The Effect of Air Pollution-Related Deaths in Malaysia: Evaluating Disease Burden Mortality and Economic Impact

Background: In 2016, the World Bank Group estimated that health costs related to PM2.5 pollution totalled approximately $5.7 trillion worldwide. Information on the estimated health costs from the environmental burden of disease caused by ambient air pollutant PM2.5 in Malaysia is limited. Therefore, this study aimed to estimate the environmental health costs associated with PM2.5 for all-cause and respiratory mortality at the national level. Methods: The population-weighted exposure level (PWEL) of PM10 concentrations across all Malaysian states for 2000, 2008, and 2013 was calculated using publicly available remote sensing data, air quality data from the Department of Environment, and burden-of-disease mortality statistics from the Institute of Public Health. The PWEL was then converted to PM2.5 using the World Health Organization's ambient air conversion factors. The AirQ+ 2.2.4 software was used to calculate mortality proportions for all-cause mortality, chronic obstructive pulmonary disease (COPD), lung cancer (LC), and acute lower respiratory infection (ALRI) in children under five, based on the National Burden of Disease data from 2000, 2008, and 2013. Results: The cost per disability-adjusted life-year (DALY) ranged from one (low estimate) to three times the Gross Domestic Product (GDP) per capita (high estimate). These costs were projected for 2022 using a GDP deflator. The estimated PWEL for PM2.5 in 2000, 2008, and 2013 was 22µg/m³, 18µg/m³, and 24µg/m³, respectively. The mortality cost of all-cause deaths increased from MYR 3.3 billion in 2000 to MYR 5.1 billion in 2008, and then to MYR 12.8 billion in 2013, accounting for nearly 1% of Malaysia's 2013 GDP. Conclusions:This indicates a rise in disease burden and mortality costs due to ambient air PM2.5 levels. Therefore, policymakers should remain highly vigilant.