Measuring public health accountability of air quality management |
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Authors: | Hwashin Hyun Shin Richard T Burnett David M Stieb Barry Jessiman |
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Institution: | (1) Air Health Science Division, Safe Environments Programme, Health Canada, 269 Laurier, Avenue West, Ottawa, ON, K1A 0K9, Canada;(2) Biostatistics and Epidemiology Division, Health Canada, 50 promenade Columbine, Driveway, Ottawa, ON, K1A 0K9, Canada;(3) R. Samuel McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, 1 Stewart St., Ottawa, ON, K1N 6N5, Canada |
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Abstract: | Accountability of air quality management is often measured by tracking ambient pollution concentrations over time. These changes
in ambient air quality are rarely linked to changes in public health, a major driver for such programs. We propose a method
to assess the accountability of air quality management programs with respect to improvements in public health by estimating
national temporal trends in health risk attributable to air pollution. The air health indicator (AHI) is a function of two
temporal functions, annual air pollutant concentrations and annual estimates of health risk obtained by time series statistical
methods, to indicate the trend in annual percent attributable risk (the product of concentration and risk times 100). Random
effects models are used to obtain a distribution of risk over space. The model is illustrated by examining the association
between daily nonaccidental deaths in 24 of Canada’s largest cities and daily concentrations of ozone and nitrogen dioxide
over the 17-year period 1984–2000. Our analysis demonstrates that examining trends in exposure alone, which has typically
been the approach to air quality indicators, provides an incomplete picture of trends in the impact of air pollution. The
AHI appears to provide a more informative measure of the population burden of illness associated with air pollution over time. |
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Keywords: | Air pollution Air quality management Mortality Poisson regression model Public health Spatial– temporal model |
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