the loss of productivity associated to that sickness andor caregiving for

The loss of productivity associated to that sickness

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the loss of productivity associated to that sickness and/or caregiving for oneself or others [ 12 ]. Thus, significant cost savings can be added to the health gains attainable through air pollution abatement. In this paper, we estimate for the city of Skopje the current health burdens and mitigation benefits of pollution on the local population in terms of hospital admissions and premature mortality, and in terms of their associated costs. The WHO air quality guidelines [ 13 ] and European Union (EU) reference values for PM 2.5 (Directive 2008/50/EC) are used as counterfactual policy scenarios for a reduction of air pollution. 2. Materials and Methods 2.1. Selection of Pollutants and Data Processing PM 2.5 (or PM 10 ) is an indicator for estimating health impacts of ambient air pollution mixture. PM is highly correlated with other air pollutants, such as NO 2 from transport. PM exposure has been linked to a variety of adverse health outcomes, including short-term symptoms, chronic morbidity effects, and premature mortality [ 14 ]. For data validation and processing, we used the methods developed by the World Health Organization and others for health impact assessment of air pollution [ 15 , 16 ]. These methods identified criteria to select the appropriate monitoring stations. For particulate matter, a monitoring station was considered eligible for the study only if daily data were available for more than 50% of the study period; the daily average value of concentration was considered valid only if more than 50% of hourly data were available. In Skopje, five air quality monitoring stations were in operation at some point between 2005 and 2013, and these stations recorded PM 10 . Monitoring of PM 2.5 was initiated in two of the stations in autumn 2011. Three stations have continuously monitored PM: Gazi Baba (urban background), Lisice (suburban industrial), and Rektorat (urban traffic) [ 17 ]. Overall, there was a high and significant correlation of measured PM 10 for the 5 monitoring stations over the period 2012–2013. Average values
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Int. J. Environ. Res. Public Health 2018 , 15 , 626 3 of 11 measured by the monitoring stations for PM 2.5 and PM 10 were high (see Table 1 ), but availability of data were limited. The observed ratio PM 2.5 /PM 10 was 0.610 for Centar and 0.609 for Karpos, both urban traffic monitoring stations. Table 1. Data availability and mean values by pollutant and monitoring station in Skopje for three consecutive years. Centar (Traffic) Gazi Baba (Background) Karpos (Traffic) Lisice (Industrial) Rektorat (Traffic) PM 2.5 (mean, μ g/m 3 ) 48.3 n.a. 41.6 n.a. n.a. 13 December 2011 availability (% per year) 28 91 85 n.a. 29 97 50 n.a. n.a. PM 10 (mean, μ g/m 3 ) 79.2 84.4 68.3 108.6 71.7 13 December 2011 availability (% per year) 28 91 90 3 58 58 29 97 91 86 92 98 21 96 99 2.2. Health Impact Assessment 2.2.1. Population Data The geographical area for the health impact assessment comprises the municipalities of Skopje in 2012 (not including Sopishte, physically segregated from the Skopje agglomeration). The target population considered is all residents exposed to the measured pollutants. This study focuses on health impacts of PM on the population of Skopje in 2012 and includes persons living in the surrounding municipalities of Skopje with the exception of Sopishte. According to official municipality statistics [
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  • Fall '18
  • Noor Shah

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