Health impact assessment of particulate matter in Sanandaj, Kurdistan, Iran

Document Type : Original Article


1 Kurdistan Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Department of Natural Resources and Environment, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran

4 Deputy of Research, Kurdistan University of Medical Sciences, Sanandaj, Iran


Air pollution is a major environmental issue in all regions of the world. We aimed to assess the health impacts of particulate matter with an aerodynamic diameter  10 µm (PM10) in Sanandaj, Kurdistan, Iran. The air pollution data were obtained from Sanandaj Department of Environment Protection. The annual mortality and morbidity, including cardiovascular and respiratory diseases attributable to PM10 exposure were estimated using AirQ model, which is the proposed method for health impact assessment of air pollution by World Health Organization. The annual, winter, and summer averages of PM10 in 2013 were 81.5, 64.7, and 98.3 μg/m3, respectively. The total mortality, cardiovascular mortality, respiratory mortality, hospital admissions due to cardiovascular diseases, and hospital admissions due to respiratory diseases, respectively, were estimated 228, 120, 23, 118, and 305 cases. Approximately 11.7% of total mortality was associated with concentrations more than 20 μg/m3. This study was the first attempt to assess the health impacts of air pollution in Sanandaj, Kurdistan, Iran. In summary, we found increased mortality and morbidity attributable to PM10 exposure.    


  1. Kunzli N, Kaiser R, Medina S, Studnicka M, Chanel O, Filliger P, et al. Public-health impact of outdoor and traffic-related air pollution: a European assessment. Lancet 2000; 356(9232): 795-801.
  2. Amini H, Taghavi-Shahri SM, Henderson SB, Naddafi K, Nabizadeh R, Yunesian M. Land use regression models to estimate the annual and seasonal spatial variability of sulfur dioxide and particulate matter in Tehran, Iran. Sci Total Environ 2014; 488-489C: 343-53.
  3. Cohen AJ, Ross AH, Ostro B, Pandey KD, Krzyzanowski M, Kunzli N, et al. The global burden of disease due to outdoor air pollution. J Toxicol Environ Health A 2005; 68(13-14): 1301-7.
  4. Gauderman WJ, Avol E, Gilliland F, Vora H, Thomas D, Berhane K, et al. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med 2004; 351(11): 1057-67.
  5. Breitner S, Liu L, Cyrys J, Bruske I, Franck U, Schlink U, et al. Sub-micrometer particulate air pollution and cardiovascular mortality in Beijing, China. Sci Total Environ 2011; 409(24): 5196-204.
  6. Janssen NA, Fischer P, Marra M, Ameling C, Cassee FR. Short-term effects of PM2.5, PM10 and PM2.5-10 on daily mortality in The Netherlands. Sci Total Environ 2013; 463-464: 20-6.
  7. Jimenez E, Linares C, Rodriguez LF, Bleda MJ, Diaz J. Short-term impact of particulate matter (PM2.5) on daily mortality among the over-75 age group in Madrid (Spain). Sci Total Environ 2009; 407(21): 5486-92.
  8. Zhang LW, Chen X, Xue XD, Sun M, Han B, Li CP, et al. Long-term exposure to high particulate matter pollution and cardiovascular mortality: a 12-year cohort study in four cities in northern China. Environ Int 2014; 62: 41-7.
  9. Goudarzi G, Zallaghi E, Neissi A, Ankali KA, Saki A, Babaei AA, et al. Cardiopulmonary mortalities and chronic obstructive pulmonary disease attributed to ozone air pollution.2013. Arch Hyg Sci 2013; 2(2): 62-72.
  10. Downs SH, Schindler C, Liu LJ, Keidel D, Bayer-Oglesby L, Brutsche MH, et al. Reduced exposure to PM10 and attenuated age-related decline in lung function. N Engl J Med 2007; 357(23): 2338-47.
  11. Kunzli N, Jerrett M, Mack WJ, Beckerman B, LaBree L, Gilliland F, et al. Ambient air pollution and atherosclerosis in Los Angeles. Environ Health Perspect 2005; 113(2): 201-6.
  12. Amini H, Shamsipour M, Sowlat MH, Parsaeian M, Kasaeian A, Hassanvand MS, et al. National and sub-national Environmental Burden of Disease in Iran from 1990 to 2013-study profile. Arch Iran Med 2014; 17(1): 62-70.
  13. Dockery DW, Pope CA, III. Acute respiratory effects of particulate air pollution. Annu Rev Public Health 1994; 15: 107-32.
  14. Schwartz J, Slater D, Larson TV, Pierson WE, Koenig JQ. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis 1993; 147(4): 826-31.
  15. Xie RK, Seip HM, Leinum JR, Winje T, Xiao JS. Chemical characterization of individual particles (PM10) from ambient air in Guiyang City, China. Sci Total Environ 2005; 343(1-3): 261-72.
  16. Reisen VA, Sarnaglia AJQ, Reis J, Levy-Leduc C+, Santos JM. Modeling and forecasting daily average PM10 concentrations by a seasonal long-memory model with volatility. Environmental Modelling & Software 2014; 51(0): 286-95.
  17. Lopez JM, Callen MS, Murillo R, Garcia T, Navarro MV, de la Cruz MT, et al. Levels of selected metals in ambient air PM10 in an urban site of Zaragoza (Spain). Environ Res 2005; 99(1): 58-67.
  18. Maheswaran R, Haining RP, Brindley P, Law J, Pearson T, Fryers PR, et al. Outdoor air pollution, mortality, and hospital admissions from coronary heart disease in Sheffield, UK: a small-area level ecological study. Eur Heart J 2005; 26(23): 2543-9.
  19. Pisoni E, Volta M. Modeling Pareto efficient PM10 control policies in Northern Italy to reduce health effects. Atmospheric Environment 2009; 43(20): 3243-8.
  20. Wang S, Feng X, Zeng X, Ma Y, Shang K. A study on variations of concentrations of particulate matter with different sizes in Lanzhou, China. Atmospheric Environment 2009; 43(17): 2823-8.
  21. Gharehchahi E, Mahvi AH, Amini H, Nabizadeh R, Akhlaghi AA, Shamsipour M, et al. Health impact assessment of air pollution in Shiraz, Iran: a two-part study. J Environ Health Sci Eng 2013; 11(1): 11.
  22. Statistical Centre of Iran. Estimated population of country cities for 2011 [Online]. [cited 2011]; Available from: URL:
  24. Krzyzanowski M. Methods for assessing the extent of exposure and effects of air pollution. Occup Environ Med 1997; 54(3): 145-51.
  25. Naddafi K, Hassanvand MS, Yunesian M, Momeniha F, Nabizadeh R, Faridi S, et al. Health impact assessment of air pollution in megacity of Tehran, Iran. Iranian J Environ Health Sci Eng 2012; 9(1): 28.
  26. Hassanvand MS, Amini H, Yunesian M. The evaluation of PM10, PM2.5, and PM1 concentrations during the Middle Eastern Dust (MED) events in Ahvaz, Iran. Journal of Arid Environments 2013; 97: 1-2.
  27. Goudarzi GH, Naddafi K, MesdaghiniaAR. Quantifying the health effects of air pollution in Tehran and the third axis of the comprehensive plan to reduce air pollution in Tehran [Thesis]. Tehran, Iran: Tehran University of Medical Sciences; 2009.
  28. Tominz R, Mazzoleni B, Daris F. Estimate of potential health benefits of the reduction of air pollution with PM10 in Trieste, Italy. Epidemiol Prev 2005; 29(3-4): 149-55.
  29. Katsouyanni K, Touloumi G, Samoli E, Gryparis A, Le TA, Monopolis Y, et al. Confounding and effect modification in the short-term effects of ambient particles on total mortality: results from 29 European cities within the APHEA2 project. Epidemiology 2001; 12(5): 521-31.
  30. Samet JM, Zeger SL, Dominici F, Curriero F, Coursac I, Dockery DW, et al. The National Morbidity, Mortality, and Air Pollution Study. Part II: Morbidity and mortality from air pollution in the United States. Res Rep Health Eff Inst 2000; 94(Pt 2): 5-70.
  31. Ezzati M. Comparative Quantification of Health Risks: Sexual and reproductive health. Geneva, Switzerland: World Health Organization; 2004. p. 1177-320.
  32. Health Effects Institute. Health Effects of Outdoor Air Pollution in Developing Countries of Asia: A Literature Review [Online]. [cited 2004 Jan 1]; Available from: URL: