National estimates of the health and economic burdens of exposure to ambient fine particulate matter (PM 2.5 ) in India reveal substantial impacts. This information, often lacking at the local level, can justify and drive mitigation interventions. Here, we assess the health and economic gains resulting from attainment of WHO guidelines for PM 2.5 concentrations -including interim target 2 (IT-2), interim target 3 (IT-3), and the WHO air quality guideline (AQG) -in Nagpur district to inform policy decision making for mitigation. We conducted a detailed assessment of concentrations of PM 2.5 in 9 areas, covering urban, peri-urban and rural environments, from February 2013 to June 2014. We used a combination of hazard and survival analyses based on the life table method to calculate attributed annual number of premature deaths and disability-adjusted life years (DALYs) for five health outcomes linked to PM 2.5 exposure: acute lower respiratory infection for children b 5 years, ischemic heart disease, chronic obstructive pulmonary disease, stroke and lung cancer in adults ≥25 years. We used GBD 2013 data on deaths and DALYs for these diseases. We calculated averted deaths, DALYs and economic loss resulting from planned reductions in average PM 2.5 concentration from current level to IT-2, IT-3 and AQG by the years 2023, 2033 and 2043, respectively. The economic cost for premature mortality was estimated as the product of attributed deaths and value of statistical life for India, while morbidity was assumed to be 10% of the mortality cost. The annual average PM 2.5 concentration in Nagpur district is 34 ± 17 μg m −3 and results in 3.3 (95% confidence interval [CI]: 2.6, 4.2) thousand premature deaths and 91 (95% CI: 68, 116) thousand DALYs in 2013 with economic loss of USD 2.2 (95% CI: 1.7, 2.8) billion in that year. It is estimated that interventions that achieve IT-2, IT-3 and AQG by 2023, 2033 and 2043 and 36%, of the attributed health and economic loss in those years, translating into an impressively large health and economic gain. To achieve this, we recommend an exposure-integrated source reduction approach.

Global burden of disease estimates reveal that people in Nigeria are living shorter lifespan than the regional or global average life expectancy. Ambient air pollution is a top risk factor responsible for the reduced longevity. But, the magnitude of the loss or the gains in longevity accruing from the pollution reductions, which are capable of driving mitigation interventions in Nigeria, remain unknown. Thus, we estimate the loss, and the gains in longevity resulting from ambient PM pollution reductions at the local sub-national level using life table approach. Surface average PM concentration datasets covering Nigeria with spatial resolution of ∼1 km were obtained from the global gridded concentration fields, and combined with ∼1 km gridded population of the world (GPWv4), and global administrative unit layers (GAUL) for territorial boundaries classification. We estimate the loss or gains in longevity using population-weighted average pollution level and baseline mortality data for cardiopulmonary disease and lung cancer in adults ≥25 years and for respiratory infection in children under 5. As at 2015, there are six "highly polluted", thirty "polluted" and one "moderately polluted" States in Nigeria. People residing in these States lose ∼3.8-4.0, 3.0-3.6 and 2.7 years of life expectancy, respectively, due to the pollution exposure. But, assuming interventions achieve global air quality guideline of 10 μg/m, longevity would increase by 2.6-2.9, 1.9-2.5 and 1.6 years for people in the State-categories, respectively. The longevity gains are indeed high, but to achieve them, mitigation interventions should target emission sources having the highest population exposures.

No abstract

No abstract

Recent evidence shows that water distribution system (WDS) is a major risk factor in piped water supply system and the degree of contamination of water in WDS is usually influenced by seasonal variation. Risk assessment studies eliminate the effect of seasonality whenever annualized estimate of concentration of contaminants in water is used to determine the risk to health. In tropical climate where strong seasonal variation prevails, the excess risk during dry and hot season, above the annualized risk can be significant. This study investigates what impact seasonal adjustment may have on health improvement targets for WDS. Water quality data of two Nigerian water supply schemes were used to estimate the impact of WDS on water quality. Seasonal deviation from the annualized impact was quantified as the latent risk in disability-adjusted life years (DALYs). The hazards identified in both WDSs were cadmium and lead, and the estimated 95th-percentile risk of the metals, over the course of dry season was about 31-38%, and 1-3% higher than the estimated yearly average risk, respectively. Wilcoxon signed-rank test showed that the risk distributions during the dry season was significantly higher (p < 0.05) than the yearly average. The median latent risks (5th, 95th-percentiles), for both WDS were 0.014 (7.6 × 10(-3), 0.023) and 4.8 × 10(-3) (-, 7.6 × 10(-3)) DALYs/person/year for cadmium and 0.87 × 10(-3) (0, 0.1 × 10(-3)) and 0.16 × 10(-3) (0, 0.031 × 10(-3)) DALYs/person/year, respectively, for lead. These risks are substantially higher than the WHO limit (1 × 10(-6) DALYs/person/year). Therefore, to achieve effective health improvement target, mitigation measures should be planned and executed by season.