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Article: An evaluation of the air quality health index program on respiratory diseases in Hong Kong: An interrupted time series analysis

TitleAn evaluation of the air quality health index program on respiratory diseases in Hong Kong: An interrupted time series analysis
Authors
KeywordsAQHI
Respiratory diseases
Interrupted time series
Segmented regression
Issue Date2019
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/atmosenv
Citation
Atmospheric Environment, 2019, v. 211, p. 151-158 How to Cite?
AbstractBackground: On December 30th, 2013, the Hong Kong government implemented the Air Quality Health Index (AQHI) alert programme warnings designed to reduce short-term effects of air pollution on population health. However, whether air quality alert programme warnings, such as the AQHI, reduce morbidity is still questionable. Using a quasi-experimental design, we conducted the first evaluation of the AQHI in Hong Kong focusing on respiratory morbidity. Method: Interrupted time series with Poisson segmented regression from 2010 to 2016 was used to detect any sudden or gradual changes in emergency respiratory hospital admissions, adjusted for air pollutants (NO2, SO2, PM10, O3), temperature and humidity, when the AQHI policy was implemented. The findings were validated using three false policy study periods and digestive diseases as a control. We also assessed effects on specific respiratory diseases (respiratory tract infections (RTI), asthma, chronic obstructive pulmonary disease and pneumonia) and by age. Results: From January 1st, 2010 to December 31st, 2016, 10576.98 deseasonalized, age-standardized hospital admissions for respiratory disease occurred in Hong Kong. On implementation of the AQHI, RTI admissions immediately dropped by 14% (relative risk (RR) 0.86 95% confidence interval (CI) 0.76–0.98). In age specific analysis, immediate reductions in hospital admissions were only apparent in children for RTI (RR 0.84, 95% CI 0.74–0.96) and pneumonia (RR 0.88, 95% CI 0.60–0.96). Conclusion: Hong Kong's AQHI helped reduced hospital admissions in children, particularly for RTI and pneumonia. To maximize health benefits of the policy, at risk groups need to be able to follow the behavioral changes recommended by the AQHI warnings.
Persistent Identifierhttp://hdl.handle.net/10722/277764
ISSN
2020 Impact Factor: 4.798
2015 SCImago Journal Rankings: 1.999
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMASON, TG-
dc.contributor.authorSchooling, CM-
dc.contributor.authorChan, KP-
dc.contributor.authorTian, L-
dc.date.accessioned2019-10-04T08:00:53Z-
dc.date.available2019-10-04T08:00:53Z-
dc.date.issued2019-
dc.identifier.citationAtmospheric Environment, 2019, v. 211, p. 151-158-
dc.identifier.issn1352-2310-
dc.identifier.urihttp://hdl.handle.net/10722/277764-
dc.description.abstractBackground: On December 30th, 2013, the Hong Kong government implemented the Air Quality Health Index (AQHI) alert programme warnings designed to reduce short-term effects of air pollution on population health. However, whether air quality alert programme warnings, such as the AQHI, reduce morbidity is still questionable. Using a quasi-experimental design, we conducted the first evaluation of the AQHI in Hong Kong focusing on respiratory morbidity. Method: Interrupted time series with Poisson segmented regression from 2010 to 2016 was used to detect any sudden or gradual changes in emergency respiratory hospital admissions, adjusted for air pollutants (NO2, SO2, PM10, O3), temperature and humidity, when the AQHI policy was implemented. The findings were validated using three false policy study periods and digestive diseases as a control. We also assessed effects on specific respiratory diseases (respiratory tract infections (RTI), asthma, chronic obstructive pulmonary disease and pneumonia) and by age. Results: From January 1st, 2010 to December 31st, 2016, 10576.98 deseasonalized, age-standardized hospital admissions for respiratory disease occurred in Hong Kong. On implementation of the AQHI, RTI admissions immediately dropped by 14% (relative risk (RR) 0.86 95% confidence interval (CI) 0.76–0.98). In age specific analysis, immediate reductions in hospital admissions were only apparent in children for RTI (RR 0.84, 95% CI 0.74–0.96) and pneumonia (RR 0.88, 95% CI 0.60–0.96). Conclusion: Hong Kong's AQHI helped reduced hospital admissions in children, particularly for RTI and pneumonia. To maximize health benefits of the policy, at risk groups need to be able to follow the behavioral changes recommended by the AQHI warnings.-
dc.languageeng-
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/atmosenv-
dc.relation.ispartofAtmospheric Environment-
dc.subjectAQHI-
dc.subjectRespiratory diseases-
dc.subjectInterrupted time series-
dc.subjectSegmented regression-
dc.titleAn evaluation of the air quality health index program on respiratory diseases in Hong Kong: An interrupted time series analysis-
dc.typeArticle-
dc.identifier.emailSchooling, CM: cms1@hkucc.hku.hk-
dc.identifier.emailChan, KP: kpchanaa@hku.hk-
dc.identifier.emailTian, L: linweit@hku.hk-
dc.identifier.authoritySchooling, CM=rp00504-
dc.identifier.authorityTian, L=rp01991-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.atmosenv.2019.05.013-
dc.identifier.scopuseid_2-s2.0-85065643928-
dc.identifier.hkuros306384-
dc.identifier.volume211-
dc.identifier.spage151-
dc.identifier.epage158-
dc.identifier.isiWOS:000471735000016-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1352-2310-

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