New Model Shows Air Pollution Linked With Many More Deaths Than Previously Estimated

Air pollution may be responsible for double the number of excess deaths per year across Europe than previously thought, results from a new study suggest.

The paper, published in the European Heart Journal, used a novel modeling method to determine the associations between air pollution and death rates. Previous research has attempted to capture the extent of the effect of air pollution on cardiovascular disease. The researchers for the study focused on the mechanistic factors that could explain the large impact that air pollution has on cardiovascular disease.

Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions https://t.co/Q0lMwhSvQs @escardio @TomLuscher #EHJ #ESCCoT #openaccess pic.twitter.com/WMn5CUOVFH

— European Society of Cardiology Journals (@ESC_Journals) March 12, 2019

GEMM Model

The authors used exposure data from the Global Exposure Mortality Model (GEMM) and modified the hazard ratio functions of previous research results from 41 cohort studies across 16 European countries. The model, according to the authors, “accounts for a much larger range of air pollution concentrations than the Global Burden of Disease.”

Air pollution, according to the press release accompanying the study, “caused twice as many deaths from cardiovascular disease as from respiratory diseases.” The researchers said that some air pollutants such as PM_2.5, gaseous compounds O₃ and NO₂ (nitrogen dioxide) could potentially be aggravating atherosclerosis “through yet non-explicitly identified risk factors that cause CVD mortality.”

Annual excess mortality rate from ambient air pollution in Europe is 790 000 [(95% CI) 645 000–934 000], and 659 000 (95% CI 537 000–775 000) in the EU-28. Between 40% and 80% are due to cardiovascular events, which dominate health outcomes https://t.co/LOJrlpXSUy #AirPollution

— Nick Hopkinson (@COPDdoc) March 12, 2019

The researchers estimated the overall attributable excess mortality rate to be 8.79 million per year with an overall uncertainty of ±50% and a mean loss of life expectancy of 2.2 years in Europe. In the European Union, the researchers reported between 15% and 28% of the total cardiovascular disease-related mortality (1.85 million deaths per year) was attributable just to air pollution.

Annual excess mortality rate from ambient air pollution in Europe is 790 000 [(95% CI) 645 000–934 000], and 659 000 (95% CI 537 000–775 000) in the EU-28. Between 40% and 80% are due to cardiovascular events, which dominate health outcomes https://t.co/LOJrlpXSUy #AirPollution

— Nick Hopkinson (@COPDdoc) March 12, 2019

A Warning

The authors put the results into simple and stark terms.

“To put this into perspective, this means that air pollution causes more extra deaths a year than tobacco smoking, which the World Health Organization estimates was responsible for an extra 7.2 million deaths in 2015,” said study co-author Dr. Thomas Münzel, of the Department of Cardiology of the University Medical Centre Mainz in Mainz, Germany, in the press release. “The number of deaths from cardiovascular disease that can be attributed to air pollution is much higher than expected. In Europe alone, the excess number of deaths is nearly 800,000 a year and each of these deaths represents an average reduction in life expectancy of more than two years.”

Regarding future research directions, the authors noted that their results suggested a higher disease burden than previously estimated, and that “it will be important to reconcile the air pollution-induced mechanisms responsible for relatively well-established causes of cardiovascular disease and mortality and potentially newly identified ones that contribute to other non-communicable diseases (like hypertension and diabetes).”

#CVD deaths from air #pollution double what was previously thought (& are higher than deaths from #tobacco) @ESCardioNews https://t.co/EAP1am5IAj

— J Partarrieu (@JPartarrieu) March 12, 2019