The Impact of NO2 and SO2 Pollutants on Respiratory Diseases: A Case Study of Indonesia
DOI:
https://doi.org/10.59188/eduvest.v6i2.52788Keywords:
Pollution, Respiratory Diseases, Quasiexperimental Analysis, Case StudyAbstract
Air pollution remains a significant public health challenge in Indonesia, driven by rapid industrialization and urbanization. Key pollutants such as NO₂ and SO₂ are strongly linked to respiratory conditions, yet comprehensive national evidence on their age-specific impacts remains limited. This study aims to examine the causal effects of NO₂ and SO₂ exposure on the incidence of acute respiratory infections (ARI), pneumonia, and asthma in Indonesia, with a particular focus on differences across age groups. This study employs a quasi-experimental design using district-level pollution data and individual health data from Riskesdas 2018. Analysis was conducted via multiple linear regression, coefficient stability testing, and IPW to estimate robust causal associations. Age-stratified analysis was performed across five groups: 0–4, 5–17, 18–49, 50–74, and 75+ years. Results show that NO₂ exhibits a strong positive association with ARI incidence, particularly among children aged 0–4 and 5–17 years, and is linked to asthma in adults aged 18–49. SO₂ shows significant positive effects on ARI among older adults (50–74 years) and on asthma in those aged 75 and above. However, unexpected negative or non-significant relationships were found between NO₂ and pneumonia/asthma, and between SO₂ and certain outcomes, likely reflecting data constraints and unobserved confounders. In conclusion, this study reveals age-specific pollutant–health relationships and underscores the need for targeted air quality interventions. Recommendations include strengthening monitoring systems, implementing pollutant-specific warnings, and integrating environmental–health data to support evidence-based policies and protect vulnerable groups.
References
Andriati, R., Adha, M. Z., & Hadi, T. E. Z. (2021). The Analysis of Meteorological Factors and Ambient Air Quality (PM10, CO, SO2, NO2, and O3) with the Incidence of Acute Respiratory Infection (ARI) in Tangerang City, Indonesia During 2010-2019. International Journal of Advancement in Life Sciences Research, 4(4), 7–14. https://doi.org/10.31632/ijalsr.2021.v04i04.002
Anurogo, D., Sulaeman, S., Yamtana, Y., & Andarmoyo, S. (2023). Assessing the Impact of Air Quality on Respiratory Health in Urban Environments: A Case Study of Tangerang. West Science Interdisciplinary Studies, 1(10), 928–939. https://doi.org/10.58812/wsis.v1i10.278
Arsyad, K. A., & Priyana, Y. (2023). Studi Kausalitas antara Polusi Udara dan Kejadian Penyakit Saluran. Jurnal Multidisiplin West Science, 02(06), 462–472. https://doi.org/https://doi.org/10.58812/jmws.v2i6.434
Azmi, S., Aljunid, S. M., Maimaiti, N., Ali, A. A., Muhammad Nur, A., De Rosas-Valera, M., Encluna, J., Mohamed, R., Wibowo, B., Komaryani, K., & Roberts, C. (2016). Assessing the burden of pneumonia using administrative data from Malaysia, Indonesia, and the Philippines. International Journal of Infectious Diseases, 49, 87–93. https://doi.org/10.1016/j.ijid.2016.05.021
Chang, T. Y., Zivin, J. G., Gross, T., & Neidell, M. (2019). The effect of pollution on worker productivity: Evidence from call center workers in China. American Economic Journal: Applied Economics, 11(1), 151–172. https://doi.org/10.1257/app.20160436
Direktorat Jenderal Pengendalian Pencemaran dan Kerusakan Lingkungan Kementerian Lingkungan Hidup dan Kehutanan RI. (2018). Laporan Tahunan Direktorat Pengendalian Pencemaran Udara 2018. In Kementerian Lingkungan Hidup dan Kehutanan.
Dong, R., Fisman, R., Wang, Y., & Xu, N. (2021). Air pollution, affect, and forecasting bias: Evidence from Chinese financial analysts. Journal of Financial Economics, 139(3), 971–984. https://doi.org/10.1016/j.jfineco.2019.12.004
Feng, P., Zhou, Z., Cohen, J. P., & Yasar, M. (2024). Air Pollution and the Effects on House Prices: A Push for Sustainability. Journal of Real Estate Research, 46(3), 336–359. https://doi.org/10.1080/08965803.2024.2344999
Fu, S., Viard, V. B., & Zhang, P. (2021). Air Pollution And Manufacturing Firm Productivity: Nationwide Estimates For China. 131(April), 3241–3273.
Global Burden of Disease Collaborative Network. (2021). Global Burden of Disease Study 2019 (GBD 2019) Air Pollution Exposure Estimates 1990-2019. https://doi.org/https://doi.org/10.6069/70JS-NC54
Global Modeling and Assimilation Office (GMAO). (2015a). MERRA-2 tavgM_2d_aer_Nx: 2d,Monthly mean,Time-averaged,Single-Level,Assimilation,Aerosol Diagnostics V5.12.4. https://doi.org/10.5067/FH9A0MLJPC7N
Global Modeling and Assimilation Office (GMAO). (2015b). MERRA-2 tavgM_2d_flx_Nx: 2d,Monthly mean,Time-Averaged,Single-Level,Assimilation,Surface Flux Diagnostics V5.12.4. https://doi.org/10.5067/0JRLVL8YV2Y4
Goodwin, M. B., Fontenla, M., & Gonzalez, F. (2021). Estimating the impact of pollution on wages and housing prices using satellite imagery. Applied Economics Letters, 28(20), 1750–1753. https://doi.org/10.1080/13504851.2020.1853665
Heyes, A., Neidell, M., & Saberian, S. (2016). The Effect of Air Pollution on Investor Behavior: Evidence from the S&P 500. National Bureau of Economic Research, w22753.
Kementerian Kesehatan RI. (2018). Basic Health Research (Riset Kesehatan Dasar) 2018.
Lestari, P. A., & Haryanto, B. (2022). SO2 Concentration and the Occurrence of Acute Respiratory Infection in Children Under Five. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal), 17(4), 292–296. https://doi.org/10.21109/kesmas.v17i4.6290
Liu, Y. M., & Ao, C. K. (2021). Effect of air pollution on health care expenditure: Evidence from respiratory diseases. Health Economics (United Kingdom), 30(4), 858–875. https://doi.org/10.1002/hec.4221
Oster, E. (2019). Unobservable Selection and Coefficient Stability: Theory and Evidence. Journal of Business and Economic Statistics, 37(2), 187–204. https://doi.org/10.1080/07350015.2016.1227711
Ramakrishnan, S., Hishan, S. S., Nabi, A. A., Arshad, Z., Kanjanapathy, M., Zaman, K., & Khan, F. (2016). An interactive environmental model for economic growth: evidence from a panel of countries. Environmental Science and Pollution Research, 23(14), 14567–14579. https://doi.org/10.1007/s11356-016-6647-8
Sofwan, N. M., Mahiyuddin, W. R. W., Latif, M. T., Ayub, N. A., Yatim, A. N. M., Mohtar, A. A. A., Othman, M., Aizuddin, A. N., & Sahani, M. (2021). Risks of exposure to ambient air pollutants on the admission of respiratory and cardiovascular diseases in Kuala Lumpur. Sustainable Cities and Society, 75(2), 103390. https://doi.org/10.1016/j.scs.2021.103390
Surury, I., Azizah, M., & Prastiwi, N. D. (2022). Spatial Analysis of Acute Respiratory Infection (ARI) Based on the Air Pollution Standard Index (PSI) at DKI Jakarta Region in 2018-2019. Jurnal Kesehatan Lingkungan, 14(2), 90–98. https://doi.org/10.20473/jkl.v14i2.2022.90-98
Wu, T. J., Wu, C. F., Lee, Y. L., Hsiue, T. R., & Guo, Y. L. (2014). Asthma incidence, remission, relapse and persistence: A population-based study in southern Taiwan. Respiratory Research, 15(1), 1–9. https://doi.org/10.1186/s12931-014-0135-9
Zhao, Y., Dong, L., Sun, Y., Ma, Y., & Zhang, N. (2024). Is air pollution the original sin of firms? The impact of air pollution on firms’ ESG scores. Energy Economics, 136(January), 107704. https://doi.org/10.1016/j.eneco.2024.107704
Zivin, J. G., & Neidell, M. (2012). The impact of pollution on worker productivity. American Economic Review, 102(7), 3652–3673. https://doi.org/10.1257/aer.102.7.3652
Zou, G., Lai, Z., Li, Y., Liu, X., & Li, W. (2022). Exploring the nonlinear impact of air pollution on housing prices: A machine learning approach. Economics of Transportation, 31(July). https://doi.org/10.1016/j.ecotra.2022.100272
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Reizka Asadelia Rafmawan

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.





