Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
Environ Int. 2018 May;114:37-49. doi: 10.1016/j.envint.2018.02.026. Epub 2018 Feb 22.
The main objectives of this study were (1) investigation of the temporal variations of ambient fine particulate matter (PM) and ground level ozone (O) concentrations in Tehran megacity, the capital and most populous city in Iran, over a 10-year period from 2006 to 2015, and (2) estimation of their long-term health effects including all-cause and cause-specific mortality. For the first goal, the data of PM and O concentrations, measured at 21 regulatory monitoring network stations in Tehran, were obtained and the temporal trends were investigated. The health impact assessment of PM and O was performed using the World Health Organization (WHO) AirQ+ software updated in 2016 by WHO European Centre for Environment and Health. Local baseline incidences in Tehran level were used to better reveal the health effects associated with PM and O. Our study showed that over 2006-2015, annual mean concentrations of PM and O varied from 24.7 to 38.8 μg m and 35.4 to 76.0 μg m, respectively, and were significantly declining in the recent 6 years (2010-2015) for PM and 8 years (2008-2015) for O. However, Tehran citizens were exposed to concentrations of annual PM exceeding the WHO air quality guideline (WHO AQG) (10 μg m), U.S. EPA and Iranian standard levels (12 μg m) during entire study period. We estimated that long-term exposure to ambient PM contributed to between 24.5% and 36.2% of mortality from cerebrovascular disease (stroke), 19.8% and 24.1% from ischemic heart disease (IHD), 13.6% and 19.2% from lung cancer (LC), 10.7% and 15.3% from chronic obstructive pulmonary disease (COPD), 15.0% and 25.2% from acute lower respiratory infection (ALRI), and 7.6% and 11.3% from all-cause annual mortality in the time period. We further estimated that deaths from IHD accounted for most of mortality attributable to long-term exposure to PM. The years of life lost (YLL) attributable to PM was estimated to vary from 67,970 to 106,706 during the study period. In addition, long-term exposure to O was estimated to be responsible for 0.9% to 2.3% of mortality from respiratory diseases. Overall, long-term exposure to ambient PM and O contributed substantially to mortality in Tehran megacity. Air pollution is a modifiable risk factor. Appropriate sustainable control policies are recommended to protect public health.
(1) 调查 2006 年至 2015 年期间，伊朗首都和人口最多的城市德黑兰大都市中环境细颗粒物（PM）和地面臭氧（O）浓度的时间变化；(2) 估计其长期健康影响，包括全因和特定原因死亡率。为了实现第一个目标，我们获得了在德黑兰 21 个监管监测网络站测量的 PM 和 O 浓度数据，并研究了时间趋势。PM 和 O 的健康影响评估使用了世界卫生组织（WHO）欧洲环境与健康中心在 2016 年更新的世界卫生组织（WHO）AirQ+软件进行。使用德黑兰当地的基线发病率来更好地揭示与 PM 和 O 相关的健康影响。我们的研究表明，在 2006 年至 2015 年期间，PM 和 O 的年平均浓度分别在 24.7 至 38.8 μg/m 和 35.4 至 76.0 μg/m 之间变化，并且在最近 6 年（2010 年至 2015 年）PM 浓度显著下降，在 8 年（2008 年至 2015 年）O 浓度显著下降。然而，在整个研究期间，德黑兰市民接触的 PM 年平均浓度均超过世界卫生组织空气质量指南（WHO AQG）（10 μg/m）、美国环保署和伊朗标准水平（12 μg/m）。我们估计，长期暴露于环境 PM 导致脑血管疾病（中风）死亡率增加 24.5%至 36.2%，缺血性心脏病（IHD）死亡率增加 19.8%至 24.1%，肺癌（LC）死亡率增加 13.6%至 19.2%，慢性阻塞性肺疾病（COPD）死亡率增加 10.7%至 15.3%，急性下呼吸道感染（ALRI）死亡率增加 15.0%至 25.2%，全因年死亡率增加 7.6%至 11.3%。我们进一步估计，IHD 导致的死亡占长期暴露于 PM 导致的死亡的大部分。估计在此期间，由 PM 导致的预期寿命损失（YLL）每年变化范围为 67970 至 106706。此外，长期暴露于 O 估计与呼吸系统疾病的 0.9%至 2.3%的死亡率有关。总体而言，长期暴露于环境 PM 和 O 导致德黑兰大都市的死亡率大幅增加。空气污染是一个可改变的风险因素。建议采取适当的可持续控制政策，以保护公众健康。
