Goals of air quality measures are to reduce air pollutant emissions, reduce ambient air pollution concentrations and reduce health burdens due to air pollutants. Consequences of these various measures are evaluated mainly focusing on reductions of air pollutant emissions and concentrations using calculated air pollutant emissions and monitored air pollutant concentration data. However, the effectiveness of these measures on health burden has been rarely evaluated. Thus, research on whether these measures can reduce health burden is needed. In this study, we aimed to estimate reductions in health burden due to introductions of various air quality measures since early 2000 in Seoul, Korea.
To estimate reductions of health burden due to air quality measures, it was hypothesized that the health burden was reduced in 2008 and 2015 when the first and second Master Plan for Air Quality Management in the Seoul Metropolitan Area were estiblased and related measures were implemented. Estimated reductions in premature mortality were 18,865 and 7,308 for non-accidental and cardiovascular mortality from 2008 to 2014 and 2,676 and 663 for non-accidental and respiratory mortality from 2015 to 2018. Estimated reductions in hospital visits from 2008 to 2014 were 16,859 for outpatient visits by cardiovascular diseases for 20-39 years old and 16,679 for inpatient visits by cardiovascular diseases for 40-64 years old. Estimated reductions in hospital visits for outpatient visits by cardiovascular diseases from 2015 to 2018 were 96.379, 814, 313 and 1,976,341 for 30-39, 40-64 and more than 65 years old, respectively.
As another way to analyse the impact of air quality measures, 1,000 Seoul citizens were surveyed on awareness, anxiety and political requirements of air pollution and their health effect. More then 70% of respondents felt that the air quality in Seoul continued to deteriorate and more than 60% felt that it would continue to deteriorate. One in four respondents experienced air pollution related health symptoms and more than 84% of respondents showed a high level of anxiety of air quality due to their health effect. Political requirements required information to reduce air quality-related anxiety on air pollutant emissions, air quality and associated health effects, individual-level action tips to reduce exposure and associated air quality measurements and performance. As a result of extensive analysis of current status of air quality management measures, changes in air pollutant emissions and concentrations and requirements to reduce health effects due to air pollution, we proposed the following three policy directions to reduce health burden due to air pollution: 1) strengthening measures to reduce emissions and concentration, 2) providing information to strengthen Seoul citizens' right to know and 3) preparing strategies for risk communication to induce voluntary policy participation and behavioral improvement.