Projecting future air pollution-related mortality under a changing climate: progress, uncertainties and research needs

Background: Climate change may affect mortality associated with air pollutants, especially for fine particulate matter (PM2.5) and ozone (O-3). Projection studies of such kind involve complicated modelling approaches with uncertainties. Objectives: We conducted a systematic review of researches and methods for projecting future PM2.5-/O-3-related mortality to identify the uncertainties and optimal approaches for handling uncertainty. Methods: A literature search was conducted in October 2013, using the electronic databases: PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 to September 2013. Discussion: Fifteen studies fulfilled the inclusion criteria. Most studies reported that an increase of climate change-induced PM2.5 and O-3 may result in an increase in mortality. However, little research has been conducted in developing countries with high emissions and dense populations. Additionally, health effects induced by PM2.5 may dominate compared to those caused by O-3, but projection studies of PM2.5-related mortality are fewer than those of O-3-related mortality. There is a considerable variation in approaches of scenario-based projection researches, which makes it difficult to compare results. Multiple scenarios, models and downscaling methods have been used to reduce uncertainties. However, few studies have discussed what the main source of uncertainties is and which uncertainty could be most effectively reduced. Conclusions: Projecting air pollution-related mortality requires a systematic consideration of assumptions and uncertainties, which will significantly aid policymakers in efforts to manage potential impacts of PM2.5 and O-3 on mortality in the context of climate change. Crown Copyright (C) 2014 Published by Elsevier Ltd. All rights reserved.