Trends in Excess Morbidity and Mortality Associated with Air Pollution above American Thoracic Society-Recommended Standards, 2008-2017
Trends in Excess Morbidity and Mortality Associated with Air Pollution above American Thoracic Society-Recommended Standards, 2008-2017
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DOI：
10.1513/annalsats.201812-914oc
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发表时间：
2019-07-01
影响因子：
8.3
通讯作者：
Ewart, Gary
中科院分区：
文献类型：
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作者：
Cromar, Kevin R.;Gladson, Laura A.;Ewart, Gary
理由：随着现代污染控制技术和措施在美国的广泛应用，空气质量的改善越来越难以实现。虽然在过去几十年里空气质量有了显著改善，但重要的是评估最近一段时间内空气污染对健康影响的变化，以便更好地了解当前空气质量改善的轨迹。目的：提供美国各地年度空气污染相关健康结果的县级估计，并评估2008年至2017年这些趋势，作为美国胸科学会(ATS)/马龙研究所年度“空气健康”报告的一部分。方法：从2008年至2017年，从美国环境保护署的空气质量系统中获取美国监测仪的每日空气污染值。将ATS/Marron研究所“空气健康”报告中使用的浓度响应函数应用于3年滚动设计值（报告为第三年）与ATS推荐的年度颗粒物（PM2.5; 11 μ g/m(3)）、短期PM2.5 （25 μ g/m(3)）和臭氧（O-3; 60 ppb）之间的差异所对应的污染增量。在具有有效监测数据的地点，对县一级的健康影响进行了估计。结果：由于空气污染水平高于ATS推荐水平，美国每年的超额死亡率从2010年的约12,600人（95%置信区间[CI]， 5,470-21,040）下降到2017年的7,140人（95% CI, 2,290-14,040）。这一改善几乎完全可以归因于pm2.5相关死亡率的下降，其下降了约60%（从每年8 330人减少到3 260人），而o- 3相关死亡率除了逐年变化外，在同一时期基本保持不变（从每年4 270人减少到3 880人）。结论：在过去十年中，美国大多数地区都观察到环境PM2.5浓度对健康影响的改善，尽管近年来这些改善的速度趋于平稳。尽管2008年和2015年两次修订《国家环境空气质量标准》，加强了对O-3的标准，但在这段时间内，O-3对健康的影响尚未得到实质性改善。在美国许多城市，在过去十年中，暴露于臭氧的人口的增长速度超过了环境臭氧浓度的改善速度，导致臭氧对健康的净影响随着时间的推移而增加。
Rationale: Air quality improvements are increasingly difficult to come by as modern pollution control technologies and measures have been widely implemented in the United States. Although there have been dramatic improvements in air quality over the last several decades, it is important to evaluate changes in the health impacts of air pollution for a more recent time period to better understand the current trajectory of air quality improvements.Objectives: To provide county-level estimates of annual air pollution-related health outcomes across the United States and to evaluate these trends from 2008 to 2017, presented as part of the annual American Thoracic Society (ATS)/Marron Institute "Health of the Air" report.Methods: Daily air pollution values were obtained from the U.S. Environmental Protection Agency's Air Quality System for monitors in the United States from 2008 to 2017. Concentration-response functions used in the ATS/Marron Institute "Health of the Air" report were applied to the pollution increments corresponding to differences between the rolling 3-year design values (reported as the third year) and ATS-recommended levels for annual particulate matter less than or equal to 2.5 mu m aerodynamic diameter (PM2.5; 11 mu g/m(3)), short-term PM2.5 (25 mu g/m(3)), and ozone (O-3; 60 ppb). Health impacts were estimated at the county level in locations with valid monitor data.Results: Annual excess mortality in the United States due to air pollution levels greater than recommended by the ATS decreased from approximately 12,600 (95% confidence interval [CI], 5,470-21,040) in 2010 to 7,140 (95% CI, 2,290-14,040) in 2017. This improvement can be attributed almost entirely to reductions in PM2.5-related mortality, which decreased by approximately 60% (reduced from 8,330 to 3,260 annual deaths), whereas O-3-related mortality remained largely unchanged, other than year-to-year variability, over the same time period (reduced from 4,270 to 3,880 annual deaths).Conclusions: Improvements in health impacts attributable to ambient PM2.5 concentrations have been observed across most regions of the United States over the last decade, although the rate of these improvements has leveled off in recent years. Despite two revisions of the National Ambient Air Quality Standards strengthening the standard for O-3 in 2008 and 2015, there has not yet been a substantial improvement in the health impacts attributable to O-3 during this time period. In many U.S. cities, an increase in the exposed population over the last decade has outpaced the improvements in ambient O3 concentrations, resulting in a net increase in O-3-related health impacts over time.