Long-term trends and spatial patterns of PM2.5-induced premature mortality in South and Southeast Asia from 1999 to 2014.

Fine particulate matter (PM2.5) poses a potential threat to human health, including premature mortality under long-term exposure. Based on a long-term series of high-resolution (0.01°×0.01°) satellite-retrieved PM2.5 concentrations, this study estimated the premature mortality attributable to PM2.5 in South and Southeast Asia (SSEA) from 1999 to 2014. Then, the long-term trends and spatial characteristics of PM2.5-induced premature deaths (1999-2014) were analyzed using trend analyses and standard deviation ellipses. Results showed the estimated number of PM2.5-induced average annual premature deaths in SSEA was 1,447,000. The numbers increased from 1,179,400 in 1999 to 1,724,900 in 2014, with a growth rate of 38% and net increase of 545,500. Stroke and ischemic heart disease were the two principal contributors, accounting for 39% and 35% of the total, respectively. High values were concentrated in North India, Bangladesh, East Pakistan, and some metropolitan areas of Southeast Asia. An estimated 991,600 deaths in India was quantified (i.e., ~69% of the total premature deaths in SSEA). The long-term trends (1999-2014) of PM2.5-related premature mortality exhibited consistent incremental tendencies in all countries except Sri Lanka. The findings of this study suggest that strict controls of PM2.5 concentrations in SSEA are urgently required.