life expectancy typically on the order of a few months from mortality risk

Life expectancy typically on the order of a few

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life expectancy, typically on the order of a few months, from mortality risk reductions in the context of exposure to ambient pollution. Unlike the VSL literature, only few studies in selected European countries have been carried out to date on the VOLY estimation. Further, these studies lack statistical strength due to the small sample sizes that were used in the analysis. Another frequent criticism in using this metric to value mortality impacts has been the lack of information on how VOLY might vary with age. For small changes in life expectancy, (i.e., on the order of months or at most a few years, such as would be the case of chronic exposure to air pollution) the VOLY has been used, while the VSL is the preferred valuation metric for accidental or immediate (also referred to acute mortality) deaths [ 29 ]. As the current population of Skopje ages over time, the mortality damage cost in future years varies depending on YLL and the VOLY. For our analysis, we chose a VOLY of 49,356 euros (2013 prices) in year 2012, calculated using the same benefit-transfer methodology applied to the VSL, and assuming a reference VOLY value of 126,000 euros for EU-27 (adapted from Holland, 2014). 3. Results 3.1. Mortality and Ylls Attributable to Air Pollution in 2012 under Different Scenarios At current pollution levels (49 μ g/m 3 ), the PM attributable mortality is 1199 premature deaths (CI95% 821–1519) in 2012. A hypothetical implementation of the EU limits could have averted an estimated 545 premature deaths, which is equivalent to a 45% decrease compared to the current situation, while a hypothetical reduction of PM levels to the WHO AQG could have averted an estimated 926 premature deaths (77% decrease). Regarding the years of life lost (YLL) by the 1199 estimated premature attributable deaths in 2012, these were estimated at 16,209 YLLs. This number is interpreted as the sum of lost years of life accrued by these individuals as a result of dying before their expected remaining lifetime at the time of death. The YLL per death equals 13.5, and the average loss of life expectancy among adults older than 30 years is 18 days (See Figure S1)—this figure applies to the population alive in year 2012 in this cohort and decreases as the population ages. Overall, a significant number of YLLs could be prevented by policies that aim to mitigate air pollution. During the first year alone, the avoidable YLLs under Scenario 1 are 306, while the figure increases to 476 for Scenario 2. The life expectancy of the population at the current pollution level is 76.4 years at birth and 16.3 years for individuals older than 65 (See Table 3 ). The data listed in the table in columns “Number of deaths” and “Years of life lost” represent the current burden in year 2012 (“Current situation”), as well as the residual burdens under the two specified scenarios. In other words, under Scenario 2 (WHO AQG), there will still be 32.4 thousand deaths and 372 thousand YLL across the population aggregated over a time horizon of 105 years (i.e., the follow-up time until everyone alive in 2012 has died). Life expectancy increases as pollution levels are reduced (top to bottom in column 2). Thus, a shift from the current situation to Scenario 2
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  • Fall '18
  • Noor Shah

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