The effect of air pollution exposure on mortality: a time series study in Sivas, Türkiye

Using a generalized linear model (GLM), the relationships between daily changes in air pollutants and mortality rates in Sivas Central District (Türkiye) were examined over five years (2017–2021), controlling for long–term time trends, seasonal effects, and meteorological factors in this study. The impacts of major pollutants (PM₁₀, PM 2.5 , and NO₂) on daily mortality were analyzed at different time lags (0–10 days). Relative risks (RR) were calculated to estimate the excess risk (ER) of mortality related to a 10 µg/m 3 increase in pollutant concentrations from the current day (lag 0) to tenth day (lag 9). Significant relationships have been identified between air pollution and mortality from cardiovascular, respiratory, and total non-accidental mortality in Sivas city. The highest relation of each pollutant with cardiovascular mortality was observed with PM 10 at lag 8 (ER = 1.59; 95% CI = 1.48–1.71), NO 2 at lag 2 (ER = 5.26; 95% CI = 4.12 – 6.71) and PM 2.5 at lag 7 (ER = 1.18; 95% CI = 1.18 – 1.20) for an increase of 10 µg/m 3 in air pollutant concentrations. As a result, this study demonstrated that short–term exposure to air pollution was positively related to deaths in Sivas between 2017 and 2021. As the initial study utilizing a GLM to assess air pollution–related mortality in Sivas, the outcomes may hold implications for local social and environmental policies.