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Preventable mortality attributable to exposure to air pollution at the rural district of Punjab, India

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Air pollution has emerged as a leading global health risk in recent decades, where its health impacts are primarily focused on urban areas. In India, semi-urban and rural areas are also emerging as air pollution hotspots. As these regions are out of focus, the current study monitored air pollution (PM2.5) at a rural district of Punjab in North India and attempted to study the associated health impacts. Hospital data of outpatient department (OPD), inpatient department (IPD) and all-cause mortality was correlated with change in PM2.5 concentrations. PM2.5 concentrations showed seasonal variations having relatively higher concentrations during post-monsoon and winter seasons. This rise in air pollution (annual average 92 µg/m3) was found to be mainly due to crop residue burning, including local meteorology. In comparison, hospital data shows that hospital visits and admissions were higher during monsoon. This shows that hospital admissions could not be directly linked to air pollution in rural areas as other factors such as short days during winters and self-medication, socio-economic factors and dependency on local unauthorised traditional healers may influence. The application of the AirQ + model for short-term health effects reveals that out of 2582 total deaths, preventable deaths ranging from 246 (WHO guidelines value – 10 µg/m3) to 159 (Indian NAAQS – 40 µg/m3) could be ascribed to air pollution exposure and specifically PM2.5. However, these deaths are avoidable by developing strategies to minimise air pollution in rural areas. Hence, a comprehensive approach is needed to plan air pollution reduction strategies, including urban, semi-urban and rural areas.

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The authors are thankful to SMO CHC-Khera and CMO Fatehgarh Sahib District hospital for providing the hospital data and logistics support at sampling locations.

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Authors and Affiliations



Khaiwal Ravindra: conceptualization, methodology, formal analysis, validation, writing – review and editing.

Tanbir Singh: methodology, formal analysis, validation, writing – review and editing.

Suman Mor: methodology, formal analysis, validation, writing – review and editing.

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Correspondence to Khaiwal Ravindra.

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The study was conducted with the approval of Institute Ethic Committee (intramural) of PGIMER, Chandigarh vide letter no. INT/IEC/2015/791 dated 11th December 2015.

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Responsible Editor: Lotfi Aleya

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Estimated preventable mortality attributable to exposure to PM2.5 at the rural district

Seasonal increase in PM2.5 was found to be mainly due to crop residue burning, including local meteorology

Hospital admissions could not be directly linked to air pollution in rural areas due to socio-economic factors

246 (93–389) premature deaths are attributable to short-term exposure to PM2.5

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Ravindra, K., Singh, T. & Mor, S. Preventable mortality attributable to exposure to air pollution at the rural district of Punjab, India. Environ Sci Pollut Res 29, 32271–32278 (2022).

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