Spatial analysis of annual air pollution exposure and mortality.

The aim of this study was to relate ambient air pollution levels to mortality in Auckland, New Zealand. We used urban airshed modelling and GIS-based techniques to quantify long-term exposure to ambient air pollution levels and associated mortality. After adjusting for age, sex, ethnicity, socio-economic status, and urban/rural domicile there was a 1.3% (95%CI: 1-1.5%) increase in non-external cause mortality, and 1.8% (95%CI: 1.5-2.1%) increase in circulatory and respiratory causes per 1 microg/m(3) increase in annual average NO(2). Based on these exposure-response relationships and applying an annual average threshold of 13 microg/m(3), the average annual (for 1996-1999) number of people estimated to die from non-external causes and circulatory and respiratory causes attributable to air pollution in Auckland is 268 (95% range: 227-310) (3.9% of total all cause deaths) and 203 (95% range: 169-237) (5.9% of total circulatory and respiratory deaths) per year, respectively. The number of attributable deaths found in this study are consistent with a previous New Zealand risk assessment using a different methodology, and is approximately twice the number of people dying from motor vehicle accidents in the region, which is on average (1996-1999) 103 per year. The GIS-based exposure maps identify high exposure areas for policy developers and planners in a simple and realistic manner. Taken together with overseas studies the study provides additional evidence that long-term exposure to poor air quality, even at levels below current standards, is a hazard to the public health.