Health benefits of improving air quality in the rapidly aging Korean society

Abstract

Korea is experiencing an extraordinarily rapid demographic transition. We investigated the short-term association between air pollution and mortality and assessed the impact of improved air quality on mortality in a rapidly aging city, Seoul, Korea. The generalized additive model (GAM) was used to estimate the relative risks (RR) of mortality associated with changes in air pollution. The time trends, seasonal variations, day of the week effects, and weather effects were controlled in the models. To estimate the health benefits, we used the US Environmental Protection Agency's BenMAP. For people 0-64 years of age, elderly people (65+ years), and all age groups, an increase of 10 microg/m(3) in PM(10) was associated with increases in daily death counts of 0.27% (95% CI: 0.04-0.50), 0.45% (95% CI: 0.27-0.64), and 0.37% (95% CI: 0.23-0.52), respectively. For ages 0-64 years, elderly people, and all age groups, a 10 ppb increase in 1-hour maximum ozone concentration resulted in an increased risk of daily death counts of 0.28% (95% CI: -0.19-0.74), 0.96% (95% CI: 0.46-1.47), and 0.81% (95% CI: 0.35-1.26), respectively. For elderly people, it was estimated that the health benefits of attaining the World Health Organization's (WHO) air quality guidelines (AQGs) for PM(10) (24-hour average 50 microg/m(3)) would suggest an annual reduction of 964 (95% CI: 564-1366) premature deaths, and 329 (95% CI: 159-500) premature deaths could be prevented annually in 2015 from attaining the WHO's guidelines for ozone (8-hour average 100 microg/m(3)). The rapid increase of the elderly population has major consequences and implications for society and public health. This study showed that elderly people are at higher risk for the acute mortality effects of air pollution. Therefore, cleaner air will substantially contribute to improved public health in Seoul, given the growing concern about the adverse effects of air pollution for elderly people.