School of Public Administration, Hangzhou Normal University, Hangzhou, China.
College of Public Administration, Zhejiang University, Hangzhou, China.
Front Public Health. 2022 Feb 7;9:819123. doi: 10.3389/fpubh.2021.819123. eCollection 2021.
In the epidemiological literature, the impact of environmental pollution on cardiac mortality has been well documented. There is, however, a paucity of evidence on the impact of air pollution exposure on ischemic heart disease (IHD) mortality among the Asian aged population. In response, this research seeks to investigate the degree of proximity between exposure to ambient PM, household PM, ground-level ozone (O), and IHD mortality in the top seven Asian economies with the highest aging rates. This investigation is held in two phases. In the first phase, grey modeling is employed to assess the degree of proximity among the selected variables, and then rank them based on their estimated grey weights. In addition, a grey-based Technique for Order of Preference by Similarity to Ideal Solution (G-TOPSIS) is adopted to identify the key influencing factor that intensifies IHD mortality across the selected Asian economies. According to the estimated results, South Korea was the most afflicted nation in terms of IHD mortality owing to ambient PM and ground-level O exposure, whereas among the studied nations India was the biggest contributor to raising IHD mortality due to household PM exposure. Further, the outcomes of G-TOPSIS highlighted that exposure to household PM is a key influencing risk factor for increased IHD mortality in these regions, outweighing all other air pollutants. In conclusion, this grey assessment may enable policymakers to target more vulnerable individuals based on scientific facts and promote regional environmental justice. Stronger emission regulations will also be required to mitigate the adverse health outcomes associated with air pollution exposure, particularly in regions with a higher elderly population.
在流行病学文献中，环境污染对心脏死亡率的影响已有充分记录。然而，关于空气污染暴露对亚洲老年人口中缺血性心脏病（IHD）死亡率的影响，证据很少。有鉴于此，本研究旨在调查在老龄化率最高的七个亚洲经济体中，环境 PM、家庭 PM、地面臭氧（O）暴露与 IHD 死亡率之间的接近程度。这项研究分两个阶段进行。在第一阶段，采用灰色模型评估所选变量之间的接近程度，然后根据估计的灰色权重对其进行排名。此外，采用基于灰色的逼近理想解排序法（G-TOPSIS）来确定加剧所选亚洲经济体 IHD 死亡率的关键影响因素。根据估计结果，韩国是受环境 PM 和地面 O 暴露影响导致 IHD 死亡率最高的国家，而在所研究的国家中，印度是由于家庭 PM 暴露导致 IHD 死亡率上升的最大贡献者。此外，G-TOPSIS 的结果强调，家庭 PM 暴露是这些地区 IHD 死亡率增加的关键影响风险因素，超过了所有其他空气污染物。总之，这种灰色评估可以使政策制定者根据科学事实确定更脆弱的个体，并促进区域环境公正。还需要更严格的排放法规来减轻与空气污染暴露相关的不良健康后果，特别是在老年人口比例较高的地区。
