Health Impacts and Economic Costs of Air Pollution in the Metropolitan Area of Skopje

Abstract

Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. Methods: we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. Results: In 2012, long-term exposure to PM2.5 (49.2 μg/m3) caused an estimated 1199 premature deaths (CI95% 821–1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104–977) from cardiovascular diseases, and 937 admissions (CI95% 937–1869) for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m3) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m3) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Conclusions: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city.

Air Pollution Management in North Macedonia

“…A recent study by Martinez et al (2018) estimated 1,199 premature deaths attributed to AAP for only the Skopje metropolitan area, implying a health burden that is significantly higher than estimated by both the World Bank (2014) study and this report. This discrepancy is explained by the use of a linear concentrationresponse function applied by Martinez et al (2018). The same methodology is used in a recent study that estimated annual mortality attributed to air pollution in all major urban areas of Macedonia (Dimovska and Gjorgjev 2018).…”

Does Air Pollution Affect the Impact of Economic Development on Cancer Mortality? The Case of OECD Countries

“…This is a reasonable value, if compared with the rest of the literature. For the Metropolitan Area of Skopje, Sanchez Martinez et al [13] estimate that, in the year 2012, social cost for the estimated premature mortality attributable to PM 2.5 has been between 570 M€ and 1470 M€. On the same issue, the contribution of Croituru and Sarraf [14] reports new evidence for the case of Morocco.…”

Numerical and Experimental Analysis of Inhalation Airflow Dynamics in a Human Pharyngeal Airway

“…Biomechanical modelling of the human upper airway has attracted intensive research attention for decades since it enables a better understanding of its physiology and pathophysiology. Growing interest in the pharynx is largely due to the recognition of obstructive sleep apnea (OSA) [1,2] and pollutant-related epidemiology [3][4][5]. Therefore, detailed knowledge of airflow dynamics in the pharyngeal airway is central to these issues as it underpins the mechanisms of air-structure and air-particle interactions in the upper and lower airways.…”