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Effects of the lockdown measure amid COVID-19 pandemic on outpatient department visits associated with air pollution reduction in Thailand

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Abstract

We investigated the effects of COVID-19 lockdown on air quality and its consequences health and economic benefits in Thailand. The conditional Poisson regression model was applied to examine the association between air pollution and outpatient department (OPD) visits in each province and pooled the province-specific estimates using the random-effects meta-analysis to derive the national estimates. We then applied a random forest model with meteorological normalization approach to predict the concentration of air pollutants by means of business as usual during the lockdown period (April 3–May 3) in 2020 and further calculated the changes in the number of OPD visits and their consequent expenditure attributable to air pollution reduction using the obtained risk function performed earlier. The number of cardiovascular OPD visits attributed to PM10, PM2.5 and NO2 decreased by 4,414 (95% CI 982, 8,401), 4,040 (95% CI 326, 7,770), and 13,917 (95% CI 1,675, 27,278) cases, respectively, leading to reduced medical expenditure by 14,7180.21, 13,4708.31, and 46,4025.04 USD, respectively. The number of respiratory OPD visits attributed to PM10, PM2.5, NO2, and O3 reduction decreased by 2,298 (95% CI 1,223, 3,375), 2,056 (95% CI 740, 3,252), 3,326 (95% CI 542, 6,295), and 1,160 (95% CI 5,26, 1,804) cases, respectively, where the consequent medical expenditure was reduced by 76,618.48, 68,566.36, 11,0908.31, and 38,685.50 USD, respectively. Finding from this study showed that air quality during the lockdown period in Thailand was improved, contributing to the reduction of cardiovascular and respiratory OPD visits, and consequent medical service costs attributable to air pollution.

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The data are available in supplementary materials and from the corresponding author on reasonable request.

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Acknowledgements

We would like to express our sincere gratitude to the National Health Security Office, as well as the Pollution Control Department and Thai Meteorological Department for providing useful data for the analyses in this study. We also thank Mr. Thomas McManamon for professional English editing.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not for-profit sectors.

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AP conceptualized the research and responsible for the whole research work, including data collection and curation, data analysis. PS assisted in data collection, as well as data wrangling and analysis. AP and PS wrote this manuscript.

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Correspondence to Arthit Phosri.

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The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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This study was approved by the Ethics Review Board (ERB) of the Faculty of Public Health, Mahidol University as exemption review category (Protocol No. 18/2565), where written informed consent was not required because aggregated secondary data was utilized in this study.

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Saengsawang, P., Phosri, A. Effects of the lockdown measure amid COVID-19 pandemic on outpatient department visits associated with air pollution reduction in Thailand. Environ Geochem Health 45, 7861–7876 (2023). https://doi.org/10.1007/s10653-023-01694-6

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  • DOI: https://doi.org/10.1007/s10653-023-01694-6

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