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ABSTRACT: Background
Estimating the burden of disease attributable to long-term exposure to fine particulate matter (PM2.5) in ambient air requires knowledge of both the shape and magnitude of the relative risk (RR) function. However, adequate direct evidence to identify the shape of the mortality RR functions at the high ambient concentrations observed in many places in the world is lacking.Objective
We developed RR functions over the entire global exposure range for causes of mortality in adults: ischemic heart disease (IHD), cerebrovascular disease (stroke), chronic obstructive pulmonary disease (COPD), and lung cancer (LC). We also developed RR functions for the incidence of acute lower respiratory infection (ALRI) that can be used to estimate mortality and lost-years of healthy life in children < 5 years of age.Methods
We fit an integrated exposure-response (IER) model by integrating available RR information from studies of ambient air pollution (AAP), second hand tobacco smoke, household solid cooking fuel, and active smoking (AS). AS exposures were converted to estimated annual PM2.5 exposure equivalents using inhaled doses of particle mass. We derived population attributable fractions (PAFs) for every country based on estimated worldwide ambient PM2.5 concentrations.Results
The IER model was a superior predictor of RR compared with seven other forms previously used in burden assessments. The percent PAF attributable to AAP exposure varied among countries from 2 to 41 for IHD, 1 to 43 for stroke, < 1 to 21 for COPD, < 1 to 25 for LC, and < 1 to 38 for ALRI.Conclusions
We developed a fine particulate mass-based RR model that covered the global range of exposure by integrating RR information from different combustion types that generate emissions of particulate matter. The model can be updated as new RR information becomes available.
SUBMITTER: Burnett RT
PROVIDER: S-EPMC3984213 | biostudies-literature | 2014 Apr
REPOSITORIES: biostudies-literature
Burnett Richard T RT Pope C Arden CA Ezzati Majid M Olives Casey C Lim Stephen S SS Mehta Sumi S Shin Hwashin H HH Singh Gitanjali G Hubbell Bryan B Brauer Michael M Anderson H Ross HR Smith Kirk R KR Balmes John R JR Bruce Nigel G NG Kan Haidong H Laden Francine F Prüss-Ustün Annette A Turner Michelle C MC Gapstur Susan M SM Diver W Ryan WR Cohen Aaron A
Environmental health perspectives 20140211 4
<h4>Background</h4>Estimating the burden of disease attributable to long-term exposure to fine particulate matter (PM2.5) in ambient air requires knowledge of both the shape and magnitude of the relative risk (RR) function. However, adequate direct evidence to identify the shape of the mortality RR functions at the high ambient concentrations observed in many places in the world is lacking.<h4>Objective</h4>We developed RR functions over the entire global exposure range for causes of mortality i ...[more]