the population of India, were exposed to annual population-weighted mean PM2·5 greater than 40 μg/m3, which is the limit recommended by the National Ambient Air Quality Standards in India. Delhi had the highest annual population-weighted mean PM2·5 in 2017, followed by Uttar Pradesh, Bihar, and Haryana in north India, all with mean values greater than 125 μg/m3. The proportion of population using solid fuels in India was 55·5% (54·8-56·2) in 2017, which exceeded 75% in the low SDI states of Bihar, Jharkhand, and Odisha. 1·24 million (1·09-1·39) deaths in India in 2017, which were 12·5% of the total deaths, were attributable to air pollution, including 0·67 million (0·55-0·79) from ambient particulate matter pollution and 0·48 million (0·39-0·58) from household air pollution. Of these deaths attributable to air pollution, 51·4% were in people younger than 70 years. India contributed 18·1% of the global population but had 26·2% of the global air pollution DALYs in 2017. The ambient particulate matter pollution DALY rate was highest in the north Indian states of Uttar Pradesh, Haryana, Delhi, Punjab, and Rajasthan, spread across the three SDI state groups, and the household air pollution DALY rate was highest in the low SDI states of Chhattisgarh, Rajasthan, Madhya Pradesh, and Assam in north and northeast India. We estimated that if the air pollution level in India were less than the minimum causing health loss, the average life expectancy in 2017 would have been higher by 1·7 years (1·6-1·9), with this increase exceeding 2 years in the north Indian states of Rajasthan, Uttar Pradesh, and Haryana. Interpretation: India has disproportionately high mortality and disease burden due to air pollution. This burden is generally highest in the low SDI states of north India. Reducing the substantial avoidable deaths and disease burden from this major environmental risk is dependent on rapid deployment of effective multisectoral policies throughout India that are commensurate with the magnitude of air pollution in each state. Funding: Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
A limited number of studies have addressed environmental inequality, using various study designs and methodologies and often reaching contradictory results. Following a standardized multi-city data collection process within the European project EURO-HEALTHY, we conducted an ecological study to investigate the spatial association between nitrogen dioxide (NO 2 ), as a surrogate for traffic related air pollution, and ten socioeconomic indicators at local administrative unit level in nine European Metropolitan Areas. We applied mixed models for the associations under investigation with random intercepts per Metropolitan Area, also accounting for the spatial correlation. The stronger associations were observed between NO 2 levels and population density, population born outside the European Union (EU28), total crimes per 100,000 inhabitants and unemployment rate that displayed a highly statistically significant trend of increasing concentrations with increasing levels of the indicators. Specifically, the highest vs the lowest quartile of each indicator above was associated with 48.7% (95% confidence interval (CI): 42.9%, 54.8%), 30.9% (95%CI: 22.1%, 40.2%), 19.8% (95%CI: 13.4%, 26.6%) and 15.8% (95%CI: 9.9%, 22.1%) increase in NO 2 respectively. The association with population density most probably reflects the higher volume in vehicular traffic, which is the main source of NO 2 in urban areas. Higher pollution levels in areas with higher percentages of people born outside EU28, crime or unemployment rates indicate that worse air quality is typically encountered in deprived European urban areas. Policy makers should consider spatial environmental inequalities to better inform actions aiming to lower urban air pollution levels that will subsequently lead to improved quality of life, public health and health equity across the population.
Objective: To investigate the relationship between acute exposure to air pollutants and spontaneous pregnancy loss. Design: Case-crossover study from 2007 to 2015. Setting: An academic emergency department in the Wasatch Front area of Utah. Patient(s): A total of 1,398 women who experienced spontaneous pregnancy loss events. Intervention(s): None. Main outcome measure(s): Odds of spontaneous pregnancy loss. Result(s): We found that a 10-ppb increase in 7-day average levels of nitrogen dioxide was associated with a 16% increase in the odds of spontaneous pregnancy loss (odds ratio [OR] = 1.16; 95% confidence interval [CI] 1.01-1.33; P=.04). A 10-μg/m3 increase in 3-day and 7-day averages of fine particulate matter were associated with increased risk of spontaneous pregnancy loss, but the associations did not reach statistical significance (OR3-day average = 1.09; 95% CI 0.99-1.20; P=.05) (OR7-day average = 1.11; 95% CI 0.99-1.24; P=.06). We found no evidence of increased risk for any other metrics of nitrogen dioxide or fine particulate matter or any metric for ozone. Conclusions: We found that short-term exposure to elevated levels of air pollutants was associated with higher risk for spontaneous pregnancy loss.