{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:08:55Z","timestamp":1791126535938,"version":"4.1.0"},"reference-count":39,"publisher":"American Chemical Society (ACS)","issue":"1","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":1906,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Exposure to air pollution has been linked to the exacerbation of respiratory diseases. The Air Quality Health Index (AQHI), developed in Canada, is a new health risk scale for reporting air quality and advising risk reduction actions.<\/jats:p>\n                  <jats:p>Objective: We used the AQHI to estimate the impact of air quality on asthma morbidity, adjusting for potential confounders.<\/jats:p>\n                  <jats:p>Methods: Daily air pollutant measures were obtained from 14 regional monitoring stations in Ontario. Daily counts of asthma-attributed hospitalizations, emergency department (ED) visits, and outpatient visits were obtained from a provincial registry of 1.5 million patients with asthma. Poisson regression was used to estimate health services rate ratios (RRs) as a measure of association between the AQHI or individual pollutants and health services use. We adjusted for age, sex, season, year, and region of residence.<\/jats:p>\n                  <jats:p>Results: The AQHI values were significantly associated with increased use of asthma health services on the same day and on the 2 following days, depending on the specific outcome assessed. A 1-unit increase in the AQHI was associated with a 5.6% increase in asthma outpatient visits (RR = 1.056; 95% CI: 1.053, 1.058) and a 2.1% increase in the rate of hospitalization (RR = 1.021; 95% CI: 1.014, 1.028) on the same day and with a 1.3% increase in the rate of ED visits (RR = 1.013; 95% CI: 1.010, 1.017) after a 2-day lag.<\/jats:p>\n                  <jats:p>Conclusions: The AQHI values were significantly associated with the use of asthma-related health services. Timely AQHI health risk advisories with integrated risk reduction messages may reduce morbidity associated with air pollution in patients with asthma.<\/jats:p>","DOI":"10.1289\/ehp.1104816","type":"journal-article","created":{"date-parts":[[2012,11,20]],"date-time":"2012-11-20T08:21:22Z","timestamp":1353399682000},"page":"46-52","source":"Crossref","is-referenced-by-count":93,"title":["The Air Quality Health Index and Asthma Morbidity: A Population-Based Study"],"prefix":"10.1021","volume":"121","author":[{"given":"Teresa","family":"To","sequence":"first","affiliation":[{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shixin","family":"Shen","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshetu G.","family":"Atenafu","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Guan","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"McLimont","sequence":"additional","affiliation":[{"name":"Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Stocks","sequence":"additional","affiliation":[{"name":"Ontario Lung Association, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Licskai","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Western Ontario, London, Ontario, Canada"},{"name":"St. Joseph\u2019s Health Care, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2012,10,10]]},"reference":[{"issue":"1","key":"2026080505022378900_micit1","doi-asserted-by":"crossref","first-page":"92","DOI":"10.2337\/dc11-1155","article-title":"Diabetes incidence and long-term exposure to air pollution: a cohort study.","volume":"35","author":"Andersen","year":"2012","journal-title":"Diabetes Care"},{"issue":"8","key":"2026080505022378900_micit2","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1177\/003335490712200510","article-title":"Ischemic heart disease and ambient air pollution of particulate matter 2.5 in 51 counties in the US.","volume":"122","author":"Balluz","year":"2007","journal-title":"Public Health Rep"},{"issue":"2","key":"2026080505022378900_micit3","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.1398-9995.2006.01305.x","article-title":"GINA guidelines on asthma and beyond.","volume":"62","author":"Bousquet","year":"2007","journal-title":"Allergy"},{"issue":"3","key":"2026080505022378900_micit4","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/BF03404464","article-title":"The effect of the urban ambient air pollution mix on daily mortality rates in 11 Canadian cities.","volume":"89","author":"Burnett","year":"1998","journal-title":"Can J Public Health"},{"key":"2026080505022378900_micit5","unstructured":"Canadian Medical Association\n          . 2008. 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Air Quality Health Index.Available: http:\/\/www.ec.gc.ca\/cas-aqhi\/default.asp?lang=En&n=CB0ADB16-1 [accessed 11 March 2011]."},{"key":"2026080505022378900_micit10","unstructured":"Environment Canada\n          . 2012b. Air Quality Health Index Categories and Health Messages.Available: http:\/\/www.ec.gc.ca\/cas-aqhi\/default.asp?lang=En&n=79A8041B-1 [accessed 11 March 2011]."},{"key":"2026080505022378900_micit11","unstructured":"Farrar JR\n          . 2005. The global burden of asthma and current approaches to its management. 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