Where there’s smoke . . .

Air pollution has received much attention in the past year. The Global Burden of Disease Study estimated that 3.2 million deaths a year are attributable to particulate matter in outdoor air,1 the International Agency for Research on Cancer classified polluted outdoor air as carcinogenic,2 and we witnessed extreme episodes in Beijing and Shanghai. While effects on respiratory health have long been recognised, it is the impacts on cardiovascular disease3 that are responsible for most of the disease burden attributable to air pollution. Two linked papers provide new insight into the role of air pollution on cardiovascular disease and subsequent impacts on population health.4 5

Perhaps nowhere are the health impacts of outdoor air pollution more acutely felt than in China, where air pollution is the fourth most important risk factor for disease burden6 and is responsible for 1.2 million deaths each year. In one linked paper (doi:10.1136/bmj.f7139), Guo and colleagues applied the well known time series methods to age of death and life table statistics to assess the relation between daily pollution levels in Beijing and years of life lost.4 The results suggest that air pollution has …