Evaluation of the relationship between air pollution levels and mortality in İstanbul province

Aims: This study aims to determine the levels of pollutant parameters measured at all stations in Istanbul province between 2013 and 2019 and to establish the relationship between air pollution parameters and all non-accidental deaths that occurred during the study years. Materials and Methods: In this ecological study, daily air pollution parameters provided by the Ministry of Environment, Urbanization, and Climate Change of the Republic of Turkey and Istanbul Metropolitan Municipality Air Quality Monitoring Center for the years 2013-2019 in Istanbul province were utilized. Data on deaths attributable to all causes that occurred during the same years were used. The correlation between daily air pollution levels and death counts was evaluated. Death rates attributed to air pollution were calculated using a regression model. Days with consecutive increases in pollutant levels were identified, and their effects on death counts were determined. A statistical significance threshold of p <0.05 was accepted. Results: In Istanbul, it was observed that air pollution parameters were above the annual limit value specified by the World Health Organization (although showing a decrease over the years) between 2013 and 2019. Moderate to high levels of correlation were found among air pollution parameters. Correlations were observed between air pollution parameters and total deaths, adult deaths, infant deaths, and deaths of individuals over 65 years old. During the study period in Istanbul, an increase of 10 µg/m3 in PM10 levels was found to cause a 1.017 (1.009-1.025) times increase in the number of deaths, while an increase of 10 µg/m3 in PM2,5 levels caused a 1.033 (1.021-1.046) times increase in the number of deaths. An increase in deaths attributed to air pollution was observed on days with consecutive increases in pollutant levels. Conclusion: The study has demonstrated that an increase in air pollution levels has an impact on deaths. Regular and systematic monitoring of air pollution levels, along with the development of policies and effective intervention methods, should be ensured.