Health burden and economic loss attributable to ambient PM2.5 in Iran based on the ground and satellite data

We estimated mortality and economic loss attributable to PM2·5 air pollution exposure in 429 counties of Iran in 2018. Ambient PM2.5-related deaths were estimated using the Global Exposure Mortality Model (GEMM). According to the ground-monitored and satellite-based PM2.5 data, the annual mean population-weighted PM2·5 concentrations for Iran were 30.1 and 38.6 μg m−3, respectively. We estimated that long-term exposure to ambient PM2.5 contributed to 49,303 (95% confidence interval (CI) 40,914–57,379) deaths in adults ≥ 25 yr. from all-natural causes based on ground monitored data and 58,873 (95% CI 49,024–68,287) deaths using satellite-based models for PM2.5. The crude death rate and the age-standardized death rate per 100,000 population for age group ≥ 25 year due to ground-monitored PM2.5 data versus satellite-based exposure estimates was 97 (95% CI 81–113) versus 116 (95% CI 97–135) and 125 (95% CI 104–145) versus 149 (95% CI 124–173), respectively. For ground-monitored and satellite-based PM2.5 data, the economic loss attributable to ambient PM2.5-total mortality was approximately 10,713 (95% CI 8890–12,467) and 12,792.1 (95% CI 10,652.0–14,837.6) million USD, equivalent to nearly 3.7% (95% CI 3.06–4.29) and 4.3% (95% CI 3.6–4.5.0) of the total gross domestic product in Iran in 2018.