Aug 2026· Toxics· Vol 14· 0 citations· 49 references
Medicine
Abstract
Long-term exposure to ambient fine particulate matter (PM2.5) is the leading environmental risk factor for premature mortality worldwide, yet comprehensive province-level evidence quantifying its health burden across Türkiye remains limited. This study investigated the spatial relationship between long-term PM2.5 exposure and all-cause attributable mortality across all 81 Turkish provinces in 2022 using province-level annual mean PM2.5 concentrations and World Health Organisation (WHO) AirQ+ estimates of PM2.5-attributable deaths among adults aged ≥30 years, assuming a counterfactual concentration of 5 µg/m3. The association between PM2.5 exposure and mortality was evaluated using Pearson and Spearman correlation analyses, ordinary least squares (OLS) regression, a log–log elasticity model, and population-weighted regional and exposure-quartile comparisons, while national temporal indicators for 2010–2023 were reported solely as supplementary context for the primary single-year 2022 cross-sectional analysis. The population-weighted annual mean PM2.5 concentration was 27.0 µg/m3, exceeding the WHO Air Quality Guideline by a factor of 5.4, and all 81 provinces exceeded the recommended threshold. The bivariate OLS model accounted for 41% of the between-province variation in attributable mortality rates (OLS slope = 3.23 additional deaths per 100,000 population for each 1 µg/m3 increase in PM2.5; 95% CI: 2.37–4.10; R2 = 0.41; p < 0.001), while the log–log elasticity model indicated that a 1% increase in PM2.5 concentration was associated with a 0.80% increase in the attributable mortality rate (95% CI: 0.65–0.95). The attributable fraction of natural-cause mortality increased progressively from 8.8% in the lowest exposure quartile to 24.6% in the highest. Nationwide, an estimated 68,440 premature deaths, representing 14.2% of all natural-cause deaths among adults aged ≥30 years, were attributable to PM2.5 exposure. These findings quantify a steep, spatially graded PM2.5-attributable mortality burden across Türkiye. As the attributable estimates derive from the WHO AirQ+ concentration–response function, the gradient describes the magnitude and spatial distribution of the modelled burden rather than an independently estimated exposure–response relationship, and on that basis the results support the adoption of WHO-aligned air-quality standards and accelerated decarbonization strategies to reduce the national health burden attributable to ambient air pollution.
Background: Ambient particulate matter ≤2.5 μm (PM2.5) is a major environmental health risk contributing to global morbidity and mortality. Although its link with cardiovascular diseases is well established, evidence on the stroke burden attributable to PM2.5 exposure remains limited in Indonesia. Methods: This ecological study used Global Burden of Disease (GBD) 2021 data to analyze the association between PM2.5 exposure and stroke burden, including incidence, prevalence, and mortality, across 34 Indonesian provinces from 2011 to 2020. Age-standardized rates (ASRs) were assessed using a linear mixed model, with year as a repeated measure and province as a random effect to account for spatial and temporal variations. Findings: Mean PM2.5 concentrations ranged from 16.96 to 20.10 µg/m³, exceeding WHO and national air quality standards. Despite minor annual fluctuations in PM2.5, stroke mortality attributable to air pollution showed an increasing trend. Higher PM2.5 levels were significantly associated with ischemic stroke (IS) incidence (β = -0.117, p <0.001) and mortality (β = 0.152, p <0.001), as well as intracerebral hemorrhage (ICH) incidence (β = 0.017, p = 0.015), prevalence (β = 1.641, p <0.001), and mortality (β = 0.773, p = 0.004). The effect of PM2.5 exposure was greater for ICH than for IS. Conclusion: Long-term exposure to PM2.5 is significantly associated with stroke burden in Indonesia, particularly for ICH. Strengthening air quality management and stroke prevention policies is crucial, especially in high-risk regions. Novelty/Originality of this article: This study is the first to comprehensively assess the long-term association between PM2.5 and stroke subtypes using national-level GBD data across all Indonesian provinces, providing spatially and temporally robust evidence for public health policy in low- and middle-income tropical settings.
Salma Dhiya Rachmadani· Public Health Risk Assesment...· 0 citations
Fine particulate matter (PM2.5) pollution is a leading cause of the global mortality burden, but public health risks from short-term fluctuations, in addition to long-term exposure, have been insufficiently studied. Potentially influenced by climate change, the daily variability of PM2.5 has significantly increased over the past 60 years, particularly in densely populated regions of East Asia, South Asia, and western North America. To quantify the short-term mortality burden exacerbated by this growing variability, we developed a novel method, the Meta-Regression of Distributional Derivatives (MR-ODDs), to construct nonlinear exposure-response relationships from published summary statistics without requiring individual-level data. Using this approach, we estimate that an average of 672,867 (95% CI: 579,452–740,680) deaths per year globally were attributable to short-term PM2.5 exposure between 2000 and 2023. The mortality burden is especially pronounced in regions where intensifying climate variability drives more frequent extreme pollution events. Western North America, in particular, has emerged as the region with the fastest-rising risk from such events. These findings indicate that extreme pollution events pose a new and growing threat to global public health, demanding a shift in policy from managing annual average concentrations to focusing on early warning and intervention for extreme pollution peaks.
Jianyu Deng, Peng Zhou, Jinting Guo et al.· The Innovation Medicine· 0 citations
Ambient air pollution remains an environmental health concern, yet national evidence in Türkiye integrating multiple pollutants, WHO guideline exceedance, mortality patterns, and monitoring network changes is limited. We analyzed seven annual observations (2018–2024) for PM10, SO2, CO, NO2, and O3. For each pollutant-year, the national indicator was the unweighted mean of eligible station annual means from official bulletins; mortality outcomes were crude national rates. Linear trends were estimated by OLS regression and assessed alongside Mann–Kendall tests, Sen’s slopes, and strict common-station sensitivity analyses. PM2.5 was excluded because monitoring coverage and annual reporting were not sufficiently comparable across years. PM10 decreased from 50.4 to 41.0 µg/m3 and SO2 from 13.2 to 8.5 µg/m3, with significant negative linear trends. The all-station NO2 indicator increased from 29.2 to 34.4 µg/m3, but its linear trend was not statistically significant (slope = 0.879 µg/m3/year; p = 0.055) and was absent in the common-station analysis (slope = −0.021; p = 0.950). PM10 guideline exceedance remained nearly universal, and NO2 exceedance remained high. Among mortality outcomes, only neoplasm mortality declined significantly. Air quality trends were pollutant-specific and, for NO2, sensitive to monitoring network composition. The ecological design does not permit causal inference regarding pollutant–mortality relationships.
Ömer Acat, Sibel Acat, Okan Imre· Atmosphere· 0 citations
INTRODUCTION
Air pollution is a leading environmental risk factor for cardiovascular disease (CVD), yet its relationship with metabolic syndrome (MetS) and its components in sub-Saharan Africa are unclear. This study aimed to examine the association between long-term PM2.5 exposure and MetS (and its component conditions) in a Ghanaian adult cohort.
METHODS
We performed a cross-sectional analysis of 1,833 adults (40-60 years) from the Awi-Gen study. Long-term PM2.5 exposure (2007-2015) was estimated via a satellite-based model. MetS was defined using harmonized criteria. We used multivariable logistic regression with sequential adjustment for covariates.
RESULTS
A positive association was observed between PM2.5 and hypertension, while no association was found for MetS overall or its component conditions. Each 1 μg/m3 increase in PM2.5 was associated with 6% higher odds of hypertension (OR: 1.06, 95% CI: 1.02-1.11). PM2.5 quartiles also showed a dose-response relationship with hypertension (p-trend=0.003), with the highest exposure linked to a 50% greater likelihood of hypertension. The calculated population attributable fraction for PM2.5 and hypertension was 18.6%.
INTERPRETATION
In this rural Ghanaian population, long-term PM2.5 exposure was associated with hypertension but not with metabolic syndrome or its other components. These findings provide important evidence from an understudied sub-Saharan African population and support the integration of air quality management into cardiovascular disease prevention strategies.
Ali Moro, E. Nonterah, Godfred Agongo et al.· Environmental Research· 0 citations
Fine particulate matter (PM2.5) is a major human health risk factor. Despite significant efforts to reduce air pollution in Europe the aging population, urbanization, and climate change, demand an assessment of potential impacts of future pollution trends. The interactions of climate change and PM2.5 pollution, and their effects on adverse health outcomes require a comprehensive approach to effectively address these environmental and public health challenges and link them with future scenarios. In this study, we use three shared socio-economic pathways (SSPs) to examine potential changes in societal, demographic, and economic trends over the century in combination with three future radiative forcing trajectories. We use three scenarios: the SSP1-2.6, SSP2-4.5, and SSP5-8.5. We examine the consequences of these pathways on population exposure to PM2.5 in the coming decades, focusing on the years 2030, 2040, 2050 and 2100. The study evaluates excess mortality across various health outcomes, such as cardiovascular and respiratory diseases, using novel relative risk functions and public health data. We find that air pollution in Europe will continue to decline over the coming decades across all scenarios. The projected excess mortality attributable to PM2.5 exposure varies by region, future pathway, and period, and is mainly driven by the projected demographic changes of each scenario. After the mid-century, excess mortality will almost stabilize under the SS1-2.6 and SSP2-4.5 pathways and increase under SSP5-8.5. Population aging and urbanization will amplify vulnerability, particularly in densely populated areas, highlighting the need to protect the elderly. We project that by 2100, excess mortality in Europe will be 199 (56–561), 323 (98–719), 808 (341–1489) thousands per year according to SSP1-2.6, SSP2-4.5 and SSP5-8.5, respectively. Our findings suggest that current or additional air pollution control measures will offset the excess mortality burden in Europe only under the SSP1-2.6 or SSP2-4.5 pathways.
Paisi Niki, Pozzer Andrea, Steffens Brendan et al.· Environmental Research: Heal...· 0 citations
Air pollution remains a major public health concern, particularly in large metropolitan areas. This study aimed to evaluate the short-term association between ambient air pollution levels and non-accidental mortality in Istanbul between 2013 and 2019. In this ecological time-series study, daily mortality data were analyzed using quasi-Poisson regression models incorporating distributed lag non-linear models (DLNM) to estimate exposure-response relationships. Citywide daily mean concentrations of major air pollutants were derived from all eligible monitoring stations. Effect estimates were expressed as relative risks (RRs) with 95% confidence intervals (CIs) per 10 µg/m2 increase in particulate matter concentrations. During the 7-year period, average particulate matter levels frequently exceeded World Health Organization (WHO) guideline values. A 10 µg/m2 increase in PM10 was associated with a 1.7% increase in daily mortality (RR: 1.017; 95% CI: 1.009-1.025), while a similar increase in PM2.5 was associated with a 3.3% increase (RR: 1.033; 95% CI: 1.021-1.046). Mortality increases were more pronounced among individuals aged ≥ 65 years. Periods of consecutive high pollution were also associated with excess mortality. Short-term increases in particulate matter concentrations were associated with elevated mortality in Istanbul, particularly among older adults. These results support the relevance of WHO guideline values in the local context and highlight the importance of sustained air quality control policies.