 OK, thank you very much. Thank you very much for the invitation to be here. I changed the title a little bit. I thought it was a little bit too challenging and also maybe a bit more geared towards solutions. So air pollution, climate change, hotspot in the Mediterranean. And also my work is also focusing on the Middle East. This work, by the way, of climate change, hotspot was proposed by Filippo Guioghi here more than 10 years ago. He said, ICTP here. And showing that the Mediterranean is actually, from a global perspective, a climate change hotspot. And I'll talk about this in terms of heat extremes. A little bit about wind-blown dust, which is also something that is very specific for the region. We also find that it is increasing. And pollution trends we can see from space. Atmospheric chemistry and climate modeling. Topospheric ozone and particulate matter, which are actually the two components that are mostly related to health issues. Also a few words on how the mineral dust is changing its properties under the influence of air pollution. And then the main part of my talk will be on global fine particulates and health impacts and also try to attribute to sources. So first on this climate change hotspot, if you would look into, say, data or model output for the region that is indicated here. So this is not only Mediterranean but also North Africa, Middle East. You will find that the annual global mean is not very particularly different from the rest of the globe. It doesn't stand out very much in terms of the annual average. As you can see here to the left, the upper left is the mid-century in winter. So December, January, February. This is the end of the century. This is the mid-century in the summer and this is end of the century in the summer. And this is according to an IPCC scenario. And as you know, what is being predicted or being believed that will happen unless something very strict will be undertaken in terms of emissions that roughly by the middle of the century will be at two degrees warming. And you can see to the left by the middle of the century, this is actually what the models predict. This is the ensemble average of about almost 30 climate models that have been used for the IPCC assessment. And then if you look to the right, you look at the summer, you see that the colors are suddenly turning red. So winter climate change is not very special in this region, at least not in terms of temperature, but summer temperatures are increasing very strongly. And we also see this in meteorological data. Heat extremes are increasing strongly in this region. And that of course is something to worry about because this is a region that's already quite hot. So if the summers are hot and getting so much hotter, and of course if this scenario comes true by the end of the century, we're talking about something like more than six degrees in a region where summer average is already close to 40. So this is really an important issue. What you also see in this slide is the stippling here and the hatching, and this indicates robustness. And robustness is a measure of how the models, to what degree the models agree. And these results are extremely robust. That means that all the climate models agree on these projections, at least for temperature. And if you look at for these four regions that have been defined to look at meteorological data, if you look at the climate calculations and compare them with a reference period, which was from 1986 to 2005, you can see that the models really do well in terms of reproducing the data. This is the seasonal cycle for these four regions. And you see that especially in summer, the models are spot on. In winter, there are some differences, and this is mostly related, I believe, to the fact that the models have more problems in dealing with precipitation than they have with temperature. And this is shown here. This is the same type of panels, but now for precipitation in terms of percentage change. And you can see that there is some robustness here around the Mediterranean, where it is projected that the precipitation will decrease. And in parts of Africa, it will be increasing. This is most relevant here. In the summer, there is not much rain anywhere in this area, so these percentage changes do not have a lot of meaning. And it's also projected that, for example, in the southern part of Saudi Arabia and the Sahel, precipitation will be increasing. And actually, these things are coupled because the question is also, why is this a climate change hotspot? And one of the main reasons is that it's also dry because if you warm a region, it's like when you cook water, evaporation will counterbalance the warming by removing heat through evaporation. But if there is no water, then this mechanism doesn't work. So this is basically a sort of a desert heating amplification mechanism. And the reason why the Mediterranean is so strongly affected in general is also because the region is becoming much drier. This is also something that comes out of climate models and also is being confirmed by meteorological data, is that the region is becoming drier. So the soils are drying up, they lose their capability of cooling by evaporation and by this mechanism, this causes a warming amplification. And you also see this in heat extremes and these are four measures. This is cool night going down and you can see that the measurement data are in blue here and the model projections are, the averages are in black and the ranges, the standard deviation is in light blue and the maximum and minimum values are here indicated in light blue. And you can see cool nights going down, warm nights going up. Also coincident with the measurements, cool days going down and here warm days, so these are the warmest days and the hottest days actually you can see over 40 and the very hot days are close to 60 and even going up further. So these are really extremely hot temperatures that can become quite threatening for this region. Now a few words on the dust. This is also something that is quite peculiar in at least part of the region. These are dust or at least there's aerosol trends based on Modesis Satellite Instrument that has been measuring since 2000 and you can see here the trend between 2000 and 2015. And you can see again in the Middle East there is quite a large increase of the dust and the stippling indicates the significance of the trends. Let's focus a bit more on the Middle East and here we see this is Saudi Arabia or the Arabian Peninsula and the Eastern Mediterranean and Cyprus where I also work and you can see there's a very high statistical significance in increasing the concentration of aerosol particles over this region and this is actually dust because we also notice from other information. And one of the things that was found in this study is that there is a relationship between warming and dust because when you warm most of the world especially over the sea you will have more evaporation and that keeps the relative humidity almost constant. So higher temperatures relative humidity stays constant but if there is no evaporation then the relative humidity goes down. And actually if the relative humidity goes down that promotes the mobilization of the dust. Now this is only one of theories here because there has been a drought in Syria and Iraq for the last since about 2000 but of course many other things have also happened in this region so we're not entirely sure that this is one region but we think that there is a feedback between climate warming in dry regions and dust mobilization. Now the Middle East is an interesting place as you know and this is on air pollution. It also has a few advantages. One of them being that there is almost no clouds in the summer and very few clouds in other times of the year so that we can see very clearly from space what the concentrations are for example of nitrogen oxides and sulfur dioxide. And you can see that here and this is a result over 10 years of a satellite instrument called OME, the ozone monitoring instrument between 2005 and 2014 and you can see the NO2 over the cities mostly and NO2 also has natural sources but in the Middle East it almost only has anthropogenic sources. It comes from fossil fuel combustion so we have traffic, power generation, et cetera so you can very clearly see cities in satellite observations of NO2. And since we have measurements since 2005 we can also look at trends in these things so what we see for example from 2005 to 2010 that there is a very strong upper trend in most of the region and you can see that again in these urbanized areas, industrial areas, Cairo, but not in Athens because in Greece in 2008 a financial crisis contributed to the fact that nitrogen dioxide concentrations went down but the much of the rest of the region up to 2010 the concentrations were increasing. Now if we take the next step between 2010 and 2014 things look really very different and this has to do with many special things that are happening in the Middle East. The trend over Athens has continued. We have a political turnover in Cairo associated also with in Egypt with strongly decreasing pollution. We have decreasing pollution in some areas over the in the Persian Gulf area or Arabian Gulf depending on your perspective. We have still increasing in some part of Iraq but you can see in the area where the ISIS has become active, the concentrations are going down. We have negative trends after 2010 in Syria but positive trends in Lebanon. Now people fleeing from Syria to Lebanon taking their cars, et cetera, you can actually see that from space. And also in Iran there was a conflict you remember on the use of nuclear power and the suspicion of building a nuclear bomb. And after 2010 the international community strengthened the embargo on Iran and you can see that this had economic impact but also on air pollution. And if we take it one year further now so we can follow this from year to year, we now also see that in Lebanon the trends have become negative. So people are fleeing now also to other areas in Turkey and in Europe actually. We see negative emissions in the entire area where the ISIS is active, continuing negative emissions in Iran, continuing negative emissions here. And we have the same to some degree for SO2. The satellite instrument is not as sensitive for SO2 as it is for NO2 but since the area is very accessible to satellite measurements, we see here SO2 concentrations over the Persian Gulf. And you can see that there is quite a high concentrations in this area which has to do with the processing of fossil fuels but also shipping, shipping is a big source of SO2. And if we look at trends now, we can see up to 2010 we had positive trends in most of the area, so strongly positive trends here. But now if we take the years after 2010 we see very negative trends. This is Al-Qaik, this is the largest oil processing facility in the world in Saudi Arabia where trends have become slightly negative but the largest negative trend is here. This is a terminal from Iran where oil exports are being concentrated. So ships go there are being filled with oil and you can see the very negative trend is simply due to the fact that the ships that take the oil were no longer taking oil into the world. So this was also a consequence of the oil embargo that hit Iran. And if you take it one year further, actually Iran was not sleeping because they also have gas and this is a gas processing unit and the natural gas contains quite a lot of sulfur and they take the sulfur out before they liquefy it and transport it and you can actually see that after 2014 the Iranians have become very active in exporting gas because that was not hit by the embargo. Anyway, the bottom line is you can see a lot of things from space and since we do not have emission data from this region, we can use these space measurements to evaluate at least the trends in these emissions. Now I want to put these things a little bit together using models, atmosphere chemistry and aerosol and climate modeling. So you can see here things like aerosols and oxidants, greenhouse gases, causing radiative forcings, change in the surface temperature but also there are many feedbacks on clouds. For example, there are also direct relationships between aerosol particles and clouds and we try to evaluate these things with models. Now I do not have the time to go into very much detail but I just want to show you a few things that we do with these models and actually we also use them to address health impacts. One of the results here is that we can see that from the model results that ozone concentrations are very high. The name of the model is EMAC. It's surface ozone in the summer, June, July, August and you can see this entire area is very conspicuous in terms of high ozone. It's also in California and some parts of the United States which you see the concentrations here over this area are even higher and they're definitely higher than the air quality standard. And you can see here the wind arrow so actually this is pollution being transported from Europe and also local pollution added pollution from shipping and here you see the hotspot actually of ozone pollution related to a fossil energy use and fossil energy production and ozone is actually quite relevant for human health. Here we can see over Europe what the model is doing so we have these measurement stations here and we can see we can follow it in time. This is the spread and actually the model although there are some discrepancies if you look closely but you can see that the model can do this pretty well even the spread. The other thing is aerosols so how well do models do aerosols? So we see here aerosols measured from a satellite at a radiation wavelength of 550 nanometers which is in the middle of the visible light where the extinction is most important and you can see here the model and here the satellite data and here's the aerosol optical depth. This is the solar radiation extinction by aerosol particles and here you can see the same but this is now for 10 micrometers and this actually highlights the dust because the dust particles are bigger and they scatter and absorb solar radiation in higher wavelengths and you can see at least qualitatively that the model is doing a fairly good job and of course we have done a lot to study the behavior and improve it according to models, to measurements but there's no time to go into this and one of the things that you can calculate with these models is for example the radiative forcing of aerosol particles and here you see that aerosol particles is mostly pollution is mostly negative so causing a cooling forcing of the climate so this is in watts per square meter but that aerosols cause a warming over the deserts and this has to do also with the surface albedo if the surface albedo is reflective like over deserts and over ice then the particles are usually warming and if the surface albedo is dark so more absorbing solar radiation you see that the forcing is mostly negative causing a cooling and this is also very clearly the case over the Mediterranean because it is a polluted area and it of course also has a dark sea surface so this is an area that's also quite important in terms of climate forcing which has been confirmed also by direct measurements a few things about the dust and the interactions between dust and air pollution this is something we've started working on recently and this now appears to be a quite important impact and unfortunately it makes climate models more complicated but also more interesting I find so because the dust particles are usually particles that do not have a lot of soluble material in them so that means that they do not absorb water very efficiently they can actually physically absorb a little water but not much to absorb in but then if the particles become polluted when covered by air pollution then they start taking up water because the air pollution is hygroscopic so air pollution like ammonium sulfide, ammonium nitrate and there's also minerals in the aerosol that react with these with sulfuric acid and nitric acid in the atmosphere that are then being mobilized and these are very hygroscopic so the particles actually can grow and take up more air pollution and ultimately they can become little droplets and there are a few things that are important about this firstly they become more scattering so the aerosols are becoming more white and you can actually see this if you look at polluted dust in the atmosphere it is white and if it is clean dust it is more like yellowish depending on the color of the dust and there is another thing is that these particles are much more efficient in influencing the formation of cloud droplets and it has a number of effects on climate that are partly counterbalancing let me first show you some model result here in the Mediterranean area these are measurements, the black dots and the model results are in blue here and so this is in Italy, in Israel, in Cyprus, in Turkey and in Greece and you can see that the model is doing this fairly well but if we use the same model to look at the impact of the aging as we call it of the dust so the air pollution influence on the dust we see that the dust removal becomes much more efficient if we include this process if we do not include it you see a very much less efficient removal so the particles become little droplets they become more scattering, they become whiter so they become more cooling but they are also being removed more efficiently because they are becoming more efficient cloud condensation nuclei so that they can actually rain out so there are a number of effects that we are currently studying and if you would like to know more about this please contact me because there is not much time to go into it but I just wanted to mention this is an area that is of increasing importance not only for climate but also for health impacts because the dust particles are interacting with pollutants that may be more toxic than the particles when they are being emitted from the deserts directly now a few more words on the model so here you see the column integral of modelled black carbon particulate organic matter dust as we have already seen and sea salt so these are the sort of particles that we are trying to model and also their interactions there's also inorganics like sulfate and nitrate ammonium and you can see the maxima in parts of the world where you probably expect them and actually water is also important this is mostly important for climate not so much for health but if the particles become more hygroscopic and take up water as I mentioned also for the dust then they become more scattering so actually the air pollution impact on or the water uptake of the air pollution and the interactions with water are quite important for the climate forcing calculations of aerosol particles actually if you take an aerosol particle over the Mediterranean and you could analyze it as it was under ambient conditions you would find that water is the main component of the particle and the second most important is probably like sulfate and organics here's some comparison for different continents and you can see these are the observations and these are the model results and you can see the ideal line on one to one it's perfect agreement but there is agreement roughly within a factor of two or so which is for aerosol calculations quite good here's some more comparisons for this is a network in the United States for nitrate, ammonium, sulfate this is in Europe and this is in Asia you can see the toughest one to do actually is nitrate because it interacts with all kinds of other components in the aerosol so if you have for example more ammonia it will trap nitric acid as nitrate in the particles so this is a tough one to do but I think this is as reasonable as you can expect for a model here's another one these are background stations background stations we do fairly well actually pollution stations are more difficult to do also because of the resolution of the model because near pollution sources you have strong gradients and these models typically have a rather coarse resolution so now I want to get more into health and also see show you how these things all link together so you have emissions from high volatility gases that are being oxidized into lower volatility gases making secondary particles we have primary particles like particulate organic aerosols black carbon and sea salt and dust and they can actually interact with the pollution and then become what we call aged aerosols then they affect the optical properties of the particles making influence in climate or they can influence clouds that influence climate ecosystems can be because of nutrients for example the dust contains phosphorus and nitrogen and this can be mobilized by air pollution these are trapped in minerals so this can actually also influence ecosystems but now I want to focus a little bit more on the air quality aspect of it so all of these things are clearly linked and I also think that if we want to achieve solutions we have to integrate the entire picture and not just focus on one particular one because sometimes if you solve one problem you aggravate another problem so what's the problem here? the problem is actually mostly fine particulate this is PM 2.5 so these are particular small aerosol particles with a diameter smaller than 2.5 micrometers the satellite cannot measure this directly but it has been derived from satellite measurements and you can immediately see the problem here because the WHO air quality guideline is 10 micrograms per cubic meter and if you overlay this map this is annual averages with a population map you can very easily see straightforward very clearly see that more than 90% of all people on this globe are being exposed to to air pollution that exceeds the air quality guideline of the WHO and actually I will be showing you that this guideline is actually a very optimistic one so this is the problem actually is that 7 billion people are exposed to pollution levels that cause illness now how do we do this? How do we derive illness from from satellite maps or from from global model calculations and we follow here the method of the global burden of disease this is sort of like the IPCC of the disease community and we calculated the excess mortality by taking the baseline mortality for any particular disease and diseases that are relevant are listed here so we have ischemic heart disease that leads to heart attacks we have cerebrovascular disease leading to strokes we have chronic obstructive pulmonary disease lung cancer and lower respiratory tract infections that can by the way also affect children so these are the five disease categories that are have been proven to be related to air pollution and the mortality is calculated by using the baseline mortality from these diseases multiplying that with the attributable fraction and the population now the attributable fraction is based on epidemiological studies that study the relative risk is that the attributable fraction tells us which part of the number of people that die from a certain disease can be attributed to air pollution and this has been as I said taken from epidemiological studies then we need population this is the relative risk I just mentioned and then of course we have the pollution coming in ozone and PM 2.5 so we use this to calculate premature mortality and related to these diseases now a few more words on this attributable fraction this is on chronic obstructive pulmonary disease and you can see here the PM 2.5 concentration here is the attributable fraction and you can see it goes up and actually the global burden of disease in 2010 used this curve and 2015 used this curve because there are new epidemiological studies coming in that indicate that the values were higher and what you can see is a number of things first of all that attributable fraction can be quite high of course if the concentrations are getting very very high we are getting close to 40 percent but what you can also see that there is a non-linear relationship is that actually when you go down here at lower concentrations there is a lot to be gained from cleaning up the air and here up here the concentration decrease does something of course but you really have to decrease the concentrations quite drastically to really get to clean air and another thing that you can see here is that the safe threshold changed actually from 7.3 roughly to a little bit more than four micrometers and if we now look at the WHO standard which is 10 micrograms per cubic meter you can see that actually there is quite a lot of attributable fraction below this WHO guideline so it will probably not be very easy in many regions of the world to get below 10 micrograms but actually this is something you need to know if you really want to clean up the air you need to go even down further and these are some global estimates which are quite in line with the global burden of disease of 2015 the mortality of PM 2.5 is almost 4.3 million per year so more than four million people per year ozone is 270,000 total more than four and a half million so there is a Lancet report on global health and it estimates that environmental environment related disease and mortality is about nine million per year so this is poor water, poor air, indoor air pollution etc and you can see half of it is outdoor air pollution which is a big number and this is the uncertainty this is the statistical uncertainty ranges of the order of plus and minus 30% I would claim that the actual uncertainty is a little bit larger even but it's still the numbers are still large even if you would assume that we were at the lower part of the uncertainty limit you can see that the main causes is chemically heart disease one and a half million chronic obstructive pulmonary disease cerebral vascular disease linked to stroke almost a million and lower respiratory tract infections and about one-third to a half of this is related to children mostly in low-income countries this is pneumonia being caused by air pollution and in some countries children die from pneumonia not so much in the western world but in southern asia and in africa this is the case so some more numbers for you so this is chemically heart disease this is now in percentages here and so these are basically numbers I have just given is chemically heart disease is the number one COPD the number two you can actually distinguish here between ischemic and hemorrhagic stroke and this is lower respiratory illness and lung cancer so actually these are the sort of diseases you also get from smoking so I would call this passive outdoor smoking this is what you can compare it with and uh... now also trying to get more to the sources also maybe on the country level if you take these countries together china, india, europe and north america you can explain sixty-seven percent two-thirds of all the the deaths related to air pollution and so if you add up these numbers you get to sixty-seven percent you see the largest fraction is in china and then india actually china is now starting to really control air pollution and in india the air pollution is going up tremendously mostly because of the use of coal and this is uh... eastern europe and this is uh... the european union europe six percent so together about thirteen percent if you look at the per capita this is quite it was also surprising to me is that this is north america this is europe india china eastern europe so the per capita effect of air pollution on mortality is highest in eastern europe like in russia and in ukraine and this not only has to do with air pollution but also with the meteorological conditions because the meteorological conditions trapped the air pollution in the lower part of the atmosphere there is no monsoon in the ukraine or in russia and for this reason air quality in these regions can be quite poor so let me summarize this and uh... so mortality attributable to outdoor air pollution is about four and a half million per year it is the main environmental health risk globally and it's actually one of the top five health risks overall so with high blood pressure diabetes tobacco smoking and being overweight is air pollution i'm sure that some of you were not aware of this and it is not that people when they die from air pollution use a few weeks of their life no they lose twenty eight years person affected on a statistical basis so the total number of years of life lost is hundred and twenty million per year and for smoking is still a bit larger six and a half million but the number of years of life lost is almost the same because children are less affected by smoking and uh... the individual years of life lost for a person who dies from smoking is twenty four years so i think this is a very important message that uh... air pollution can even be worse than smoking of course depending on how you look at it but it is involuntary because you're exposed to something that you have no control over if you're a smoker you have some control yourself and this is now getting to the sources whenever i talk to people about air pollution the first thing they always say urban air pollution traffic that's what people always say actually this is a wrong way of thinking about air pollution because traffic produces nitrogen oxides for example but it takes time to make particles or ozone out of the nitrogen oxides actually air pollution is not an urban problem maybe because many people live in the urban environment so that they get exposed to poor air pollution but actually it goes much beyond the urban environment and for this region we see the reason we see that other sources are very important on the global scale residential energy use is the largest source of air pollution related mortality agriculture is very important because it produces ammonia and ammonia catalyzes the formation of particles power production, biomass burning and of course we have natural sources industry and traffic and i'll give two more examples of individual countries that will give you some flavor of the importance and by the way this was the map of the global air pollution attributable death and this is now the same this is for all ages and this is now the years of life lost this is for all ages and this is for children and you can see hundred and twenty million years of life are lost per year and you can see the areas i mean india and china africa but also europe here northeast in the united states but if you focus on children only is twenty two million and it's actually mostly in sub-saharan africa and southern asia the reason being as i mentioned earlier is that these children sometimes die from air pollution from pneumonia actually in europe and united states children can also get pneumonia but they typically don't die from it but these are some more numbers here on years of life lost i'm not sure if you can read all these countries the number one with the per capita highest years of life lost in children is chart so these are regions also in sub-saharan africa which are affected by air pollution and which are also poor and this is again the disease categories now in terms of years of life lost and you can see here this is lung cancer this chemical heart disease, cerebrovascular disease chronic obstructive pulmonary disease and lower respiratory tract infections is about almost thirty percent and eleven percent is it's more than five years old and eighteen percent is uh... more than fifty less than five years old of age so actually if you if you look at it in terms of years of life lost eighteen percent is related to children and here you see a summary of the source categories being indicated the largest or the leading source category of course dust is important here by the way dust is not all natural it's very difficult to estimate which part is not natural but i would say the recent estimate indicated about twenty five percent of the dust is man-made or human-made and here you see residential energy used as this one is most important in india and in china and also here on java for example in indonesia here we have power production and traffic and here we have biomass burning so these are the leading source categories of air pollution that lead to mortality and here's a comparison of two countries just to show you that it can be really different uh... even though the pollution effects may be quite similar this is the united states where a hundred and twenty thousand people die per year from air pollution you see traffic is much larger than the global average residential energy small agriculture is important power production and here biomass burning in natural is almost negligible if you take fossil fuel together is almost sixty percent and if you take it in india you see residential energy use is the main one in agriculture power production biomass burning some natural dust from the star desert for example industry and traffic if you take the fossil fuel together it's twenty six percent if you read many reports also the lancet report on global health and many of these reports just mention because the aerosols are the most important in terms of health that almost everything is related to fossil fuels and this is i believe not true it's just a simple assumption people haven't really looked very carefully there are many other sources of particulates that need to be controlled if you want to deal with health and also climate by the way so let me summarize that again outdoor air pollution causes respiratory and cardiovascular diseases leading to four and a half million premature deaths per year on a global scale it's mostly in asia seventy five percent is in asia and this is related to the fact that the population density is high and the pollution density is high so if you bring these things together fossil energy use if you take them together is a large source but actually residential energy use is from household combustion emissions for heating and cooking is the dominant source category mostly because it is so prevalent in china and india and of course this is it this is a short category that also contributes to indoor air pollution and indoor air pollution is believed to also lead to almost two million deaths per year so that comes on top the sum overlap by the way and then agriculture is important actually in europe and northeastern united states because not in terms of mass emissions but in terms of making the particles that influence health and then the child childhood low respiratory tract infections in lower income countries they contribute about five percent to attributable deaths but if you turn if you translate this into life expectancy is eighteen percent so it's quite a big number actually and implementing the w-h-o guideline which is ten micrograms per cubic meter i think it will be great if it could be achieved actually some countries have this as a guideline like canada has this as a as a standard australia has even less eight micrograms and united states twelve and i think even president trump is not going to change yet but in europe we have twenty five so the standard in europe is twenty five micrograms which is much much too high because actually the ten micrograms is already too high if you have the ten microgram you can you can reduce by half and so further reductions will be needed so there's a lot of work for you guys to be done to clean up the air and make people healthier thanks very much