Deaths and DALYs Attributable to PM Pollution Increasing

The age-standardized rate (ASR) of the cardiovascular disease (CVD) burden attributable to particulate matter (PM) pollution decreased from 1990 to 2019, although all-age disability-adjusted life-years (DALYs) increased by 31% in the same period, according to a study in the Journal of the American Heart Association.

Researchers assessed the global burden of CVD attributed to PM pollution with use of global burden of disease (GBD) data from the Institute for Health Metrics and Evaluation from 1990 to 2019. Years of life lost (YLLs), years lived with disability (YLDs), DALYs, and mortality were investigated in 204 countries, 21 GBD regions, and in sociodemographic index (SDI) quintiles.

In 2019, about 3.5 million (95% UI, 3.1 million-4.0 million) deaths from CVD attributed to PM occurred, with men accounting for 56.5% of deaths. Regarding the ASR of death, 44 deaths (95% UI, 38.9-49.4) were reported per 100,000. Globally, 8.9 million (95% UI, 7.9 million-9.9 million) DALYs were reported, with men accounting for 40.6%. Ambient PM and household air pollution from solid fuels had 2.5 million (95% UI, 2.0 million-2.9 million) and 1.1 million (95% UI, 0.7 million-1.5 million) CVD-attributed deaths, respectively.

The total number of deaths and DALYs attributable to PM pollution increased by about one-third from 1990 to 2019. All-age deaths increased from 2.6 million (95% UI, 2.3 million-2.9 million) in 1990 to 3.5 million (95% UI, 3.1 million-4.0 million) in 2019, with a higher increase in men (43.0%; 95% UI, 25.3%-61.5%) vs women (28.2%; 95% UI, 10.7%-48.0%).

A similar increasing pattern occurred with DALYs (6.8 million; 95% UI, 6.1 million-7.5 million) in 1990 vs 2019 (8.9 million; 95% UI, 7.9 million-9.9 million). YLLs increased from 6.4 million (95% UI, 5.7 million-7.1 million) to 8.2 million (95% UI, 7.3 million-9.2 million). A 73.1% (95% UI, 62.3%-83.6%) increase in YLDs occurred and was relatively similar in both sexes. For ASRs, a similar decrease of about 35% occurred for deaths, DALYs, and YLLs, although the age-standardized YLD of CVDs attributable to PM pollution had a small decrease (12.6%; 95% UI, 7.1%-18.3%).

Mortality related to ambient PM pollution increased by 121.9% (95% UI, 82.1%-181.2%), and DALYs and YLLs more than doubled from 1990 to 2019. YLDs increased by approximately 200.9% (95% UI, 146.4%-282.1%), with similar rates in women and men.

For PM pollution, decreasing trends were observed in ASR for all measures, especially for YLLs, deaths, and DALYs. All-ages numbers had increasing trends from 1990 to 2019.

The ASR of DALYs for CVD attributed to PM pollution decreased in most countries from 1990 to 2019. The PM-attributed CVD age-standardized YLLs/YLDs ratio for both sexes was 18.1 in 1990 and decreased to 13.2 in 2019.

The low-middle SDI region had the highest burden of YLLs/YLDs ratio caused by CVD attributed to PM pollution for men and women in 1990 and 2019.

Among several limitations, data for some countries may not be representative of the entire population of the region. Also, PM composition may vary over time and location, which can affect the spatial homogeneity assumption. Furthermore, cause-specific mortalities from different countries are heterogeneous, and no causal relationship can be deduced from the findings.

“The differences in the burden of CVD attributable to PM pollution among regions and between sexes can guide policy making to reduce the negative impacts of this environmental issue,” wrote study authors.