Estimated mortality attributable to ambient PM2.5, PM10, and NO2 in Kütahya, Türkiye: an AirQ + analysıs

It is important to understand the epidemiological relationships between the health burden of air pollution and the deaths it may cause in order to reduce future morbidity and mortality. In this study, it was aimed to estimate early all-cause deaths and respiratory system-related deaths in Kütahya province due to exposure to PM 2.5 , PM 10 , and NO 2 using the AirQ + program. This ecological study used all-cause mortality and respiratory mortality as dependent outcomes, with the annual average PM 2.5 , PM 10 , and NO 2 concentrations (µg/m 3 ). Pollutant levels were calculated by taking the average of daily measurements between 01.01.2024 and 31.12.2024 from the National Air Quality Monitoring Network system module. Death counts for the year 2024, categorized by cause and age groups, were obtained from the Turkish Statistical Institute (TÜİK) data. The data were analyzed using SPSS and AirQ + (v.2.2.4) software. The average annual PM 2.5 , PM 10 , and NO 2 concentrations in the city of Kütahya were 15.38 ± 10.53, 49.41 ± 23.75, and 62.25 ± 35.06 µg/m 3 , and there were positive correlations among all pollutants. AirQ + calculation results revealed that exposure to PM 10 , PM 2.5 , and NO 2 , respectively, led to an estimated 453, 276, and 353 all-cause deaths and 245, 71, and 108 respiratory deaths. The cumulative relative risk (RR) for all-cause mortality ranged from 1.08 to 1.14, while the cumulative RR for respiratory mortality ranged from 1.10 to 1.47, reflecting the excess mortality risk associated with the full concentration gap between observed levels and WHO guideline values. If the concentrations of PM 10 , PM 2.5 , and NO 2 had been below the WHO limit values, it was estimated that 12.62%, 7.68%, and 9.83% of all deaths caused by each pollutant, respectively, could have been prevented. It has been predicted that 32.29%, 9.42%, and 14.31% of respiratory deaths caused by PM 10 , PM 2.5 , and NO 2 pollutants, respectively, could have been prevented. Considering the contribution of pollutants to total emissions in our province, it is known that the highest contributions come from residential heating, power plants, and traffic. In this context, the projects that local governments will implement in urban planning are important.