Burden of disease attributable to ambient air pollution in Kazakhstan

Abstract

Background. Ambient air pollution causes increased mortality from diseases of the circulatory and respiratory systems. The recent Global Burden of Disease study ranked exposure to the ambient particulate matter pollution as one of the top five reasons of premature mortality. Only high blood pressure, smoking, high fasting plasma glucose (prediabetes), high body-mass index and childhood undernutrition were ranked higher than ambient particulate matter. Exposure to the ambient air pollution was attributed to 4.2 million premature deaths worldwide. The overall burden of disease was considerably larger than from such diseases like malaria and HIV-AIDS combined which were attributed 1.5 million deaths combined. Methods. We estimated burden of disease attributable to ambient air pollution across regions and two major cities of Kazakhstan for the years 2005, 2010, and 2015. We conducted spatially resolved analysis at 0.01 x 0.01o (~1 km) grid resolution. By applying the Global Burden of Disease study methodology we calculated relative risks of premature mortality among four disease endpoints – namely ischemic heart disease, stroke, chronic obstructive pulmonary disease, lower respiratory infections. Findings. In 2015 there were total 5970 ambient air pollution attributable mortality cases, 6178 cases in 2010 and 9698 cases in 9698. There was a downwards trend for ischemic heart disease and stroke. Mortality from chronic obstructive pulmonary disease, and lower respiratory infections are on rise. Western and South regions of Kazakhstan are found to be the most polluted areas of the country. During the period of our study there was little change in ambient air pollution attributable mortality. Our sensitivity scenarios showed that pulmonary diseases are the most responsive to the changes in air quality