title: Can the Air Pollution Index be used to communicate the health risks of air pollution?
abstract: The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM10, SO2, NO2 and the weighted combined API (APIw) with mortality during 2003-2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0-2 days. Harvesting effects appeared after 2 days' exposure. The effect estimate of API over lag 0-15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution.
authors.affiliation: State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
authors.forename: Guo-Zhen
authors.initials: GZ
authors.lastname: Lin
authors.affiliation: Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China.
authors.forename: Hua-Zhang
authors.initials: HZ
authors.lastname: Liu
authors.affiliation: Division of Epidemiology and Biostatistics, School of Population Health, The University of Queensland, Brisbane, Queensland 4006, Australia.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China. Electronic address: ouchunquan@hotmail.com.
authors.forename: Chun-Quan
authors.initials: CQ
authors.lastname: Ou
authors.affiliation: State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China. Electronic address: chenpy99@126.com.
authors.forename: Ping-Yan
authors.initials: PY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis; D002681:China; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D000393:Air Pollutants
keywords: Air Pollution Index; Harvesting (mortality displacement); Risk communication; Vulnerable populations