Ambient air pollution remains an environmental health concern, yet national evidence in Türkiye integrating multiple pollutants, WHO guideline exceedance, mortality patterns, and monitoring network changes is limited. We analyzed seven annual observations (2018–2024) for PM10, SO2, CO, NO2, and O3. For each pollutant-year, the national indicator was the unweighted mean of eligible station annual means from official bulletins; mortality outcomes were crude national rates. Linear trends were estimated by OLS regression and assessed alongside Mann–Kendall tests, Sen’s slopes, and strict common-station sensitivity analyses. PM2.5 was excluded because monitoring coverage and annual reporting were not sufficiently comparable across years. PM10 decreased from 50.4 to 41.0 µg/m3 and SO2 from 13.2 to 8.5 µg/m3, with significant negative linear trends. The all-station NO2 indicator increased from 29.2 to 34.4 µg/m3, but its linear trend was not statistically significant (slope = 0.879 µg/m3/year; p = 0.055) and was absent in the common-station analysis (slope = −0.021; p = 0.950). PM10 guideline exceedance remained nearly universal, and NO2 exceedance remained high. Among mortality outcomes, only neoplasm mortality declined significantly. Air quality trends were pollutant-specific and, for NO2, sensitive to monitoring network composition. The ecological design does not permit causal inference regarding pollutant–mortality relationships.
Objective: This study aimed to estimate the excess mortality risk associated with ambient SO₂ exposure in Hakkari province for the year 2023.Method: Daily SO2 concentration data for 2023 were obtained from the National Air Quality Monitoring Network. Mortality data were sourced from the Turkish Statistical Institute. The analysis utilized the WHO AirQ+ version 2.2 software, employing a short-term risk ratio (RR) of 1.0059 for a 10 µg/m³ increase in the 24-hour average SO2 concentration to estimate the short-term attributable mortality burden.Results: In 2023, the WHO 24-hour air quality guideline (40 µg/m³) was exceeded on 71 days. The AirQ+ model estimated that the short-term attributable proportion of mortality was 9.46% (95% CI: 7.46 - 11.27) for all natural-cause mortality in Hakkari due to SO2 exposure. This burden corresponds to approximately 62 (95% CI: 49 - 73) attributable deaths annually.Conclusion: The findings indicate that high SO2 pollution in Hakkari, driven by residential heating and topographical entrapment, is associated with a significant mortality burden. Specifically, the 'double burden' of extreme cold stress and peak pollution levels in winter creates a high-risk window for vulnerable populations. Urgent interventions, including a transition to cleaner energy sources and improved insulation strategies, are required to mitigate this public health crisis.
İ. Demir, Ö. Ayvaz· Türkiye Halk Sağlığı Dergisi· 0 citations
Background: Ambient particulate matter ≤2.5 μm (PM2.5) is a major environmental health risk contributing to global morbidity and mortality. Although its link with cardiovascular diseases is well established, evidence on the stroke burden attributable to PM2.5 exposure remains limited in Indonesia. Methods: This ecological study used Global Burden of Disease (GBD) 2021 data to analyze the association between PM2.5 exposure and stroke burden, including incidence, prevalence, and mortality, across 34 Indonesian provinces from 2011 to 2020. Age-standardized rates (ASRs) were assessed using a linear mixed model, with year as a repeated measure and province as a random effect to account for spatial and temporal variations. Findings: Mean PM2.5 concentrations ranged from 16.96 to 20.10 µg/m³, exceeding WHO and national air quality standards. Despite minor annual fluctuations in PM2.5, stroke mortality attributable to air pollution showed an increasing trend. Higher PM2.5 levels were significantly associated with ischemic stroke (IS) incidence (β = -0.117, p <0.001) and mortality (β = 0.152, p <0.001), as well as intracerebral hemorrhage (ICH) incidence (β = 0.017, p = 0.015), prevalence (β = 1.641, p <0.001), and mortality (β = 0.773, p = 0.004). The effect of PM2.5 exposure was greater for ICH than for IS. Conclusion: Long-term exposure to PM2.5 is significantly associated with stroke burden in Indonesia, particularly for ICH. Strengthening air quality management and stroke prevention policies is crucial, especially in high-risk regions. Novelty/Originality of this article: This study is the first to comprehensively assess the long-term association between PM2.5 and stroke subtypes using national-level GBD data across all Indonesian provinces, providing spatially and temporally robust evidence for public health policy in low- and middle-income tropical settings.
Salma Dhiya Rachmadani· Public Health Risk Assesment...· 0 citations
Long-term exposure to ambient fine particulate matter (PM2.5) is the leading environmental risk factor for premature mortality worldwide, yet comprehensive province-level evidence quantifying its health burden across Türkiye remains limited. This study investigated the spatial relationship between long-term PM2.5 exposure and all-cause attributable mortality across all 81 Turkish provinces in 2022 using province-level annual mean PM2.5 concentrations and World Health Organisation (WHO) AirQ+ estimates of PM2.5-attributable deaths among adults aged ≥30 years, assuming a counterfactual concentration of 5 µg/m3. The association between PM2.5 exposure and mortality was evaluated using Pearson and Spearman correlation analyses, ordinary least squares (OLS) regression, a log–log elasticity model, and population-weighted regional and exposure-quartile comparisons, while national temporal indicators for 2010–2023 were reported solely as supplementary context for the primary single-year 2022 cross-sectional analysis. The population-weighted annual mean PM2.5 concentration was 27.0 µg/m3, exceeding the WHO Air Quality Guideline by a factor of 5.4, and all 81 provinces exceeded the recommended threshold. The bivariate OLS model accounted for 41% of the between-province variation in attributable mortality rates (OLS slope = 3.23 additional deaths per 100,000 population for each 1 µg/m3 increase in PM2.5; 95% CI: 2.37–4.10; R2 = 0.41; p < 0.001), while the log–log elasticity model indicated that a 1% increase in PM2.5 concentration was associated with a 0.80% increase in the attributable mortality rate (95% CI: 0.65–0.95). The attributable fraction of natural-cause mortality increased progressively from 8.8% in the lowest exposure quartile to 24.6% in the highest. Nationwide, an estimated 68,440 premature deaths, representing 14.2% of all natural-cause deaths among adults aged ≥30 years, were attributable to PM2.5 exposure. These findings quantify a steep, spatially graded PM2.5-attributable mortality burden across Türkiye. As the attributable estimates derive from the WHO AirQ+ concentration–response function, the gradient describes the magnitude and spatial distribution of the modelled burden rather than an independently estimated exposure–response relationship, and on that basis the results support the adoption of WHO-aligned air-quality standards and accelerated decarbonization strategies to reduce the national health burden attributable to ambient air pollution.
This study comprehensively evaluates air pollution in Adana, one of Türkiye’s key industrial, urban, and transportation hubs. Using monitoring data from 2023–2025, the concentrations of major pollutants—PM2.5., PM10, SO2, NO2, CO, and O3—were analyzed. The results were compared with standards set by the World Health Organization (WHO), the European Union (EU), and Türkiye’s national regulations, showing that PM2.5 and PM10 thresholds were frequently exceeded at several stations. A significant finding was that data capture rates remained below 60%, indicating reliability gaps in the monitoring infrastructure and weakening evidence-based policymaking. Primary sources of pollution include coal-fired power plants, the use of low-quality fuels, open burning of agricultural residues, and vehicular emissions. These factors are aggravated by Adana’s geographic and meteorological conditions, such as temperature inversions and low wind speeds, which facilitate pollutant accumulation and increase public health risks. Statistical analyses revealed notable rises in SO2 and particulate matter concentrations during winter due to residential heating, coinciding with higher respiratory illness rates. The study recommends reducing coal dependency, expanding access to natural gas, promoting sustainable transportation, restricting agricultural waste burning, and improving data transparency. The Adana case highlights air pollution as both an environmental and social justice issue.
E. Turan· Doğal Afetler ve Çevre Dergi...· 0 citations
This study investigated the spatiotemporal variability of fine particulate matter (PM2.5) in Addis Ababa, Ethiopia and assessed its associated health risks and economic burden using data from January 2022 to December 2023. Hourly PM2.5 concentrations were collected through a hybrid monitoring network comprising seven low-cost sensors and two Beta Attenuation Monitors (BAM). Spatiotemporal analysis was performed using Python, and health risks were assessed by estimating the Hazard Quotient (HQ) and Excess Lifetime Cancer Risk (ELCR). The economic burden attributable to PM2.5 exposure was assessed by monetizing disease-specific Disability-Adjusted Life Years (DALYs) using a locally adapted Value of Statistical Life (VSL) approach. Over the two-year periods, mean PM2.5 concentrations ranged from 15 to 33 μg/m3 across monitoring sites, with an overall a citywide average of 27 μg/m3, exceeding the World Health Organization (WHO) Air Quality Guideline (AQG) of 5 μg/m3 by more than fivefold. Seasonal analysis revealed elevated PM2.5 concentrations during the wet season (Kiremt), while diurnal patterns showed peaks of 38 µg/m3 at 7:00 AM. The HQ values for all age groups exceeded the acceptable threshold of 1, indicating non-carcinogenic health risks. ELCR estimates calculated using a slope factor of 0.008 exceeded the risk threshold (1 ×10-4), whereas estimates based on the slope factor of 0.0012 remained within the acceptable limits, highlighting the sensitivity of cancer risk estimates to the toxicity parameter applied. The economic burden attributable to PM2.5 exposure was estimated at USD 652.95 million over the two-year study period, contributing an external cost share to national GDP of 0.25% in 2022 and 0.25% in 2023. Cardiovascular diseases, particularly ischemic heart disease (IHD), accounted for the largest share of economic losses, significantly exceeding acute respiratory infections and PM2.5 related cancers. These findings provide evidence to support targeted policies aimed at reducing PM2.5 related cancers combined.
