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.

中文翻译：

---

汉城都市区的空气质量管理政策和降低的死亡率：一项准实验研究

背景

从2005年到2014年，在韩国的首尔和仁川大城市引入了空气质量管理政策。尽管在政策实施后颗粒物浓度降低，但并未评估由此带来的健康益处。因此，我们评估了空气质量管理政策对首尔和仁川特定原因死亡率的影响。

方法

使用具有广义Poisson回归模型的间断时间序列分析，我们比较了政策实施之前（基准，2004-2005年）和之后（2006-2007年，2008-2009年，2010-2011年，2012-2013年）的日平均死亡率。为了说明长期死亡率趋势，我们将首尔和仁川的每日死亡率与大田（同一时期未实施空气质量管理政策的另一个大城市）的每日死亡率进行加权。

结果

首尔和仁川的颗粒物浓度下降幅度大于大田。调整潜在的混杂因素后，与基准期相比，2012-2013年首尔的心血管疾病死亡率降低了8％，脑血管疾病死亡率降低了10％。在仁川，2012-2013年的脑血管疾病死亡率降低了8％。政策实施后，由于外部原因或呼吸系统疾病引起的死亡率没有变化。

结论

我们的研究表明，空气质量管理政策可有效降低首尔的心脑血管死亡率和仁川的脑血管死亡率。