School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China.
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, China.
Environ Int. 2020 May;138:105594. doi: 10.1016/j.envint.2020.105594. Epub 2020 Mar 3.
A new Air Quality Health Index (AQHI) was developed in Canada or several single cities as a promising health risk communication tool.
To construct a national AQHI in China and compare its validity in predicting daily mortality risk with the existing Air Quality Index (AQI).
We established the AQHI as the sum of excess total mortality risks associated with multiple air pollutants in 272 representative Chinese cities from 2013 to 2015 (termed as "total AQHI"). The mortality risks per unit change of air pollutant concentrations were determined according to a time-series analysis in each city. Separate AQHIs were established for subgroups classified by age and sex and for main cardiopulmonary diseases (termed as "specific AQHIs"). For validation, AQHIs and AQI were established using the data of 2015 (N = 272) and compared their associations with daily mortality using the data of 2013-2014 (N = 144).
The concentration-response coefficients of fine particulate matter, nitrogen dioxide and ozone were adopted in constructing AQHI. There were almost linear exposure-response relationships between AQHIs and daily mortality. The total AQHI and specific AQHIs had very similar associations with daily mortality. AQHI and AQI showed similar associations with daily cause-specific mortality in terms of average magnitude, numbers of cities of positive associations and model fit statistics.
AQHI may have comparable performance with AQI in communicating acute health risks of air pollution in China. There seems no need to establish specific AQHIs for different age groups, gender and causes of deaths.
加拿大或一些单个城市开发了一种新的空气质量健康指数 (AQHI)，作为一种有前途的健康风险沟通工具。
在中国构建一个国家 AQHI，并将其预测每日死亡率风险的有效性与现有的空气质量指数 (AQI) 进行比较。
我们将 AQHI 定义为 2013 年至 2015 年 272 个具有代表性的中国城市中与多种空气污染物相关的超额总死亡风险的总和（称为“总 AQHI”）。根据每个城市的时间序列分析确定了污染物浓度每单位变化的死亡率风险。根据年龄和性别分类以及主要心肺疾病（称为“特定 AQHI”）建立了单独的 AQHI。为了验证，我们使用 2015 年的数据（N=272）建立了 AQHI 和 AQI，并使用 2013-2014 年的数据（N=144）比较了它们与每日死亡率的关联。
细颗粒物、二氧化氮和臭氧的浓度-反应系数用于构建 AQHI。AQHI 与每日死亡率之间存在几乎线性的暴露-反应关系。总 AQHI 和特定 AQHI 与每日死亡率的关联非常相似。AQHI 和 AQI 与每日特定原因死亡率的关联在平均幅度、阳性关联城市数量和模型拟合统计数据方面非常相似。
AQHI 在中国传达空气污染急性健康风险方面的表现可能与 AQI 相当。似乎没有必要为不同年龄组、性别和死因建立特定的 AQHI。
