American Thoracic Society and Marron Institute Report. Estimated Excess Morbidity and Mortality Caused by Air Pollution above American Thoracic Society-Recommended Standards, 2011-2013

Ann Am Thorac Soc. 2016 Aug;13(8):1195-201. doi: 10.1513/AnnalsATS.201602-103AR.


Estimates of the health impacts of air pollution are needed to make informed air quality management decisions at both the national and local levels. Using design values of ambient pollution concentrations from 2011-2013 as a baseline, the American Thoracic Society (ATS) and the Marron Institute of Urban Management estimated excess morbidity and mortality in the United States attributable to exposure to ambient ozone (O3) and fine particulate matter (PM2.5) at levels above the American Thoracic Society-recommended standards. Within the subset of counties with valid design values for each pollutant, 14% had PM2.5 concentrations greater than the ATS recommendation, whereas 91% had O3 concentrations greater than the ATS recommendation. Approximately 9,320 excess deaths (69% from O3; 31% from PM2.5), 21,400 excess morbidities (74% from O3; 26% from PM2.5), and 19,300,000 adversely impacted days (88% from O3; 12% from PM2.5) in the United States each year are attributable to pollution exceeding the ATS-recommended standards. California alone is responsible for 37% of the total estimated health impacts, and the next three states (Pennsylvania, Texas, and Ohio) together contributed to 20% of the total estimates. City-specific health estimates are provided in this report and through an accompanying online tool to help inform air quality management decisions made at the local level. Riverside and Los Angeles, California have the most to gain by attaining the ATS recommendations for O3 and PM2.5. This report will be revised and updated regularly to help cities track their progress.

Keywords: environmental policy; ozone; particulate matter; risk assessment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Air Pollution / adverse effects*
  • Environmental Policy
  • Humans
  • Morbidity / trends*
  • Mortality / trends*
  • Ozone / analysis
  • Ozone / standards
  • Particulate Matter / analysis
  • Particulate Matter / standards
  • Research Report
  • Risk Assessment
  • Societies, Medical*
  • United States


  • Particulate Matter
  • Ozone