Background: To communicate health risks associated with short-term changes in air pollution the US EPA reports air quality through the Air Quality Index (AQI). However, it remains unclear whether the current regulatory-based, single-pollutant AQI fully represents the actual risks of air pollution related illness. A revised AQI, using a multiple pollutant approach based on health effects, could potentially improve public health by better reflecting the health risks associated with exposure to multiple pollutants. Methods: Daily concentrations and AQI values of five criteria pollutants (CO, NO2, O3, PM2.5, and SO2) from 2000-2010 in Bronx, Erie, Queens and Suffolk Counties of New York were used to estimate the burden of illness (cardiovascular hospital admissions and respiratory department emergency department (ED) visits) attributable to each pollutant when the criteria pollutant was the driver pollutant versus days when the AQI of other pollutants was reported. Time-series analyses of total respiratory ED visits using a Poisson generalized linear model from 2005-2010 was completed to generate region-specific beta coefficients, which were used to develop a multi-pollutant air quality health index (AQHI). Multi-pollutant and single pollutant AQI values (2011-2013) were regressed against several health endpoints (i.e. total respiratory ED visits and total respiratory hospital admissions) to determine their effectiveness in representing population level air pollution risks. Results: Cardiovascular hospital admissions and respiratory ED visits attributable to individual pollutants occurred even when the pollutant was not reported as the driver pollutant, and the majority of the burden of illness occurred when the AQI was less than 100 (“good” or “moderate” level of health concern), regardless of whether or not a pollutant was the AQI driver pollutant. Based upon time-series analysis, each pollutant considered was shown to have significant positive associations with respiratory ED visits for at least part of the year and therefore was eligible for potential inclusion in a multi-pollutant index. A multi-pollutant AQHI model with NO2, O3, PM2.5, and SO 2 was found to have stronger associations with total respiratory ED visits than a single pollutant AQI model and was significant annually and seasonally, while associations between respiratory ED visits and the AQI were not significant in the warm season. Conclusions: These results indicate that a single-pollutant index may inadequately communicate the full adverse health risks of air pollution. A multi-pollutant AQI model was more effective than the currently utilized single pollutant model in representing risks across the entire range of pollutant concentrations. The Clean Air Act stipulates that an air quality index must be used to communicate the short term risks of exposure to air pollution; the development and validation of a multi-pollutant AQI for use in the United States will not only improve risk communication to the public, but could also advance the development of multi-pollutant air quality standards.
|Advisor:||Cromar, Kevin R.|
|Commitee:||Gordon, Terry, Nadas, Arthur, Payne, Melissa, Stieb, David, Thurston, George D.|
|School:||New York University|
|Department:||Environmental Health Science|
|School Location:||United States -- New York|
|Source:||DAI-B 77/05(E), Dissertation Abstracts International|
|Subjects:||Environmental Health, Public health, Epidemiology|
|Keywords:||Air pollution, Air quality index, Cardiovascular hospital admissions, Criteria pollutants, Respiratory emergency department visits, Time-series analysis|
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