Hidden health effects and economic burden of stroke and coronary heart disease attributed to ambient air pollution (PM2.5) in Tehran, Iran: Evidence from an assessment and forecast up to 2030

• Published in: Ecotoxicology and environmental safety 2024-11, Vol.286, p.117158, Article 117158
• Main Authors: Kazemi, Zohreh, Yunesian, Masud, Hassanvand, Mohammad Sadegh, Daroudi, Rajabali, Ghorbani, Askar, Emamgholipour Sefiddashti, Sara
• Format: Article
• Language: English
• Subjects: Air Pollutants - adverse effects; Air Pollutants - analysis; Air Pollution - adverse effects; Coronary Disease - epidemiology; Coronary Disease - mortality; Coronary heart disease; Cost of Illness; Economic burden; Environmental Exposure - adverse effects; Forecast; Forecasting; Health effect; Humans; Iran - epidemiology; Particulate matter (PM2.5); Particulate Matter - adverse effects; Particulate Matter - analysis; Stroke; Stroke - epidemiology
• ISSN: 0147-6513; 1090-2414; 1090-2414
• DOI: 10.1016/j.ecoenv.2024.117158

Air pollution is one of the main causes of global disease burden, especially in low-income and middle-income countries. Estimation of the current situation and prediction of the future health effects of death and incidence of stroke and coronary heart disease (CHD) attributed to PM2.5 were done using BenMAP-CE software. Estimating and forecasting the economic burden of these diseases were done in 4 scenarios: Stability of the current PM2.5 concentration, annual 10 % reduction of PM2.5 concentration, reduction to 5 µg/m3, and reduction to 12 µg/m3, with three approaches for calculating the economic burden in mortality costs, including the human capital(HC), years of life lost(YLL) and value of statistical life(VSL) was performed. With the stability of the PM2.5 concentration, the economic burden of stroke attributed to PM2.5 with the approach of calculating the cost of death with the HC, the YLL, and VSL will reach from 64, 82 and 172 million USD in 2020–849, 1120 and 2703 million USD in 2030 and these costs for CHD in the mentioned approaches of calculating the cost of death will reach respectively from 499, 568 and 898 million USD in 2020–7096, 8088, and 13,621 million USD in 2030. We find that the morbidity economic burden (including direct, indirect, and intangible costs) of stroke compared to the cost of death with the HC, and YLL approaches are 67.58 times, 3.15 times respectively, and in the VSL approach is 47.32 % of stroke death cost. Also, the costs of CHD morbidity economic burden compared to the cost of death in the method of calculating the cost of death with the HC, YLL, and VSL approaches are 42.09, 7.25, and 1.16 times, respectively. This study provides comprehensive baseline information for health policymakers to understand the benefits of air pollution control policies globally, especially in LMICs. •Age groups above 60 years are more vulnerable to PM2.5 pollutant.•Health effects and economic burden of stroke and CHD attributed PM2.5 were underestimated until now.•Stroke morbidity economic burden compared to the mortality cost (VSL) is 47.32 %.•CHD morbidity economic burden compared to the mortality cost (VSL) is 1.16 times.