Short- and Long-Term Effects of Urban Air Pollution on Cardiopulmonary and Malignant Death Rates

Substantial scientific evidence suggests that exposure to even modest levels of air pollutants is associated with premature mortality. While relative contributions of pollutant species remain a matter of scientific debate, the current findings converge on the statement that short-term exposure over a period of few hours to weeks can aggravate the pre-existing health conditions, sometimes leading to a fatal outcome, whereas longer-term exposure reduces life expectancy by a several years. Susceptible groups including children and the elderly are at greater risk, as well as the people living in overpopulated low-income regions, due to being exposed up to twenty times higher pollutant concentrations than those commonly observed in modern countries. The goal of this study is to present the findings regarding the effects of short- and long-term exposure to air pollution on death rates in Belgrade area (Serbia), based on the 6-year (2009-2014) regular pollutant monitoring and the corresponding administrative records on mortality. To that end, a quasi-Poisson regression model was combined with distributed lag non-linear model to examine this association after controlling for confounding variables such as temperature, seasonal trends and day of the week. The study discusses relative rates, expressed as % increase in circulatory, respiratory and malignant mortality per unit increase in daily average pollutant concentrations, together with the observed age- and gender-specific effects. According to the results, short-term exposure to elevated concentrations of PM10, SO2 and NO2 is associated with relatively small mortality risk, whereas exposure during the last year appears to be more significant, particularly for circulatory mortality.