Construction of an air quality health index for pediatric respiratory diseases in Shanghai

Lijun Zhang; Huihui XU; Fengming Zhu; Chunyang Dong; Dong XU; Xianbiao Shen; Limin Ling; Mingjia XU; Biao Zhang; Jian Chen; Jin SU

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Construction of an air quality health index for pediatric respiratory diseases in Shanghai

VernacularTitle:上海市儿童呼吸系统疾病空气质量健康指数的建立
Author: Lijun ZHANG ^{1
,

2} ; Huihui XU ² ; Fengming ZHU ³ ; Chunyang DONG ² ; Dong XU ⁴ ; Xianbiao SHEN ⁵ ; Limin LING ⁶ ; Mingjia XU ⁷ ; Biao ZHANG ⁸ ; Jian CHEN ^{1
,

2} ; Jin SU ²
Author Information

1. Division of Public Health Service and Safety Assessment, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
2. Shanghai Institutes of Preventive Medicine, Shanghai 200336, China.
3. Shanghai University of Medicine & Health Science, Shanghai 201318, China.
4. Environmental Health Department, Shanghai Xuhui District Center for Disease Control and Prevention, Shanghai 200237, China.
5. Environmental Health Department, Shanghai Baoshan District Center for Disease Control and Prevention, Shanghai 201901, China.
6. Environmental Health Department, Shanghai Hongkou District Center for Disease Control and Prevention, Shanghai 200082, China.
7. Environmental Health Department, Shanghai Jinshan District Center for Disease Control and Prevention, Shanghai 201500, China.
8. Environmental Health Department, Shanghai Chongming District Center for Disease Control and Prevention, Shanghai 202150, China.
Publication Type:Selectedarticle
Keywords: air quality health index; air pollution; health effect; respiratory disease; outpatient visit
From: Journal of Environmental and Occupational Medicine 2022;39(7):730-736
CountryChina
Language:Chinese
Abstract: Background Air quality health index (AQHI) has been widely used to quantify the health effects of multiple pollutants observed in population-based epidemiological studies, and can better reflect the widespread linear non-threshold between air pollution and health effects. Objective To explore an AQHI for pediatric respiratory diseases (AQHI_r) in Shanghai and evaluate its feasibility. Methods The daily numbers of hospital outpatient visits for pediatric respiratory diseases from 2015 to 2019 were obtained from five general hospitals in Xuhui, Baoshan, Hongkou, Jinshan, and Chongming Districts of Shanghai. Monitoring data on air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, and O₃), air quality index (AQI), and meteorological variables (temperature, relative humidity, air pressure, and wind speed) were collected from five air quality monitoring sites nearest to selected hospitals. Time-series analysis using generalized additive model (GAM) was conducted to estimate the associations between respiratory-related pediatric outpatient visits and the concentrations of air pollutants. The sum of excess risk (ER) of hospital outpatient visits was used to construct AQHI_r. To assess the predictive power of AQHI_r, the associations of AQHI_r and AQI with the number of pediatric respiratory outpatient visits in three hospitals in Xuhui, Hongkou, and Chongming districts were compared. Results Air pollutants had various effects on respiratory diseases outpatient visits. PM_2.5, NO₂, and O₃ had most significant impacts on lag0 day and the associated ERs of hospital outpatient visits for each 10 μg·m⁻³ increase in pollutant concentration were 1.27% (95%CI: 0.88%-1.66%), 0.75% (95%CI: 0.40%-1.11%), and 0.36% (95%CI: 0.10%-0.62%), respectively. PM₁₀ and SO₂ had most significant impacts on lag3 day and the associated ERs of hospital outpatient visits for each 10 μg·m⁻³ increase in pollutant concentration were 0.81% (95%CI: 0.51%-1.12%) and 5.64% (95%CI: 3.37%-7.96%), respectively. There were significant effects of combinations of two pollutants among PM_2.5, PM₁₀, NO₂, SO₂, and O₃ except for PM₁₀+NO₂, SO₂+PM_2.5, and SO₂+NO₂ (P<0.05). According to the results of single-pollutant and two-pollutant models, PM_2.5, NO₂, SO₂, and O₃ were selected to construct AQHI_r. The comparison showed that for every interquartile range increase in AQHI_r, the ER for pediatric outpatient visits was higher than that for the value corresponding to AQI. Conclusion Air pollutants in Shanghai have an impact on the number of pediatric respiratory outpatient visits. The AQHI_r based on and outpatient visits for pediatric respiratory diseases can be a sensitive index to predict the effects of air pollution on children's respiratory health.