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Open AccessArticle

A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden

1
Atmospheric Science Unit, Department of Environmental Science and Analytical Chemistry, Stockholm University, 11418 Stockholm, Sweden
2
Environment and Health Administration, SLB, Box 8136, 104 20 Stockholm, Sweden
3
Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
4
Swedish Museum of Natural History, 114 18 Stockholm, Sweden
5
Umeå School of Business, Economics and Statistics (USBE), Umeå University, 90187 Umeå, Sweden
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(1), 105; https://doi.org/10.3390/ijerph16010105
Received: 27 September 2018 / Revised: 19 December 2018 / Accepted: 27 December 2018 / Published: 2 January 2019
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, O3, PM10 and birch pollen in Stockholm during 2001–2005. This analysis showed per 10 µg·m–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, O3 and PM10, respectively. For birch pollen, the AEDV increased with 0.26% (95% CI: 0.18–0.34) for 10 pollen grains·m–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 O3, 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. O3 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 O3 with 2.0%. View Full-Text
Keywords: AQHI; asthma; NOx; ozone; PM10; birch pollen; risk coefficients AQHI; asthma; NOx; ozone; PM10; birch pollen; risk coefficients
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MDPI and ACS Style

Olstrup, H.; Johansson, C.; Forsberg, B.; Tornevi, A.; Ekebom, A.; Meister, K. A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden. Int. J. Environ. Res. Public Health 2019, 16, 105. https://doi.org/10.3390/ijerph16010105

AMA Style

Olstrup H, Johansson C, Forsberg B, Tornevi A, Ekebom A, Meister K. A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden. International Journal of Environmental Research and Public Health. 2019; 16(1):105. https://doi.org/10.3390/ijerph16010105

Chicago/Turabian Style

Olstrup, Henrik; Johansson, Christer; Forsberg, Bertil; Tornevi, Andreas; Ekebom, Agneta; Meister, Kadri. 2019. "A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden" Int. J. Environ. Res. Public Health 16, no. 1: 105. https://doi.org/10.3390/ijerph16010105

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