Air quality management policy and reduced mortality rates in Seoul Metropolitan Area: A quasi-experimental study

TY - JOUR

T1 - Air quality management policy and reduced mortality rates in Seoul Metropolitan Area

T2 - A quasi-experimental study

AU - Han, Changwoo

AU - Lim, Youn-Hee

AU - Yorifuji, Takashi

AU - Hong, Yun-Chul

N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.

PY - 2018/12

Y1 - 2018/12

N2 - BACKGROUND: The air quality management policy was introduced in Seoul and Incheon metropolitan cities in the Republic of Korea, from 2005 to 2014. Despite particulate matter concentrations decreasing after policy implementation, the consequent health benefits have not been evaluated. Therefore, we evaluated the effects of the air quality management policy on cause-specific mortality rates in Seoul and Incheon.METHODS: Using interrupted time series analysis with a generalized Poisson regression model, we compared daily average mortality rates before (baseline, 2004-2005) and after (2006-2007, 2008-2009, 2010-2011, 2012-2013) the policy implementation. To account for the long term mortality trends, we weighted daily mortality rate of Seoul and Incheon with daily mortality rate of Daejeon (another metropolitan city with no air quality management policy implemented during the same period).RESULTS: Decline in the particulate matter concentration was greater in Seoul and Incheon than in Daejeon. After adjusting for potential confounders, there were 8% decrease in cardiovascular disease mortality rates and 10% decrease in cerebrovascular disease mortality rates in Seoul in 2012-2013 compared to the baseline period. In Incheon, an 8% reduction in cerebrovascular disease mortality rates in 2012-2013 was calculated. There was no change in mortality rates due to external causes or respiratory disease after policy implementation.CONCLUSIONS: Our study suggests that the air quality management policy was effective in reducing cardiovascular and cerebrovascular mortality rates in Seoul and cerebrovascular mortality rates in Incheon.

AB - BACKGROUND: The air quality management policy was introduced in Seoul and Incheon metropolitan cities in the Republic of Korea, from 2005 to 2014. Despite particulate matter concentrations decreasing after policy implementation, the consequent health benefits have not been evaluated. Therefore, we evaluated the effects of the air quality management policy on cause-specific mortality rates in Seoul and Incheon.METHODS: Using interrupted time series analysis with a generalized Poisson regression model, we compared daily average mortality rates before (baseline, 2004-2005) and after (2006-2007, 2008-2009, 2010-2011, 2012-2013) the policy implementation. To account for the long term mortality trends, we weighted daily mortality rate of Seoul and Incheon with daily mortality rate of Daejeon (another metropolitan city with no air quality management policy implemented during the same period).RESULTS: Decline in the particulate matter concentration was greater in Seoul and Incheon than in Daejeon. After adjusting for potential confounders, there were 8% decrease in cardiovascular disease mortality rates and 10% decrease in cerebrovascular disease mortality rates in Seoul in 2012-2013 compared to the baseline period. In Incheon, an 8% reduction in cerebrovascular disease mortality rates in 2012-2013 was calculated. There was no change in mortality rates due to external causes or respiratory disease after policy implementation.CONCLUSIONS: Our study suggests that the air quality management policy was effective in reducing cardiovascular and cerebrovascular mortality rates in Seoul and cerebrovascular mortality rates in Incheon.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Air Pollutants/analysis

KW - Air Pollution/analysis

KW - Child

KW - Child, Preschool

KW - Cities

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Middle Aged

KW - Mortality/trends

KW - Particulate Matter/analysis

KW - Public Policy

KW - Republic of Korea

KW - Respiration Disorders/mortality

KW - Seoul

KW - Young Adult

U2 - 10.1016/j.envint.2018.09.047

DO - 10.1016/j.envint.2018.09.047

M3 - Journal article

C2 - 30308471

SN - 0160-4120

VL - 121

SP - 600

EP - 609

JO - Environment International

JF - Environment International

IS - Part 1

ER -