HTAP2 multi-model estimates of premature human mortality due to intercontinental transport of air pollution

Abstract. Ambient air pollution from ozone and fine particulate matter is associated with premature mortality. As emissions from one continent influence air quality over others, changes in emissions can also influence human health on other continents. We estimate global air pollution-related premature mortality from exposure to PM2.5 and ozone, and the avoided deaths from 20 % anthropogenic emission reductions from six source regions, North America (NAM), Europe (EUR), South Asia (SAS), East Asia (EAS), Russia/Belarus/Ukraine (RBU) and the Middle East (MDE), three emission sectors, Power and Industry (PIN), Ground Transportation (TRN) and Residential (RES) and one global domain (GLO), using an ensemble of global chemical transport model simulations coordinated by the second phase of the Task Force on Hemispheric Transport of Air Pollution (TF-HTAP2), and epidemiologically-derived concentration-response functions. We build on results from previous studies of the TF-HTAP by using improved atmospheric models driven by new estimates of 2010 emissions, with more source and receptor regions, new consideration of source sector impacts, and new epidemiological mortality functions. We estimate 290,000 (95 % CI: 30,000, 600,000) premature O3-related deaths and 2.8 million (0.5 million, 4.6 million) PM2.5-related premature deaths globally for the baseline year 2010. While 20 % emission reductions from one region generally lead to more avoided deaths within the source region than outside, reducing emissions from MDE and RBU can avoid more O3-related deaths outside of these regions than within, and reducing MDE emissions also avoids more PM2.5-related deaths outside of MDE than within. In addition, EUR, MDE and RBU have more avoided O3-related deaths from reducing foreign emissions than from domestic reductions. For six regional emission reductions, the total avoided extraregional mortality is estimated as 10,300 (6,700, 13,400) deaths/year and 42,000 (12,400, 60,100) deaths/year through changes in O3 and PM2.5, respectively. Interregional transport of air pollutants leads to more deaths through changes in PM2.5 than in O3, even though O3 is transported more on interregional scales, since PM2.5 has a stronger influence on mortality. In sectoral emission reductions, TRN emissions account for the greatest fraction (26–53 % of global emission reduction) of O3-related premature deaths in most regions, except for EAS (58 %) and RBU (38 %) where PIN emissions dominate. In contrast, PIN emission reductions have the greatest fraction (38–78 % of global emission reduction) of PM2.5-related deaths in most regions, except for SAS (45 %) where RES emission dominates. The spread of air pollutant concentration changes across models contributes most to the overall uncertainty in estimated avoided deaths, highlighting the uncertainty in results based on a single model. Despite uncertainties, the health benefits of reduced intercontinental air pollution transport suggest that international cooperation may be desirable to mitigate pollution transported over long distances.

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HTAP2 multi-model estimates of premature human mortality due to intercontinental transport of air pollution and emission sectors

Atmospheric Chemistry and Physics ◽

10.5194/acp-18-10497-2018 ◽

2018 ◽

Vol 18 (14) ◽

pp. 10497-10520 ◽

Cited By ~ 18

Author(s):

Ciao-Kai Liang ◽

J. Jason West ◽

Raquel A. Silva ◽

Huisheng Bian ◽

Mian Chin ◽

...

Keyword(s):

Air Pollution ◽

Air Pollutants ◽

Emission Reduction ◽

Premature Mortality ◽

Ambient Air ◽

Second Phase ◽

Emission Reductions ◽

Premature Deaths ◽

Global Emission ◽

Concentration Changes

Abstract. Ambient air pollution from ozone and fine particulate matter is associated with premature mortality. As emissions from one continent influence air quality over others, changes in emissions can also influence human health on other continents. We estimate global air-pollution-related premature mortality from exposure to PM2.5 and ozone and the avoided deaths due to 20 % anthropogenic emission reductions from six source regions, North America (NAM), Europe (EUR), South Asia (SAS), East Asia (EAS), Russia–Belarus–Ukraine (RBU), and the Middle East (MDE), three global emission sectors, power and industry (PIN), ground transportation (TRN), and residential (RES), and one global domain (GLO), using an ensemble of global chemical transport model simulations coordinated by the second phase of the Task Force on Hemispheric Transport of Air Pollutants (TF HTAP2), and epidemiologically derived concentration response functions. We build on results from previous studies of TF HTAP by using improved atmospheric models driven by new estimates of 2010 anthropogenic emissions (excluding methane), with more source and receptor regions, new consideration of source sector impacts, and new epidemiological mortality functions. We estimate 290 000 (95 % confidence interval (CI): 30 000, 600 000) premature O3-related deaths and 2.8 million (0.5 million, 4.6 million) PM2.5-related premature deaths globally for the baseline year 2010. While 20 % emission reductions from one region generally lead to more avoided deaths within the source region than outside, reducing emissions from MDE and RBU can avoid more O3-related deaths outside of these regions than within, and reducing MDE emissions also avoids more PM2.5-related deaths outside of MDE than within. Our findings that most avoided O3-related deaths from emission reductions in NAM and EUR occur outside of those regions contrast with those of previous studies, while estimates of PM2.5-related deaths from NAM, EUR, SAS, and EAS emission reductions agree well. In addition, EUR, MDE, and RBU have more avoided O3-related deaths from reducing foreign emissions than from domestic reductions. For six regional emission reductions, the total avoided extra-regional mortality is estimated as 6000 (−3400, 15 500) deaths per year and 25 100 (8200, 35 800) deaths per year through changes in O3 and PM2.5, respectively. Interregional transport of air pollutants leads to more deaths through changes in PM2.5 than in O3, even though O3 is transported more on interregional scales, since PM2.5 has a stronger influence on mortality. For NAM and EUR, our estimates of avoided mortality from regional and extra-regional emission reductions are comparable to those estimated by regional models for these same experiments. In sectoral emission reductions, TRN emissions account for the greatest fraction (26–53 % of global emission reduction) of O3-related premature deaths in most regions, in agreement with previous studies, except for EAS (58 %) and RBU (38 %) where PIN emissions dominate. In contrast, PIN emission reductions have the greatest fraction (38–78 % of global emission reduction) of PM2.5-related deaths in most regions, except for SAS (45 %) where RES emission dominates, which differs with previous studies in which RES emissions dominate global health impacts. The spread of air pollutant concentration changes across models contributes most to the overall uncertainty in estimated avoided deaths, highlighting the uncertainty in results based on a single model. Despite uncertainties, the health benefits of reduced intercontinental air pollution transport suggest that international cooperation may be desirable to mitigate pollution transported over long distances.

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Impacts of emission changes in China from 2010 to 2017 on domestic and intercontinental air quality and health effect

Atmospheric Chemistry and Physics ◽

10.5194/acp-21-16051-2021 ◽

2021 ◽

Vol 21 (20) ◽

pp. 16051-16065

Author(s):

Yuqiang Zhang ◽

Drew Shindell ◽

Karl Seltzer ◽

Lu Shen ◽

Jean-Francois Lamarque ◽

...

Keyword(s):

Air Pollution ◽

Air Quality ◽

Surface Ozone ◽

Health Effect ◽

Premature Mortality ◽

The United States ◽

Premature Deaths ◽

Concentration Changes ◽

Emission Changes ◽

Pm2.5 Concentration

Abstract. China has experienced dramatic changes in emissions since 2010, which accelerated following the implementation of the Clean Air Action program in 2013. These changes have resulted in significant air quality improvements that are reflected in observations from both surface networks and satellite observations. Air pollutants, such as PM2.5, surface ozone, and their precursors, have long enough lifetimes in the troposphere to be easily transported downwind. Emission changes in China will thus not only change the domestic air quality but will also affect the air quality in other regions. In this study, we use a global chemistry transport model (CAM-chem) to simulate the influence of Chinese emission changes from 2010 to 2017 on both domestic and foreign air quality. We then quantify the changes in air-pollution-associated (including both PM2.5 and O3) premature mortality burdens at regional and global scales. Within our simulation period, the population-weighted annual PM2.5 concentration in China peaks in 2011 (94.1 µg m−3) and decreases to 69.8 µg m−3 by 2017. These estimated national PM2.5 concentration changes in China are comparable with previous studies using fine-resolution regional models, though our model tends to overestimate PM2.5 from 2013 to 2017 when evaluated with surface observations. Relative to 2010, emission changes in China increased the global PM2.5-associated premature mortality burdens through 2013, among which a majority of the changes (∼ 93 %) occurred in China. The sharp emission decreases after 2013 generated significant benefits for human health. By 2017, emission changes in China reduced premature deaths associated with PM2.5 by 108 800 (92 800–124 800) deaths per year globally, relative to 2010, among which 92 % were realized in China. In contrast, the population-weighted, annually averaged maximum daily 8 h ozone concentration peaked in 2014 and did not reach 2010 levels by 2017. As such, O3 generated nearly 8500 (6500–9900) more premature deaths per year in 2017 compared to 2010. Downwind regions, such as South Korea, Japan, and the United States, generally experienced O3 improvements following 2013 due to the decreased export of ozone and its precursors. Overall, we conclude that the sharp emission reductions in China over the past decade have generated substantial benefits for air quality that have reduced premature deaths associated with air pollution at a global scale.

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Ambient Air Quality Measurement with Low-Cost Optical and Electrochemical Sensors: An Evaluation of Continuous Year-Long Operation

Environments ◽

10.3390/environments8110114 ◽

2021 ◽

Vol 8 (11) ◽

pp. 114

Author(s):

Jiří Bílek ◽

Ondřej Bílek ◽

Petr Maršolek ◽

Pavel Buček

Keyword(s):

Air Pollution ◽

Air Quality ◽

Sensor Network ◽

Electrochemical Sensors ◽

Reference Method ◽

Ambient Air ◽

Sensor Data ◽

Dust Particles ◽

Concentration Changes ◽

The Impact

Sensor technology is attractive to the public due to its availability and ease of use. However, its usage raises numerous questions. The general trustworthiness of sensor data is widely discussed, especially with regard to accuracy, precision, and long-term signal stability. The VSB-Technical University of Ostrava has operated an air quality sensor network for more than two years, and its large sets of valid results can help in understanding the limitations of sensory measurement. Monitoring is focused on the concentrations of dust particles, NO2, and ozone to verify the impact of newly planted greenery on the reduction in air pollution. The sensor network currently covers an open field on the outskirts of Ostrava, between Liberty Ironworks and the nearby ISKO1650 monitoring station, where some of the worst air pollution levels in the Czech Republic are regularly measured. In the future, trees should be allowed to grow over the sensors, enabling assessment of the green barrier effect on air pollution. As expected, the service life of the sensors varies from 1 to 3 years; therefore, checks are necessary both prior to the measurement and regularly during operation, verifying output stability and overall performance. Results of the PMx sensory measurements correlated well with the reference method. Concentration values measured by NO2 sensors correlated poorly with the reference method, although timeline plots of concentration changes were in accordance. We suggest that a comparison of timelines should be used for air quality evaluations, rather than particular values. The results showed that the sensor measurements are not yet suitable to replace the reference methods, and dense sensor networks proved useful and robust tools for indicative air quality measurements (AQM).

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Impacts of emission changes in China from 2010 to 2017 on domestic and intercontinental air quality and health effect

10.5194/acp-2021-385 ◽

2021 ◽

Author(s):

Yuqiang Zhang ◽

Drew Shindell ◽

Karl Seltzer ◽

Lu Shen ◽

Jean-Francois Lamarque ◽

...

Keyword(s):

Air Pollution ◽

Air Quality ◽

Air Pollutants ◽

Transport Model ◽

Surface Ozone ◽

Health Effect ◽

Premature Deaths ◽

Concentration Changes ◽

Emission Changes ◽

Related Mortality

Abstract. China has seen dramatic emission changes from 2010, especially after the implementation of Clean Air Action in 2013, with significant air quality and human health benefits observed. Air pollutants, such as PM2.5 and surface ozone, as well as their precursors, have long enough lifetime in the troposphere which can be easily transported downwind. So emission changes in China will not only change the regional air quality domestically, but also affect the air quality in downwind regions. In this study, we use a global chemistry transport model to simulate the influence on both domestic and foreign air quality from the emission change from 2010 to 2017 in China. By applying the health impact functions derived from epidemiology studies, we then quantify the changes in air pollution-related (including both PM2.5 and O3) mortality burdens at regional and global scales. The majority of air pollutants in China reach their peak values around 2012 and 2013. Compared with the year 2010, the population-weighted annual PM2.5 in China increases till 2011 (94.1 μg m−3), and then begins to decrease. In 2017, the population-weighted annual PM2.5 decreases by 17.6 %, compared with the values in 2010 (84.7 μg m−3). The estimated national PM2.5 concentration changes in China are comparable with previous studies using fine-resolution regional models, though our model tends to overestimate PM2.5 from 2013 to 2017 when evaluated with surface observation in China during the same periods. The emission changes in China increased the global PM2.5-related mortality burdens from 2010 to 2013, by 27,700 (95 %CI: 23,900–31, 400) deaths yr−1 in 2011, and 13, 300 (11,400–15,100) deaths yr−1 in 2013, among which at least 93 % occurred in China. The sharp emission decreases after 2013 bring significant benefits for reduced avoided premature mortality in 2017, reaching 108, 800 (92,800–124,800) deaths yr−1 globally, among which 92 % happening in China. Different trend as PM2.5, the annual maximum daily 8-hr ozone in China increased, and also the ozone-related premature deaths, ranging from 3,600 (2,700–4,300) deaths yr−1 in 2011 (75 % of global total increased premature deaths), and 8,500 (6,500–9,900) deaths yr−1 in 2017 (143 % of the global total). Downwind regions, such as South Korea, Japan, and U.S. generally see a decreased O3-related mortality burden after 2013 as a combination of increased export of ozone and decreased export of ozone precursors. In general, we conclude that the sharp emission reductions in China after 2013 bring benefits of improved air quality and reduced premature deaths associated with air pollution at global scale. The benefits are dominated by the PM2.5 decreases since the ozone is shown to actually increase with the emission decrease.

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Deaths Attributable to Air Pollution in Nordic Countries: Disparities in the Estimates

Atmosphere ◽

10.3390/atmos11050467 ◽

2020 ◽

Vol 11 (5) ◽

pp. 467 ◽

Cited By ~ 1

Author(s):

Heli Lehtomäki ◽

Camilla Geels ◽

Jørgen Brandt ◽

Shilpa Rao ◽

Katarina Yaramenka ◽

...

Keyword(s):

Air Pollution ◽

Spatial Resolution ◽

Premature Mortality ◽

Ambient Air ◽

Nordic Countries ◽

Assessment Tools ◽

Ambient Air Pollution ◽

Exposure Model ◽

Separate Analysis ◽

Response Functions

Particulate matter air pollution is widely considered as the leading environmental cause of premature mortality. However, there are substantial differences in the estimated health burden between the assessments. The aim of this work is to quantify the deaths attributable to ambient air pollution in Nordic countries applying selected assessment tools and approaches, and to identify the main disparities. We quantified and compared the estimated deaths from three health risk assessment tools and from a set of different concentration-response functions. A separate analysis was conducted for the impacts of spatial resolution of the exposure model on the estimated deaths. We found that the death rate (deaths per million) attributable to PM2.5 and O3 were the highest in Denmark and the lowest in Iceland. In the five Nordic countries, the results between the three tools ranged from 8500 to 11,400 for PM2.5 related deaths, and for ozone from 230 to 260 deaths in 2015. Substantially larger differences were found between five concentration-response functions. The shape of concentration-response functions, and applied theoretical thresholds led to substantial differences in the estimated deaths. Nordic countries are especially sensitive to theoretical thresholds due to low exposures. Sensitivity analysis demonstrated that when using spatial exposure assessment methods, high spatial resolution is necessary to avoid underestimation of exposures and health effects.

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Effects of atmospheric transport and trade on air pollution mortality in China

Atmospheric Chemistry and Physics ◽

10.5194/acp-17-10367-2017 ◽

2017 ◽

Vol 17 (17) ◽

pp. 10367-10381 ◽

Cited By ~ 27

Author(s):

Hongyan Zhao ◽

Xin Li ◽

Qiang Zhang ◽

Xujia Jiang ◽

Jintai Lin ◽

...

Keyword(s):

Air Pollution ◽

Environmental Concern ◽

Atmospheric Transport ◽

Economic Value ◽

Premature Mortality ◽

Health Impacts ◽

Economic Activities ◽

Premature Deaths ◽

Development Framework ◽

Multi Stage

Abstract. Air quality is a major environmental concern in China, where premature deaths due to air pollution have exceeded 1 million people per year in recent years. Here, using a novel coupling of economic, physical and epidemiological models, we estimate the premature mortality related to anthropogenic outdoor PM2.5 air pollution in seven regions of China in 2010 and show for the first time how the distribution of these deaths in China is determined by a combination of economic activities and physical transport of pollution in the atmosphere. We find that 33 % (338 600 premature deaths) of China's PM2.5-related premature mortality in 2010 were caused by pollutants emitted in a different region of the country and transported in the atmosphere, especially from north to south and from east to west. Trade further extended the cross-regional impact; 56 % of (568 900 premature deaths) China's PM2.5-related premature mortality was related to consumption in another region, including 423 800 (42 % of total) and 145 100 (14 %) premature deaths from domestic consumption and international trade respectively. Our results indicate that multilateral and multi-stage cooperation under a regional sustainable development framework is in urgent need to mitigate air pollution and related health impacts, and efforts to reduce the health impacts of air pollution in China should be prioritized according to the source and location of emissions, the type and economic value of the emitting activities, and the related patterns of consumption.

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Health Risk Associated with Near-Road Ambient Air Concentration of Particulate Matter in Mukono Municipal Council, Uganda

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.09.01.art014 ◽

2021 ◽

Vol 9 (1) ◽

pp. 127-137

Author(s):

Edward Kibikyo Mukooza

Keyword(s):

Air Pollution ◽

Health Risk ◽

Ambient Air ◽

Air Concentration ◽

Middle Income ◽

Middle Income Countries ◽

Premature Deaths ◽

Increased Risk ◽

The Mean ◽

Pm2.5 Concentration

More than 98% of urban centres exceeding 100,000 people in Low and Middle-Income Countries (LMICs), do not meet the WHO air quality limits. Data on air pollution from LMICs is scarce. We measured the mean concentrations of near-road PM2.5 in the period of Aug.-Dec. 2020, described the Mukono Municipality’s near-road populations’ exposure to PM2.5, and assessed the associated health risk. PurpleAir PA-II laser particle counters, measured near-road ambient air PM2.5 concentration in Mukono Municipality during the period of 09/1/20 to 12/04/20. Excel Toolpak was used for data analysis and the health risk assessed with the WHO AirQ+ tool. The mean ambient near–road PM2.5 in Mukono Municipality were 30.97, 33.84 and 47.74 ug/m3for background, near-unpaved and near-paved roads, respectively. Mukono Municipality’s population was exposed to ambient PM2.5 concentrations higher than the WHO annual limit of 10 ug/m3. This level of air pollution is associated with preventable annual premature deaths of up to 133.11 per 100,000 population. Vehicles were assumed to be the predominant source of near-road ambient air PM2.5 pollution. The Municipality’s population was exposed to near-road ambient air PM2.5 exceeding the WHO annual limit by as much as *4.7 for the paved roads, *3.3 for the unpaved roads and *3 for the background. This leads to increased risk of preventable premature deaths in the Municipality.Mukono Municipality could monitor PM2.5; guide developers to placebuildings more than 100 meters away from roadsides and should promotepolicies for newer vehicles on Ugandan roads.

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Assessment of the Effect of the Three-Year Action Plan to Fight Air Pollution on Air Quality and Associated Health Benefits in Sichuan Basin, China

Sustainability ◽

10.3390/su131910968 ◽

2021 ◽

Vol 13 (19) ◽

pp. 10968

Author(s):

Juihui Chen ◽

Xiaoqiong Feng ◽

Yonghui Zhu ◽

Ling Huang ◽

Min He ◽

...

Keyword(s):

Air Pollution ◽

Air Quality ◽

Pollution Control ◽

Emission Reduction ◽

Sichuan Basin ◽

Action Plan ◽

Control Measures ◽

Air Pollution Control ◽

Premature Deaths ◽

Pm2.5 Concentration

To continuously improve air quality, after implementation of the “Clean Air Action Plan, 2013–2017” (CAAP), the “Three-year Action Plan to Fight Air Pollution” (TYP) was further conducted from 2018 to 2020. However, the effectiveness of the TYP remains unclear in one of the major city-clusters of China, the Sichuan Basin. In this study, the bottom-up method was used to quantify the emission reduction during TYP based on the emissions inventory in Sichuan Basin in 2017 and the air pollution control measures adopted from 2018 to 2020 in each city. The reduction of PM2.5 concentration and the avoided premature deaths due to implementation of air pollution control measures were assessed by using an integrated meteorology and air quality modeling system and a concentration-response algorithm. Emissions of SO2, NOx, PM2.5, and VOCs in the Sichuan Basin have been reduced by 42.6, 105.2, 40.2, and 136.6 Gg, respectively. The control of non-electricity industry contributed significantly to the emission reduction of all pollutants, accounting for 26–49%. In addition, the control of mobile sources contributes the most to NOx reductions, accounting for 57%. The results illustrate that the focus of air pollution control in Sichuan Basin is still industrial sources. We also found that the emission reduction of NOx, PM2.5, and VOCs in Chengdu is significantly higher than that of other cities, which were about 3.4~15.4 times, 2.2~40.1 times, and 4.3~24.4 times that of other cities, respectively. In Sichuan Basin, the average reduction rate of PM2.5 concentration due to air pollution control measures was 5% on average, with the highest contributions from industry, mobile source, and dust emission control. The decrease rate in each city ranges between 1~10%, and the decreasing ratios in Dazhou (10%), Chengdu (8%), and Zigong (7%) are relatively higher. The number of premature deaths avoided due to air pollution control measures in Sichuan Basin is estimated to be 22,934. Chengdu and Dazhou have benefitted most from the air pollution control measures, with 6043 and 2713 premature deaths avoided, respectively. Our results indicate that the implementation of TYP has achieved remarkable environmental and health benefits.

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Revealing the air pollution burden associated with internal Migration in Peru

Scientific Reports ◽

10.1038/s41598-020-64043-y ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Gabriel Carrasco-Escobar ◽

Lara Schwarz ◽

J. Jaime Miranda ◽

Tarik Benmarhnia

Keyword(s):

Air Pollution ◽

Census Data ◽

Meta Analysis ◽

Fine Particulate Matter ◽

Premature Mortality ◽

Ambient Air ◽

Ambient Air Pollution ◽

Mortality Data ◽

P Value ◽

Migration Patterns

AbstractThis study aims to quantify changes in outdoor (ambient) air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality. Data on ambient fine particulate matter (PM2.5) was obtained from the National Aeronautics and Space Administration (NASA). Census data was used to calculate rates of within-country migration at the district level. We calculated differences in PM2.5 exposure between “current” (2016–2017) and “origin” (2012) districts for each migration patterns. Using an exposure-response relationship for PM2.5 extracted from a meta-analysis, and mortality rates from the Peruvian Ministry of Health, we quantified premature mortality attributable to each migration pattern. Changes in outdoor PM2.5 exposure were observed between 2012 and 2016 with highest levels of PM2.5 in the Department of Lima. A strong spatial autocorrelation of outdoor PM2.5 values (Moran’s I = 0.847, p-value=0.001) was observed. In Greater Lima, rural-to-urban and urban-to-urban migrants experienced 10-fold increases in outdoor PM2.5 exposure in comparison with non-migrants. Changes in outdoor PM2.5 exposure due to migration drove 185 (95% CI: 2.7, 360) premature deaths related to air pollution, with rural-urban producing the highest risk of mortality from exposure to higher levels of ambient air pollution. Our results demonstrate that the rural-urban and urban-urban migrant groups have higher rates of air pollution-related deaths.

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Environmental Degradation: Estimating the Health Effects of Ambient PM2.5 Air Pollution in Developing Countries

10.1093/acrefore/9780199389414.013.559 ◽

2021 ◽

Author(s):

Ernesto Sánchez-Triana ◽

Bjorn Larsen ◽

Santiago Enriquez ◽

Andreia Costa Santos

Keyword(s):

Air Pollution ◽

Health Effects ◽

Ground Level ◽

Ambient Air ◽

Ambient Air Pollution ◽

Population Exposure ◽

Middle Income ◽

Middle Income Countries ◽

Premature Deaths ◽

Level Monitoring

Air pollution of fine particulates (PM2.5) is a leading cause of mortality worldwide. It is estimated that ambient PM2.5 air pollution results in between 4.1 million and 8.9 million premature deaths annually. According to the World Bank, the health effects of ambient PM2.5 air pollution had a cost of $6.4 trillion in purchasing power parity (PPP) adjusted dollars in 2019, equivalent to 4.8% of global gross domestic product (PPP adjusted) that year. Estimating the health effects and cost of ambient PM2.5 air pollution involves three steps: (1) estimating population exposure to pollution; (2) estimating the health effects of such exposure; and (3) assigning a monetary value to the illnesses and premature deaths caused by ambient air pollution. Estimating population exposure to ambient PM2,5 has gone from predominantly using ground level monitoring data mainly in larger cities to estimates of nationwide population weighted exposures based on satellite imagery and chemical transport models along with ground level monitoring data. The Global Burden of Disease 2010 (GBD 2010) provided for the first time national, regional and global estimates of exposures to ambient PM2.5. The GBD exposure estimates have also evolved substantially from 2010 to 2019, especially national estimates in South Asia, the Middle East and North Africa, Sub-Saharan Africa and Latin America and the Caribbean. Estimation of health effects of ambient PM2.5 has also undergone substantial developments during the last two decades. These developments involve: i) going from largely estimating health effects associated with variations in daily exposures to estimating health effects of annual exposure; ii) going from estimating all-cause mortality or mortality from broad disease categories (i.e., cardiopulmonary diseases) to estimating mortality from specific diseases; and iii) being able to estimate health effects over a wide range of exposure that reflect ambient and household air pollution exposure levels in low- and middle-income countries. As to monetary valuation of health effects of ambient air pollution, estimates in most low- and middle-income countries still rely on benefit transfer of values of statistical life (VSL) from high-income countries.

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