Premature mortality in the Kingdom of Saudi Arabia associated with particulate matter air pollution from the 1991 Gulf War

The State of Kuwait oil fires and military operations associated with the 1991 Gulf War resulted in substantially increased levels of airborne particulate matter (PM) in the Kingdom of Saudi Arabia (KSA) during 1991 and 1992. Using quantitative risk assessment methodology, this article estimates the increase in premature deaths in citizens of the KSA associated with the Gulf War-related increase in PM air pollution levels. Meta-analysis of daily time-series studies of non-accidental mortality associated with increased PM(10) levels using two alternative methodologies yielded exposure-response relative risk functions of 2.7% and 3.5% per 50 mu g/m(3) increase in PM(10) concentration. Combining these exposure-response functions with estimates of the magnitude and duration of the increased PM(10) exposure, the size of the exposed population and baseline mortality rates provided an estimate of approximately 1,080 to 1,370 excess non-accidental deaths of Saudi citizens during 1991-1992 associated with the Gulf War-related increase in PM levels.