Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
Chengdu Center for Diseases Control and Prevention, Chengdu 610041, China.
Sci Total Environ. 2020 Jun 20;722:137892. doi: 10.1016/j.scitotenv.2020.137892. Epub 2020 Mar 13.
Establishing an optimal indicator to communicate health risks of multiple air pollutants to public is much important. The Air Quality Health Index (AQHI) has been developed in many countries as a communication tool of multiple air pollutants related health risks. However, the current AQHI is based on the sum of the excess health risks which are typically derived from the single-pollutant statistical models. Such a strategy may overestimate the joint effect of multiple pollutants. We proposed an improved strategy to construct the AQHI based on a Bayesian multipollutant weighted model. Using this strategy, two improved indices - Bayesian multipollutant AQHI (BMP-AQHI) and Bayesian multipollutant AQHI with seasonal specificity (SBMP-AQHI) were calculated to present the multiple pollutants related health risks to the cardiovascular system based on data collected in Chengdu, China during 2013 to 2018. The two improved indices were compared to current Air Quality Index (AQI) and AQHI to evaluate the effectiveness of the improved indices in characterizing multipollutant health risks. The AQI risk classification suggested much smaller health risks than AQHIs. Among three AQHI types, the BMP-AQHI and SBMP-AQHI suggested slightly lower health risks to the cardiovascular system than the current AQHI. In the evaluation analysis, the SBMP-AQHI had the strongest association with the mortality of cardiovascular disease (CVD) (2.66%; 95%CI, 1.57%, 3.76%). In the subgroup analysis, an interquartile increase (IQR) of the SBMP-AQHI was associated with 3.21% (95%CI, 2.06%, 4.38%), 1.34% (95%CI, -0.13%, 2.82%), and 4.20% (95%CI, 2.59%, 5.84%) increases for CVD mortality in the elderly, male, and female subgroups, respectively. The study shows that the improved AQHIs can communicate the health information of multiple air pollutants more efficiently. The study also indicates the necessity to consider seasonal specificity in the construction of the AQHI.
建立一个最优的指标来向公众传达多种空气污染物的健康风险非常重要。空气质量健康指数（AQHI）已在许多国家开发出来，作为一种与多种空气污染物相关健康风险的沟通工具。然而，目前的 AQHI 是基于超额健康风险的总和，这些风险通常是从单一污染物的统计模型中得出的。这种策略可能会高估多种污染物的联合效应。我们提出了一种改进的策略，基于贝叶斯多污染物加权模型来构建 AQHI。使用这种策略，根据 2013 年至 2018 年在中国成都收集的数据，计算了两个改进的指数-贝叶斯多污染物 AQHI（BMP-AQHI）和具有季节性特异性的贝叶斯多污染物 AQHI（SBMP-AQHI），以呈现心血管系统与多种污染物相关的健康风险。将这两个改进的指数与当前的空气质量指数（AQI）和 AQHI 进行比较，以评估改进的指数在描述多污染物健康风险方面的有效性。AQI 风险分类建议的健康风险比 AQHI 小得多。在三种 AQHI 类型中，BMP-AQHI 和 SBMP-AQHI 对心血管系统的健康风险略低于当前的 AQHI。在评估分析中，SBMP-AQHI 与心血管疾病（CVD）死亡率的相关性最强（2.66%；95%CI，1.57%，3.76%）。在亚组分析中，SBMP-AQHI 的四分位距（IQR）增加与 CVD 死亡率在老年人、男性和女性亚组中的分别增加 3.21%（95%CI，2.06%，4.38%）、1.34%（95%CI，-0.13%，2.82%）和 4.20%（95%CI，2.59%，5.84%）相关。研究表明，改进的 AQHI 可以更有效地传达多种空气污染物的健康信息。该研究还表明，在构建 AQHI 时考虑季节性特异性是必要的。
