[Application of AirQ+ software in air pollution acute health risk assessment in China].

OBJECTIVE: To promote the application of software AirQ +developed by WHO in the air pollution health risk assessment in China. METHODS: Introduced the calculation principle, scope of application, required data, results output and application examples of the model. Meta-analysis result of exposure-response relationship coefficients of acute health risks of air pollution in China are also provided in this paper. RESULTS: The air quality and other related parameters of the study area in China can be input into AirQ+ software to obtain the attributable risk value of the health outcome of the exposed population compared with the reference concentration. CONCLUSION: The AirQ + software can be used for quantitative assessment of acute health risks of air pollution in China.

Acute myocardial infarction and COPD attributed to ambient SO2 in Iran.

Acute myocardial infarction (MI) and chronic obstructive pulmonary disease (COPD) are important diseases worldwide. Inhalation is the major route of short-term exposure to air sulfur dioxide (SO2) that negatively affect human health. The objective of this study was to estimate the health effects of short-term exposure to SO2 in Khorramabad, Iran using the AirQ software developed by the World Health Organization (WHO). Daily mean SO2 concentrations were used as the estimates of human short-term exposure and allow calculation of the attributable excess relative risk of an acute MI and hospital admissions due to COPD (HACOPD). The annual mean SO2 concentration in Khorramabad was 51.33µg/m3. Based on the relative risk (RR) and baseline incidence (BI) approach of WHO, an increased risk of 2.7% (95% CI: 1.1-4.2%) of acute MI and 2.0% (95% CI: 0-4.6%) of HACOPD, respectively, were attributed to a 10µg/m3 SO2 increase. Since the geographic, demographic, and climatic characteristics are different from the areas in which the risk relationships were developed and not evaluated here, further investigations will be needed to fully quantify other health impacts of SO2. A decreased risk for MIs and COPD attributable to SO2 could be achieved if mitigation strategies and measures are implemented to reduce the exposure.

Health benefits of PM10 reduction in Iran.

Air pollution contains a complex mixture of poisonous compounds including particulate matter (PM) which has wide spectrum of adverse health effects. The main purpose of this study was to estimate the potential health impacts or benefits due to any changes in annual PM10 level in four major megacities of Iran. The required data of PM10 for AirQ software was collected from air quality monitoring stations in four megacities of Iran. The preprocessing was carried out using macro coding in excel environment. The relationship between different presumptive scenarios and health impacts was determined. We also assessed the health benefits of reducing PM10 to WHO Air Quality Guidelines (WHO-AQGs) and National Ambient Air Quality Standards (NAAQSs) levels with regard to the rate of mortality and morbidity in studied cities. We found that the 10 µg/m3 increase in annual PM10 concentration is responsible for seven (95% CI 6-8) cases increase in total number of deaths per 2 × 105 person. We also found that 10.7, 7.2, 5.7, and 5.3% of total death is attributable to short-term exposure to air pollution for Ahvaz, Isfahan, Shiraz, and Tehran, respectively. We found that by attaining the WHO's proposed value for PM10, the potential health benefits of 89, 84, 79, and 78% were obtained in Ahvaz, Isfahan, Shiraz, and Tehran, respectively. The results also indicated that 27, 10, 3, and 1% of health impacts were attributed to dust storm days for Ahvaz, Isfahan, Shiraz, and Tehran, respectively.

Health risk assessment of exposure to the Middle-Eastern Dust storms in the Iranian megacity of Kermanshah.

OBJECTIVE: This study assessed the effects of particulate matter (PM), equal or less than 10 µm in aerodynamic diameter (PM10), from the Middle-Eastern Dust events on public health in the megacity of Kermanshah (Iran). STUDY DESIGN: This study used epidemiological modeling and monitored ambient air quality data to estimate the potential PM10 impacts on public health. METHODS: The AirQ2.2.3 model was used to calculate mortality and morbidity attributed to PM10 as representative of dust events. Using Visual Basic for Applications, the programming language of Excel software, hourly PM10 concentrations obtained from the local agency were processed to prepare input files for the AirQ2.2.3 model. RESULTS: Using baseline incidence, defined by the World Health Organization, the number of estimated excess cases for respiratory mortality, hospital admissions for chronic obstructive pulmonary disease, for respiratory diseases, and for cardiovascular diseases were 37, 39, 476, and 184 persons, respectively, from 21st March, 2014 to 20th March, 2015. Furthermore, 92% of mortality and morbidity cases occurred in days with PM10 concentrations lower than 150 µg/m3. The highest percentage of person-days occurred for daily concentrations range of 100-109 µg/m3, causing the maximum health end-points among the citizens of Kermanshah. CONCLUSIONS: Calculating the number of cumulative excess cases for mortality or morbidity attributed to PM10 provides a good tool for decision and policy-makers in the field of health care to compensate their shortcomings particularly at hospital and healthcare centers for combating dust storms. To diminish these effects, several immediate actions should be managed in the governmental scale to control dust such as spreading mulch and planting new species that are compatible to arid area.

Evaluation of Chronic Obstructive Pulmonary Disease (COPD) attributed to atmospheric O3, NO2, and SO2 using Air Q Model (2011-2012 year).

Chronic obstructive pulmonary disease (COPD) is an important disease worldwide characterized by chronically poor airflow. The economic burden of COPD on any society can be enormous if not managed. We applied the approach proposed by the World Health Organization (WHO) using the AirQ2.2.3 software developed by the WHO European Center for Environment and Health on air pollutants in Tabriz (Iran) (2011-2012 year). A 1h average of concentrations of ozone (O3), daily average concentrations of nitrogen dioxide (NO2) and sulfur dioxide (SO2) were used to assess human exposure and health effect in terms of attributable proportion of the health outcome and annual number of excess cases of Hospital Admissions for COPD (HA COPD). The results of this study showed that 2% (95% CI: 0.8-3.1%) of HA COPD were attributed to O3 concentrations over 10 µg/m(3). In addition, 0.7 % (95% CI: 0.1-1.8%) and 0.5% (95% CI: 0-1%) of HA COPD were attributed to NO2 and SO2 concentrations over 10 µg/m(3) respectively. In this study, we have shown that O3, NO2 and SO2 have a significant impact on COPD hospitalization. Given these results the policy decisions are needed in order to reduce the chronic pulmonary diseases caused by air pollution and furthermore better quantification studies are recommended.

Evaluating the mortality and health rate caused by the PM2.5 pollutant in the air of several important Iranian cities and evaluating the effect of variables with a linear time series model.

All over the world, the level of special air pollutants that have the potential to cause diseases is increasing. Although the relationship between exposure to air pollutants and mortality has been proven, the health risk assessment and prediction of these pollutants have a therapeutic role in protecting public health, and need more research. The purpose of this research is to evaluate the ill-health caused by PM2.5 pollution using AirQ + software and to evaluate the different effects on PM2.5 with time series linear modeling by R software version 4.1.3 in the cities of Arak, Esfahan, Ahvaz, Tabriz, Shiraz, Karaj and Mashhad during 2019-2020. The pollutant hours, meteorology, population and mortality information were calculated by the Environmental Protection Organization, Meteorological Organization, Statistics Organization and Statistics and Information Technology Center of the Ministry of Health, Treatment and Medical Education for 24 h of PM2.5 pollution with Excel software. In addition, having 24 h of PM2.5 pollutants and meteorology is used to the effect of variables on PM2.5 concentration. The results showed that the highest and lowest number of deaths due to natural deaths, ischemic heart disease (IHD), lung cancer (LC), chronic obstructive pulmonary disease (COPD), acute lower respiratory infection (ALRI) and stroke in The effect of disease with PM2.5 pollutant in Ahvaz and Arak cities was 7.39-12.32%, 14.6-17.29%, 16.48-8.39%, 10.43-18.91%, 12.21-22.79% and 14.6-18.54 % respectively. Another result of this research was the high mortality of the disease compared to the mortality of the nose. The analysis of the results showed that by reducing the pollutants in the cities of Karaj and Shiraz, there is a significant reduction in mortality and linear modeling provides a suitable method for air management planning.

Estimating the health impacts of exposure to Air pollutants and the evaluation of changes in their concentration using a linear model in Iran.

In big and industrial cities of developing countries, illness and mortality from long-term exposure to air pollutants have become a serious issue. This research was carried out in 2019-2020 to estimate the health impacts of PM10, NO2 and O3 pollutants by using AirQ+ and R statistical programming software in Arak, Isfahan, Tabriz, Shiraz, Karaj, and Mashhad. Mortality statistics, number of people in required age groups, and amount of pollutants were gathered respectively from different agencies like Statistics and Information Technology of the Ministry of Health, Statistical Center, and Department of Environment and by using Excel, the average 24-hour and 1-hour concentration and maximum 8-hour concentration for PM10, NO2 and O3 pollutants were gathered. We used linear mixed impacts model to account for the longitudinal observations and heterogeneity of the cities. The results of the study showed high number of deaths due to chronic bronchitis in adults, premature death of infants, and respiratory diseases in Mashhad. This research highlights the importance of estimation of health impacts from exposure to air pollutants on residents of the studied cities.

Health Risk Assessment of Exposure to Air Pollutants Exceeding the New WHO Air Quality Guidelines (AQGs) in São Paulo, Brazil.

We applied the AirQ+ model to analyze the 2021 data within our study period (15 December 2020 to 17 June 2022) to quantitatively estimate the number of specific health outcomes from long- and short-term exposure to atmospheric pollutants that could be avoided by adopting the new World Health Organization Air Quality Guidelines (WHO AQGs) in São Paulo, Southeastern Brazil. Based on temporal variations, PM2.5, PM10, NO2, and O3 exceeded the 2021 WHO AQGs on up to 54.4% of the days during sampling, mainly in wintertime (June to September 2021). Reducing PM2.5 values in São Paulo, as recommended by the WHO, could prevent 113 and 24 deaths from lung cancer (LC) and chronic obstructive pulmonary disease (COPD) annually, respectively. Moreover, it could avoid 258 and 163 hospitalizations caused by respiratory (RD) and cardiovascular diseases (CVD) due to PM2.5 exposure. The results for excess deaths by RD and CVD due to O3 were 443 and 228, respectively, and 90 RD hospitalizations due to NO2. Therefore, AirQ+ is a useful tool that enables further elaboration and implementation of air pollution control strategies to reduce and prevent hospital admissions, mortality, and economic costs due to exposure to PM2.5, O3, and NO2 in São Paulo.

Spatial patterns and temporal variations of traffic-related air pollutants and estimating its health effects in Isfahan city, Iran.

Isfahan as an important industrial city has faced with air pollution recently. Thus, we assessed the spatial and temporal trends of ambient PM2.5, CO, SO2, and O3 and for estimating their health effect on Isfahan citizens between March 2018 and March 2019 through the AirQ+ software. Our results showed that citizens of Isfahan in almost 240, 167, and 134 of the days in the year has exposure to PM2.5, SO2, and O3 higher than the WHO daily guideline, respectively. Daily variations of PM2.5, CO, and SO2 concentration showed the increasing trend of pollutants in the morning to evening. The maximum concentrations of O3 were observed in the noonday. Also, the concentrations of these pollutants on Friday due to the holiday effect were higher than the weekdays. Except for O3, the PM2.5, CO, and SO2 concentrations in the cold months and cold seasons was higher compared with the hot months and hot seasons. The total number of deaths because of lung cancer, natural mortality, ischemic heart disease, chronic obstructive pulmonary disease,, stroke associated with ambient PM2.5 with the attributable proportion (AP) 11.43%, 11.63%, 15.96%, 15.15%, and 13.1% (95% CI) were 683, 19, 2, 202, and 55 cases, respectively. Therefore, the present study provides additional data for the provincial managers and politicians useful in planning proper strategies of air pollution control to decrease exposure and attributable mortalities.

Concentrations and mortality due to short- and long-term exposure to PM2.5 in a megacity of Iran (2014-2019).

The present study aimed to survey the spatial and temporal trends of ambient concentration of PM2.5 and to estimate mortality attributed to short- and long-term exposure to PM2.5 in Isfahan from March 2014 to March 2019 using the AirQ+ software. The hourly concentrations of PM2.5 were obtained from the Isfahan Department of Environment and Isfahan Air Quality Monitoring Center. Then, the 24-h mean concentration of PM2.5 for each station was calculated using the Excel software. According to the results, the annual mean concentration of PM2.5 in 2014-2019 was 29.9-50.9 µg/m3, approximately 3-5 times higher than the WHO guideline (10 µg/m3). The data showed that people of Isfahan in almost 58% to 96% of the days of a year were exposed to PM2.5 higher than the WHO daily guideline. The concentrations of PM2.5 in cold months such as October, November, December and January were higher than those in the other months. The zoning of the annual concentrations of PM2.5 in urban areas showed that the highest PM2.5 concentrations were related to the northern, northwestern, southern and central areas of the city. On average, from 2014 to 2019, the number of deaths due to natural mortality, lung cancer (LC), chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and stroke associated with ambient PM2.5 were 948, 16, 18, 281 and 60, respectively. The present study estimated that on average, 14.29% of the total mortality, 17.2% of lung cancer (LC), 15.54% of chronic obstructive pulmonary disease (COPD), 17.12% of ischemic heart disease (IHD) and 14.94% of stroke mortalities were related to long-term exposure to ambient PM2.5. So provincial managers and politicians must adopt appropriate strategies to control air pollution and reduce the attributable health effects and economic losses.

Mortality and Morbidity Due to Exposure to Ambient NO2, SO2, and O3 in Isfahan in 2013-2014.

BACKGROUND: The presence of air pollutants such as CO, NO2, SO2, O3, and PM in the ambient air mainly emitted from fossil fuels combustion has become a major health concern. The aims of this study were to estimate the attribution of NO2, SO2, and O3 in the premature deaths and prevalence of cardiovascular and respiratory diseases in Isfahan in 2013-2014. METHODS: In this study, short-term health effects (total mortality, cardiovascular and respiratory mortality, chronic obstructive pulmonary disease, and acute myocardial infarction) of exposure NO2, SO2, and O3 on the population of Isfahan were assessed using AirQ 2.2.3 software suggested by the World Health Organization (WHO). RESULTS: The result showed that from nonaccident total mortality in 2013-2014 in Isfahan, the attributable proportion related to NO2, SO2, and O3 were 1.03% (109 cases), 3.46% (365 cases), and 1.29% (136 cases), respectively. The percentage of days that people were exposed to the highest concentration of NO2 (40-49 µg/m3), SO2 (60-69 µg/m3), and O3 (40-49 µg/m3) was 34.46%, 16.85%, and 42.74% of a year, respectively. Total mortality attributed to NO2, SO2, and O3 exposure was 0.36%, 0.79%, and 0.83%, respectively. CONCLUSIONS: The concentrations of NO2 and SO2 were upper than the WHO guidelines. The Air-Q software in spite of its limitations can provide useful information regarding the health outcome of the air pollutants. The results estimated in this study were considerable. This information can help the health authorities and policy makers to draw suitable strategies and fulfill effective emission control programs.

Asthma disease as cause of admission to hospitals due to exposure to ambient oxidants in Mashhad, Iran.

Nowadays, asthma is one of the most common chronic respiratory diseases, worldwide. Many reports have emphasized the correlation between the short-term exposure to the ambient air pollutants and acute respiratory diseases, especially among children with asthmatic symptoms. The aim of this study was to evaluate the relationship between the exposure to three atmospheric antioxidants (NO2, SO2, and O3) and hospital admission due to asthmatic disease (HAAD) in the city of Mashhad, Iran. The concentrations of atmospheric antioxidants were obtained from the real-time monitoring stations located in the city. The collected data were employed for developing predictive models in the AirQ software. In order to investigate the association between short-term exposure to air pollutants and HAAD, the study participants were categorized into two age groups: less than 15 and from 15 to 64 years old. The results indicated that in people less than 15 years increase in NO2 (attributable proportion (AP) = 3.775%, 95% CI 0.897-6.883%), SO2 (AP = 3.649%, 95% CI 1.295-5.937%), and O3 (AP = 0.554%,95% CI 0.00-3.321) results in increase in HAAD. While for those aged between 15 and 64 years, the AP was 4.192% (95% CI 0.450-7.662%) for NO2; 0.0% (95% CI 0.00-1.687%) for SO2; and 0.236% (95% CI 0.00-1.216%) for O3. The number of asthmatic cases who were less than 15 years admitted to the hospitals during the study period was higher than that of those within the age groups between 15 and 64 years as a consequence of exposure to NO2 (101 vs. 75), SO2 (98 vs. 0), and O3 (15 vs. 3), respectively. To the best of our knowledge, the AirQ model has not been applied before to estimate the effect of atmospheric antioxidant exposure on hospital admission because of asthma disease. Eventually, this model is proposed to be applicable for other cities around the world.

Cardiovascular, respiratory, and total mortality ascribed to PM10 and PM2.5 exposure in Isfahan, Iran.

BACKGROUND: Air pollution is an important environmental issue due to its proven serious impacts on human health. The aim of this study was to estimate the attribution of particulate matter with an aerodynamic diameters of ≤ 2.5 and 10 (PM2.5 and PM10) in the prevalence of cardiovascular and respiratory diseases and premature deaths in Isfahan in 2013-2014. MATERIALS AND METHODS: This descriptive, ecological study was conducted to assess health impacts of PM2.5 and PM10 on the population using Air Q2.2.3 software, suggested by the World Health Organization (WHO). RESULTS: The results showed that the annual mean, winter mean, summer mean, and the 98 percentile of PM10 concentration in Isfahan were 108, 100, 116, and 264 µg/m3, respectively. The number of deaths per year related to PM2.5 was 670 and that for PM10 was 713 cases. The number of annual deaths due to cardiovascular and respiratory diseases attributed to PM10 was 316 and 68 cases, respectively. CONCLUSION: The results of this study revealed that about 44.3% of total annual death due to cardiovascular diseases and 9.55% of that due to respiratory diseases were attributed to PM10 exposure. In the other word, residents were exposed to PM2.5 and PM10 concentrations higher than the WHO guidelines which caused a notable increase in the rate of mortality.

A review of AirQ Models and their applications for forecasting the air pollution health outcomes.

Even though clean air is considered as a basic requirement for the maintenance of human health, air pollution continues to pose a significant health threat in developed and developing countries alike. Monitoring and modeling of classic and emerging pollutants is vital to our knowledge of health outcomes in exposed subjects and to our ability to predict them. The ability to anticipate and manage changes in atmospheric pollutant concentrations relies on an accurate representation of the chemical state of the atmosphere. The task of providing the best possible analysis of air pollution thus requires efficient computational tools enabling efficient integration of observational data into models. A number of air quality models have been developed and play an important role in air quality management. Even though a large number of air quality models have been discussed or applied, their heterogeneity makes it difficult to select one approach above the others. This paper provides a brief review on air quality models with respect to several aspects such as prediction of health effects.