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A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden
Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry.
Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry. Environment and Health Administration, SLB, Stockholm, Sweden.ORCID iD: 0000-0002-8459-9852
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Number of Authors: 62019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 1, article id 105Article in journal (Refereed) Published
Abstract [en]

In this study, an Air Quality Health Index (AQHI) for Stockholm is introduced as a tool to capture the combined effects associated with multi-pollutant exposure. Public information regarding the expected health risks associated with current or forecasted concentrations of pollutants and pollen can be very useful for sensitive persons when planning their outdoor activities. For interventions, it can also be important to know the contribution from pollen and the specific air pollutants, judged to cause the risk. The AQHI is based on an epidemiological analysis of asthma emergency department visits (AEDV) and urban background concentrations of NOx, O-3, PM10 and birch pollen in Stockholm during 2001-2005. This analysis showed per 10 mu gm(-3) increase in the mean of same day and yesterday an increase in AEDV of 0.5% (95% CI: -1.2-2.2), 0.3% (95% CI: -1.4-2.0) and 2.5% (95% CI: 0.3-4.8) for NOx, O-3 and PM10, respectively. For birch pollen, the AEDV increased with 0.26% (95% CI: 0.18-0.34) for 10 pollen grainsm(-3). In comparison with the coefficients in a meta-analysis, the mean values of the coefficients obtained in Stockholm are smaller. The mean value of the risk increase associated with PM10 is somewhat smaller than the mean value of the meta-coefficient, while for O-3, it is less than one fifth of the meta-coefficient. We have not found any meta-coefficient using NOx as an indicator of AEDV, but compared to the mean value associated with NO2, our value of NOx is less than half as large. The AQHI is expressed as the predicted percentage increase in AEDV without any threshold level. When comparing the relative contribution of each pollutant to the total AQHI, based on monthly averages concentrations during the period 2015-2017, there is a tangible pattern. The AQHI increase associated with NOx exhibits a relatively even distribution throughout the year, but with a clear decrease during the summer months due to less traffic. O-3 contributes to an increase in AQHI during the spring. For PM10, there is a significant increase during early spring associated with increased suspension of road dust. For birch pollen, there is a remarkable peak during the late spring and early summer during the flowering period. Based on monthly averages, the total AQHI during 2015-2017 varies between 4 and 9%, but with a peak value of almost 16% during the birch pollen season in the spring 2016. Based on daily mean values, the most important risk contribution during the study period is from PM10 with 3.1%, followed by O-3 with 2.0%.

Place, publisher, year, edition, pages
2019. Vol. 16, no 1, article id 105
Keywords [en]
AQHI, asthma, NOx, ozone, PM10, birch pollen, risk coefficients
National Category
Earth and Related Environmental Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Applied Environmental Science
Identifiers
URN: urn:nbn:se:su:diva-166604DOI: 10.3390/ijerph16010105ISI: 000459111400105PubMedID: 30609753OAI: oai:DiVA.org:su-166604DiVA, id: diva2:1300692
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-05-07Bibliographically approved
In thesis
1. Air pollution and health – Indicators, trends and impacts
Open this publication in new window or tab >>Air pollution and health – Indicators, trends and impacts
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on some of the limitations and difficulties that exist when it comes to quantifying the human health effects that arise as a result of air pollution exposure. The following four issues are particularly analysed and discussed: 1) The measurement techniques used for carbonaceous particles and their lack of consistency; 2) Do the health risks associated with exposure to PM10 depend on the content of elemental carbon in the aerosol?; 3) Trends in air pollutants and the health effects that arise as a result of changed exposure to the measured pollutants; 4) The associations between the measured concentrations of different air pollutants in Stockholm and the daily number deaths; 5) Air quality indicators and health outcomes as basis for an air quality health index (AQHI).

The method that has been used is largely based on empirical data analysis, where further statistical processing has been used in order to clarify the scientific issues. The overall conclusions are the following: 1) The health impact assessments associated with exposure to carbonaceous particles would benefit from the introduction of a more uniform measurement technique in order to get more consistent and reliable results; 2) The health risks associated with exposure to PM10 are dependent on the content of elemental carbon; 3) The life expectancy increase associated with decreasing NOx trends during 1990–2015 in Stockholm, Gothenburg and Malmo make up as much as about 20 % of the total gain in life expectancy during this period, which clearly shows the beneficial effects related to decreased exposure; 4) The associations between daily mortality and the concentrations of O3 and PM2.5-10 in Stockholm are statistically significant, which does not apply to the exhaust-related pollutants, possibly reflecting behavioural factors affecting the degree of exposure; 5) In comparison with the currently used air quality index (AQI), the air quality health index (AQHI) is a more useful tool in order to address the short-term health effects associated with multi-pollutant exposure to NOx, O3, PM10 and birch pollen.

We hope that these findings will be useful from a policy point of view. Introducing a more consistent measurement technique for soot particles would be beneficial in assessing the health effects related to exposure to these particles. The increase in life expectancy associated with decreasing NOx trends shows the benefits from a public health perspective when it comes to introducing emission-reducing measures from traffic. The AQHI would be beneficial to implement in legislation, as it is based on several pollutants, which means that the cumulative health effects associated exposure to several different air pollutants are accounted for.  

Place, publisher, year, edition, pages
Stockholm: Department of Environmental Science and Analytical Chemistry, Stockholm University, 2019. p. 50
Keywords
air pollution, health, measurements, trends, impacts, mortality, NOx, elemental carbon, AQHI
National Category
Meteorology and Atmospheric Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Applied Environmental Science
Identifiers
urn:nbn:se:su:diva-168306 (URN)978-91-7797-468-0 (ISBN)978-91-7797-469-7 (ISBN)
Public defence
2019-06-13, Nordenskiöldsalen, Geovetenskapens hus, Svante Arrhenius väg 12, Stockholm, 10:00 (English)
Opponent
Supervisors
Available from: 2019-05-21 Created: 2019-04-29 Last updated: 2019-05-07Bibliographically approved

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