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Environ Health Perspect. 2010 October; 118(10): A424–A425.
PMCID: PMC2957940
Perspectives
Correspondence

The Global Burden of Air Pollution on Mortality: Anenberg et al. respond

Susan C. Anenberg and J. Jason West
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, E-mail: ude.cnu.liame@tsewjj
Larry W. Horowitz
National Oceanic and Atmospheric Administration, Geophysical Fluid Dynamics Laboratory, Princeton, New Jersey

We appreciate the comments by Rylance et al. stimulated by our analysis of the global burden of disease due to outdoor air pollution (Anenberg et al. 2010). We acknowledge that indoor air pollution is—and has long been recognized as—a significant burden on public health, particularly in developing countries where solid fuels are used extensively for cooking and heating (e.g., Smith 1987; Smith et al. 2004), but these comments on indoor air pollution do not affect our conclusions about the impacts of outdoor air pollution on global mortality.

In the 2004 World Health Organization (WHO) comparative risk assessment, Ezzati et al. (2004) estimated that indoor air pollution associated with household use of solid fuels is responsible for more premature mortalities than outdoor air pollution. Although our estimate of premature mortality due to outdoor air pollution is higher than the previous WHO estimate (Cohen et al. 2004), it should only be compared with indoor air pollution when methods for both risk factors are updated consistently, as in the forthcoming Global Burden of Diseases, Injuries, and Risk Factors Study (Institute for Health Metrics and Evaluation 2010).

We agree with Rylance et al. that the approach used by Pope et al. (2009) to integrate outdoor air pollution and cigarette smoking on a common scale would potentially also be useful for analyzing indoor air pollution. More broadly, additional research is needed to understand and differentiate indoor and outdoor exposures to multiple air pollutants and their ultimate effects on health in different parts of the world.

References

  • Anenberg SC, Horowitz LW, Tong DQ, West JJ. An estimate of the gobal burden of anthropogenic ozone and fine particulate matter on premature human mortality using atmospheric modeling. Environ Health Perspect. 2010;118:1189–1195. doi: 10.1289/ehp.0901220. [PMC free article] [PubMed] [Cross Ref]
  • Cohen AJ, Anderson HR, Ostro B, Pandey KD, Krzyzanowski M, Künzli N, et al. Urban air pollution. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attribution to Selected Major Risk Factors. Geneva: World Health Organization; 2004. [[accessed 3 September 2010]]. pp. 1353–1434. Available: http://www.who.int/publications/cra/chapters/volume2/1353-1434.pdf.
  • Ezzati M, Rodgers A, Lopez AD, Vander Hoorn S, Murray CJL. Mortality and burden of disease attributable to individual risk factors. Geneva: World Health Organization; 2004.
  • Institute for Health Metrics and Evaluation. Global Burden of Diseases Study. 2010. [[accessed 3 September 2010]]. Available: http://www.globalburden.org/
  • Pope CA, III, Burnett RT, Krewski D, Jerrett M, Shi Y, Calle EE, et al. Cardiovascular mortality and exposure to airborne fine particulate matter and cigarette smoke: shape of the exposure-response relationship. Circulation. 2009;120(11):941–948. [PubMed]
  • Smith KR. Biofuels, Air Pollution, and Health: a Global Review. Plenum, New York: Plenum; 1987.
  • Smith KR, Mehta S, Maeusezahl-Feuz M. Indoor air pollution from household use of solid fuels. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attribution to Selected Major Risk Factors. Geneva: World Health Organization; 2004. [[accessed 3 September 2010]]. pp. 1435–1494. Available: http://www.who.int/publications/cra/chapters/volume2/1435-1494.pdf.

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Science