The Establishment of a New Air Health Index Integrating the Mortality Risks Due to Ambient Air Pollution and Non-Optimum Temperature

Qingli Zhang; Renjie Chen; Guanjin Yin; Xihao Du; Xia Meng; Yang Qiu; Haidong Kan; Maigeng Zhou

doi:10.1016/j.eng.2021.05.006

PDF(507 KB)

Engineering ›› 2022, Vol. 14 ›› Issue (7) : 156-162. DOI: 10.1016/j.eng.2021.05.006

Research

Article

The Establishment of a New Air Health Index Integrating the Mortality Risks Due to Ambient Air Pollution and Non-Optimum Temperature

Qingli Zhang^a^,^* ,
Renjie Chen^a^,^b^,^* ,
Guanjin Yin^a ,
Xihao Du^a ,
Xia Meng^a^,^b ,
Yang Qiu^c ,
Haidong Kan^a^,^d ,
Maigeng Zhou^e

Author information +

History +

Abstract

A composite Air Health Index (AHI) is helpful for separately emphasizing the health risks of multiple stimuli and communicating the overall risks of an adverse atmospheric environment to the public. We aimed to establish a new AHI by integrating daily mortality risks due to air pollution with those due to non-optimum temperature in China. Based on the exposure-response (E-R) coefficients obtained from time-series models, the new AHI was constructed as the sum of excess mortality risk associated with air pollutants and non-optimum temperature in 272 Chinese cities from 2013 to 2015. We examined the association between the ″total AHI″ (based on total mortality) and total mortality, and further compared the ability of the ″total AHI″ to predict specific cardiopulmonary mortality with that of ″specific AHIs″ (based on specific mortalities). On average, air pollution and non-optimum temperature were associated with 28.23% of daily excess mortality, of which 23.47% was associated with non-optimum temperature while the remainder was associated with fine particulate matter (PM_2.5) (1.12%), NO₂ (2.29%,), and O₃ (2.29%). The new AHI uses a 10-point scale and shows an average across all 272 cities of 6 points. The E-R curve for AHI and mortality is approximately linear, without any thresholds. Each one unit increase in ″total AHI″ is associated with a 0.84% increase in all-cause mortality and 1.01%, 0.98%, 1.02%, 1.66%, and 1.71% increases in cardiovascular disease, coronary heart disease, stroke, respiratory diseases, and chronic obstructive pulmonary disease mortality, respectively. Cause-specific mortality risk estimates using the ″total AHI″ are similar to those predicted by ″specific AHIs.″ In conclusion, the ″total AHI″ proposed herein could be a promising tool for communicating health risks related to exposure to the ambient environment to the public.

Keywords

Air pollution / Temperature / Air Health Index / Mortality / Time-series / Risk communication

Cite this article

EndNote

Ris (Procite)

Bibtex

Download citation ▾

Qingli Zhang, Renjie Chen, Guanjin Yin, Xihao Du, Xia Meng, Yang Qiu, Haidong Kan, Maigeng Zhou. The Establishment of a New Air Health Index Integrating the Mortality Risks Due to Ambient Air Pollution and Non-Optimum Temperature. Engineering, 2022, 14(7): 156‒162 https://doi.org/10.1016/j.eng.2021.05.006

References

Publishing order | Descend order by publishing year | Descend order by cited within

[1]	Liu C, Chen R, Sera F, Vicedo-Cabrera AM, Guo Y, Tong S, et al. Ambient particulate air pollution and daily mortality in 652 cities. N Engl J Med 2019;381(8):705–15.

[2]	Chen R, Yin P, Wang L, Liu C, Niu Y, Wang W, et al. Association between ambient temperature and mortality risk and burden: time series study in 272 main Chinese cities. BMJ 2018;363:k4306.

[3]	Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al.; GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396(10258):1223–49.

[4]	General Administration of Quality Supervision, Inspection and Quarantine of the People’s Republic of China; Standardization Administration of the People’s Republic of China. GB/T 21987–2008: Grades of cold wave. Chinese standard. Beijing: Standards Press of China; 2008. Chinese.

[5]	General Administration of Quality Supervision, Inspection and Quarantine of the People’s Republic of China; Standardization Administration of the People’s Republic of China. GB/T 29457–2012: Grade of the heat wave 2012. Chinese Standard. Beijing: Standards Press of China; 2013. Chinese.

[6]	Wilker EH, Yeh G, Wellenius GA, Davis RB, Phillips RS, Mittleman MA. Ambient temperature and biomarkers of heart failure: a repeated measures analysis. Environ Health Perspect 2012;120(8):1083–7.

[7]	Xu H, Wang T, Liu S, Brook RD, Feng B, Zhao Q, et al. Extreme levels of air pollution associated with changes in biomarkers of atherosclerotic plaque vulnerability and thrombogenicity in healthy adults. Circ Res 2019;124(5): e30–43.

[8]	Chen R, Yin P, Meng X, Liu C, Wang L, Xu X, et al. Fine particulate air pollution and daily mortality. A nationwide analysis in 272 Chinese cities. Am J Respir Crit Care Med 2017;196(1):73–81.

[9]	Chen R, Yin P, Meng X, Wang L, Liu C, Niu Y, et al. Associations between coarse particulate matter air pollution and cause-specific mortality: a nationwide analysis in 272 Chinese cities. Environ Health Perspect 2019;127(1):017008.

[10]	Yin P, Chen R, Wang L, Meng X, Liu C, Niu Y, et al. Ambient ozone pollution and daily mortality: a nationwide study in 272 Chinese cities. Environ Health Perspect 2017;125(11):117006.

[11]	Liu S, Wu X, Lopez AD, Wang L, Cai Y, Page A, et al. An integrated national mortality surveillance system for death registration and mortality surveillance, China. Bull World Health Organ 2016;94(1):46–57.

[12]	Zhou M, Wang H, Zhu J, Chen W, Wang L, Liu S, et al. Cause-specific mortality for 240 causes in China during 1990–2013: a systematic subnational analysis for the Global Burden of Disease Study 2013. Lancet 2016;387(10015): 251–72.

[13]	Chen R, Yin P, Meng X, Wang L, Liu C, Niu Y, et al. Associations between ambient nitrogen dioxide and daily cause-specific mortality: evidence from 272 Chinese cities. Epidemiology 2018;29(4):482–9.

[14]	Du X, Chen R, Meng X, Liu C, Niu Y, Wang W, et al. The establishment of National Air Quality Health Index in China. Environ Int 2020;138:105594.

[15]	Samoli E, Analitis A, Touloumi G, Schwartz J, Anderson HR, Sunyer J, et al. Estimating the exposure-response relationships between particulate matter and mortality within the APHEA multicity project. Environ Health Perspect 2005;113(1):88–95.

[16]	Hu J, Ying Q, Wang Y, Zhang H. Characterizing multi-pollutant air pollution in China: comparison of three air quality indices. Environ Int 2015;84: 17–25.

[17]	Shang Y, Sun Z, Cao J, Wang X, Zhong L, Bi X, et al. Systematic review of Chinese studies of short-term exposure to air pollution and daily mortality. Environ Int 2013;54:100–11.

[18]	Wang Y, Ying Q, Hu J, Zhang H. Spatial and temporal variations of six criteria air pollutants in 31 provincial capital cities in China during 2013–2014. Environ Int 2014;73:413–22.

[19]	Wang L, Liu C, Meng X, Niu Y, Lin Z, Liu Y, et al. Associations between shortterm exposure to ambient sulfur dioxide and increased cause-specific mortality in 272 Chinese cities. Environ Int 2018;117:33–9.