{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T19:49:14Z","timestamp":1780602554454,"version":"3.54.1"},"reference-count":29,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: There is a large literature that documents the negative health implications of exposure to air pollution, particularly PM2.5. Much of this literature, however, relies on short-term cross-sectional data, which cannot establish a true causal link between pollution and health. There are also very few studies that document long- and very long-term effects. Purpose: This study intends to estimate a causal relationship between exposure to severe air pollution and negative health outcomes that persist over long periods of time. Methods: We use a large longitudinal dataset that spans almost 2 decades and that allows us to not only document the persistence of negative health effects, but also a pattern of recovery from a severe pollution episode. We use multivariate regression methods to estimate a causal link between air pollution and health over time. A large pollution shock that occurred in 1997 in Indonesia is used as a natural experiment to pinpoint the true causal effects of pollution exposure and not mere correlations. Results: Exposure to an additional unit of pollution in 1997 leads to a loss of roughly six units of lung capacity and to an increase of 4.3% in the probability of being in poor general health, as measured ten years after the pollution exposure. These effects somewhat diminish over time, to a loss of roughly three units of lung capacity and to an increase of only about 3% in the probability of being in poor general health, as measured 17 years after exposure. Conclusions: Our study finds significant health consequences of exposure to air pollution, which persist over long periods of time, with some patterns of recovery. Policymakers should pay special attention to such massive sources of pollution and try to mitigate these negative health consequences.<\/jats:p>","DOI":"10.3390\/ijerph192114019","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T20:37:58Z","timestamp":1666903078000},"page":"14019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Severe Air Pollution Exposure and Long-Term Health Outcomes"],"prefix":"10.3390","volume":"19","author":[{"given":"Younoh","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Economics and International Business, Sam Houston State University, 1905 University Ave, Huntsville, TX 77340, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9099-9449","authenticated-orcid":false,"given":"Vlad","family":"Radoias","sequence":"additional","affiliation":[{"name":"Department of Economics and International Business, Sam Houston State University, 1905 University Ave, Huntsville, TX 77340, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1289\/ehp.108-1637679","article-title":"Epidemiology of fine particulate air pollution and human health: Biologic mechanisms and who\u2019s at risk?","volume":"108","author":"Pope","year":"2000","journal-title":"Environ. 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