Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, 28029 Madrid, Spain.
Environ Int. 2011 Feb;37(2):342-8. doi: 10.1016/j.envint.2010.10.004. Epub 2010 Nov 5.
Health effects linked to exposure to high air pollutant levels have been described in depth, and many recent epidemiologic studies have also consistently reported positive associations between exposure to air pollutants at low concentrations (particularly PM(2.5)) and adverse health outcomes.
To estimate the number of avoidable deaths associated with reducing PM(2.5) levels in Spain.
For exposure assessment, we used the US Environmental Protection Agency's Community Multiscale Air Quality model to simulate air pollution levels with a spatial resolution of 18×18 km(2). Two different scenarios were compared, namely, a baseline 2004 scenario based on Spain's National Emissions Inventory and a projected 2011 scenario in which a reduction in PM(2.5) was estimated on the basis of the benefits that might be attained if specific air quality policies were implemented. Using an 18×18 km(2) grid, air pollution data were estimated for the entire Iberian Peninsula, the Balearic Islands, Ceuta and Melilla. For these strata, crude all-cause mortality rates (ICD-10: A00-Y98) were then calculated for the over-30 and 25-74 age groups, taking into account the 2004 population figures corresponding to these same age groups, selected in accordance with the concentration-response functions (Pope CA 3rd, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 2002; 287:1132-41; Laden F, Schwartz J, Speizer FE, Dockery DW. Reduction in fine particulate air pollution and mortality: extended follow-up of the Harvard Six Cities study. Am J Respir Crit Care Med 2006; 173:667-72.). Health impacts were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP).
Air quality improvement was defined as an average annual reduction of 0.7 μg/m(3) in PM(2.5) levels. Using long-term health impact assessment analysis, we estimated that 1720 (673-2760) all-cause deaths (6 per 100,000 population) in the over-30 age group and 1450 (780-2108) all-cause deaths (5 per 100,000 population) in the 25-74 age group could be prevented annually.
The results showed the potential benefits in general mortality which could be expected if pollution control policies were successfully implemented by 2011. A specifically adapted BenMAP could be used as a tool for estimating health impacts associated with changes in air pollution in Spain.
与接触高空气污染物水平相关的健康影响已被深入描述，并且许多最近的流行病学研究也一致报告了在低浓度（特别是 PM（2.5））接触空气污染物与不良健康结果之间的正相关关系。
估计与降低西班牙 PM（2.5）水平相关的可避免死亡人数。
为了进行暴露评估，我们使用美国环境保护署的社区多尺度空气质量模型，以 18×18 km（2）的空间分辨率模拟空气污染水平。比较了两种不同的情景，即基于西班牙国家排放清单的基准 2004 年情景和假设如果实施具体的空气质量政策可能实现的收益，则估计的 2011 年情景中的 PM（2.5）减少情景。使用 18×18 km（2）的网格，估计了整个伊比利亚半岛、巴利阿里群岛、休达和梅利利亚的空气污染数据。对于这些层，计算了 30 岁以上和 25-74 岁年龄组的所有原因死亡率（ICD-10：A00-Y98），同时考虑了与这些相同年龄组相对应的 2004 年人口数据，根据浓度-反应函数（教皇 CA 3rd，Burnett RT，Thun MJ，Calle EE，Krewski D，Ito K 等人。肺癌，心肺死亡率和长期暴露于细颗粒物空气污染。JAMA 2002; 287:1132-41; Laden F，Schwartz J，Speizer FE，Dockery DW。减少细颗粒物空气污染和死亡率：哈佛六城市研究的扩展随访。美国呼吸与危重病医学杂志 2006; 173:667-72。）。使用环境效益映射和分析程序（BenMAP）评估健康影响。
空气质量改善定义为 PM（2.5）水平平均每年降低 0.7μg/m（3）。使用长期健康影响评估分析，我们估计每年可预防 30 岁以上年龄组的 1720 例（6/100,000 人口）和 25-74 岁年龄组的 1450 例（5/100,000 人口）所有原因死亡（6/100,000 人口）。
结果表明，如果到 2011 年成功实施污染控制政策，可能会带来一般死亡率的潜在收益。可以使用专门改编的 BenMAP 作为估计与西班牙空气污染变化相关的健康影响的工具。
