TY - JOUR
T1 - Burden of cardiovascular disease attributable to particulate matter pollution in the eastern Mediterranean region
T2 - analysis of the 1990–2019 global burden of disease
AU - Motairek, Issam
AU - Junior, Steven Ajluni
AU - Khraishah, Haitham
AU - AlAhmad, Barrak
AU - Al-Dulaimi, Sarah
AU - Khalil, Charbel Abi
AU - Rajagopalan, Sanjay
AU - Al-Kindi, Sadeer
N1 - Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Aims Particulate matter pollution is the most important environmental mediator of global cardiovascular morbidity and mortality. Air pollution evidence from the Eastern Mediterranean Region (EMR) is limited, owing to scarce local studies, and the omission from multinational studies. We sought to investigate trends of particulate matter (PM2.5)-related cardiovascular disease (CVD) burden in the EMR from 1990 to 2019. Methods We used the 1990–2019 global burden of disease methodology to investigate total PM2.5, ambient PM2.5, and household and results PM2.5-related CVD deaths and disability-adjusted life years (DALYs) and cause-specific CVD mortality in the EMR. The average annual population-weighted PM2.5 exposure in EMR region was 50.3 μg/m3 [95% confidence interval (CI):42.7–59.0] in 2019, which was comparable with 199 048.1 μg/m3 (95% CI: 36.5–65.3). This was despite an 80% reduction in household air pollution (HAP) sources since 1990. In 2019, particulate matter pollution contributed to 25.67% (95% CI: 23.55–27.90%) of total CVD deaths and 28.10% (95% CI: 25.75–30.37%) of DALYs in the region, most of which were due to ischaemic heart disease and stroke. We estimated that 353 071 (95% CI: 304 299–404 591) CVD deaths in EMR were attributable to particulate matter in 2019, including 264 877 (95% CI: 218 472–314 057) and 88 194.07 (95% CI: 60 149–119 949) CVD deaths from ambient PM2.5 pollution and HAP from solid fuels, respectively. DALY’s in 2019 from CVD attributable to particulate matter was 28.1% when compared with 26.69% in 1990. The age-standardized death and DALY rates attributable to air pollution was 2122 per 100 000 in EMR in 2019 and was higher in males (2340 per 100 000) than in females (1882 per 100 000). Conclusion The EMR region experiences high PM2.5 levels with high regional heterogeneity and attributable burden of CVD due to air pollution. Despite significant reductions of overall HAP in the past 3 decades, there is continued HAP exposure in this region with rising trend in CVD mortality and DALYs attributable to ambient sources. Given the substantial contrast in disease burden, exposures, socio-economic and geo-political constraints in the EMR region, our analysis suggests substantial opportunities for PM2.5 attributable CVD burden mitigation.
AB - Aims Particulate matter pollution is the most important environmental mediator of global cardiovascular morbidity and mortality. Air pollution evidence from the Eastern Mediterranean Region (EMR) is limited, owing to scarce local studies, and the omission from multinational studies. We sought to investigate trends of particulate matter (PM2.5)-related cardiovascular disease (CVD) burden in the EMR from 1990 to 2019. Methods We used the 1990–2019 global burden of disease methodology to investigate total PM2.5, ambient PM2.5, and household and results PM2.5-related CVD deaths and disability-adjusted life years (DALYs) and cause-specific CVD mortality in the EMR. The average annual population-weighted PM2.5 exposure in EMR region was 50.3 μg/m3 [95% confidence interval (CI):42.7–59.0] in 2019, which was comparable with 199 048.1 μg/m3 (95% CI: 36.5–65.3). This was despite an 80% reduction in household air pollution (HAP) sources since 1990. In 2019, particulate matter pollution contributed to 25.67% (95% CI: 23.55–27.90%) of total CVD deaths and 28.10% (95% CI: 25.75–30.37%) of DALYs in the region, most of which were due to ischaemic heart disease and stroke. We estimated that 353 071 (95% CI: 304 299–404 591) CVD deaths in EMR were attributable to particulate matter in 2019, including 264 877 (95% CI: 218 472–314 057) and 88 194.07 (95% CI: 60 149–119 949) CVD deaths from ambient PM2.5 pollution and HAP from solid fuels, respectively. DALY’s in 2019 from CVD attributable to particulate matter was 28.1% when compared with 26.69% in 1990. The age-standardized death and DALY rates attributable to air pollution was 2122 per 100 000 in EMR in 2019 and was higher in males (2340 per 100 000) than in females (1882 per 100 000). Conclusion The EMR region experiences high PM2.5 levels with high regional heterogeneity and attributable burden of CVD due to air pollution. Despite significant reductions of overall HAP in the past 3 decades, there is continued HAP exposure in this region with rising trend in CVD mortality and DALYs attributable to ambient sources. Given the substantial contrast in disease burden, exposures, socio-economic and geo-political constraints in the EMR region, our analysis suggests substantial opportunities for PM2.5 attributable CVD burden mitigation.
KW - Air pollution
KW - Cardiovascular disease
KW - Eastern mediterranean region
KW - Global burden of disease
KW - Particulate matter
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U2 - 10.1093/eurjpc/zwac256
DO - 10.1093/eurjpc/zwac256
M3 - Article
C2 - 36321426
AN - SCOPUS:85148113851
SN - 2047-4873
VL - 30
SP - 256
EP - 263
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 3
ER -