Paper of the Month

April 2019

Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions. European Heart Journal. DZHK authors: Daiber, Münzel

Air pollution is clearly underestimated as a health hazard, notwithstanding the heated discussion about diesel cars, nitrogen oxides and fine particulate matter. A team of scientists headed by Professor Jos Lelieveld of the Max Planck Institute for Chemistry and Professor Thomas Münzel of Mainz University Medical Center has revealed that air pollution shortens the average life expectancy of Europeans by about two years. According to the study, around 120 people per 100,000 population die prematurely from the effects of air pollution on a global scale. The corresponding figure for Europe stands at 133 per 100,000 population, which thus exceeds the global average. Cardiovascular diseases are the cause of death in at least half the incidents.

Poor air quality, especially by fine particulates, can lead to respiratory and cardiovascular diseases, and are associated with a remarkable high mortality risk. In their study, published in the European Heart Journal, the researchers adjusted the most recent calculations of the Global Burden of Disease (GBD), a global health study, as well as their own values substantially upward: Until recently, it had been assumed that the global mortality rate due to air pollution was around 4.5 million people a year. The recalculated value puts that figure at 8.8 million per year. In Europe alone, nearly 800,000 people die prematurely every year as a result of air pollution.To put this into perspective, the WHO estimates that the excess death rate from tobacco smoking is 7.2 million per year; hence air pollution is now rated as the larger risk factor.

The consequences are that the air pollution emission  levels have to be reduced. Currently, the WHO recommends 11 µg/m3 while the Europe particulate matter emission levels are with 25µg/m2 by far too high.  Thus, air pollution has to be acknowledged as an important cardiovascular risk factor that can be treated efficiently not by patients and their doctors but rather by politicians lowering emission limits that protect exposed people from cardiovascular disease.