Trends in all-cause mortality attributable to particulate matter 2.5 pollution in Sub-Saharan Africa: An age-period-cohort analysis

Particulate matter 2.5 (PM_2.5) pollution, comprising ambient PM_2.5 pollution (APMP) and household air PM_2.5 pollution from solid fuels (HAP), significantly impacts population health in Sub-Saharan Africa. This study extracted mortality data and various socio-economic indices in Sub-Saharan Africa from the Global Burden of Disease 2021 and World Bank databases, aiming to evaluate PM_2.5-related disease burden. The analysis revealed that APMP predominantly affected Southern and Western Sub-Saharan Africa, while Central and Eastern Sub-Saharan Africa were primarily influenced by HAP. Additionally, Additionally, PM_2.5-related death proportions decreased in individuals < 5 years of age and increased in those ≥ 50 years in Sub-Saharan Africa. Between 1990 and 2021, Central Sub-Saharan Africa demonstrated the highest net drift in APMP-related mortality (0.82 % per year), while all four Sub-Saharan African regions showed a negative net drift in HAP-related mortality (ranging from -1.94 % to -1.43 % per year). Central (risk rate: 1.25 compared to reference period) and Western Sub-Saharan Africa (1.17) exhibited increased APMP-related mortality risk in the most recent period, while all four regions showed decreased HAP-related mortality risk in both the recent period (ranging from 0.49 to 0.79) and birth cohort (ranging from 0.19 to 0.35). Notably, factors including access to clean cooking fuels and technologies, forest area, and urban population may affect APMP- and HAP-related age-standardized mortality rate (ASMR). Future projections indicate most Sub-Saharan African regions will experience increased PM_2.5-related deaths, and sustained initiatives targeting specific populations, implementing industrial pollution control, and enhacing energy consumption patterns remain essential.