National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan.
Environ Res. 2023 Aug 15;231(Pt 2):116214. doi: 10.1016/j.envres.2023.116214. Epub 2023 May 22.
The currently used air quality index (AQI) is not able to capture the additive effects of air pollution on health risks and reflect non-threshold concentration-response relationships, which has been criticized. We proposed the air quality health index (AQHI) based on daily air pollution-mortality associations, and compared its validity in predicting daily mortality and morbidity risks with the existing AQI. We examined the excess risk (ER) of daily elderly (≥65-year-old) mortality associated with 6 air pollutants (PM, PM, SO, CO, NO, and O) in 72 townships across Taiwan from 2006 to 2014 by performing a time-series analysis using a Poisson regression model. Random effect meta-analysis was used to pool the township-specified ER for each air pollutant in the overall and seasonal scenarios. The integrated ERs for mortality were calculated and used to construct the AQHI. The association of the AQHI with daily mortality and morbidity were compared by calculating the percentage change per interquartile range (IQR) increase in the indices. The magnitude of the ER on the concentration-response curve was used to evaluate the performance of the AQHI and AQI, regarding specific health outcomes. Sensitivity analysis was conducted using coefficients from the single- and two-pollutant models. The coefficients of PM, NO, SO, and O associated with mortality were included to form the overall and season-specific AQHI. An IQR increase in the overall AQHI at lag 0 was associated with 1.90%, 2.96%, and 2.68% increases in mortality, asthma, and respiratory outpatient visits, respectively. The AQHI had higher ERs for mortality and morbidity on the validity examinations than the current AQI. The AQHI, which captures the combined effects of air pollution, can serve as a health risk communication tool to the public.
目前使用的空气质量指数 (AQI) 无法捕捉空气污染对健康风险的累积效应，也无法反映无阈值浓度-反应关系，因此受到了批评。我们基于每日空气污染与死亡率之间的关联提出了空气质量健康指数 (AQHI)，并将其预测每日死亡率和发病率风险的有效性与现有的 AQI 进行了比较。我们通过使用泊松回归模型进行时间序列分析，研究了台湾 72 个乡镇 2006 年至 2014 年期间 6 种空气污染物（PM、PM、SO、CO、NO 和 O）与老年（≥65 岁）人每日死亡率相关的超额风险 (ER)。使用随机效应荟萃分析汇总了每个乡镇在总体和季节情况下每种空气污染物的 ER。计算了死亡率的综合 ER，并用于构建 AQHI。通过计算指数每增加一个四分位距 (IQR) 的百分比变化来比较 AQHI 与每日死亡率和发病率的关联。使用浓度-反应曲线上的 ER 大小来评估 AQHI 和 AQI 对特定健康结果的性能。使用单污染物和双污染物模型的系数进行了敏感性分析。包含与死亡率相关的 PM、NO、SO 和 O 的系数，形成了总体和特定季节的 AQHI。总体 AQHI 在滞后 0 时的 IQR 增加与死亡率、哮喘和呼吸道门诊就诊率分别增加 1.90%、2.96%和 2.68%相关。在有效性检验中，AQHI 对死亡率和发病率的 ER 高于现行的 AQI。AQHI 可捕捉空气污染的综合影响，可作为向公众传达健康风险的工具。
