Objective: This study aims to assess the estimated premature deaths attributable to long-term particulate matter 2.5 (PM2.5) exposure in Izmir from 2019 to 2023.

Material and Method: This ecological study utilized air pollution data obtained from the Ministry of Environment and Urbanization, with annual PM2.5 averages collected from monitoring stations in Izmir Mortality data and information on the at-risk population were sourced from the Turkish Statistical Institute (TUIK), and the data were analyzed using the WHO's AirQ+ software to estimate health impacts.

Results: The study found that none of the annual PM2.5 averages from the monitoring stations were below the WHO limit of 10 μg/m³. Between 2019 and 2023, an estimated 16457 (95% CI: 12,571–18,000) premature deaths in Izmir were associated with PM2.5 exposure. On average, 10.77% (95% CI: 8.35–12.08) of annual deaths were attributed to PM2.5, with the highest attributable proportion of 14.2% (95% CI: 10.95–15.76) observed in 2022, and the lowest of 7.27% (95% CI: 5.9–8.6) in 2021.

Conclusion: The premature deaths linked to air pollution in Izmir reflect a significant public health burden. The rising pollution levels following the pandemic emphasize the need for sustainable air quality and public health policies. Given Izmir’s status as one of Turkey's most populous cities, targeted interventions for densely populated areas and industrial sources are crucial to safeguarding public health, along with the implementation of green infrastructure and environmental measures.

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