Kuo said that with the exception of eastern Taiwan, much of the rest of the country, including northern, central, and southern Taiwan record annual average concentrations exceed the annual standard of 15 micrograms per cubic meter, with air quality in central and southern Taiwan in most urgent need of attention.
The study focused on deaths from 2000 to 2012 for people in more than 39,000 ZIP codes nationwide who were insured by Medicare, the USA health program for the elderly and disabled.
In reviewing data from the US Centers for Medicare and Medicaid Services and comparing it with air pollution data in zip codes where individuals died, they found a direct correlation between higher mortality rates and higher levels of fine inhalable matter known as (PM2.5), small particles that can be made up of hundreds different chemicals that can be emitted from cars or from construction sites, and ozone, a harmful gas.
The 24-hour standard is 35 μg/m3.
During the study period, 22 million people in the study population died. "Any level of air pollution", Dominici said, "no matter how low, is harmful to human health".
Each 10-μg/m daily increase in fine particulate mater and each 10-ppb daily increase in warm-season ozone exposures were associated with statistically significant increases of 1.42 and 0.66 deaths per 1 million persons at risk per day, respectively. "Warm-season ozone was defined as ozone levels for the months April to September of each year".
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While this may seem a small increase, the public health impact is enormous if it is applied to the whole USA population of seniors, researchers said. The results indicated that although pollution might be at the low level or might be on a short-term basis, regular exposure of elderly people to this type of pollution can increase the mortality rate.
For example, an increase of just 1 μg/m3 in daily PM2.5 over the course of one summer would lead to 550 extra deaths per year and 7,150 extra deaths over the course of the 13-year study period.
Even when air quality still met EPA standards, each 10 ug/m3 daily increase in PM 2.5 levels was associated with an increase of 1.42 deaths per day for every million people, the researchers report in the Journal of the American Medical Association.
Women, non-white individuals and the very elderly had higher mortality rate increases associated with PM2.5 than other groups.
The increased risk of death associated with daily spikes in PM 2.5 and ozone levels persisted even when researchers restricted their analysis to days when the air quality complied with EPA standards. Poverty, unhealthy lifestyle, or poor access to healthcare may play a role in such disparities, the researchers speculated.
Joel Schwartz, professor of environmental epidemiology at Harvard Chan School, said that the new findings about the short-term mortality risk from air pollution suggest that the EPA should re-evaluate the daily NAAQS as well.
"No matter where you live - in cities, in the suburbs, or in rural areas - as long as you breathe air pollution, you are at risk", said Qian Di, lead author of the study and a Ph.D. student in the Department of Environmental Health.