As part of the World Health Organization (WHO) Global Burden of Disease Comparative Risk Assessment, the burden of disease attributable to urban ambient air pollution was estimated in terms of deaths and disability-adjusted life years (DALYs). Air pollution is associated with a broad spectrum of acute and chronic health effects, the nature of which may vary with the pollutant constituents. Particulate air pollution is consistently and independently related to the most serious effects, including lung cancer and other cardiopulmonary mortality. The analyses on which this report is based estimate that ambient air pollution, in terms of fine particulate air pollution (PM2.5 ), causes about 3% of mortality from cardiopulmonary disease, about 5% of mortality from cancer of the trachea, bronchus, and lung, and about 1% of mortality from acute respiratory infections in children under 5 yr, worldwide. This amounts to about 0.8 million (1.2%) premature deaths and 6.4 million (0.5%) years of life lost ( YLL). This burden occurs predominantly in developing countries; 65% in Asia alone. These estimates consider only the impact of air pollution on mortality (i.e., years of life lost) and not morbidity (i.e., years lived with disability), due to limitations in the epidemiologic database. If air pollution multiplies both incidence and mortality to the same extent (i.e., the same relative risk), then the DALYs for cardiopulmonary disease increase by 20% worldwide.

H. Ross Anderson (Community Health Services, St. George’s Hospital Medical School)

Bart Ostra (California Environmental Protection Agency)

Kiran Dev Pandey (Global Environmental Facility)

Michal Krzyanowski (WHO European Center for Environment and Health)

Nino Kunzli (Keck School of Medicine, University of Southern California)

Kersten Gutschmidt (WHO International Programme for Protection of the Human Environment)

Arden Pope (Brigham Young University)

Isabelle Romieu (Insituto Nacional de Salud Publico, Cuenavaca)

Jonathan Samet (Johns Hopkins Bloomberg School of Public Health)

Kirk Smith (University of California Berkeley, School of Public Health)

Cohen, Aaron et al. (2005) The Global Burden of Disease Due to Outdoor Air Pollution. Journal of Toxicology and Environmental Health, Part A, 68:1–7.  DOI: 10.1080/15287390590936166