Abstract The objective of this study was to determine the population exposure to PM2.5, and to quantify the effect of eliminating short-term pollution peaks on the number of cause-specific deaths, the number of years of life lost (YLL), and economic losses attributed to exposure to PM2.5 in 25 Iranian cities with available air quality data. Number of deaths and YLL were estimated with AirQ + software tool using available concentration-response functions and life table approach. Furthermore, the value of lost life in each city were calculated using the Value of Statistical Life (VSL) method. Two scenarios were defined; Scenario A, considering actual observed concentrations to estimate the real health effects of PM2.5, and Scenario B, controlling for the effect of air pollution episodes. The results showed that the annual average concentrations of PM2.5 in cities were 1.5–6.1 times higher than the guideline value of WHO (10 μg/m³). The total number of all-cause deaths due to long-term exposure exceeding WHO air quality guideline level was 13321 (95% C.I.: 8837–17378) cases per year in all cities. The total numbers of chronic obstructive pulmonary disease (COPD), lung cancer, ischemic heart disease (IHD), and stroke deaths attributed to the exposure were 274, 315, 1536, and 963 cases, respectively. The total number of YLL over 10 years period in all 25 cities was 486,289 years and the loss of life expectancy ranged from 0.43 to 1.87 years. The sum of economic losses due to lost life exceeded 5.8 billion USD. Except for some cities, avoiding highly polluted days in Scenario B would result in only 5% reduction in overall health or economic effects. These results indicate an urgent need for new comprehensive plans to tackle air pollution in Iranian cities focused on reduction of long term average pollution levels since programs for avoiding highly polluted days lead to a limited health benefits only.

中文翻译：

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伊朗城市因 PM2.5 暴露导致的死亡负担；短期污染峰值的贡献

摘要 本研究的目的是确定人群暴露于 PM2.5，并量化消除短期污染峰值对特定原因死亡人数、生命损失年数 (YLL) 和有可用空气质量数据的 25 个伊朗城市因暴露于 PM2.5 而造成的经济损失。使用可用的浓度响应函数和生命表方法，使用 AirQ + 软件工具估计死亡人数和 YLL。此外，每个城市的生命损失价值是使用统计生命价值（VSL）方法计算的。定义了两种情况；情景 A，考虑实际观察到的浓度来估计 PM2.5 的实际健康影响，情景 B，控制空气污染事件的影响。结果表明，城市PM2.5年平均浓度比WHO指导值（10微克/立方米）高1.5-6.1倍。在所有城市中，由于长期暴露于超过 WHO 空气质量指南水平的全因死亡总数为每年 13321（95% CI：8837–17378）例。慢性阻塞性肺病 (COPD)、肺癌、缺血性心脏病 (IHD) 和中风导致的死亡总数分别为 274、315、1536 和 963 例。所有 25 个城市的 10 年期间 YLL 总数为 486,289 岁，预期寿命损失范围为 0.43 至 1.87 岁。因生命损失造成的经济损失总额超过58亿美元。除了部分城市，在情景 B 中避免高度污染的日子只会使整体健康或经济影响降低 5%。这些结果表明，迫切需要制定新的综合计划来解决伊朗城市的空气污染问题，重点是降低长期平均污染水平，因为避免高污染日的计划只会带来有限的健康益处。