Burden of Disease Due to Ambient Particulate Matter in Germany—Explaining the Differences in the Available Estimates
Abstract
:1. Introduction
2. Materials and Methods
2.1. Quantification Method
2.2. PM2.5 Exposure Data
2.3. BoD Input Data
3. Results
3.1. PM2.5 Exposure in Germany
3.2. Time Trend per Health Outcome from 2010 to 2018 in Germany
3.3. Comparison of Our Results with IHME’s GBD-2019 Study Estimates
3.4. Method A: AirQ+ Estimates
3.5. Method B: Natural All-Cause Mortality
3.6. Method C: Reduction in Life Expectancy-Life Table Approach
3.7. Comparison of the Different Methods
4. Discussion
4.1. Overall Decrease in PM2.5 Exposure
4.2. Input Data and Risk Measures
- PM2.5 concentration calculations only represent rural and urban background outdoor air pollution, no hot spots,
- Factor of 0.7 for PM10-to-PM2.5 conversion,
- Constant population density data for Germany for the considered time span,
- No correction to the official cause-of-death statistics,
- Constant prevalence rates for the considered time span,
- Limited representativeness of prevalence rates for oldest age group,
- We assume the RR and DW are applicable for Germany.
4.3. Estimates by Different Institutions
4.4. On the Use of Different Indicators
- Population-weighted annual mean PM2.5 exposure,
- Percentage of people exposed to PM2.5 levels above WHO guideline value 2005,
- PAF,
- YLLs,
- YLDs,
- DALYs,
- Number of attributable deaths,
- Reduction in life expectancy.
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Analysis Name | Approach | Health Outcomes (Number) | Relative Risk | Indicator(s) | Target Year(s) | Software Used | Comparison |
---|---|---|---|---|---|---|---|
Main analysis | EBD incl. PAF | Cause-specific (5): COPD, stroke, IHD, LC, T2DM | [17] | YLLs, YLDs | 2010–2018 | Excel | [17], Method A |
Method A | EBD incl. PAF | Cause-specific (4): COPD, stroke, IHD, LC | IHME as provided in AirQ+ * | YLLs | 2018 | AirQ+ (WHO) | Main analysis |
Method B | EBD incl. PAF | Natural all-cause mortality | [14] | YLLs | 2018 | Excel | [5] |
Method C | Life table | Natural all-cause mortality | [14] | Life expectancy reduction in days | 2017 | Excel | [8] |
YLD | YLD | Prevalence | Prevalence | Disability Weight | Disability Weight | |
---|---|---|---|---|---|---|
Age | Male | Female | Male | Female | Male | Female |
<1 year | 0 | 0 | 0 | 0 | 0.000 | 0.000 |
1 to 4 | 0 | 0 | 0 | 0 | 0.000 | 0.000 |
5 to 9 | 0 | 0 | 0 | 0 | 0.000 | 0.000 |
10 to 14 | 0 | 0 | 0 | 0 | 0.000 | 0.000 |
15 to 19 | 12 | 9 | 273 | 216 | 0.045 | 0.042 |
20 to 24 | 54 | 44 | 1069 | 822 | 0.051 | 0.054 |
25 to 29 | 142 | 104 | 2732 | 1991 | 0.052 | 0.052 |
30 to 34 | 263 | 194 | 5653 | 3747 | 0.047 | 0.052 |
35 to 39 | 460 | 330 | 11,914 | 7093 | 0.039 | 0.047 |
40 to 44 | 863 | 589 | 24,036 | 13,238 | 0.036 | 0.044 |
45 to 49 | 1950 | 1226 | 55,432 | 28,204 | 0.035 | 0.043 |
50 to 54 | 3495 | 2084 | 104,267 | 49,695 | 0.034 | 0.042 |
55 to 59 | 4797 | 2743 | 147,306 | 68,581 | 0.033 | 0.040 |
60 to 64 | 6185 | 3423 | 181,049 | 85,943 | 0.034 | 0.040 |
65 to 69 | 8218 | 4735 | 230,099 | 116,939 | 0.036 | 0.040 |
70 to 74 | 9201 | 5683 | 240,107 | 137,598 | 0.038 | 0.041 |
75 to 79 | 12,692 | 8735 | 326,060 | 217,370 | 0.039 | 0.040 |
80 to 84 | 9736 | 7731 | 235,017 | 194,260 | 0.041 | 0.040 |
85 to 89 | 5155 | 5077 | 115,685 | 130,013 | 0.045 | 0.039 |
90 to 94 | 1853 | 2373 | 38,284 | 61,610 | 0.048 | 0.039 |
95 plus | 455 | 661 | 7387 | 15,436 | 0.062 | 0.043 |
PAF | YLLs | YLDs | DALYs | Attributable Deaths | ||
---|---|---|---|---|---|---|
IHD | Sum | 10.3% (6.5–14.6%) | 85,483 (52,676–122,380) | 16,293 (10,037–23,264) | 101,776 (62,713–145,644) | 6977 (4285–10,069) |
Male | 56,189 (34,675–80,219) | 9774 (6033–13,934) | 65,962 (40,708–94,152) | 4094 (2515–5887) | ||
Female | 29,294 (18,001–42,162) | 6519 (4005–9330) | 35,814 (22,005–51,492) | 2882 (1770–4181) | ||
Rate per 100,000 | 135.63 (83.58–194.17) | 25.85 (15.93–36.91) | 161.48 (99.50–231.08) | 11.07 (6.80–15.97) | ||
Lung cancer | Sum | 7.1% (5.0–9.2%) | 59,487 (42,414–77,611) | 1355 (966–1768) | 60,843 (43,380–79,379) | 3785 (2699–4939) |
Male | 34,450 (24,562–44,945) | 896 (639–1169) | 35,346 (25,201–46,115) | 2297 (1638–2997) | ||
Female | 25,037 (17,851–32,666) | 459 (327–599) | 25,497 (18,179–33,265) | 1488 (1061–1942) | ||
Rate per 100,000 | 94.38 (67.29–123.14) | 2.15 (1.53–2.81) | 96.53 (68.83–125.94) | 6.01 (4.28–7.84) | ||
Stroke | Sum | 11.0% (7.8–14.6%) | 25,019 (17,579–34,225) | 13,399 (9396–18,365) | 38,417 (26,975–52,590) | 1871 (1314–2582) |
Male | 12,533 (8804–17,117) | 5917 (4150–8098) | 18,450 (12,955–25,215) | 891 (625–1228) | ||
Female | 12,486 (8775–17,107) | 7481 (5245–10,267) | 19,967 (14,020–27,375) | 980 (689–1354) | ||
Rate per 100,000 | 36.69 (27.89–54.30) | 21.26 (14.91–29.14) | 60.95 (42.80–83.44) | 2.97 (2.08–4.10) | ||
COPD | Sum | 6.4% (4.5–8.3%) | 27,847 (19,578–36,269) | 15,931 (11,200–20,749) | 43,777 (30,777–57,017) | 2241 (1588–2919) |
Male | 14,680 (10,321–19,120) | 7620 (5357–9925) | 22,300 (15,678–29,044) | 1219 (857–1588) | ||
Female | 13,167 (9257–17,149) | 8310 (5843–10,824) | 21,477 (15,099–27,973) | 1022 (719–1331) | ||
Rate per 100,000 | 44.18 (31.06–57.54) | 25.28 (17.77–32.92) | 69.46 (48.83–90.46) | 3.56 (2.50–4.63) | ||
T2DM | Sum | 9.8% (6.5–12.0%) | 8128 (5388–10,004) | 37,760 (25,031–46,477) | 45,888 (30,419–56,481) | 778 (516–957) |
Male | 4196 (2781–5164) | 20,596 (13,653–25,350) | 24,791 (16,434–30,515) | 364 (241–448) | ||
Female | 3932 (2607–4840) | 17,164 (11,378–21,127) | 21,096 (13,985–25,967) | 414 (274–509) | ||
Rate per 100,000 | 12.90 (8.55–15.87) | 59.91 (39.71–73.74) | 65.08 (48.26–89.61) | 1.23 (0.82–1.52) |
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Tobollik, M.; Kienzler, S.; Schuster, C.; Wintermeyer, D.; Plass, D. Burden of Disease Due to Ambient Particulate Matter in Germany—Explaining the Differences in the Available Estimates. Int. J. Environ. Res. Public Health 2022, 19, 13197. https://doi.org/10.3390/ijerph192013197
Tobollik M, Kienzler S, Schuster C, Wintermeyer D, Plass D. Burden of Disease Due to Ambient Particulate Matter in Germany—Explaining the Differences in the Available Estimates. International Journal of Environmental Research and Public Health. 2022; 19(20):13197. https://doi.org/10.3390/ijerph192013197
Chicago/Turabian StyleTobollik, Myriam, Sarah Kienzler, Christian Schuster, Dirk Wintermeyer, and Dietrich Plass. 2022. "Burden of Disease Due to Ambient Particulate Matter in Germany—Explaining the Differences in the Available Estimates" International Journal of Environmental Research and Public Health 19, no. 20: 13197. https://doi.org/10.3390/ijerph192013197