Atmospheric pollution and mortality in Portugal: Quantitative assessment of the environmental burden of disease using the AirQ plus model

In Portugal, data on mortality rate attributed to household and ambient air pollution are not reported due to shortness and irregularity of the available data series, and therefore, the disclosure of the national progress in reducing the number of deaths and illnesses from air contamination in exposures to multiple pollutants is incomplete. The present work describes the application of the AirQ+ model developed by the WHO to calculate how much of specific health outcomes is attributable to long-term exposure to atmospheric NO2, PM2.5, and O-3 in the population of various municipalities in Portugal, from 2010 to 2019. Linear Mixed Models were used for data analysis and have shown that (i) approximately 5000 deaths per year are attributable to exposure to mixtures of NO2 and PM2.5; (ii) the spatial distribution of the proportion of deaths attributable to NO2, PM2.5 and O-3 shows significant differences between locations, and (iii) that AirQ+ is a useful tool for the purpose of effective Public Health policymaking and reporting on the national progress to implement the 2030 Agenda.