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 PM2.5 has grown, the focus of PM2.5-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 PM2.5 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 PM2.5 exposure on health losses among the 350 cohorts. Potential avoidable disability-adjusted life years (DALYs) by assuming that ambient PM2.5 met the air quality standard was estimated. Results: Each 10 μg/m3 increase in lifetime mean exposure to PM2.5 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 PM2.5 pollution in Taiwan associated with significant health co-benefits, providing important implications for public health and environmental management.