Effect of air pollution on health care expenditure: Evidence from respiratory diseases

Association of air quality index (AQI) with incidence of atopic dermatitis in Taiwan: A nationwide population-based cohort study

BACKGROUND

Air pollutants may aggravate atopic dermatitis (AD). However, the association between Air Quality Index (AQI) and incidence of AD remains unknown.

OBJECTIVE

To investigate association between AQI and incidence of AD, using the nationwide cohort in the Taiwan National Health Insurance Research Database (NHIRD).

METHODS

We included 21,278,938 participants from the NHIRD not diagnosed with AD before 2008. Long-term average AQI value, obtained from the Taiwan Air Quality Monitoring System Network, before AD diagnosis was calculated and linked for each participant.

RESULTS

199,205 incident cases of AD were identified from 2008 to 2018. Participants were classified into 4 quantiles (Q) by AQI value. With the lowest quantile, Q1, as reference, the AD risk increased significantly in the Q2 group (adjusted hazard ratio [aHR]: 1.29, 95% confidence interval [CI]: 1.04-1.65), Q3 group (aHR: 4.71, 95% CI: 3.78-6.04), and was highest in the Q4 group (aHR: 13.20, 95% CI: 10.86-16.60). As AQI treated as a continuous variable, an increase of 1 unit of AQI value added 7% of AD risk (aHR, 1.07, 95% CI: 1.07-1.08).

LIMITATIONS

The NHIRD lacks detailed information on individual subjects.

CONCLUSIONS

The results demonstrated a significant positive association between AQI and incidence of AD with a clear dose-response relationship.

Alive but not well: The neglected cost of air pollution

Besides medical expenses, hospitalizations associated with air pollution will incur the welfare loss due to activity restrictions and the wage loss due to inability to work. We fill in the gap in the literature by examining the impact of air pollution on volume and intensity of hospitalizations, which allows us to incorporate the welfare loss and the wage loss. Using a data set that covers most of the inpatients in a major Chinese city during 2015-16, we find that worse air quality causes more hospital admissions, more total inpatient days, and higher total inpatient expenditure for various diseases, particularly diseases of the respiratory and circulatory systems. We also find that there would be an underestimate of the loss from air pollution if we had ignored the loss associated with activity restrictions and the wage loss during hospitalization.

Synergic effects of PM1 and thermal inversion on the incidence of small for gestational age infants: a weekly-based assessment

BACKGROUND

The synergic effects of thermal inversion (TI) and particulate matter with an aerodynamic diameter ≤1 μm (PM₁) exposure and incidence of small for gestational age (SGA) was not clear.

OBJECTIVE

We aimed to explore the independent effects of prenatal TI and PM₁ exposure on incidence of SGA and their potential interactive effects.

METHODS

A total of 27,990 pregnant women who delivered in Wuhan Children's Hospital from 2017 to 2020 were included. The daily mean concentration of PM₁ was obtained from ChinaHighAirPollutants (CHAP) and matched with the residential address of each woman. Data on TI was derived from National Aeronautics and Space Administration (NASA). The independent effects of PM₁ and TI exposures on SGA in each gestational week were estimated by the distributed lag model (DLM) nested in Cox regression model, and the potential interactive effects of PM₁ and TI on SGA were investigated by adapting the relative excess risk due to interaction (RERI) index.

RESULTS

Per 10 μg/m³ increase in PM₁ was associated with an increase in the risk of SGA at 1-3 and 17-23 gestational weeks, with the strongest effect at the first gestational week (HR = 1.043, 95%CI: 1.008, 1.078). Significant links between one day increase of TI and SGA were found at the 1-4 and 13-23 gestational weeks and the largest effects were observed at the 17^th gestational week (HR = 1.018, 95%CI: 1.009, 1.027). Synergistic effects of PM₁ and TI on SGA were detected in the 20^th gestational week, with RERI of 0.208 (95%CI: 0.033,0.383).

IMPACT STATEMENT

Both prebirth PM₁ and TI exposure were significantly associated with SGA. Simultaneous exposure to PM₁ and TI might have synergistic effect on SGA. The second trimester seems to be a sensitive window of environmental and air pollution exposure.

Formation mechanism of residents' intention to purchase commercial health insurance: the moderating effect of environmental pollution perception

Aim

With the development of the social economy, commercial health insurance in China has gradually been recognized by residents, but it is still in the initial stage of the market. To identify influencing factors of residents' intention to purchase commercial health insurance and to explore the influencing mechanism and heterogeneity of intention, this study aimed to reveal the formation mechanism of intention to purchase commercial health insurance.

Methods

This study introduced water and air pollution perceptions as moderating variables and, constructed a theoretical framework combining the stimulus-organism-response model and the theory of reasoned action models. The structural equation model was developed, and multigroup analysis and moderating effect analysis were carried out.

Results

The results show that advertising marketing and the behavior of relatives and friends positively influence cognition. Cognition, as well as advertising marketing and behavior of relatives and friends, has a positive impact on attitude. Furthermore, purchase intention is positively affected by cognition and attitude. Both gender and residence play a significant moderating role in influencing purchase intention. Air pollution perceptions positively moderate the path from  attitude to purchase intention.

Conclusion

The validity of the constructed model was verified and could be used to predict the willingness of residents to purchase commercial health insurance. Furthermore, policy recommendations to promote the further development of commercial health insurance were proposed. This study provides a valuable reference for insurance companies to expand the market and for the government to improve commercial insurance policies.

Dynamic analysis and optimal control of a class of SISP respiratory diseases

In this paper, the actual background of the susceptible population being directly patients after inhaling a certain amount of PM2.5 is taken into account. The concentration response function of PM2.5 is introduced, and the SISP respiratory disease model is proposed. Qualitative theoretical analysis proves that the existence, local stability and global stability of the equilibria are all related to the daily emission P0 of PM2.5 and PM2.5 pathogenic threshold K. Based on the sensitivity factor analysis and time-varying sensitivity analysis of parameters on the number of patients, it is found that the conversion rate β and the inhalation rate η has the largest positive correlation. The cure rate γ of infected persons has the greatest negative correlation on the number of patients. The control strategy formulated by the analysis results of optimal control theory is as follows: The first step is to improve the clearance rate of PM2.5 by reducing the PM2.5 emissions and increasing the intensity of dust removal. Moreover, such removal work must be maintained for a long time. The second step is to improve the cure rate of patients by being treated in time. After that, people should be reminded to wear masks and go out less so as to reduce the conversion rate of susceptible people becoming patients.

Temperature and non-communicable diseases: Evidence from Indonesia's primary health care system

Climate change induced rising temperatures will pose a detrimental threat to decent health in the coming decades. Especially at risk are individuals with chronic diseases, since heat can exacerbate a variety of health conditions. In this article, I examine the heat-morbidity relationship in the context of Indonesia, focusing on chronic, non-communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Using a novel dataset from the Indonesian national health insurance scheme Jaminan Kesehatan Nasional/Badan Penyelenggara Jaminan Sosial (BPJS) and linking it with meteorological data on the daily-district level, I estimate the causal effect of high temperatures on the daily number of primary health care visits. The results show that on a hot day all-cause visits and visits with a diagnosis of diabetes and cardiovascular diseases increase by 8%, 25% and 14%, respectively. These increases are permanent and not offset by visit displacement or 'harvesting'. Visits related to respiratory diseases seem not to be affected by high temperatures. I use several climate change scenarios to predict the increase in visits and costs by the end of the century, which all forecast a substantial financial burden for the health care system. These results might have relevance for other middle-income countries with similar climatic conditions.

Influence of Engine Electronic Management Fault Simulation on Vehicle Operation

The preparation of the fuel mixture of a conventional internal combustion engine is currently controlled exclusively electronically. In order for the electrical management of an internal combustion engine to function properly, it is necessary that all its electronic components work flawlessly and fulfill their role. Failure of these electronic components can cause incorrect fuel mixture preparation and also affect driving safety. Due to the effect of individual failures, it has a negative impact on road safety and also negatively affects other participants. The task of the research is to investigate the effect of the failure of electronic engine components on the selected operating characteristics of a vehicle. The purpose of this article is to specify the extent to which a failure of an electronic engine component may affect the operation of a road vehicle. Eight failures of electronic systems (sensors and actuators) were simulated on a specific vehicle, with a petrol internal combustion engine. Measurements were performed in laboratory conditions, the purpose of which was to quantify the change in the operating characteristics of the vehicle between the faulty and fault-free state. The vehicle performance parameters and the production of selected exhaust emission components were determined for selected vehicle operating characteristics. The results show that in the normal operation of vehicles, there are situations where a failure in the electronic system of the engine has a significant impact on its operating characteristics and, at the same time, some of these failures are not identifiable by the vehicle operator. The findings of the publication can be used in the drafting of legislation, in the field of production and operation of road vehicles, and also in the mathematical modeling of the production of gaseous emissions by road transport.

How Air Quality Affect Health Industry Stock Returns: New Evidence From the Quantile-on-Quantile Regression

This paper discusses the asymmetric effect of air quality (AQ) on stock returns (SR) in China's health industry through the quantile-on-quantile (QQ) regression method. Compared to prior literature, our study provides the following contributions. Government intervention, especially industrial policy, is considered a fresh and essential component of analyzing frameworks in addition to investors' physiology and psychology. Next, because of the heterogeneous responses from different industries to AQ, industrial heterogeneity is thus considered in this paper. In addition, the QQ method examines the effect of specific quantiles between variables and does not consider structural break and temporal lag effects. We obtain the following empirical results. First, the coefficients between AQ and SR in the health service and health technology industries change from positive to negative as AQ deteriorates. Second, AQ always positively influences the health business industry, but the values of the coefficients are larger in good air. In addition, different from other industries, the coefficients in the health equipment industry are negative, but the values of the coefficients change with AQ. The conclusions provide important references for investors and other market participants to avoid biased decisions due to poor AQ and pay attention to government industrial policies.

The Respiratory Impacts of Air Pollution in Children: Global and Domestic (Taiwan) Situation

Air pollution is a global issue that threatens the health of human beings. Epidemiologic reports have shown air pollution exposures to result in millions of deaths annually. Infancy and childhood, the period of organ and lung development, is most susceptible to these environmental hazards; as a result, the risks of respiratory diseases are increased after air pollution exposure. These pollutants can originate from indoor and ambient environment, presenting as vapor or particles, and differ in chemical compositions. This review will give brief introduction to various major pollutants and their origin, as well the correlation with respiratory diseases after exposure. We will also present several current facts in domestic area (Taiwan), regarding the status of local air-pollution, and discuss its impacts on pediatric respiratory health. This report will provide useful information for clinicians and offer advice for policy makers to develop public health guidelines of pollution control and prevention.