Epidemiological research suggests that air pollution may cause chronic diseases, as well as exacerbation of related pathologies such as cardiovascular and respiratory morbidity and mortality. This study evaluates air pollution scenarios considering a Health Impact Assessment approach in São Paulo, Brazil. We have analyzed abatement scenarios of Particulate Matter (PM) with an aerodynamic diameter <10 μm (PM₁₀), <2.5 μm (PM_2.5) and ozone concentrations and the health effects on respiratory and cardiovascular morbidity and mortality in the period from 2009 to 2011 through the APHEKOM tool, as well as the associated health costs. Considering World Health Organization (WHO) standards of PM_2.5 (10 μg/m³), São Paulo would avoid more than 5012 premature deaths (equivalent to 266,486 life years’ gain) and save US$15.1 billion annually. If São Paulo could even diminish the mean of PM_2.5 by 5 μg/m³, nearly 1724 deaths would be avoided, resulting in a gain of US$ 4.96 billion annually. Reduced levels of PM₁₀, PM_2.5 and ozone could save lives and an impressive amount of money in a country where economic resources are scarce. Moreover, the reduced levels of air pollution would also lower the demand for hospital care, since hospitalizations would diminish. In this sense, Brazil should urgently adopt WHO air pollution standards in order to improve the quality of life of its population.

Petroleum refining and petrochemical complexes are significant sources of air pollution, emitting a variety of harmful pollutants with substantial health risks for nearby populations. While much of the information regarding this issue and the potential health impacts of this pollution has been documented, it remains fragmented across studies focusing on specific regions or health outcomes. These studies are often clustered into meta-analyses or reviews or exist as undeclared knowledge held by experts in the field, making it difficult to fully grasp the scope of the issue. To address this gap, our review consolidates the existing knowledge on the sources of air pollution from petroleum refining and petrochemical industries, the main pollutants involved, and their associated health outcomes. Additionally, we conducted an umbrella review of systematic reviews and meta-analysis and also included critical reviews. With this approach, we identified 12 reviews that comprehensively evaluate the health impacts in populations living near petroleum refining and/or petrochemical complexes. These reviews included studies spanning several decades (from 1980 to 2020) and encompassing regions across North America, Europe, Asia, South America, and Africa, reflecting diverse industrial practices and regulatory frameworks. From these studies, our umbrella review demonstrates that residents living near these facilities face elevated risks related to leukemia, lung and pancreatic cancer, nonmalignant respiratory conditions (such as asthma, cough, wheezing, bronchitis, and rhinitis), chronic kidney disease, and adverse reproductive outcomes. Furthermore, we discuss the key challenges in mitigating these health impacts and outline future directions, including the integration of cleaner technologies, which can significantly reduce harmful emissions; strengthening policy frameworks, emphasizing stringent emission limits, continuous monitoring, and regulatory enforcement; and advancing research on underexplored health outcomes. This review emphasizes the need for coordinated global efforts to align the industry’s evolution with sustainable development goals and climate action strategies to protect the health of vulnerable communities.

The COVID-19 pandemic has imposed a unique situation for humanity, reaching up to 5623 deaths in Sao Paulo city during the analyzed period of this study. Due to the measures for social distancing, an improvement of air quality was observed worldwide. In view of this scenario, we investigated the air quality improvement related to PM₁₀, PM_2.5, and NO₂ concentrations during 90 days of quarantine compared to an equivalent period in 2019. We found a significant drop in air pollution of 45% of PM₁₀, 46% of PM_2.5, and 58% of NO₂, and using a relative-risk function, we estimated that this significant air quality improvement avoided, respectively, 78, 337, and 387 premature deaths, respectively, and prevented approximately US $720 million on health costs. Moreover, we estimated that 5623 deaths by COVID-19 represent an economic health loss of US $10.5 billion. Both health and economic gains associated with air pollution reductions give a positive perspective of the efforts towards keeping air pollution reduced even after the pandemic, highlighting the importance of improving the strategies of air pollution mitigation actions, as well as the crucial role of adopting efficient measures to protect human health both during and after the COVID-19 global health crisis.