The effect of particulate air pollution on life expectancy

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Abstract

Two recent US cohort studies suggest that current levels of particulate pollution in urban air are associated not only with short-term, but also with long-term increases in cardiorespiratory morbidity and mortality. The aim of the present analyses was to evaluate the change in life expectancy assuming the long-term increase in mortality rates as suggested by these studies. The method of competing causes of death was used and the effect of particulate air pollution on life expectancy was found to be notable in countries with high cardiovascular mortality like the US.

Introduction

Several recent studies suggest that short-term changes in current levels of urban particulate air pollution are associated with short-term changes in respiratory morbidity, mortality and declines in lung function. The studies have recently been reviewed (Dockery and Pope III, 1994; Brunekreef et al., 1995; Schwartz, 1995). Fairly consistent associations have been reported in a large number of time-series studies, and for a number of related outcomes, such as respiratory mortality, hospital admissions due to pulmonary disease, symptom status and pulmonary function. Several recent studies have also suggested short-term associations with cardiovascular mortality (Pope III et al., 1992). The short-term health effects of particulate pollution are therefore well documented in epidemiological studies, although the precise mechanism through which these health effects are produced is unknown (World Health Organization, 1994).

The most controversial issue is whether particulate pollution also has an effect on life expectancy. Two US cohort studies (Dockery et al., 1993; Pope III et al., 1995) have found an association between particulate pollution and mortality due to cardiorespiratory causes and lung cancer. The aim of the present analyses is to estimate the change in life expectancy, assuming an increase in mortality rates as estimated by these two cohort studies, and to examine the sensitivity of this estimate to the estimation method.

Section snippets

Methods

The method of competing causes of death was used (Chiang, 1968, Mackenbach et al., 1995). The three competing causes of death were lung cancer (ICD-9 162), cardiopulmonary (ICD-9 400–440 and 485–495) and other causes of death.

Life table and life expectancy (Chiang, 1968; Lee, 1992) were estimated for a sample population of 100 000 people, who were assumed to be exposed to the current death risks of the area of interest for their whole life. A life table was constructed with 5-year intervals;

Results

Life expectancy in Finland was 76.5 years in 1994 (Table 1). Out of 100 000 persons in Finland in 1994 it is estimated that 3494 would die of lung cancer, 55 403 due to cardiopulmonary causes and 41 103 due to other causes of death (Table 1). In Table 2, the situation in Finland in 1994 is taken as the baseline situation (`less polluted area').

Life expectancy in the less polluted area was estimated to be 0.60 years higher than in the polluted area when the estimates of Pope III et al. (1995)

Discussion

The results show that if the estimates from the two cohort studies (Dockery et al., 1993Pope III et al., 1995) indicate real causal associations, the effect of increasing or reducing pollution on life expectancy is very high. It has been suggested by Warner (1987)that smoking decreases the life expectancy of the whole population from 1 to 2 years. The large effect of reducing pollution is partly due to the fact that everybody is assumed to be exposed, whereas not everybody smokes.

Competing

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