Using EPA's Air Quality Index (AQI) to reduce cardiovascular morbidity and mortality in older adults

Air pollutants, especially particulate matter, have been associated with cardiovascular morbidity, including hospital or ED visits for heart failure, cardiac dysrhythmia, myocardial infarction and stroke, as well as mortality. These cardiovascular effects occur primarily in older adults. EPA's Air Quality Index (AQI) is the nationally uniform U.S. index for informing the public about daily air quality and associated health risks if any. The AQI is forecast daily and also available in real-time air quality reports that include information about at-risk populations, potential health risks and exposure reduction measures. Information about the AQI, and related tools for healthcare providers and educators can be found on the AIRNow Website (http://www.airnow.gov). Many approaches have been used to evaluate the effectiveness of the AQI in reducing people's exposure to air pollution and morbidity effects. Several approaches will be presented, including: public awareness surveys; health surveys (e.g., the Behavioral Risk Factor Surveillance Survey); population measures of exposure reduction; an activity diary study of behavior changes in asthmatic children; and epidemiological studies of asthma-related health measures. Results from the National-Scale Activity Survey will be presented, the first activity diary study to evaluate behavior changes in older adults in response to AQI advisories. This Web-panel study recruited 1600 adults in 9 urban areas; data collected includes initial activity screening, activity diaries and a follow-up survey of awareness of the AQI and behavior changes. The AQI will be identified as a tool in the Green Heart Campaign to reduce cardiovascular morbidity and mortality in older adults.