A new multipollutant, no-threshold air quality health index based on short-term associations observed in daily time-series analyses

Air quality indices currently in use have been criticized because they do not capture additive effects of multiple pollutants, or reflect the apparent no-threshold concentration-response relationship between air pollution and health. We propose a new air quality health index (AQHI), constructed as the sum of excess mortality risk associated with individual pollutants from a time-series analysis of air pollution and mortality in Canadian cities, adjusted to a 0-10 scale, and calculated hourly on the basis of trailing 3-hr average pollutant concentrations. Extensive sensitivity analyses were conducted using alternative combinations of pollutants from single and multipollutant models. All formulations considered produced frequency distributions of the daily maximum AQHI that were right-skewed, with modal values of 3 or 4, and less than 10% of values at 7 or above on the 10-point scale. In the absence of a gold standard and given the uncertainty in how to best reflect the mix of pollutants, we recommend a formulation based on associations of nitrogen dioxide, ozone, and particulate matter of median aerodynamic diameter less than 2.5 microm with mortality from single-pollutant models. Further sensitivity analyses revealed good agreement of this formulation with others based on alternative sources of coefficients drawn from published studies of mortality and morbidity. These analyses provide evidence that the AQHI represents a valid approach to formulating an index with the objective of allowing people to judge the relative probability of experiencing adverse health effects from day to day. Together with health messages and a graphic display, the AQHI scale appears promising as an air quality risk communication tool.     

Evaluating an Air Quality Health Index (AQHI) amendment for communities impacted by residential woodsmoke in British Columbia,Canada

ABSTRACT

Smoke from burning biomass is an important source of fine particulate matter (PM_2.5), but the health risks may not be fully captured by the Canadian Air Quality Health Index (AQHI). In May 2018, the province of British Columbia launched an evidence-based amendment (AQHI-Plus) to improve AQHI performance for wildfire smoke, but the AQHI-Plus was not developed or tested on data from the residential woodsmoke season. This study assesses how the AQHI and AQHI-Plus are associated with acute health outcomes during the cooler seasons of 2010–2017 in British Columbia, Canada. Monthly and daily patterns of temperature and PM_2.5 concentrations were used to identify Local Health Areas (LHAs) that were impacted by residential woodsmoke. The effects of the AQHI and AQHI-Plus on five acute health outcomes (including non-accidental mortality, outpatient physician visits, and medical dispensations for cardiopulmonary conditions) were estimated using generalized linear mixed effect models with Poisson distributions adjusted for long- and short-term temperature trends. Values of the Akaike information criterion (AIC) were compared to evaluate whether the AQHI or AQHI-Plus was better fitted to each health outcome. Eleven LHAs were categorized as woodsmoke-impacted. In these LHAs, the AQHI and AQHI-Plus associations with acute health outcomes were sensitive to temperature adjustments. After temperature adjustments, the most consistent associations were observed for the two asthma-specific outcomes where the AQHI-Plus was better fitted than the AQHI. The improved performance of the AQHI-Plus for susceptible populations with asthma is consistent between communities impacted by residential woodsmoke and wildfire smoke.

Implications: Canada’s Air Quality Health Index (AQHI) is a three pollutant index used to communicate the short term health impact of degraded air quality. As fine particulate matter (PM_2.5) is the lowest weighted pollutant in the AQHI, the index is poorly reflective of woodsmoke impacts. The present analysis found that an AQHI amendment developed for improved sensitivity to PM_2.5 during wildfire seasons (AQHI-Plus) is also more predictive of acute asthma-related health outcomes in communities impacted by residential woodsmoke. The BC Ministry of Environment and Climate Change Strategy has piloted the AQHI-Plus year-round. Other jurisdictions should consider whether their air quality indices are reflective of the risks posed by woodsmoke.     

Daily Mortality in the Philadelphia Metropolitan Area and Size-Classified Particulate Matter

ABSTRACT

Time-series of daily mortality data from May 1992 to September 1995 for various portions of the seven-county Philadelphia, PA, metropolitan area were analyzed in relation to weather and a variety of ambient air quality parameters. The air quality data included measurements of size-classified PM, SO₄ ^2-, and H+ that had been collected by the Harvard School of Public Health, as well as routine air pollution monitoring data. Because the various pollutants of interest were measured at different locations within the metropolitan area, it was necessary to test for spatial sensitivity by comparing results for different combinations of locations. Estimates are presented for single pollutants and for multiple-pollutant models, including gaseous pollutants and mutually exclusive components of PM (PM_2.5 and coarse particles, SO₄ ^2- and non-SO₄ ^2- portions of total suspended particulate [TSP] and PM₁₀), measured on the day of death and the previous day.

We concluded that associations between air quality and mortality were not limited to data collected in the same part of the metropolitan area; that is, mortality for one part may be associated with air quality data from another, not necessarily neighboring, part. Significant associations were found for a wide variety of gaseous and particulate pollutants, especially for peak O₃. Using joint regressions on peak O₃ with various other pollutants, we found that the combined responses were insensitive to the specific other pollutant selected. We saw no systematic differences according to particle size or chemistry. In general, the associations between daily mortality and air pollution depended on the pollutant or the PM metric, the type of collection filter used, and the location of sampling. Although peak O₃ seemed to exhibit the most consistent mortality responses, this finding should be confirmed by analyzing separate seasons and other time periods.     

Daily mortality in the Philadelphia metropolitan area and size-classified particulate matter

Time-series of daily mortality data from May 1992 to September 1995 for various portions of the seven-county Philadelphia, PA, metropolitan area were analyzed in relation to weather and a variety of ambient air quality parameters. The air quality data included measurements of size-classified PM, SO4(2-), and H+ that had been collected by the Harvard School of Public Health, as well as routine air pollution monitoring data. Because the various pollutants of interest were measured at different locations within the metropolitan area, it was necessary to test for spatial sensitivity by comparing results for different combinations of locations. Estimates are presented for single pollutants and for multiple-pollutant models, including gaseous pollutants and mutually exclusive components of PM (PM2.5 and coarse particles, SO4(2-) and non-SO4(2-) portions of total suspended particulate [TSP] and PM10), measured on the day of death and the previous day. We concluded that associations between air quality and mortality were not limited to data collected in the same part of the metropolitan area; that is, mortality for one part may be associated with air quality data from another, not necessarily neighboring, part. Significant associations were found for a wide variety of gaseous and particulate pollutants, especially for peak O3. Using joint regressions on peak O3 with various other pollutants, we found that the combined responses were insensitive to the specific other pollutant selected. We saw no systematic differences according to particle size or chemistry. In general, the associations between daily mortality and air pollution depended on the pollutant or the PM metric, the type of collection filter used, and the location of sampling. Although peak O3 seemed to exhibit the most consistent mortality responses, this finding should be confirmed by analyzing separate seasons and other time periods.     

Air pollution and health studies in China--policy implications

During the rapid economic development in China, ambient air pollutants in major cities, including PM10 (particulate matter with aerodynamic diameter < or =10 microm) and SO2 have been reduced due to various measures taken to reduce or control sources of emissions, whereas NO2 is stable or slightly increased. However, air pollution levels in China are still at the higher end of the world level. Less information is available regarding changes in national levels of other pollutants such as PM2.5 and ozone. The Chinese Ministry of Environmental Protection (MOEP) set an index for "controlling/reducing total SO2 emissions" to evaluate the efficacy of air pollution control strategy in the country. Total SO2 emissions declined for the first time in 2007. Chinese epidemiologic studies evidenced adverse health effects of ambient air pollution similar to those reported from developed countries, though risk estimates on mortality/morbidity per unit increase of air pollutant are somewhat smaller than those reported in developed countries. Disease burden on health attributable to air pollution is relatively greater in China because of higher pollution levels. Improving ambient air quality has substantial and measurable public health benefits in China. It is recommended that the current Chinese air quality standards be updated/revised and the target for "controlling/reducing total SO2 emissions" be maintained and another target for "reducing total NO2 emissions" be added in view of rapid increase in motor vehicles. Continuous and persistent efforts should be taken to improve ambient air quality.     

Daily Mortality and Air Pollution in the Netherlands

ABSTRACT

We studied the association of daily mortality with short-term variations in the ambient concentrations of major gaseous pollutants and PM in the Netherlands. The magnitude of the association in the four major urban areas was compared with that in the remainder of the country. Daily cause-specific mortality counts, air quality, temperature, relative humidity, and influenza data were obtained from 1986 to 1994. The relationship between daily mortality and air pollution was modeled using Poisson regression analysis. We adjusted for potential confounding due to long-term and seasonal trends, influenza epidemics, ambient temperature and relative humidity, day of the week, and holidays, using generalized additive models.

Influenza episodes were associated with increased mortality up to 3 weeks later. Daily mortality was significantly associated with the concentration of all air pollutants. An increase in the PM₁₀ concentration by 100 u.g/m³ was associated with a relative risk (RR) of 1.02 for total mortality. The largest RRs were found for pneumonia deaths. Ozone had the most consistent, independent association with mortality. Particulate air pollution (e.g., PM₁₀, black smoke [BS]) was not more consistently associated with mortality than were the gaseous pollutants SO₂ and NO₂. Aerosol SO₄ ^-2, NO₃ ^-, and BS were more consistently associated with total mortality than was PM₁₀. The RRs for all pollutants were substantially larger in the summer months than in the winter months. The RR of total mortality for PM₁₀ was 1.10 for the summer and 1.03 for the winter. There was no consistent difference between RRs in the four major urban areas and the more rural areas.     

Air Pollution Patterns In New York City

Some preliminary analyses of data selected from three years of smoke shade and sulfur dioxide measurements from the forty air monitoring stations in New York City are presented. The purpose of these analyses is to investigate the spatial-temporal variation in concentration of these pollutants throughout the five boroughs of the city. Air pollution health effects studies in New York City have often used city-wide daily morbidity or mortality statistics and related them to air pollution levels obtained from a single monitoring station. The question of whether readings at one station in New York City can adequately represent the air pollution exposure for the population in the five boroughs is examined in this paper. Some samples of correlation matrices of daily pollution averages obtained from the forty air monitoring stations are presented to illustrate the day-to-day variation in pollution in various sections of New York City. It was found that interstation correlations are not high enough to justify the use of one central pollution measuring station as representative of a large metropolitan area. Sulfur dioxide correlates better between stations than smoke shade; this may reflect the different nature and spatial distribution of sources of the two pollutants. Close proximity of stations, or the fact that they were at similar heights above street or sea level did not necessarily lead to higher correlation coefficients.     

Daily mortality and air pollution in The Netherlands

We studied the association of daily mortality with short-term variations in the ambient concentrations of major gaseous pollutants and PM in the Netherlands. The magnitude of the association in the four major urban areas was compared with that in the remainder of the country. Daily cause-specific mortality counts, air quality, temperature, relative humidity, and influenza data were obtained from 1986 to 1994. The relationship between daily mortality and air pollution was modeled using Poisson regression analysis. We adjusted for potential confounding due to long-term and seasonal trends, influenza epidemics, ambient temperature and relative humidity, day of the week, and holidays, using generalized additive models. Influenza episodes were associated with increased mortality up to 3 weeks later. Daily mortality was significantly associated with the concentration of all air pollutants. An increase in the PM10 concentration by 100 micrograms/m3 was associated with a relative risk (RR) of 1.02 for total mortality. The largest RRs were found for pneumonia deaths. Ozone had the most consistent, independent association with mortality. Particulate air pollution (e.g., PM10, black smoke [BS]) was not more consistently associated with mortality than were the gaseous pollutants SO2 and NO2. Aerosol SO4(-2), NO3-, and BS were more consistently associated with total mortality than was PM10. The RRs for all pollutants were substantially larger in the summer months than in the winter months. The RR of total mortality for PM10 was 1.10 for the summer and 1.03 for the winter. There was no consistent difference between RRs in the four major urban areas and the more rural areas.     

Ambient Air Pollution and Daily Pediatric Hospitalizations for Asthma (5 pp)

Background, Aim and Scope A series of severe air pollution episodes in Europe and North America prior to 1960 have focused scientific and regulatory attention on the adverse effects of air pollution on human health. As a consequence of significant reductions in ambient air pollution levels in the intervening years, scientists and public health officials have become more concerned with the potential health effects of exposure to routine concentrations of air pollution. Several recent time series studies conducted world-wide have found relatively low levels of air pollutants that are below national standards were associated with adverse effects on mortality and morbidity. This study examined the effects of ambient air pollution indicators on the daily rate of pediatric hospital admissions for asthma in the Oklahoma City Metropolitan area from 2001-2003. Results: Negative binomial regression analysis revealed significant relationships between the total number of hospitalizations per day and the one-hour maximum NO2 level, the proportion of susceptible children < 5 years old, and the ratio of temperature to humidity. Discussion: This study of the total number of children aged ≤ 14 years old experiencing hospitalizations on a daily basis in the Oklahoma City area from 2001-2003 underscores factors other than ambient air pollution, especially when concentrations are low, affect hospitalizations for pediatric asthma. For example, information related to indoor air quality, health care, family history, and exposure to environmental tobacco smoke and other irritants are not obtainable. Yet, those factors are risk drivers for asthma. Similarly, health privacy requirements prevented obtaining data on physiological factors specific to each child such as differentials in airways functional capacity or other impairments influenced asthma exacerbation. This makes calculating relative risk inappropriate. Conclusions: Although ambient air pollution concentrations and meteorological conditions influence pediatric asthma hospitalizations, they are not the major predictors in the Oklahoma City metropolitan area. This is consistent with other research that finds limited effects associated with low levels for concentrations of the criteria pollutants.     

A real-time monitoring and assessment method for calculation of total amounts of indoor air pollutants emitted in subway stations

Subway systems are considered as main public transportation facility in developed countries. Time spent by people in indoors, such as underground spaces, subway stations, and indoor buildings, has gradually increased in the recent past. Especially, operators or old persons who stay in indoor environments more than 15 hr per day usually influenced a greater extent by indoor air pollutants. Hence, regulations on indoor air pollutants are needed to ensure good health of people. Therefore, in this study, a new cumulative calculation method for the estimation of total amounts of indoor air pollutants emitted inside the subway station is proposed by taking cumulative amounts of indoor air pollutants based on integration concept. Minimum concentration of individual air pollutants which naturally exist in indoor space is referred as base concentration of air pollutants and can be found from the data collected. After subtracting the value of base concentration from data point of each data set of indoor air pollutant, the primary quantity of emitted air pollutant is calculated. After integration is carried out with these values, adding the base concentration to the integration quantity gives the total amount of indoor air pollutant emitted. Moreover, the values of new index for cumulative indoor air quality obtained for 1 day are calculated using the values of cumulative air quality index (CAI). Cumulative comprehensive indoor air quality index (CCIAI) is also proposed to compare the values of cumulative concentrations of indoor air pollutants. From the results, it is clear that the cumulative assessment approach of indoor air quality (IAQ) is useful for monitoring the values of total amounts of indoor air pollutants emitted, in case of exposure to indoor air pollutants for a long time. Also, the values of CCIAI are influenced more by the values of concentration of NO₂, which is released due to the use of air conditioners and combustion of the fuel. The results obtained in this study confirm that the proposed method can be applied to monitor total amounts of indoor air pollutants emitted, inside apartments and hospitals as well.

Implications: Nowadays, subway systems are considered as main public transportation facility in developed countries. Time spent by people in indoors, such as underground spaces, subway stations, and indoor buildings, has gradually increased in the recent past. Especially, operators or old persons who stay in the indoor environments more than 15 hr per day usually influenced a greater extent by indoor air pollutants. Hence, regulations on indoor air pollutants are needed to ensure good health of people. Therefore, this paper presents a new methodology for monitoring and assessing total amounts of indoor air pollutants emitted inside underground spaces and subway stations. A new methodology for the calculation of cumulative amounts of indoor air pollutants based on integration concept is proposed. The results suggest that the cumulative assessment approach of IAQ is useful for monitoring the values of total amounts of indoor air pollutants, if indoor air pollutants accumulated for a long time, especially NO₂ pollutants. The results obtained here confirm that the proposed method can be applied to monitor total amounts of indoor air pollutants emitted, inside apartments and hospitals as well.     

Aerosol Research and Inhalation Epidemiological Study (ARIES): Air Quality and Daily Mortality Statistical Modeling— Interim Results

ABSTRACT

The Aerosol Research and Inhalation Epidemiological Study (ARIES) is an EPRI-sponsored project to collect air quality and meteorological data at a single site in northwestern Atlanta, GA. Seventy high-resolution air quality indicators (AQIs) are used to examine statistical relationships between air quality and health outcome end points. Contemporaneous mortality data are collected for Fulton and DeKalb counties in Georgia. Currently, 12 months of air quality and weather data are available for analysis, from August 1998 through July 1999.

The interim mortality analysis used Poisson regression in generalized additive models (GAMs). The estimated log-linear association of mortality with various AQIs was adjusted for smoothed functions of time and meteorological data. The analysis considered daily deaths due to all nonaccidental causes, deaths to persons 65 years or older, and deaths in each of the two constituent counties. The fine particle effect associated with the four mortality subgroups, using only today (lag 0), yesterday (lag 1), 2-day average (average of today and yesterday), and first difference (today minus yesterday) measurements of the air quality relative to today's number of deaths was positive for lag 0, lag 1, and 2-day average and positive only for decedents at least 65 years of age using first difference. The t values ranged from 0.81 to 1.15 for lag 0, 1.04 to 1.53 for lag 1, 1.10 to 1.66 for 2-day average, and -0.32 to 0.33 for first difference with 346 or 347 days of data. No statistically significant estimate of the linear coefficient was found for the other 14 air quality variables in our interim analysis for the four mortality subgroups. We discuss diagnostics to support these models.

These interim analyses did not include an evaluation of sensitivity to a larger set of lag structures, nonlinear model specifications, multipollutant analyses, alternative weather model and smoothing model specifications, air pollution imputation schemes, or cause-specific mortality indicators, nor did they include a full reporting of model selection or goodness-of-fit indicators. No conclusion can be drawn at this time about whether the findings from subsequent studies have sufficiently greater power to detect effects comparable to those found in other U.S. cities including at least 2 or 3 years of data.     

Contemporary threats and air pollution

It is now well understood that air pollution produces significant adverse health effects in the general public and over the past 60 years, there have been on-going efforts to reduce the emitted pollutants and their resulting health effects. There are now shifting patterns of industrialization with many heavily polluting industries moving from developed countries with increasingly stringent air quality standards to the developing world. However, even in decreasing concentrations of pollutants, health effects remain important possibly as a result of changes in the nature of the pollutants as new chemicals are produced and as other causes of mortality and morbidity are reduced. In addition, there is now the potential for deliberate introduction of toxic air pollutants by local armed conflicts and terrorists. Thus, there are new challenges to understand the role of the atmospheric environment on public health in this time of changing economic and demographic conditions overlaid with the willingness to indirectly attack governments and other established entities through direct attacks on the general public.     

Revisiting the Veterans Cohort Mortality Study: New results and synthesis

ABSTRACT

The Veterans Cohort Mortality Study began in 1999 in collaboration with Washington University in St. Louis, comprising ~70,000 male military veterans. We published six research papers on this cohort, considering the dynamics of all-cause mortality as the subjects aged and environmental parameters changed. This paper summarizes those results and presents new results by age group. Pollutants included monitored and modeled criteria pollutants, vehicular traffic density (annual km driven per unit of county land area), and modeled nationwide levels of hazardous species. In addition to spatial relationships, we examined the effects of exposure timing through separate analyses of sequential follow-up and exposure periods from 1976 to 2001. Risks associated with peak ozone decreased with lag between exposure and response, suggesting acute effects. Risks associated with traffic were invariant over time and consistent across five exposure databases. Associations with ozone were also coherent across databases; we found no consistent associations with particulate matter. Epidemiology considers both spatial and temporal relationships; most long-term studies focus on spatial gradients at a given time, thus masking effects of cohort aging and other trends during follow-up. Our new analyses distinguished between these temporal effects by analyzing age deciles for which separate mortality risks had been estimated for nationwide levels of nitrogen oxides (NO_x), benzene, and traffic density during four sequential follow-up subperiods, thus providing 40 sets of mortality risk coefficients. We used ordinary least squares regression to define relationships with subject age and follow-up year for the data set of 40 coefficients. We found strong nonlinear relationships between subject age and mortality coefficients for smoking, climate, poverty status, and air pollution; only smoking and climate coefficients changed over time as well. We concluded that these pollutant-mortality relationships reflected differences among the veterans’ residential locations rather than changes in their pollution exposures during follow-up. We saw no evidence that cleaner air reduced mortality.

Implications: Recent air pollution mortality studies emphasize PM_2.5 (particulate matter with an aerodynamic diameter <2.5 μm); we show associations with many other pollutants and a measure of traffic intensity. Control policies should thus be based on multipollutant analyses. We found no reduced risks with improved air quality after distinguishing cohort aging from purely temporal effects; longitudinal studies of accountability must thus account for changes in demography and exposures. Our studies of exposure timing indicate mainly coincident responses and no evidence for cumulative effects typical of smoking; we had no information on personal exposures. We found the strongest risks were associated with high-traffic locations rather than outdoor air quality per se.     

Short-term effect of fine particulate matter (PM<Subscript>2.5</Subscript>) and ozone on daily mortality in Lisbon,Portugal

Introduction  

Urban ambient air pollution exposures continue to be a global public health concern. Although air quality targets are often exceeded in Lisbon, the largest city in Portugal, there is currently no study that has assessed the quantitative impact of these pollutants on daily mortality.     

Extended effects of air pollution on cardiopulmonary mortality in Vienna

BackgroundCurrent standards for fine particulates and nitrogen dioxide are under revision. Patients with cardiovascular disease have been identified as the largest group which need to be protected from effects of urban air pollution.MethodsWe sought to estimate associations between indicators of urban air pollution and daily mortality using time series of daily TSP, PM₁₀, PM_2.5, NO₂, SO₂, O₃ and nontrauma deaths in Vienna (Austria) 2000–2004. We used polynomial distributed lag analysis adjusted for seasonality, daily temperature, relative humidity, atmospheric pressure and incidence of influenza as registered by sentinels.ResultsAll three particulate measures and NO₂ were associated with mortality from all causes and from ischemic heart disease and COPD at all ages and in the elderly. The magnitude of the effect was largest for PM_2.5 and NO₂. Best predictor of mortality increase lagged 0–7 days was PM_2.5 (for ischemic heart disease and COPD) and NO₂ (for other heart disease and all causes). Total mortality increase, lagged 0–14 days, per 10 μg m⁻³ was 2.6% for PM_2.5 and 2.9% for NO₂, mainly due to cardiopulmonary and cerebrovascular causes.ConclusionAcute and subacute lethal effects of urban air pollution are predicted by PM_2.5 and NO₂ increase even at relatively low levels of these pollutants. This is consistent with results on hospital admissions and the lack of a threshold. While harvesting (reduction of mortality after short increase due to premature deaths of most sensitive persons) seems to be of minor importance, deaths accumulate during 14 days after an increase of air pollutants. The limit values for PM_2.5 and NO₂ proposed for 2010 in the European Union are unable to prevent serious health effects.     

Forecasting human exposure to atmospheric pollutants in Portugal – A modelling approach

Air pollution has become one main environmental concern because of its known impact on human health. Aiming to inform the population about the air they are breathing, several air quality modelling systems have been developed and tested allowing the assessment and forecast of air pollution ambient levels in many countries. However, every day, an individual is exposed to different concentrations of atmospheric pollutants as he/she moves from and to different outdoor and indoor places (the so-called microenvironments). Therefore, a more efficient way to prevent the population from the health risks caused by air pollution should be based on exposure rather than air concentrations estimations. The objective of the present study is to develop a methodology to forecast the human exposure of the Portuguese population based on the air quality forecasting system available and validated for Portugal since 2005. Besides that, a long-term evaluation of human exposure estimates aims to be obtained using one-year of this forecasting system application. Additionally, a hypothetical 50% emission reduction scenario has been designed and studied as a contribution to study emission reduction strategies impact on human exposure.To estimate the population exposure the forecasting results of the air quality modelling system MM5-CHIMERE have been combined with the population spatial distribution over Portugal and their time-activity patterns, i.e. the fraction of the day time spent in specific indoor and outdoor places. The population characterization concerning age, work, type of occupation and related time spent was obtained from national census and available enquiries performed by the National Institute of Statistics. A daily exposure estimation module has been developed gathering all these data and considering empirical indoor/outdoor relations from literature to calculate the indoor concentrations in each one of the microenvironments considered, namely home, office/school, and other indoors (leisure activities like shopping areas, gym, theatre/cinema and restaurants). The results show how this developed modelling system can be useful to anticipate air pollution episodes and to estimate their effects on human health on a long-term basis. The two metropolitan areas of Porto and Lisbon are identified as the most critical ones in terms of air pollution effects on human health over Portugal in a long-term as well as in a short-term perspective. The coexistence of high concentration values and high population density is the key factor for these stressed areas. Regarding the 50% emission reduction scenario, the model results are significantly different for both pollutants: there is a small overall reduction in the individual exposure values of PM₁₀ (<10 μg m^?3 h), but for O₃, in contrast, there is an extended area where exposure values increase with emission reduction. This detailed knowledge is a prerequisite for the development of effective policies to reduce the foreseen adverse impact of air pollution on human health and to act on time.     

Effect of the Fine Fraction of Particulate Matter versus the Coarse Mass and Other Pollutants on Daily Mortality in Santiago,Chile

ABSTRACT

Daily counts of non-accidental deaths in Santiago, Chile, from 1988 to 1996 were regressed on six air pollutants— fine particles (PM_2.5), coarse particles (PM_10–2.5), CO, SO₂, NO₂, and O₃. Controlling for seasonal and meteorological conditions was done using three different models— a generalized linear model, a generalized additive model, and a generalized additive model on previously filtered data. Single- and two-pollutant models were tested for lags of 1-5 days and the average of the previous 2-5 days.

The increase in mortality associated with the mean levels of air pollution varied from 4 to 11%, depending on the pollutants and the way season of the year was considered. The results were not sensitive to the modeling approaches, but different effects for warmer and colder months were found. Fine particles were more important than coarse particles in the whole year and in winter, but not in summer. NO₂ and CO were also significantly associated with daily mortality, as was O₃ in the warmer months. No consistent effect was observed for SO₂. Given particle composition in Santiago, these results suggest that combustion-generated pollutants, especially from motor vehicles, may be associated with increased mortality. Temperature was closely associated with mortality. High temperatures led to deaths on the same day, while low temperatures lead to deaths from 1 to 4 days later.     

Human health risks in megacities due to air pollution

This study evaluates the health risks in megacities in terms of mortality and morbidity due to air pollution. A new spreadsheet model, Risk of Mortality/Morbidity due to Air Pollution (Ri-MAP), is used to estimate the excess numbers of deaths and illnesses. By adopting the World Health Organization (WHO) guideline concentrations for the air pollutants SO₂, NO₂ and total suspended particles (TSP), concentration-response relationships and a population attributable-risk proportion concept are employed. Results suggest that some megacities like Los Angeles, New York, Osaka Kobe, Sao Paulo and Tokyo have very low excess cases in total mortality from these pollutants. In contrast, the approximate numbers of cases is highest in Karachi (15,000/yr) characterized by a very high concentration of total TSP (～670 μg m^?3). Dhaka (7000/yr), Beijing (5500/yr), Karachi (5200/yr), Cairo (5000/yr) and Delhi (3500/yr) rank highest with cardiovascular mortality. The morbidity (hospital admissions) due to Chronic Obstructive Pulmonary Disease (COPD) follows the tendency of cardiovascular mortality. Dhaka and Karachi lead the rankings, having about 2100/yr excess cases, while Osaka-Kobe (～20/yr) and Sao Paulo (～50/yr) are at the low end of all megacities considered. Since air pollution is increasing in many megacities, and our database of measured pollutants is limited to the period up to 2000 and does not include all relevant components (e.g. O₃), these numbers should be interpreted as lower limits. South Asian megacities most urgently need improvement of air quality to prevent excess mortality and morbidity due to exceptionally high levels of air pollution. The risk estimates obtained from Ri-MAP present a realistic baseline evaluation for the consequences of ambient air pollution in comparison to simple air quality indices, and can be expanded and improved in parallel with the development of air pollution monitoring networks.     

Short-Term Effects of Gaseous Pollutants on Cause-Specific Mortality in Wuhan,China

Abstract

In Asia, limited studies have been published on the association between daily mortality and gaseous pollutants of nitrogen dioxide (NO₂), ozone (O₃), and sulfur dioxide (SO₂). Our previous studies in Wuhan, China, demonstrated long-term air pollution effects. However, no study has been conducted to determine mortality effects of air pollution in this region. This study was to determine the acute mortality effects of the gaseous pollutants in Wuhan, a city with 7.5 million permanent residents during the period from 2000 to 2004. There are approximately 4.5 million residents in Wuhan who live in the city’s core area of 201 km², where air pollution levels are highest, and pollution ranges are wider than the majority of the cities in the published literature. We used the generalized additive model to analyze pollution, mortality, and covariate data. We found consistent NO₂effects on mortality with the strongest effects on the same day. Every 10-μg/m³increase in NO₂daily concentration on the same day was associated with an increase in nonaccidental (1.43%; 95% confidence interval [CI]: 0.87–1.99%), cardiovascular (1.65%; 95% CI: 0.87–2.45%), stroke (1.49%; 95% CI: 0.56–2.43%), cardiac (1.77%; 95% CI: 0.44–3.12%), respiratory (2.23%; 95% CI: 0.52–3.96%), and cardiopulmonary mortality (1.60%; 95% CI: 0.85– 2.35%). These effects were stronger among the elderly than among the young. Formal examination of exposure-response curves suggests no-threshold linear relationships between daily mortality and NO₂, where the NO₂concentrations ranged from 19.2 to 127.4 μg/m³. SO₂and O₃were not associated with daily mortality. The exposure-response relationships demonstrated heterogeneity, with some curves showing nonlinear relationships for SO₂and O₃. We conclude that there is consistent evidence of acute effects of NO₂on mortality and suggest that a no-threshold linear relationship exists between NO₂and mortality.