Burden of Natural-Cause and Cause-Specific Mortality Associated with Long-Term Exposure to PM2.5: A Case Study in Attica Region, Greece

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Abstract
In this study, the AirQ+ software proposed by the World Health Organization (WHO) was applied in order to assess the health endpoints associated with the long-term exposure to PM2.5 in Attica Region, Greece. For this purpose, we analyzed the daily average concentrations of PM2.5 registered by the air quality monitoring stations in the region, from 1 January 2007 to 31 December 2018. Although there was a decreasing trend in PM2.5 concentrations levels, the levels of PM2.5 exceeded the AQG (Air Quality Guidelines) limit value (annual value: 5 μg/m3) established by the WHO. The findings revealed that the burden of mortality (from all-natural causes) at people above 30 years old associated with PM2.5 exposure was 4752 [3179–6152] deaths in 2007 and 2424 [1598–3179] deaths in 2018. In general, the attributable mortality from specific causes of deaths (e.g., lung cancer, IHD (ischemic heart diseases) and stroke) in people above 25 years old decreased between the years, but the mortality from COPD (chronic obstructive pulmonary diseases) was stable at 146 [79–220] deaths in 2007 and 147 [63–244] deaths in 2018. We also found differences in mortality cases from IHD and stroke among the age groups and between the years 2007 and 2018.

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