Abstract Ambient air pollution is a growing public health concern in South Africa. However, the health impacts of ambient air pollution in the country remain largely unquantified, a gap that is consistently reflected in global systematic reviews. This study investigates the association between ambient air pollution and cause-specific mortality, cardiovascular (CVD), and respiratory disease (RD), in Limpopo province, South Africa, over a decade from 2011 to 2020, with the aim of unravelling population and seasonal vulnerability. Daily mortality data were sourced from Statistics South Africa, while ambient air pollutant concentrations (PM₁₀, PM₂.₅, SO₂, NO₂, and O₃) were retrieved from the South African Air Quality Information System. Time-series and quasi-Poisson regression models within a generalized additive model framework were employed to estimate relative risks (RRs) per interquartile range (IQR) increase in pollutant concentrations, adjusting for seasonality and meteorological covariates. A total of 73,167 CVD and 62,248 RD deaths were recorded during the study period. PM and O₃ emerged as the strongest predictors of excess mortality, with O₃ particularly linked to CVD mortality and PM to RD mortality. An interquartile range increase in O₃ was associated with a 0.3–7.5% increase in CVD and RD mortality across subgroups, while PM₂.₅ showed smaller but significant increases, ranging from 0.3 to 1.2% across subgroups for CVD and RD mortality. Notably, SO₂ and NO₂ exhibited weaker and more variable effects, often manifesting at delayed lags. Vulnerable populations, particularly women, older adults (65+), and certain outdoor-exposed workers, experienced greater mortality risks, highlighting the differential susceptibility of specific subgroups. Seasonal analysis revealed elevated mortality and pollutant concentrations during the cold compared to the warm period. Short-term exposure to ambient air pollution is associated with increased cardio-respiratory mortality in Limpopo Province, with stronger effects for ozone and particulate matter and heightened vulnerability during the cold season, highlighting the need for targeted public health and regulatory interventions.
Opiyo et al. (Sat,) studied this question.