Patrice Poinat, Sandrine Cheniki, Cyrille Delpierre, Inca Ruiz, Magali Corso, Olivier Chanel, Sylvie Cassadou, Environnement, Risques & Santé, Vol. 23, No. 4, pp. 190 - 198, 07/2024
Abstract
Air pollution is currently accountable for 40,000 deaths every year in France. The main objective of this study was to characterize the evolution of urban air pollution and its impact on mortality, by comparing two air pollution exposure periods, 2008–2010 and 2017–2019, within the Toulouse area. We also aimed to estimate the presumed health benefits had tracer pollutant concentrations reached the level indicated by the updated 2021 World Health Organization (WHO) guidelines over the 2017–2019 period. The breakdown of this health impact, according to level of social deprivation, was also assessed along with an exploration of the associated economic impacts. Several quantitative health impact studies (EQIS) were conducted by modeling population exposure to PM2.5 and NO2 within the region covered by the second Toulouse Air Protection Plan (PPA). The French European Deprivation Index (F-EDI) was used as a fine-scale indicator of social deprivation, and economic impacts were estimated by assigning a monetary value to the prevention of one death linked to air pollution. Across the area of study, average annual concentration levels decreased from 17.2 μg/m3 to 10.3 μg/m3 for PM2.5, and from 21.7 μg/m3 to 18.1 μg/m3 for NO2 between 2009 and 2019. The proportion of all causes of mortality attributable to air pollution (95% confidence interval [95% CI]) thus dropped from 15.7% [5.8; 23.8] to 7.2% [2.6; 11.2] for PM2.5 between 2009 and 2019, and it decreased from 2.7% [0.9; 4.2] to 1.9% [0.7; 2.9] for NO2 over the same period. Despite this improvement, concentrations of tracer pollutants remained above WHO 2021 guidelines, and there were still 440 annual deaths attributable to overexposure to PM2.5, which could have been avoided had these values been reached in 2019. Regarding social deprivation, a low but increasing gradient of exposure to air pollution was observed between the least and most deprived population quintiles. This led to an even greater mortality gradient attributable to air pollution between these same quintiles, and this worsened between 2009 and 2019. The annual economic gains that could have potentially been achieved, had the WHO 2021 guidelines been met, are estimated at 2,772 million euros2018 in 2009 and 1,423 million euros2018 in 2019.
Keywords
Social deprivation, Cost-benefit analysis, Mortality, Air pollution, Pollution de l', air, Mortalité, Privation sociale, Analyse coût-bénéfice