title: The construction and validity analysis of AQHI based on mortality risk: A case study in Guangzhou, China.
abstract: The current air quality indices have been criticized for not capturing combined health effects of multiple air pollutants. We proposed an Air Quality Health Index (AQHI) based on the air pollution-mortality associations for communicating health risks of air pollution. Time-series studies were conducted to estimate the associations between air pollutants including sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), suspended particulate matter smaller than 2.5 μm in aerodynamic diameter (PM2.5) and mortality in Guangzhou from 2012 to 2015. The sum of excess mortality risk was calculated to construct the AQHI, which was then adjusted to an arbitrary scale. We then assessed the validity of AQHI. An interquartile increase (IQR) of AQHI was associated with 3.61% [95% confidence interval (95% CI), 2.85%-4.37%], 3.73% (95%CI, 2.18%-5.27%) and 4.19% (95%CI, 2.87%-5.52%) increase of mortality, respiratory and cardiovascular hospital admissions, respectively. Compared with the currently used Air Quality Index (AQI), AQHI had higher effects on mortality and morbidity. Our study suggests that AQHI might comprehensively capture the combined effects of air pollution, which make it be a more valid communication tool of air pollution-related health risk.
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
authors.forename: Jianpeng
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
authors.forename: Hualiang
authors.initials: H
authors.lastname: Lin
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Epidemiology, School of Public Health, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Zhengmin
authors.initials: Z
authors.lastname: Qian
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
authors.forename: Weilin
authors.initials: W
authors.lastname: Zeng
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
authors.forename: Lingchuan
authors.initials: L
authors.lastname: Guo
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong, China. Electronic address: mawj@gdiph.org.cn.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Ma
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects / Q000032:analysis*; D002681:China; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009026:Mortality; D009585:Nitrogen Dioxide / Q000032:analysis*; D010126:Ozone / Q000032:analysis*; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis*; D015203:Reproducibility of Results; D012306:Risk; D018570:Risk Assessment / Q000379:methods; D013458:Sulfur Dioxide / Q000032:analysis*; D015996:Survival Rate
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D013458:Sulfur Dioxide; D010126:Ozone; D009585:Nitrogen Dioxide
keywords: Air Quality Health Index; Air quality index; Morbidity; Mortality; Validity