According to official municipality statistics 18 the total population not

According to official municipality statistics 18 the

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municipalities of Skopje with the exception of Sopishte. According to official municipality statistics [ 18 ], the total population (not counting Sopishte) was 531,524 people, of which 260,216 (49%) were men (157,973 over the age of 30 years) and 271,308 were women (173,501 older than 30 years). Population data by district (ten in total, again not counting Sopishte) and five-year age groups were obtained from the Macedonian statistical office [ 19 ]. Mortality data (all-cause, non-accidental, disaggregated by ICD10 chapters) were obtained for the analysis period (2011–2013) from the Macedonian State Statistical Office, and morbidity data were obtained for the same years from the Skopje Center of Public Health. 2.2.2. Selection of Health Endpoints PM 2.5 relative risks (RR) were used to estimate premature mortality in adults older than 30 years old from long-term exposure and to quantify health morbidity (Table 2 ). Table 2. Selected air quality indicators and PM relative risks. Health Endpoint (Specific Population) ICD10 Codes Relative Risk (RR) Source All-cause mortality excl. accidents (Adults 30 years and older) A00-R99 For 10 μ g/m 3 increase in PM 2.5 RR = 1.062 (95% CI: 1.040–1.083) [ 20 ] Hospital admission for cardiovascular diseases (all ages) I00-I52 For 10 μ g/m 3 increases in PM 2.5 RR = 1.0091 (95% CI: 1.0017–1.0166) Air Pollution Epidemiology Database—APED [ 14 ] Hospital admissions for respiratory diseases (all ages) J00-J99 For 10 μ g/m 3 increases in PM 2.5 RR = 1.0190 (95% CI: 1.0190–1.0402) Air Pollution Epidemiology Database—APED [ 14 ] ICD10: International Classification of Diseases 10th revision. Epidemiological calculations were carried out with WHO software AirQ+ [ 21 , 22 ]. The years of life lost (YLL) due to ambient air pollution were calculated using the life table calculator developed by Joseph Spadaro (obtainable upon request, see corresponding authors’ details.) and recently integrated into AirQ+. YLL are calculated for each specific calendar year in relation to a given population that is projected until its extinction, in this case after 105 years.
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Int. J. Environ. Res. Public Health 2018 , 15 , 626 4 of 11 We computed PM 2.5 impacts by calculating a population attributable fraction PAF, the proportion of incidence of specific health endpoints that is related to PM 2.5 exposure: PAF = 1 - 1/RR and RR = RRo ( Δ C/10) (1) in which RRo are the relative risks of the health effects listed in Table 2 (e.g., for long-term mortality 1.062) and Δ C is the change in ambient air concentration relative to a counterfactual scenario in μ g/m 3 . The PM 2.5 impacts are calculated as the product of the disease-specific PAF by the baseline mortality BM in the case of premature deaths (that is, premature deaths = PAF × BM), or the disease incidence rate if assessing health morbidity. There is no safe PM 2.5 threshold level below which no negative effects are expected. However, a target concentration is needed to determine the attributable impacts or potential benefits of reducing the air pollution by a specified amount. 2.2.3. Pollution Mitigation Scenarios The following mitigation scenarios have been considered: Current situation—Annual average concentration of PM 2.5 at 49.2 μ g/m 3 Scenario 1: EU AQS—Annual average concentration of PM 2.5 reduced to 25 μ g/m 3 Scenario 2: WHO AQG—Annual average concentration of PM 2.5 reduced to 10 μ g/m 3 Since PM 2.5
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  • Fall '18
  • Noor Shah

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