Diseases Burden of Chronic Obstructive Pulmonary Disease (COPD) Attributable to Ground-Level Ozone in Thailand: Estimates Based on Surface Monitoring Measurements Data

Abstract

<p><strong>BACKGROUND: </strong>Ambient ozone (O<sub>3</sub>) pollution has increased globally since preindustrial times. At present, O<sub>3 </sub>is one of the major air pollution concerns in Thailand, and is associated with health impacts such as chronic obstructive pulmonary disease (COPD). The objective of our study is to<strong> </strong>estimate the burden of disease attributed to O<strong><sub>3</sub></strong> in 2009 in Thailand<strong> </strong>based on empirical evidence.</p> <p><strong>METHODS:</strong> We estimated disability-adjusted life years (DALYs) attributable to O<sub>3</sub> using the comparative risk assessment framework in the Global Burden of Diseases (GBD) study. We quantified the population attributable fraction (PAF), integrated from Geographic Information Systems (GIS)-based spatial interpolation, the population distribution of exposure, and the exposure-response coefficient to spatially characterize exposure to ambient O<sub>3</sub> pollution on a national scale. Exposure distribution was derived from GIS-based spatial interpolation O<sub>3</sub> exposure model using Pollution Control Department Thailand (PCD) surface air pollution monitor network sources. Relative risk (RR) and population attributable fraction (PAF) were determined using health impact function estimates for O<sub>3</sub>.</p> <p><strong>RESULT: </strong>PAF (%) of COPD attributable to O<sub>3</sub> were determined by region: at approximately, Northern = 2.1, Northeastern = 7.1, Central = 9.6, Eastern = 1.75, Western = 1.47 and Southern = 1.74. The total COPD burden attributable to O<sub>3</sub> for Thailand in 2009 was 61,577 DALYs. Approximately 0.6% of the total DALYs in Thailand is male: 48,480 DALYs; and female: 13,097 DALYs.<strong> </strong></p> <p><strong>CONCLUSION:</strong> This study provides the first empirical evidence on the health burden (DALYs) attributable to O<sub>3</sub> pollution in Thailand. Varying across regions, the disease burden attributable to O<sub>3</sub> was 0.6% of the total national burden in 2009. Better empirical data on local specific sites, e.g. urban and rural areas, alternative exposure assessment, e.g. land use regression (LUR), and a local concentration-response coefficient are required for future studies in Thailand.</p>