Punnasiri Kornwipa, Tawatsupa Benjawan, Pumipan Tipkamon, Kruon Nart, Sritong-Aon Chittamon, Phosri Arthit
Health Impact Assessment Division, Department of Health, Ministry of Public Health, Nonthaburi, Thailand.
Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
Chemosphere. 2025 Feb;371:144049. doi: 10.1016/j.chemosphere.2024.144049. Epub 2025 Jan 2.
The Air Quality Health Index (AQHI) has long been introduced as an environmental health risk communication tool. Based on an epidemiological approach, it considers the combined effects of many air pollutants. However, comprehensive AQHI development for Thailand remains. This study aimed to develop the national AQHI in Thailand and determine whether sex- and age-specific AQHIs should be developed. The AQHI was constructed by examining the mortality risk associated with short-term exposure to multiple air pollutants using a time-stratified case-crossover design with the conditional Poisson regression model. This analysis utilized data from 31 provinces in Thailand from 2017 to 2020. The mortality risk associated with five criteria air pollutants-particulate matter with either 10 μm (PM) or 2.5 μm (PM) in aerodynamic diameter, as well as nitrogen dioxide (NO), sulfur dioxide (SO), ground-level ozone (O), and carbon monoxide (CO)-was calculated to construct the national AQHI and scaled it to a range from 0 to 10. The AQHIs were developed separately for age and sex, and the mortality risk associated with this established AQHI was explored and compared with that associated with the Air Quality Index (AQI). We found that the total AQHI and sex- and age-specific AQHIs were highly correlated with a similar association with mortality. The effects of AQHI on mortality were slightly more potent than AQI's, but their model fit statistics were comparable. In conclusion, developing specific AQHIs is unnecessary because their distributions and effects are similar to total AQHIs. The AQHI seems to be the better tool for communicating health risks related to air pollution, as the mortality risk associated with AQHI was more pronounced than that associated with AQI.
空气质量健康指数（AQHI）长期以来一直作为一种环境健康风险沟通工具被引入。基于流行病学方法，它考虑了多种空气污染物的综合影响。然而，泰国全面的AQHI开发工作仍在进行中。本研究旨在开发泰国的国家AQHI，并确定是否应开发针对性别和年龄的特定AQHI。通过使用条件泊松回归模型的时间分层病例交叉设计，研究短期暴露于多种空气污染物与死亡风险之间的关系，从而构建AQHI。该分析利用了泰国31个省份2017年至2020年的数据。计算了与五种标准空气污染物相关的死亡风险，这些污染物分别是空气动力学直径为10微米（PM）或2.5微米（PM）的颗粒物，以及二氧化氮（NO）、二氧化硫（SO）、地面臭氧（O）和一氧化碳（CO），以此构建国家AQHI并将其范围设定为0至10。分别针对年龄和性别开发了AQHI，并探讨了与该既定AQHI相关的死亡风险，并与空气质量指数（AQI）相关的死亡风险进行了比较。我们发现，总AQHI以及针对性别和年龄的特定AQHI与死亡率的关联高度相关。AQHI对死亡率的影响略强于AQI，但它们的模型拟合统计数据相当。总之，开发特定的AQHI是不必要的，因为它们的分布和影响与总AQHI相似。AQHI似乎是传达与空气污染相关健康风险的更好工具，因为与AQHI相关的死亡风险比与AQI相关的更为明显。
