The effect of air pollution on respiratory diseases in the era of global warming: research from Türkiye

Authors

  • Şenay Çetin Doğruparmak Kocaeli University Faculty of Engineering, Department of Environmental Engineering, Kocaeli
  • Kazım Onur Demirarslan Artvin Coruh University Faculty of Engineering, Department of Environmental Engineering, Artvin
  • Gülşen Aydın Keskin Balikesir University, Faculty of Engineering, Department of Industrial Engineering, Balikesir
  • Kadriye Ergün Balikesir University, Faculty of Engineering, Department of Industrial Engineering, Balikesir

DOI:

https://doi.org/10.60923/issn.2281-4485/23350

Keywords:

Global Warming, Air Pollution, Respiratory Disease, Statistical Analysis, Clustering, Epidemiological Study

Abstract

Air pollution and climate change are interconnected, posing significant health risks. This study assesses air pollution levels in Türkiye, their link to respiratory disorders, and regional variations. Findings show that Istanbul, Türkiye's most populous city, has the highest patient count (mean ± SD: 387 ± 302). Positive correlations were found between air pollutants and patient numbers, except for ozone; sulfur dioxide showed the strongest correlation (r = 0.7). Multivariate regression indicated adjusted R² > 0.5 in four regions. K-means++ clustering categorized regions by population density, with the largest cluster covering 28.3% of the dataset. These results underscore the impact of air pollution on respiratory health, highlighting the need for targeted interventions to reduce environmental risks and disease prevalence.

References

AKOGLU H, (2018) User's guide to correlation coefficients. Türkiye Journal Emergency Medicine, 18 (3): 91-93. https://doi.org/10.1016/j.tjem.2018.08.001

ANGELIS D.E., RENZETTI S., VOLTA M., DONATO F., CALZA S., PLACIDI D., LUCCHINI G.R., ROTA M., (2021) Covid-19 incidence and mortality in Lombardy, Italy: An ecological study on the role of air pollution, meteo-rological factors, demographic and socioeconomic variables. Environmental Research, 195:110777. https://doi.org/10.1016/j.envres.2021.110777

BRANDT E.B., BECK A.F., MERSHA T.B. (2020) Air pollution, racial disparities, and Covid-19 mortality. The Journal of Allergy and Clinical Immunology, 146 (1):61–63. https://doi.org/10.1016/j.jaci.2020.04.035

COKER E.S., CAVALLI L., FABRIZI E., GUASTELLA G., LIPPO E., PARISI ML, PONTAROLLO N, RIZZATI M, VARACCA A., VERGALLI S., (2020) The effects of air pollution on Covid-19 related mortality in northern Italy. Environmental Research Economics, 76: 611–634. https://doi.org/10.1007/s10640-020-00486-1

COLLABORATORS G.D.B. (2016) Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Global Health Metrics. 390(10100):1345-1422. https://doi.org/10.1016/S0140-6736(17)32366-8

DETTORI M., DEIANA G., BALLETTO G., BORRUSO G., MURGANTE B., ARGHITTU A., AZARA A., CASTIGLIA P. (2021) Air pollutants and risk of death due to Covid-19 in Italy. Environmental Research, 192:110459. https://doi.org/10.1016/j.envres.2020.110459

DOMINGO L.J., ROVIRA J. (2020) Effects of air pollutants on the transmission and severity of respiratory viral infections. Environmemtal Research, 187:109650. https://doi.org/10.1016/j.envres.2020.109650

EEA (2021) Air Pollution. Europen Environmental Agency. https://www.eea.europa.eu/tr/themes/air

FRONTERA A., CIANFANELLI L., VLACHOS K., LANDONI G., CREMONA G. (2020) Severe air pollution links to higher mortality in Covid-19 patients. Journal Infection, 81(2):255–259. https://doi.org/10.1016/j.jinf.2020.05.031

HEAL, The Health and Environment Alliance (2021) EU’s Clean Air for Health Transition 2021-2030 HEAL 10 demands. Brussels-Belgium. https://www.env-health.org/wp-content/uploads/2021/09/HEAL_10-demands_-air-quality_September21.pdf

HU H., ZHENG Y., WEN X., SMITH S.S., NIZOMOV J., FISHE J., HOGAN W.R., SHENKMAN E.A., BIAN J. (2021) An external exposome-wide association study of Covid-19 mortality in the United States. Science Total Environmental, 768: 144832. https://doi.org/10.1016/j.scitotenv.2020.144832

IKOTUN A.M,, EZUGWU A.E., ABUALIGAH L., ABUHAIJA B., HEMING J., (2023) K-means clustering algorithms: A comprehensive review, variants analysis, and advances in the era of big data. Information Science, 622: 178-210. https://doi.org/10.1016/j.ins.2022.11.139

KARA E, ÖZDILEK HG, KARA EE, BALCANDI F, MESTAV B, (2021) Ambient Air Quality and General Health Outcomes in Nigde (Turkey) between 2011 and 2017. Iran Journal Public Health, 50(10):1963-1972. https://doi.org/10.18502/ijph.v50i10.7496

KONSTANTINOUDIS G, PADELLINI T, BENNETT JE, DAVIES B, EZZATI M, BLANGIARDO M, (2021) Long-term exposure to air pollution and Covid-19 mortality in England: a hierarchical spatial analysis. Environmental International, 146: 106316. https://doi.org/10.1016/j.envint.2020.106316

KHORSANDI B, FARZAD K, TAHRIRI H, MAKNOON R, (2021) Association between short term exposure to air pollution and Covid 19 hospital admission/mortality during warm seasons. Environmental Monitoring Assessment, 193: 426. https://doi.org/10.1007/s10661-021-09210-y

LAXMIPRIYA S, NARAYANAN RM, (2021) Covid-19 and its relationship to particulate matter pollution – Case study from part of greater Chennai, India. Materials Today: Proceedings, 43:1634–1639. https://doi.org/10.1016/j.matpr.2020.09.768

LI C, MANAGI S, (2022) Impacts of air pollution on Covid-19 case fatality rate: a global analysis. Environmental Science and Pollution Research International , 29(18):27496-27509. https://doi.org/10.1007/s11356-021-18442-x

LIU Q., XU S., LU X. (2021) Association between air pollution and Covid-19 infection: evidence from data at national and municipal levels. Environmental Science and Pollution Research International, 28:37231–37243.https://doi.org/10.1007/s11356-021-13319-5

MARTELLETTI L., MARTELLETTI P. (2020) Air pollution and the novel Covid-19 disease: a putative disease risk factor. SN Comprehensive Clinical Medicine, 15, 1–5. https://doi.org/10.1007/s42399-020-00274-4

MELE M., MAGAZZINO C. (2020) Pollution, economic growth, and Covid-19 deaths in India: machine learning evidence. Environmental Science Pollution Research, 28, 2669–2677. https://doi.org/10.1007/s11356-020-10689-0

NAPITUPULU D., ABDEL KADAR J., KARTIKA JATI R. (2017) Validity testing of technology acceptance model based on factor analysis approach, Indonesian Journal of Electrical Engineering and Computer Science, 5(3):697-704. http://doi.org/10.11591/ijeecs.v5.i3.pp697-704

NAQVI H.R., MUTREJA G., SHAKEEL A., SIDDIQUI M.A., (2021) Spatio-temporal analysis of air quality and its relationship with major Covid-19 hotspot places in India. Remote Sensing Applications: Soc Environ, 22:100473. https://doi.org/10.1016/j.rsase.2021.100473

OECD, (2012) OECD Environmental outlook to 2050. OECD Publishing. http://dx.doi.org/10.1787/9789264122246-en

ÖZBAY B., AYDIN KESKİN G., ÇETİN DOĞRUPARMAK Ş., AYBERK S. (2011) Multivariate methods for ground-level ozone modeling. Atmospheric Resarch, 102(1-2):57–65. http://doi.org/10.1016/j.atmosres.2011.06.005

PALA K., AYKAC N., YASIN Y., (2021) Premature deaths attributable to long-term exposure to PM2.5 in Turkey. Environmental Science Pollution Research, 28(37):51940-51947. https://doi.org/10.1007/s11356-021-13923-5

PETER S.C., DHANJAL J.K., MALİK V., RADHA-KRİSHNAN N., JAYAKANTHAN M., SUNDAR D. (2019) Quantitative Structure-Activity Relationship (QSAR): Modeling Approaches to Biological Applications. Enc Bioinformatics Computational Biology, 2:661-676. https://doi.org/10.1016/B978-0-12-809633-8.20197-0

PONİEDZİAŁEK B., RZYMSKİ P., ZARĘBSKA-MİCHALUK D., FLİSİAK R. (2024) Viral respiratory infections and air pollution: A review focused on research in Poland. Chemosphere, 359:142256. https://doi.org/10.1016/j.chemosphere.2024.142256

RCAP (2020) Right to Clean Air Platform, Black Report, 2020. https://www.temizhavahakki.org/wp-content/uploads/2020/09/Kara-Rapor-2020-Son27082020.pdf

RTMEU (2020) Air Quality Monitoring. Database. Republic of Türkiye Ministry of Environment, Urbanization and Cli-mate Change publications, Ankara, Türkiye. https://sim.csb.gov.tr

RTMH (2020) Republic of Türkiye Ministry of Health. Co-vid-19 Information Platform. https://covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html

SINGH A, (2021) Ambient air pollution and Covid-19 in Delhi, India: time-series evidence. International Journal of Environmental Health Research, 32(11):2575-2588.https://doi.org/10.1080/09603123.2021.1977258

TRAN H.M., TSAI F.J., LEE Y.L., CHANG J.H., CHANG L.T., CHANG T.Y., CHUNG K.F., KUO H.P., LEE K.Y., CHUANG K.J., CHUANG H.C. (2023) The impact of air pollution on respiratory diseases in an era of climate change: A review of the current evidence. Science of the Total Environment, 898: 166340. https://doi.org/10.1016/j.scitotenv.2023.166340

TRAVAGLIO M., YU Y-, POPOVIC R., SELLEY L., LEAL N.S., MARTINS L.M. (2021) Links between air pol-lu-tion and Covid-19 in England. Environmental Pollution, 268:115859. https://doi.org/10.1016/j.envpol.2020.115859

TÜİK (2020a) Gross domestic product. Turkish Statistical Institute. https://data.tuik.gov.tr/Bulten/Index?p=Donem sel-Gayrisafi-Yurt-Ici-Hasila-IV.-Ceyrek:-Ekim---Aralik,-2020-37180

TÜİK (2020b) Address-Based Population Registration Sy-stem Results. Turkish Statistical Institute. https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayali-Nufus-Kayit-Sistemi-Sonuclari-2020-37210

TÜRK BÖRÜ Ü., BÖLÜK C., TAŞDEMIR M-, GEZER T., SERIM V.A. (2020) Air pollution, a possible risk factor for multiple sclerosis. Acta Neurologica Scandinavica. 141(5):431-437. https://doi.org/10.1111/ane.13223

WU X., NETHERY R., SABATH M., BRAUN D., DOMINICI F. (2020) Air pollution and Covid-19 mortality in the United States: Strengths and limitations of an ecological regression analysis. Science Advances, 6(45). http://doi.org/10.1126/sciadv.abd4049

WHO, (2021) Air Pollution. World Health Organization. https://www.who.int/health-topics/air-pollution#tab=tab1

YILDIZ GÜLHAN P, GÜLEÇ BALBAY E, ELVERIŞLI MF, ERÇELIK M, ARBAK P, (2020) Do the levels of particulate matters less than 10 μm and seasons affect sleep? Aging Male, 23(1):36-41. https://doi.org/10.1080/13685538.2019.1655637

YILMAZ V, ŞIMŞEK T, (2020) The relationship between air quality and Covid-19: An application on G-7 countries. Turkish Studies, 15(4): 1353-1366. http://doi.org/10.7827/TurkishStudies.43883

ZHANG Z, XUE T, JIN X, (2020) Effects of meteoro-logical conditions and air pollution on Covid-19 trans-mission: Evidence from 219 Chinese cities. Science of the Total Environment, 741:140244. https://doi.org/10.1016/j.scitotenv.2020.140244

ZHU Y, XIE J, HUANG F, & CAO L, (2020) Association between short-term exposure to air pollution and Covid-19 infection: Evidence from China. Science of the Total Envi-ronment, 727:138704. https://doi.org/10.1016/j.scitotenv.2020.138704

ZORAN MA, SAVASTRU RS, SAVASTRU DM, TAUTAN MN, (2020) Assessing the relationship between surface levels of PM2.5 and PM10 particulate matter impact on Covid-19 in Milan, Italy. Science of the Total Environment, 738:139825.https://doi.org/10.1016/j.scitotenv.2020.139825

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Published

2026-03-02

How to Cite

Çetin Doğruparmak, Şenay, Demirarslan, K. O., Aydın Keskin, G., & Ergün, K. (2026). The effect of air pollution on respiratory diseases in the era of global warming: research from Türkiye. EQA - International Journal of Environmental Quality, 72, 125–135. https://doi.org/10.60923/issn.2281-4485/23350

Issue

Vol. 72 (2026)

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Copyright (c) 2026 Şenay Çetin Doğruparmak, Kazım Onur Demirarslan, Gülşen Aydın Keskin, Kadriye Ergün

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