The role of perceived air pollution and health risk perception in health symptoms and disease: a population-based study combined with modelled levels of PM10.
PURPOSE
Adverse health impact of air pollution on health may not only be associated with the level of exposure, but rather mediated by perception of the pollution and by top-down processing (e.g. beliefs of the exposure being hazardous), especially in areas with relatively low levels of pollutants. The aim of this study was to test a model that describes interrelations between air pollution (particles < 10 [Formula: see text]m, PM10), perceived pollution, health risk perception, health symptoms and diseases.


METHODS
A population-based questionnaire study was conducted among 1000 Estonian residents (sample was stratified by age, sex, and geographical location) about health risk perception and coping. The PM10 levels were modelled in 1 × 1 km grids using a Eulerian air quality dispersion model. Respondents were ascribed their annual mean PM10 exposure according to their home address. Path analysis was performed to test the validity of the model.


RESULTS
The data refute the model proposing that exposure level significantly influences symptoms and disease. Instead, the perceived exposure influences symptoms and the effect of perceived exposure on disease is mediated by health risk perception. This relationship is more pronounced in large cities compared to smaller towns or rural areas.


CONCLUSIONS
Perceived pollution and health risk perception, in particular in large cities, play important roles in understanding and predicting environmentally induced symptoms and diseases at relatively low levels of air pollution.
['Orru|Kati|K|0000-0003-0616-9870', 'Nordin|Steven|S|', 'Harzia|Hedi|H|', 'Orru|Hans|H|']
D000293:Adolescent D000328:Adult D000368:Aged D000397:Air Pollution D002947:Cities D004781:Environmental Exposure D004957:Estonia D005260:Female D006304:Health Status D006801:Humans D008297:Male D008875:Middle Aged D010316:Particle Size D052638:Particulate Matter D010465:Perception D012306:Risk D012424:Rural Population D011795:Surveys and Questionnaires D014505:Urban Population D055815:Young Adult
Perceived pollution Path analysis Air pollution modelling Epidemiology Questionnaire survey