Health and Economic Benefits of Complying With the World Health Organization Air Quality Guidelines for Particulate Matter in Nine Major Latin American Cities.

Objectives: This study aims to estimate the short-term preventable mortality and associated economic costs of complying with the World Health Organization (WHO) air quality guidelines (AQGs) limit values for PM10 and PM2.5 in nine major Latin American cities. Methods: We estimated city-specific PM-mortality associations using time-series regression models and calculated the attributable mortality fraction. Next, we used the value of statistical life to calculate the economic benefits of complying with the WHO AQGs limit values. Results: In most cities, PM concentrations exceeded the WHO AQGs limit values more than 90% of the days. PM10 was found to be associated with an average excess mortality of 1.88% with concentrations above WHO AQGs limit values, while for PM2.5 it was 1.05%. The associated annual economic costs varied widely, between US$ 19.5 million to 3,386.9 million for PM10, and US$ 196.3 million to 2,209.6 million for PM2.5. Conclusion: Our findings suggest that there is an urgent need for policymakers to develop interventions to achieve sustainable air quality improvements in Latin America. Complying with the WHO AQGs limit values for PM10 and PM2.5 in Latin American cities would substantially benefits for urban populations.

Latin America and the Caribbean Code Against cancer 1st edition: Environment, occupation, and cancer.

Within the framework of the Latin America and Caribbean region (LAC) Code Against Cancer 1st edition, the current work presents recommendations to reduce exposure to environmental and occupational carcinogenic agents relevant for LAC. Using the methodology established by the International Agency for Research on Cancer (IARC) in the World Code Against Cancer Framework and experience from developing the European Code Against Cancer 4th edition, a working group of LAC cancer-prevention experts reviewed the list of Group I IARC carcinogenic agents, identified prevalent environmental and occupational exposures in the region, and proposed evidence-based cancer prevention recommendations suited to the epidemiological, socioeconomic, and cultural conditions of LAC countries. Two sets of recommendations were drafted: those targeting the general public and a second set for policymakers. Outdoor and indoor air pollution, ultra-violet radiation and occupational exposures to silica dust, asbestos, benzene, diesel, and welding fumes were identified as prevalent carcinogens in LAC and as agents that could be reduced or eliminated to prevent cancers. Recommendations for additional risk factors were not included due to insufficient data of their attributable burden in LAC (sunbeds, radon, aflatoxin), or lack of a clear preventive action to be taken by the individual (arsenic in drinking water, medical radiation), or lack of evidence of carcinogenicity effect (bisphenol A, phthalates, and pesticides). A broad consensus was reached on environmental and occupational carcinogenic exposures present throughout the LAC region and on individual-level and public policy-level recommendations to reduce or eliminate these exposures. Key educational content for the dissemination of these recommendations was also developed as part of LAC Code Against Cancer 1st Edition.

Chronic exposure to fine particles (PM2.5) and mortality: Evidence from Chile.

Many Chilean cities suffer from high air pollution from industrial, mobile, and residential wood-burning sources. Several studies have linked PM2.5 air pollution exposure to higher mortality risk from cardiovascular, pulmonary, and lung cancer causes. In recent years, Chile has developed an extensive air pollution monitoring network to enforce air quality standards for PM2.5, allowing the study of the medium-term association between PM2.5 and mortality. Methods: A negative binomial regression model was used to study the association between 3-year average PM2.5 concentrations and age-adjusted mortality rates for 105 of the 345 municipalities in Chile. Models were fitted for all (ICD10 A to Q codes), cardiopulmonary (I and J), cardiovascular (I), pulmonary (J), cancer (C), and lung cancer (C33-C34) causes; controlling for meteorological, socioeconomic, and demographic characteristics. Results: A significant association of PM2.5 exposure with cardiopulmonary (relative risk for 10 µg/m3 PM2.5: 1.06; 95% confidence interval = 1.00, 1.13) and pulmonary (1.11; 1.02, 1.20) age-adjusted mortality rates was found. Cardiovascular (1.06; 0.99, 1.13) and all causes (1.02; 0.98, 1.07) were positive, but not significant. No significant association was found between cancer and lung cancer. The positive associations remained even when controlling for multiple confounding factors, model specifications, and when considering different methods for exposure characterization. These estimates are in line with results from cohort studies from the United States and European studies. Conclusion: Three-year average PM2.5 exposure is positively associated with the age-adjusted mortality rate for cardiopulmonary and cardiovascular causes in Chile. This provides evidence of the medium-term exposure effect of fine particles on long-term mortality rates.

Valuing air quality impacts using stated choice analysis: trading off visibility against morbidity effects.

Direct valuation of air quality has as a drawback; that estimated willingness to pay figures cannot be apportioned to the several environmental goods affected by air quality, such as mortality and morbidity effects, visibility, outdoor recreation, among others. To address this issue, we implemented a survey in Santiago de Chile to identify component values of confounded environmental services by means of a choice experiment. We designed a survey where two environmental goods, a morbidity health endpoint and improved visibility, had to be jointly traded off against each other and against money in a unified framework. The health endpoint is a respiratory illness that results in an emergency room visit with a probability of hospitalization being required for appropriate treatment. Visibility is described as an aesthetic effect related to the number of days per year of high visibility. Modeling comprises both a logit model with covariates and a mixed-logit model. The results suggest that the health endpoint midpoint value is in a range from USD 2,800 to USD 13,000, mainly depending on the model and age stratum. The mid point value of an extra day of high visibility per year ranges from USD 281,000 to USD 379,000.