Air pollution and mortality: quantification and valuation of years of life lost.

To analyze the loss of life expectancy (LLE) due to air pollution and the associated social cost, a dynamic model was developed that took into account the decrease of risk after the termination of an exposure to pollution. A key parameter was the time constant for the decrease of risk, for which estimates from studies of smoking were used. A sensitivity analysis showed that the precise value of the time constant(s) was not critical for the resulting LLE. An interesting aspect of the model was that the relation between population total LLE and PM2.5 concentration was numerically almost indistinguishable from a straight line, even though the functional dependence was nonlinear. This essentially linear behavior implies that the detailed history of a change in concentration does not matter, except for the effects of discounting. This model was used to correct the data of the largest study of chronic mortality for variations in past exposure, performed by Pope et al. in 1995; the correction factor was shown to depend on assumptions about the relative toxicity of the components of PM2.5. In the European Union, an increment of 1 microg/m3 of PM2.5 for 1 year implies an average LLE of 0.22 days per person. With regard to the social cost of an air pollution pulse, it was found that for typical discount rates (3% to 8% real) the cost was reduced by a factor of about 0.4 to 0.6 relative to the case with zero discount rate, if the value of a life year was taken as given; if the value of a life year was calculated from the "value of statistical life" by assuming the latter as a series of discounted annual values, the cost varied by at most +/-20% relative to the case with zero discount rate. To assess the uncertainties, this study also examined how the LLE depended on the demographics (mortality and age pyramid) of a population, and how it would change if the relative risk varied with age, in the manner suggested by smoking studies. These points were found to have a relatively small effect (compared to the epidemiological uncertainties) on the calculated LLE.