Lifetime exposure to PM_2.5 air pollution and disability-adjusted life years due to cardiopulmonary disease: A modeling study based on nationwide longitudinal data

Background: As knowledge of the health risks of PM_2.5 has grown, the focus of PM_2.5-related health impact assessments has evolved from simple risk models to burden-of-disease estimates. We proposed an ecological approach to directly estimate the impacts of lifetime exposure to PM_2.5 on expected health losses due to cardiopulmonary diseases for older adult populations in Taiwan. Methods: We created study cohorts of 3.5 million older people living in 350 townships in Taiwan. We used a weighted regression model, with adjustments of area characteristic variables, to directly estimate the impacts of lifetime mean PM_2.5 exposure on health losses among the 350 cohorts. Potential avoidable disability-adjusted life years (DALYs) by assuming that ambient PM_2.5 met the air quality standard was estimated. Results: Each 10 μg/m³ increase in lifetime mean exposure to PM_2.5 for an individual corresponded to an increment of 0.25 (95 % confidence interval (CI): 0.18–0.32) DALYs due to cardiopulmonary diseases, after adjusting for a wide range of ecological covariates. We estimated that 611.8 (95 % CI: 440.4–783.2) DALYs per 1000 older adult population could potentially be avoided by achieving air quality standards of WHO in Taiwan. Conclusions: Reducing PM_2.5 pollution in Taiwan associated with significant health co-benefits, providing important implications for public health and environmental management.