BACKGROUND Information about local air quality is reported across the United States using air quality alerts such as the Environmental Protection Agency's Air Quality Index. However, the role of such alerts in raising awareness of air quality is unknown. We conducted this study to evaluate associations between days with Air Quality Index ≥101, corresponding to a categorization of air quality as unhealthy for sensitive groups, unhealthy, very unhealthy, or hazardous, and air quality awareness among adults in the United States. METHODS Data from 12,396 respondents to the 2016-2018 ConsumerStyles surveys were linked by geographic location and survey year to daily Air Quality Index data. We evaluated associations between the number of days in the past year with Air Quality Index ≥101 and responses to survey questions about awareness of air quality alerts, perception of air quality, and changes in behavior to reduce air pollution exposure using logistic regression. RESULTS Awareness of air quality alerts (prevalence ratio [PR] = 1.23; 95% confidence interval [CI] = 1.15, 1.31), thinking/being informed air quality was bad (PR = 2.02; 95% CI = 1.81, 2.24), and changing behavior (PR = 2.27; 95% CI = 1.94, 2.67) were higher among respondents living in counties with ≥15 days with Air Quality Index ≥101 than those in counties with zero days in the past year with Air Quality Index ≥101. Each aspect of air quality awareness was higher among adults with than without asthma, but no differences were observed by heart disease status. Across quintiles of the number of days with Air Quality Index ≥101, air quality awareness increased among those with and without selected respiratory and cardiovascular diseases. CONCLUSIONS Among U.S. adults, air quality awareness increases with increasing days with alerts of unhealthy air. These findings improve our understanding of the extent to which air quality alerts prompt people to take actions to protect their health amidst poor air quality.

中文翻译：

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美国成年人的空气质量指数和空气质量意识。

背景技术使用诸如美国环境保护局的空气质量指数之类的空气质量警报来报告全美国有关本地空气质量的信息。但是，此类警报在提高空气质量意识中的作用尚不清楚。我们进行了这项研究，以评估空气质量指数≥101的日子之间的关联，这对应于美国成年人的空气质量分类为：敏感人群不健康，不健康，非常不健康或有害，以及空气质量意识。方法将2016-2018年ConsumerStyles调查的12,396名受访者的数据通过地理位置和调查年份与每日空气质量指数数据相关联。我们评估了过去一年中空气质量指数≥101的天数与对以下问题的回答之间的关联性：关于空气质量警报的意识，空气质量的感知以及使用逻辑回归分析减少空气污染暴露的行为变化的调查。结果空气质量警报意识（患病率[PR] = 1.23； 95％置信区间[CI] = 1.15，1.31），认为/知情的空气质量较差（PR = 2.02； 95％CI = 1.81，2.24），居住在空气质量指数≥101的≥15天的县的受访者中，其行为和变化行为（PR = 2.27； 95％CI = 1.94，2.67）高于空气质量指数≥101的过去一年中零天的县的受访者。有哮喘的成年人比没有哮喘的成年人对空气质量意识的各个方面都更高，但是心脏病的状况没有发现差异。在空气质量指数≥101的天数的五分位数中，有或没有选择呼吸道和心血管疾病的人的空气质量意识有所提高。结论在美国成年人中，空气质量意识随着天数的增加和空气不健康的警报而增加。这些发现使我们对空气质量警报提示人们在空气质量差的情况下采取行动保护自己的健康的程度有了更深入的了解。