Projecting non-communicable diseases attributable to air pollution in the climate change era: a systematic review

OBJECTIVES

Climate change is a major global issue with significant consequences, including effects on air quality and human well-being. This review investigated the projection of non-communicable diseases (NCDs) attributable to air pollution under different climate change scenarios.

DESIGN

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. A population-exposure-outcome framework was established. Population referred to the general global population of all ages, the exposure of interest was air pollution and its projection, and the outcome was the occurrence of NCDs attributable to air pollution and burden of disease (BoD) based on the health indices of mortality, morbidity, disability-adjusted life years, years of life lost and years lived with disability.

DATA SOURCES

The Web of Science, Ovid MEDLINE and EBSCOhost databases were searched for articles published from 2005 to 2023.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

The eligible articles were evaluated using the modified scale of a checklist for assessing the quality of ecological studies.

DATA EXTRACTION AND SYNTHESIS

Two reviewers searched, screened and selected the included studies independently using standardised methods. The risk of bias was assessed using the modified scale of a checklist for ecological studies. The results were summarised based on the projection of the BoD of NCDs attributable to air pollution.

RESULTS

This review included 11 studies from various countries. Most studies specifically investigated various air pollutants, specifically particulate matter <2.5 µm (PM2.5), nitrogen oxides and ozone. The studies used coupled-air quality and climate modelling approaches, and mainly projected health effects using the concentration-response function model. The NCDs attributable to air pollution included cardiovascular disease (CVD), respiratory disease, stroke, ischaemic heart disease, coronary heart disease and lower respiratory infections. Notably, the BoD of NCDs attributable to air pollution was projected to decrease in a scenario that promotes reduced air pollution, carbon emissions and land use and sustainable socioeconomics. Contrastingly, the BoD of NCDs was projected to increase in a scenario involving increasing population numbers, social deprivation and an ageing population.

CONCLUSION

The included studies widely reported increased premature mortality, CVD and respiratory disease attributable to PM2.5. Future NCD projection studies should consider emission and population changes in projecting the BoD of NCDs attributable to air pollution in the climate change era.

PROSPERO REGISTRATION NUMBER

CRD42023435288.

Factors influencing vulnerability to climate change-related health impacts in cities - A conceptual framework

Climate change will have adverse impacts on human health, which are amplified in cities. For these impacts, there are direct, indirect, and deferred pathways. The first category is well-studied, while indirect and deferred impacts are not well-understood. Moreover, the factors moderating the impacts have received little attention, although understanding these factors is critical for adaptation. We developed a conceptual framework that shows the pathways of climate impacts on human health, focusing specifically on the factors of urban environment moderating the emergence and severity of these health impacts. Based on the framework and literature review, we illustrate the mechanisms of direct, indirect, and deferred health impact occurrence and the factors that exacerbate or alleviate the severity of these impacts, thus presenting valuable insights for anticipatory adaptation. We conclude that an integrated systemic approach to preventing health risks from climate change can provide co-benefits for adaptation and address multiple health risks. Such an approach should be mainstreamed horizontally to all sectors of urban planning and should account for the spatiotemporal aspects of policy and planning decisions and city complexity.

Multisectoral Perspectives on Global Warming and Vector-borne Diseases: a Focus on Southern Europe

Purpose of Review

The climate change (CC) or global warming (GW) modifies environment that favors vectors' abundance, growth, and reproduction, and consequently, the rate of development of pathogens within the vectors. This review highlights the threats of GW-induced vector-borne diseases (VBDs) in Southern Europe (SE) and the need for mitigation efforts to prevent potential global health catastrophe.

Recent Findings

Reports showed astronomical surges in the incidences of CC-induced VBDs in the SE. The recently (2022) reported first cases of African swine fever in Northern Italy and West Nile fever in SE are linked to the CC-modified environmental conditions that support vectors and pathogens' growth and development, and disease transmission.

Summary

VBDs endemic to the tropics are increasingly becoming a major health challenge in the SE, a temperate region, due to the favorable environmental conditions caused by CC/GW that support vectors and pathogens' biology in the previously non-endemic temperate regions.

Displacement of Strong Acids or Bases by Weak Acids or Bases in Aerosols: Thermodynamics and Kinetics

Depletion of chloride, nitrate, or ammonium from atmospheric aerosols represents a unique class of displacement reactions in which strong acids (HCl and HNO₃) or bases (NH₃) are substituted by weaker ones (i.e., dicarboxylic acids or dicarboxylate salts, respectively). These reactions alter the aerosol composition and perturb the atmospheric cycle of volatile compounds, thereby affecting environmental systems and climate. Despite the profound implications, the mechanism of these unique displacement reactions remains unclear. Here, we elucidate the thermodynamics and kinetics of these reactions using the multiphase buffer theory and a diffusion-controlled mass-transfer function, respectively. On the thermodynamic aspect, we find that the effective dissociation constants of the strong acids and bases in aerosols are 2 to 10 orders of magnitude lower than those in bulk solutions. On the kinetic aspect, we find that displacement reactions occur rapidly in aerosol microdroplets with a radius below 10 μm. Within this size range, the characteristic reaction time is always shorter than the lifetime of the aerosols in the atmosphere. Our findings suggest that the unique displacement reactions can significantly modify the composition of atmospheric aerosols, and consequentially, these aerosols may manifest distinct properties unforeseen by the chemistry of homogeneous bulk systems.

A cold front induced co-occurrence of O3 and PM2.5 pollution in a Pearl River Delta city: Temporal variation, vertical structure, and mechanism

In this study, the spatiotemporal variabilities and characteristics of ozone (O₃) and fine particulate matter (PM_2.5) were reconstructed, and the interaction between meteorological conditions and the co-occurrence of O₃ and PM_2.5 in Zhuhai, a city in the Pearl River Delta (China), was analysed. The vertical distributions of lower tropospheric O₃, aerosol extinction coefficient, and wind velocity were measured using a ground-based LiDAR system. The diurnal variations in air pollutant concentrations and meteorological conditions at ground level were examined from 28 November to December 8, 2020 considering the weather conditions in Zhuhai. Heavy pollution episodes with increased concentrations of O₃ and PM_2.5 were observed from 6 to 7 December after a period of cold air invasion. The maximum hourly average concentrations of O₃ and PM_2.5 at the ground level reached up to 190 μg/m³, 98 μg/m³, respectively. The horizontal wind speed rapidly decreased to less than 2 m/s during the heavy pollution episodes driven by O₃ and PM_2.5, whereas the vertical wind velocity was dominated by the downdraught. When the large-scale synoptic winds were weak, a strengthening sea breeze in the afternoon could promote the landward propagation of warm marine air masses, and a lower surface wind speed was driven by the convergence of cold air from the north and warm air from the south. In turn, this increased the residence time of air pollutants and promoted their conversion to secondary pollutants. Regarding the pollution sources, the results indicated that the Pearl River Estuary represented a 'pool' of O₃ and PM_2.5 pollution. In addition, the contribution of regional pollutant transport could not be ignored when considering the accumulative increase in air pollution. Overall, the relatively weak synoptic winds, low mixing height, and high generation of pollution around Zhuhai collectively resulted in high concentrations of O₃ and PM_2.5.

Direct Measurement of pH Evolution in Aerosol Microdroplets Undergoing Ammonium Depletion: A Surface-Enhanced Raman Spectroscopy Approach

Accurately measuring the pH of atmospheric aerosols is a prerequisite for understanding the multiphase chemistry that profoundly affects the environment and climate systems. Despite the advancements of experimental techniques for in situ pH measurements in aerosols, current studies are limited to measuring the static pH of aerosol microdroplets with an unperturbed composition. This steady-state scenario, however, deviates from the real-world aerosols undergoing atmospheric aging reactions, specifically, those characterized with a spontaneous displacement of strong bases (or acids) with high volatility. Here, we introduce a continuous and in situ measurement of aerosol pH by using a 4-mercaptopyridine-functionalized silver nanoparticle probe and surface-enhanced Raman spectroscopy. We find that the ammonium depletion─a spontaneous displacement of ammonium by dicarboxylic acid salts─continuously acidifies aerosol water over time. The decaying trends of pH in the aerosols under various humidity conditions can be unified with a universal exponential function. Such an exponentially decaying function further indicates that the ammonium depletion reaction is a self-limiting process. Our technique can be applied to study the dynamic change of aerosol acidity during the complex atmospheric aging processes, toward elucidating their implications on atmospheric chloride, nitrate, and ammonium cycles.

Projection of the Near-Future PM2.5 in Northern Peninsular Southeast Asia under RCP8.5

Throughout the year, particularly during the dry season, the northern peninsula of Southeast Asia struggles with air pollution from PM2.5. In this study, we used the Nested Regional Climate and Chemistry Model (NRCM-Chem) to predict the PM2.5 concentrations over Southeast Asia’s northern peninsula during the years 2020–2029 under the Representative Concentration Pathway (RCP)8.5. In general, the model reasonably shows a good result, including temperature, precipitation, and PM2.5 concentration, compared to the observation with an Index of Agreement (IOA) in the range of 0.63 to 0.80. However, there were some underestimations for modeled precipitation and temperature and an overestimation for modeled PM2.5 concentration. As a response to changes in climatic parameters and the emission of PM2.5’s precursors, PM2.5 concentrations tend to increase across the region in the range of (+1) to (+35) µg/m3 during the dry season (November to April) and decline in the range of (−3) to (−30) µg/m3 during the wet season (May to October). The maximum increase in PM2.5 concentrations were found in March by >40 µg/m3.

Biodegradable, Efficient, and Breathable Multi-Use Face Mask Filter

The demand for face masks is increasing exponentially due to the coronavirus pandemic and issues associated with airborne particulate matter (PM). However, both conventional electrostatic- and nanosieve-based mask filters are single-use and are not degradable or recyclable, which creates serious waste problems. In addition, the former loses function under humid conditions, while the latter operates with a significant air-pressure drop and suffers from relatively fast pore blockage. Herein, a biodegradable, moisture-resistant, highly breathable, and high-performance fibrous mask filter is developed. Briefly, two biodegradable microfiber and nanofiber mats are integrated into a Janus membrane filter and then coated by cationically charged chitosan nanowhiskers. This filter is as efficient as the commercial N95 filter and removes 98.3% of 2.5 µm PM. The nanofiber physically sieves fine PM and the microfiber provides a low pressure differential of 59 Pa, which is comfortable for human breathing. In contrast to the dramatic performance decline of the commercial N95 filter when exposed to moisture, this filter exhibits negligible performance loss and is therefore multi-usable because the permanent dipoles of the chitosan adsorb ultrafine PM (e.g., nitrogen and sulfur oxides). Importantly, this filter completely decomposes within 4 weeks in composting soil.

Meteorological influences on PM2.5 and O3 trends and associated health burden since China's clean air actions

Stringent clean air actions have been implemented to improve air quality in China since 2013. In addition to anthropogenic emission abatements, the changes in air quality may be modulated also by meteorology. In this study, we developed multiple linear regression models to quantify meteorological influences on the trends in fine particulate matter (PM_2.5) and ozone (O₃) concentrations and associated health burden over three polluted regions of China, i.e., North China Plain, Yangtze River Delta, and Fen-wei Plain during 2014-2018, with a novel focus on the contributions of the most influential meteorological factors to PM_2.5 and O₃ trends as well as the meteorological contributions to PM_2.5- and O₃-related mortality trends. The meteorology-driven PM_2.5 (O₃) trends for the three regions were -0.5~-2.0 (+0.7~+0.8) μg m^-3 yr^-1, contributing 10- 26% (12- 18%) of the observed five-year decreasing PM_2.5 (increasing O₃) trends. The decreased relative humidity (increased daytime planetary boundary layer height) was identified to be the most influential meteorological factor and explained 55% (42%) of the largest meteorology-driven PM_2.5 (O₃) trend among all regions and seasons. The meteorology-driven decreases in PM_2.5 (increases in O₃) concentrations led to overall decreases in PM_2.5-related (increases in O₃-related) mortalities with trends of -2.2~-7.4 (+0.5~+0.9) thousand yr^-1 for the three regions, accounting for 10- 26% (15- 31%) of the total decreasing (increasing) trends in PM_2.5-related (O₃-related) mortalities. The results emphasize the important role of meteorology in PM_2.5 and O₃ air quality and associated health burden over China, and have important implications for China's air quality planning. In particular, more efforts in emission control should be taken to offset the adverse effects on ozone caused by meteorology.

Quantification of Atmospheric Ammonia Concentrations: A Review of Its Measurement and Modeling

Ammonia (NH3), the most prevalent alkaline gas in the atmosphere, plays a significant role in PM2.5 formation, atmospheric chemistry, and new particle formation. This paper reviews quantification of [NH3] through measurements, satellite-remote-sensing, and modeling reported in over 500 publications towards synthesizing the current knowledge of [NH3], focusing on spatiotemporal variations, controlling processes, and quantification issues. Most measurements are through regional passive sampler networks. [NH3] hotspots are typically over agricultural regions, such as the Midwest US and the North China Plain, with elevated concentrations reaching monthly averages of 20 and 74 ppbv, respectively. Topographical effects dramatically increase [NH3] over the Indo-Gangetic Plains, North India and San Joaquin Valley, US. Measurements are sparse over oceans, where [NH3] ≈ a few tens of pptv, variations of which can affect aerosol formation. Satellite remote-sensing (AIRS, CrIS, IASI, TANSO-FTS, TES) provides global [NH3] quantification in the column and at the surface since 2002. Modeling is crucial for improving understanding of NH3 chemistry and transport, its spatiotemporal variations, source apportionment, exploring physicochemical mechanisms, and predicting future scenarios. GEOS-Chem (global) and FRAME (UK) models are commonly applied for this. A synergistic approach of measurements↔satellite-inference↔modeling is needed towards improved understanding of atmospheric ammonia, which is of concern from the standpoint of human health and the ecosystem.

Short-Term Responses of Air Quality to Changes in Emissions under the Representative Concentration Pathway 4.5 Scenario over Brazil

Brazil, one of the world's fastest-growing economies, is the fifth most populous country and is experiencing accelerated urbanization. This combination of factors causes an increase in urban population that is exposed to poor air quality, leading to public health burdens. In this work, the Weather Research and Forecasting Model with Chemistry is applied to simulate air quality over Brazil for a short time period under three future emission scenarios, including current legislation (CLE), mitigation scenario (MIT), and maximum feasible reduction (MFR) under the Representative Concentration Pathway 4.5 (RCP4.5), which is a climate change scenario under which radiative forcing of greenhouse gases (GHGs) reach 4.5 W m-2 by 2100. The main objective of this study is to determine the sensitivity of the concentrations of ozone (O3) and particulate matter with aerodynamic diameter 2.5 µm or less (PM2.5) to changes in emissions under these emission scenarios and to determine the signal and spatial patterns of these changes for Brazil. The model is evaluated with observations and shows reasonably good agreement. The MFR scenario leads to a reduction of 3% and 75% for O3 and PM2.5 respectively, considering the average of grid cells within Brazil, whereas the CLE scenario leads to an increase of 1% and 11% for O3 and PM2.5 respectively, concentrated near urban centers. These results indicate that of the three emission control scenarios, the CLE leads to poor air quality, while the MFR scenario leads to the maximum improvement in air quality. To the best of our knowledge, this work is the first to investigate the responses of air quality to changes in emissions under these emission scenarios for Brazil. The results shed light on the linkage between changes of emissions and air quality.

Long-term trends in ambient fine particulate matter from 1980 to 2016 in United Arab Emirates

This paper presents the most comprehensive datasets of ambient fine particulate matter (PM_2.5) for the UAE from 1980 to 2016. The long-term distributions of PM_2.5 showed the annual average PM_2.5 concentrations constantly exceeded the EPA and WHO guidelines. They varied from 77 to 49 μg/m³ with an overall average of 61.25 μg/m³. While the inter-annual variability in PM_2.5 concentrations showed relatively a cyclic pattern, with successive ups and downs, it broadly exhibited an increasing trend, particularly, over the last 14 years. PM_2.5 concentrations displayed a strong seasonal pattern, with greatest values observed during warm summer season, a period of high demand of electricity and dust events. The lowest values found in autumn are attributable to reduced demand of energy. Decreased atmospheric temperatures and high relative humidity coinciding with this period are likely to reduce the secondary formation of PM_2.5. The spatial changes in PM_2.5 concentrations exhibited gradual downward trends to the north and northeast directions. Airborne PM_2.5 is prevalent in the southern and western regions, where the majority of oil and gas fields are located. PM_2.5/PM₁₀ ratio indicated that ambient aerosols are principally associated with anthropogenic sources. Peaks in PM_2.5/CO ratio were frequently observed during June, July, and August, although few were concurrent with March. This indicates that secondary formation plays an important role in PM_2.5 levels measured in these months, especially as the photochemical activities become relatively strong in these periods. The lowest PM_2.5/CO ratios were found during September, October, and November (autumn) suggesting a considerable contribution of primary combustion emissions, especially vehicular emissions, to PM_2.5 concentration. PM_2.5 concentrations are positively correlated with sulfate levels. In addition to sea and dust aerosols, sulfate concentration in the coastal region is also related to fossil fuel burning from power plants, oil and gas fields, and oil industries. The population-weighted average of PM_2.5 in UAE was 63.9 μg/m³, which is more than three times greater than the global population-weighted mean of 20 μg/m³.

Ambient PM2.5 exposure and expected premature mortality to 2100 in India under climate change scenarios

Premature mortality from current ambient fine particulate (PM_2.5) exposure in India is large, but the trend under climate change is unclear. Here we estimate ambient PM_2.5 exposure up to 2100 by applying the relative changes in PM_2.5 from baseline period (2001-2005) derived from Coupled Model Inter-comparison Project 5 (CMIP5) models to the satellite-derived baseline PM_2.5. We then project the mortality burden using socioeconomic and demographic projections in the Shared Socioeconomic Pathway (SSP) scenarios. Ambient PM_2.5 exposure is expected to peak in 2030 under the RCP4.5 and in 2040 under the RCP8.5 scenario. Premature mortality burden is expected to be 2.4-4 and 28.5-38.8% higher under RCP8.5 scenario relative to the RCP4.5 scenario in 2031-2040 and 2091-2100, respectively. Improved health conditions due to economic growth are expected to compensate for the impact of changes in population and age distribution, leading to a reduction in per capita health burden from PM_2.5 for all scenarios except the combination of RCP8.5 exposure and SSP3.

The potential effects of climate change on air quality across the conterminous U.S. at 2030 under three Representative Concentration Pathways

The potential impacts of climate change on regional ozone (O3) and fine particulate (PM2.5) air quality in the United States are investigated by linking global climate simulations with regional scale meteorological and chemical transport models. Regional climate at 2000 and at 2030 under three Representative Concentration Pathways (RCPs) is simulated by using the Weather Research and Forecasting (WRF) model to downscale 11-year time slices from the Community Earth System Model (CESM). The downscaled meteorology is then used with the Community Multiscale Air Quality (CMAQ) model to simulate air quality during each of these 11-year periods. The analysis isolates the future air quality differences arising from climate-driven changes in meteorological parameters and specific natural emissions sources that are strongly influenced by meteorology. Other factors that will affect future air quality, such as anthropogenic air pollutant emissions and chemical boundary conditions, are unchanged across the simulations. The regional climate fields represent historical daily maximum and daily minimum temperatures well, with mean biases less than 2 K for most regions of the U.S. and most seasons of the year and good representation of variability. Precipitation in the central and eastern U.S. is well simulated for the historical period, with seasonal and annual biases generally less than 25%, with positive biases exceeding 25% in the western U.S. throughout the year and in part of the eastern U.S. during summer. Maximum daily 8-h ozone (MDA8 O3) is projected to increase during summer and autumn in the central and eastern U.S. The increase in summer mean MDA8 O3 is largest under RCP8.5, exceeding 4 ppb in some locations, with smaller seasonal mean increases of up to 2 ppb simulated during autumn and changes during spring generally less than 1 ppb. Increases are magnified at the upper end of the O3 distribution, particularly where projected increases in temperature are greater. Annual average PM2.5 concentration changes range from -1.0 to 1.0 μg m-3. Organic PM2.5 concentrations increase during summer and autumn due to increased biogenic emissions. Aerosol nitrate decreases during winter, accompanied by lesser decreases in ammonium and sulfate, due to warmer temperatures causing increased partitioning to the gas phase. Among meteorological factors examined to account for modeled changes in pollution, temperature and isoprene emissions are found to have the largest changes and the greatest impact on O3 concentrations.

Climate change impacts on human health over Europe through its effect on air quality

This review examines the current literature on the effects of future emissions and climate change on particulate matter (PM) and O₃ air quality and on the consequent health impacts, with a focus on Europe. There is considerable literature on the effects of climate change on O₃ but fewer studies on the effects of climate change on PM concentrations. Under the latest Intergovernmental Panel on Climate Change (IPCC) 5th assessment report (AR5) Representative Concentration Pathways (RCPs), background O₃ entering Europe is expected to decrease under most scenarios due to higher water vapour concentrations in a warmer climate. However, under the extreme pathway RCP8.5 higher (more than double) methane (CH₄) abundances lead to increases in background O₃ that offset the O₃ decrease due to climate change especially for the 2100 period. Regionally, in polluted areas with high levels of nitrogen oxides (NO_x), elevated surface temperatures and humidities yield increases in surface O₃ - termed the O₃ climate penalty - especially in southern Europe. The O₃ response is larger for metrics that represent the higher end of the O₃ distribution, such as daily maximum O₃. Future changes in PM concentrations due to climate change are much less certain, although several recent studies also suggest a PM climate penalty due to high temperatures and humidity and reduced precipitation in northern mid-latitude land regions in 2100.A larger number of studies have examined both future climate and emissions changes under the RCP scenarios. Under these pathways the impact of emission changes on air quality out to the 2050s will be larger than that due to climate change, because of large reductions in emissions of O₃ and PM pollutant precursor emissions and the more limited climate change response itself. Climate change will also affect climate extreme events such as heatwaves. Air pollution episodes are associated with stagnation events and sometimes heat waves. Air quality during the 2003 heatwave over Europe has been examined in numerous studies and mechanisms for enhancing O₃ have been identified.There are few studies on health effects associated with climate change impacts alone on air quality, but these report higher O₃-related health burdens in polluted populated regions and greater PM_2.5 health burdens in these emission regions. Studies that examine the combined impacts of climate change and anthropogenic emissions change under the RCP scenarios report reductions in global and European premature O₃-respiratory related and PM mortalities arising from the large decreases in precursor emissions. Under RCP 8.5 the large increase in CH₄ leads to global and European excess O₃-respiratory related mortalities in 2100. For future health effects, besides uncertainty in future O₃ and particularly PM concentrations, there is also uncertainty in risk estimates such as effect modification by temperature on pollutant-response relationships and potential future adaptation that would alter exposure risk.

U.S. Air Quality and Health Benefits from Avoided Climate Change under Greenhouse Gas Mitigation

We evaluate the impact of climate change on U.S. air quality and health in 2050 and 2100 using a global modeling framework and integrated economic, climate, and air pollution projections. Three internally consistent socioeconomic scenarios are used to value health benefits of greenhouse gas mitigation policies specifically derived from slowing climate change. Our projections suggest that climate change, exclusive of changes in air pollutant emissions, can significantly impact ozone (O3) and fine particulate matter (PM2.5) pollution across the U.S. and increase associated health effects. Climate policy can substantially reduce these impacts, and climate-related air pollution health benefits alone can offset a significant fraction of mitigation costs. We find that in contrast to cobenefits from reductions to coemitted pollutants, the climate-induced air quality benefits of policy increase with time and are largest between 2050 and 2100. Our projections also suggest that increasing climate policy stringency beyond a certain degree may lead to diminishing returns relative to its cost. However, our results indicate that the air quality impacts of climate change are substantial and should be considered by cost-benefit climate policy analyses.

Projecting future air pollution-related mortality under a changing climate: progress, uncertainties and research needs

BACKGROUND

Climate change may affect mortality associated with air pollutants, especially for fine particulate matter (PM2.5) and ozone (O3). Projection studies of such kind involve complicated modelling approaches with uncertainties.

OBJECTIVES

We conducted a systematic review of researches and methods for projecting future PM2.5-/O3-related mortality to identify the uncertainties and optimal approaches for handling uncertainty.

METHODS

A literature search was conducted in October 2013, using the electronic databases: PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 to September 2013.

DISCUSSION

Fifteen studies fulfilled the inclusion criteria. Most studies reported that an increase of climate change-induced PM2.5 and O3 may result in an increase in mortality. However, little research has been conducted in developing countries with high emissions and dense populations. Additionally, health effects induced by PM2.5 may dominate compared to those caused by O3, but projection studies of PM2.5-related mortality are fewer than those of O3-related mortality. There is a considerable variation in approaches of scenario-based projection researches, which makes it difficult to compare results. Multiple scenarios, models and downscaling methods have been used to reduce uncertainties. However, few studies have discussed what the main source of uncertainties is and which uncertainty could be most effectively reduced.

CONCLUSIONS

Projecting air pollution-related mortality requires a systematic consideration of assumptions and uncertainties, which will significantly aid policymakers in efforts to manage potential impacts of PM2.5 and O3 on mortality in the context of climate change.

Impact of climate change on mercury concentrations and deposition in the eastern United States

The global-regional climate-air pollution modeling system (GRE-CAPS) was applied over the eastern United States to study the impact of climate change on the concentration and deposition of atmospheric mercury. Summer and winter periods (300 days for each) were simulated, and the present-day model predictions (2000s) were compared to the future ones (2050s) assuming constant emissions. Climate change affects Hg(2+) concentrations in both periods. On average, atmospheric Hg(2+) levels are predicted to increase in the future by 3% in summer and 5% in winter respectively due to enhanced oxidation of Hg(0) under higher temperatures. The predicted concentration change of Hg(2+) was found to vary significantly in space due to regional-scale changes in precipitation, ranging from -30% to 30% during summer and -20% to 40% during winter. Particulate mercury, Hg(p) has a similar spatial response to climate change as Hg(2+), while Hg(0) levels are not predicted to change significantly. In both periods, the response of mercury deposition to climate change varies spatially with an average predicted increase of 6% during summer and 4% during winter. During summer, deposition increases are predicted mostly in the western parts of the domain while mercury deposition is predicted to decrease in the Northeast and also in many areas in the Midwest and Southeast. During winter mercury deposition is predicted to change from -30% to 50% mainly due to the changes in rainfall and the corresponding changes in wet deposition.

Quantifying the health impacts of air pollution under a changing climate-a review of approaches and methodology

Climate change has been predicted to affect future air quality, with inevitable consequences for health. Quantifying the health effects of air pollution under a changing climate is crucial to provide evidence for actions to safeguard future populations. In this paper, we review published methods for quantifying health impacts to identify optimal approaches and ways in which existing challenges facing this line of research can be addressed. Most studies have employed a simplified methodology, while only a few have reported sensitivity analyses to assess sources of uncertainty. The limited investigations that do exist suggest that examining the health risk estimates should particularly take into account the uncertainty associated with future air pollution emissions scenarios, concentration-response functions, and future population growth and age structures. Knowledge gaps identified for future research include future health impacts from extreme air pollution events, interactions between temperature and air pollution effects on public health under a changing climate, and how population adaptation and behavioural changes in a warmer climate may modify exposure to air pollution and health consequences.

A review of the consequences of global climate change on human health

The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.

Global air quality and climate

Emissions of air pollutants and their precursors determine regional air quality and can alter climate. Climate change can perturb the long-range transport, chemical processing, and local meteorology that influence air pollution. We review the implications of projected changes in methane (CH(4)), ozone precursors (O(3)), and aerosols for climate (expressed in terms of the radiative forcing metric or changes in global surface temperature) and hemispheric-to-continental scale air quality. Reducing the O(3) precursor CH(4) would slow near-term warming by decreasing both CH(4) and tropospheric O(3). Uncertainty remains as to the net climate forcing from anthropogenic nitrogen oxide (NO(x)) emissions, which increase tropospheric O(3) (warming) but also increase aerosols and decrease CH(4) (both cooling). Anthropogenic emissions of carbon monoxide (CO) and non-CH(4) volatile organic compounds (NMVOC) warm by increasing both O(3) and CH(4). Radiative impacts from secondary organic aerosols (SOA) are poorly understood. Black carbon emission controls, by reducing the absorption of sunlight in the atmosphere and on snow and ice, have the potential to slow near-term warming, but uncertainties in coincident emissions of reflective (cooling) aerosols and poorly constrained cloud indirect effects confound robust estimates of net climate impacts. Reducing sulfate and nitrate aerosols would improve air quality and lessen interference with the hydrologic cycle, but lead to warming. A holistic and balanced view is thus needed to assess how air pollution controls influence climate; a first step towards this goal involves estimating net climate impacts from individual emission sectors. Modeling and observational analyses suggest a warming climate degrades air quality (increasing surface O(3) and particulate matter) in many populated regions, including during pollution episodes. Prior Intergovernmental Panel on Climate Change (IPCC) scenarios (SRES) allowed unconstrained growth, whereas the Representative Concentration Pathway (RCP) scenarios assume uniformly an aggressive reduction, of air pollutant emissions. New estimates from the current generation of chemistry-climate models with RCP emissions thus project improved air quality over the next century relative to those using the IPCC SRES scenarios. These two sets of projections likely bracket possible futures. We find that uncertainty in emission-driven changes in air quality is generally greater than uncertainty in climate-driven changes. Confidence in air quality projections is limited by the reliability of anthropogenic emission trajectories and the uncertainties in regional climate responses, feedbacks with the terrestrial biosphere, and oxidation pathways affecting O(3) and SOA.

U.S. ozone air quality under changing climate and anthropogenic emissions

We examined future ozone (O3) air quality in the United States (U.S.) under changing climate and anthropogenic emissions worldwide by performing global climate-chemistry simulations, utilizing various combinations of present (1990s) and future (Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A2 2050s) climates, and present and future (2050s; IPCC SRES A2 and B1) anthropogenic emissions. The A2 climate scenario is employed here because it lies at the upper extreme of projected climate change for the 21st century. To examine the sensitivity of U.S. O3 to regional emissions increases (decreases), the IPCC SRES A2 and B1 scenarios, which have overall higher and lower O3-precursor emissions for the U.S., respectively, have been chosen. We find that climate change, by itself, significantly worsens the severity and frequency of high-O3 events ("episodes") over most locations in the U.S., with relatively small changes in average O3 air quality. These high-O3 increases due to climate change alone will erode moderately the gains made under a U.S. emissions reduction scenario (e.g., B1). The effect of climate change on high- and average-O3 increases with anthropogenic emissions. Insofar as average O3 air quality is concerned, changes in U.S. anthropogenic emissions will play the most important role in attaining (or not) near-term U.S. O3 air quality standards. However, policy makers must plan appropriately for O3 background increases due to projected increases in global CH4 abundance and non-U.S. anthropogenic emissions, as well as potential local enhancements that they could cause. These findings provide strong incentives for more-than-planned emissions reductions at locations that are currently O3-nonattainment.

Climate change, tropospheric ozone and particulate matter, and health impacts

OBJECTIVE

Because the state of the atmosphere determines the development, transport, dispersion, and deposition of air pollutants, there is concern that climate change could affect morbidity and mortality associated with elevated concentrations of these gases and fine particles. We review how climate change could affect future concentrations of tropospheric ozone and particulate matter (PM), and what changing concentrations could mean for population health.

DATA SOURCES

We review studies projecting the impacts of climate change on air quality and studies projecting the impacts of these changes on morbidity and mortality.

DATA SYNTHESIS

Climate change could affect local to regional air quality through changes in chemical reaction rates, boundary layer heights that affect vertical mixing of pollutants, and changes in synoptic airflow patterns that govern pollutant transport. Sources of uncertainty include the degree of future climate change, future emissions of air pollutants and their precursors, and how population vulnerability may change in the future. Given these uncertainties, projections suggest that climate change will increase concentrations of tropospheric ozone, at least in high-income countries when precursor emissions are held constant, which would increase morbidity and mortality. Few projections are available for low- and middle-income countries. The evidence is less robust for PM, primarily because few studies have been conducted.

CONCLUSIONS

Additional research is needed to better understand the possible impacts of climate change on air pollution-related health impacts. If improved models continue to project higher ozone concentrations with climate change, then reducing greenhouse gas emissions would enhance the health of current and future generations.