Short-term effect of air pollution on mortality in Thailand: Influence of green areas, weather, demographic, and socioeconomic factors on its heterogeneity
Issued Date
2025-01-01
Resource Type
ISSN
21981833
eISSN
16132238
Scopus ID
2-s2.0-85217436288
Journal Title
Journal of Public Health (Germany)
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SCOPUS
Bibliographic Citation
Journal of Public Health (Germany) (2025)
Suggested Citation
Phosri A., Srisodaphol W., Sangkharat K. Short-term effect of air pollution on mortality in Thailand: Influence of green areas, weather, demographic, and socioeconomic factors on its heterogeneity. Journal of Public Health (Germany) (2025). doi:10.1007/s10389-024-02392-y Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/105320
Title
Short-term effect of air pollution on mortality in Thailand: Influence of green areas, weather, demographic, and socioeconomic factors on its heterogeneity
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Abstract
Background: The association between ambient air pollution and mortality has been well documented in many parts of the world, including Thailand. However, the association’s heterogeneity and its underlying variables remains uncertain. Therefore, this study aimed to explore the short-term effect of ambient air pollution, including particulate matter with 10 (PM10) and 2.5 (PM2.5) microns or less in aerodynamic diameter, nitrogen dioxide (NO2) and ozone (O3), on non-accidental mortality. Additionally, we aim to examine whether province-level variables explain the heterogeneity in this association. Method: The two-stage modeling approach was utilized to investigate the association between air pollution and mortality in this study. In the first stage, the quasi-Poisson generalized linear model combined with the distributed lag non-linear model was employed to explore the province-specific association between air pollution and mortality. In the second stage, the province-specific estimates were pooled to derive the national estimate and the underlying factors contributed to the heterogeneity were also examined using the mixed-effects meta-regression model. Results: Results indicated that the nationwide relative risk (RR) of non-accidental mortality associated with each 10-µg/m3 increase of PM10 (lag 0-2) and PM2.5 (lag 0-2), and each 10-ppb increase of NO2 (lag 0-2) and O3 (lag 0-7) was 1.0118 (95% CI: 1.0081, 1.0155), 1.0216 (95% CI: 1.0132, 1.0301), 1.0367 (95% CI: 1.0217, 1.0520), and 1.0146 (95% CI: 1.0050, 1.0243), respectively. The RR of mortality associated with PM10, PM2.5, and O3 was greater, while that associated with NO2 was less for warmer provinces. The RR associated with PM2.5 and O3 was larger, while that associated with NO2 was lower for provinces with higher unemployment rate. The estimated effect of NO2 was also lower for the provinces with higher proportion of educational attainment and higher family income. Conclusions: Findings from this study provides more insight into the effect modifier of air pollution – mortality association.