Long-Term Ambient PM_2.5 Exposure and Premature Mortality Across of Türkiye.

Authors

Nebile Özmen, Volkan Duran, Fatma Şencan, Yasin Paşa, Mehmet Ali Çelik

Published in

Toxics. Volume 14. Issue 8. Aug 17, 2026. Epub Aug 17, 2026.

Abstract

Long-term exposure to ambient fine particulate matter (PM_2.5) is the leading environmental risk factor for premature mortality worldwide, yet comprehensive province-level evidence quantifying its health burden across Türkiye remains limited. This study investigated the spatial relationship between long-term PM_2.5 exposure and all-cause attributable mortality across all 81 Turkish provinces in 2022 using province-level annual mean PM_2.5 concentrations and World Health Organisation (WHO) AirQ+ estimates of PM_2.5-attributable deaths among adults aged ≥30 years, assuming a counterfactual concentration of 5 µg/m³. The association between PM_2.5 exposure and mortality was evaluated using Pearson and Spearman correlation analyses, ordinary least squares (OLS) regression, a log-log elasticity model, and population-weighted regional and exposure-quartile comparisons, while national temporal indicators for 2010-2023 were reported solely as supplementary context for the primary single-year 2022 cross-sectional analysis. The population-weighted annual mean PM_2.5 concentration was 27.0 µg/m³, exceeding the WHO Air Quality Guideline by a factor of 5.4, and all 81 provinces exceeded the recommended threshold. The bivariate OLS model accounted for 41% of the between-province variation in attributable mortality rates (OLS slope = 3.23 additional deaths per 100,000 population for each 1 µg/m³ increase in PM_2.5; 95% CI: 2.37-4.10; R² = 0.41; p < 0.001), while the log-log elasticity model indicated that a 1% increase in PM_2.5 concentration was associated with a 0.80% increase in the attributable mortality rate (95% CI: 0.65-0.95). The attributable fraction of natural-cause mortality increased progressively from 8.8% in the lowest exposure quartile to 24.6% in the highest. Nationwide, an estimated 68,440 premature deaths, representing 14.2% of all natural-cause deaths among adults aged ≥30 years, were attributable to PM_2.5 exposure. These findings quantify a steep, spatially graded PM_2.5-attributable mortality burden across Türkiye. As the attributable estimates derive from the WHO AirQ+ concentration-response function, the gradient describes the magnitude and spatial distribution of the modelled burden rather than an independently estimated exposure-response relationship, and on that basis the results support the adoption of WHO-aligned air-quality standards and accelerated decarbonization strategies to reduce the national health burden attributable to ambient air pollution.

PMID:
42647010
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.