Thus a shift from the current situation to Scenario 2 increases life expectancy

Thus a shift from the current situation to scenario 2

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levels are reduced (top to bottom in column 2). Thus, a shift from the current situation to Scenario 2 increases life expectancy at birth by 2.2 years. Compared to a hypothetical population unexposed to ambient pollution, even at the recommended WHO target there would still be a loss of life expectancy at birth of about one-half year (column 3). The long-term impacts of air pollution can be considered if the data are aggregated for a population alive in 2012 over the mentioned follow up period of 105 years, assuming a constant birth rate (See Figure 1 ).
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Int. J. Environ. Res. Public Health 2018 , 15 , 626 6 of 11 Table 3. Health burdens of the different PM 2.5 scenarios, expressed as aggregate impact over a follow-up period of 105 years. PM2.5 Ambient Concentrations Life Expectancy (Years) Loss of Life Expectancy * (Years) Number of Deaths (Thousands) ** Years of Life Lost (Thousands) Current situation: 49.2 μ g/m 3 76.4 (at birth) 2.8 (at birth) 179.9 1813 16.3 (65 years) 2.1 (65 years) (123.2 - 227.9) (1177 - 2413) Scenario 1: EU AQS (25 μ g/m 3 ) 77.7 (at birth) 1.4 (at birth) 84.8 926.5 17.3 (65 years) 1.1 (65 years) (59.7 - 104.6) (600.3 - 1235) Scenario 2: WHO AQG (10 μ g/m 3 ) 78.6 (at birth) 0.6 (at birth) 32.4 372.0 18.0 (65 years) 0.5 (65 years) (23.2 - 39.4) (240.7 - 496.6) * Loss of life expectancy compared to a hypothetical unexposed population (life expectancy = 79.15 years at birth and 18.45 years at age 65) ** Values in brackets show 95% confidence intervals of estimates based solely on the RR uncertainty interval indicated in Table 2 . Figure 1. Health burden in terms of YLL and potential benefits under different mitigation scenarios. 3.2. Morbidity Attributable to Air Pollution in Year 2012 and Avoidable Impacts under Different Mitigation Scenarios Morbidity outcomes were calculated for hospital admissions due to cardiovascular and respiratory diseases. The results under different scenarios are summarized in Table 4 . Different proportions of the attributable morbidity in 2012 could have been “avoided” in scenarios with lower concentrations of PM 2.5 . Specifically, 19.9% of hospital admissions for cardiac disease and 19.6% for respiratory disease could have been “avoided” by achieving the EU standards; and 50.2% of hospital admissions for cardiac disease and 49.6% for respiratory disease could have been “avoided” by attaining the WHO air quality guidelines. Table 4. Morbidity outcomes under different PM 2.5 scenarios in year 2012. Morbidity Current Situation Scenario 1 EU Limits (95% CI) Scenario 2 WHO AQG (95% CI) Hospital admission for cardiovascular diseases 547 (104–977) 438 (83–784) 272 (51–490) Hospital admissions for respiratory disease 937 (937–1869) 753 (753–1516) 472 (472–964) 3.3. Economic Benefits of Reduced Premature Mortality The social cost for the estimated premature mortality attributable to PM 2.5 in the year 2012 in Skopje was between 570 M (VOLY metric) and 1470 M (VSL metric). Significant cost savings at the social level could be attained through air pollution abatement. Assuming a long-term real income
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Int. J. Environ. Res. Public Health 2018 , 15 , 626 7 of 11 growth of 2% and a 3% discount rate, the mean annual benefit of the mortality reduction achieved through Scenario 1 is between 251 M (using the VOLY metric) and 697 M (VSL metric). For scenario 2, the annual accrued benefit would be between 407 M (using the VOLY metric) and 1081 M (VSL metric). The health benefits and social costs of the two alternative scenarios can be visualized in a
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  • Fall '18
  • Noor Shah

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