Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Effects of Air Pollution on Asthma in Seoul: Comparisons across Subject Characteristics

서울지역 대기오염이 천식에 미치는 급성영향: 연구대상의 특성에 따른 비교

  • Kim, Sun-Young (Department of Epidemiology and Biostatistics, School of Public Health and Institute of Health and Environment, Seoul National University) ;
  • Kim, Jai-Yong (Primary Health Care Team, Research Department, Korea Health Insurance Review Agency) ;
  • Kim, Ho (Department of Epidemiology and Biostatistics, School of Public Health and Institute of Health and Environment, Seoul National University)
  • 김선영 (서울대학교 보건대학원 및 보건환경연구소) ;
  • 김재용 (건강보험 심사평가원 조사연구실) ;
  • 김호 (서울대학교 보건대학원 및 보건환경연구소)
  • Published : 2006.07.31
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Abstract

Objectives: Korean epidemiological studies have used reduced samples according to the subject's characteristics, such as the health services provided, the historical note with asthma, and age, to examine the acute effect of air pollution on asthma using the Korean National Health Insurance records. However, there have been few studies on whether the effects shown in these reduced samples are different from those of all samples. This study compared the effects of air pollution on asthma attacks in three reduced samples with those of entire samples. Methods: The air pollution data for $PM_{10},\;CO,\;SO_2,\;NO_2,\;and\;O_3$, and weather conditions including temperature, relative humidity, and air pressure in Seoul, 2002, were obtained from outdoor monitoring stations in Seoul. The emergency hospital visits with an asthma attack in Seoul, 2002 were extracted from the Korean National Health Insurance records. From these, the reduced samples were created by health service, historical notes with asthma, and age. A case-crossover design was adopted and the acute effects of air pollution on asthma were estimated after adjusting for weather, time trend, and seasonality. The model was applied to each reduced sample and the entire sample. Results: With respect to the health service, the effects on outpatients were similar to those for the total sample but were different for inpatients. These similar effect sizes were also observed in the reduced samples according to the historical note with asthma and age. The relative risks of $PM_{10},\;CO,\;SO_2,\;NO_2,\;and\;O_3$, among the reduced and entire samples were 1.03, 1.04-1.05, 1.02-1.03, 1.04-1.06, and 1.10-1.17, respectively. Conclusions: There was no clear evidence to show a difference between the reduced samples and the entire samples.

Keywords

References

  1. Dockery DW, Pope CA 3rd, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG Jr, Speizer FE. An association between air pollution and mortality in six U.S. cities. N Engl J Med 1993(24); 329: 1753-1759
  2. Schwartz J, Dockery DW. Increased mortality in Philadelphia associated with daily air pollution concentrations. Am Rev Respir Dis 1992; 145(3): 600-604 https://doi.org/10.1164/ajrccm/145.3.600
  3. Schwartz J, Slater D, Larson TV, Pierson WE, Koenig JQ. Particulate air pollution and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis 1993; 147(4): 826-831 https://doi.org/10.1164/ajrccm/147.4.826
  4. Ju YS, Cho SH. Effect of air pollution on emergency room visits for asthma: a time series analysis. Korean J Prev Med 2001; 34(1): 61-72 (Korean)
  5. Norris G, YoungPong SN, Koenig JQ, Larson TV, Sheppard L, Stout JW. An association between fme particles and asthma emergency department visits for children in Seattle. Environ Health Perspect 1999; 107(6): 489-493 https://doi.org/10.1289/ehp.99107489
  6. Anderson HR, de Leon A Ponce, Bland JM, Bower JS, Emberlin J, Strachan DP. Air pollution, pollens, and daily admissions for asthma in London 1987-92. Thorax 1998; 53(10): 842-848
  7. Im HJ, Lee SY, Yun KJ, Ju YS, Kang DH, Cho SH. A case-crossover study between air pollution and hospital emergency room visits by asthma attack. Korean J Occup Environ Med 2000; 12(2): 249-257 (Korean)
  8. Lee YJ, Lee JT, Ju YS, Shin DC, Im HJ, Cho SH. Short-term effect of air pollution on respiratory disease in Seoul: A case-crossover study. Korean J Prev Med 2001; 34(3): 253-261 (Korean)
  9. Lee JT. Association between air pollution and asthma-related hospital admissions in children Seoul, Korea: A case-crossover study. Korean J Prev Med 2003; 36(1): 47-53 (Korean)
  10. Kim SY. Air pollution effect on asthma according to socioeconomic position. [dissertation]. Korea: Seoul National Univ; 2005 (Korean)
  11. Medical College, Seoul National University. Assessment of the Validity for Disease Code in National Health Insurance and Development of Plan for Utilization. Park BJ, Sung JH, Park GD, et al. Health Insurance Review Agency 2003.6 (Korean)
  12. Kim SY, Lee JT, Hong YC, Ahn KJ, Kim H Determining the threshold effect of ozone on daily mortality: an analysis of ozone and mortality in Seoul, Korea, 1995-1999. Environ Res 2004; 94(2): 113-119 https://doi.org/10.1016/j.envres.2003.09.006
  13. Lee JT, Kim H, Schwartz J, Bidirectional casecrossover studies of air pollution: bias from skewed and incomplete waves, Environ Health Perspect 2000; 108(12): 1107-1111 https://doi.org/10.2307/3434821
  14. Zainudin BM, Lai CK, Soriano JB, Jia-Horng W, De Guia TS, Asthma Insights and Reality in Asia-Pacific (AIRIAP) Steering Committee. Asthma control in adults in Asia-Pacific. Respirology 2005; 10(5): 579-586 https://doi.org/10.1111/j.1440-1843.2005.00753.x
  15. Sheppard L, Levy D, Norris G, Larson TV, Koenig JQ. Effects of ambient air pollution on nonelderly asthma hospital admissions in Seattle, Washington, 1987-1994. Epidemiology 1999; 10(1): 23-30 https://doi.org/10.1097/00001648-199901000-00006
  16. Castellsague J. Sunyer J, Saez M, Anto JM. Short-term association between air pollution and emergency room visits in Barcelona. Thorax 1995; 50(10): 1051-1056 https://doi.org/10.1136/thx.50.10.1051
  17. Atkinson RW, Anderson HR, Sunyer J, Ayres J, Baccini M, Vonk JM, Boumghar A, Forastiere F, Forsgerg B, Toulourni G, Shwartz J, Katsouyanni K. Acute effects of particulate air pollution on respiratory admissions: results from APHEA2 project. Air pollution and health: a European approach. Am J Respir Crit Care Med 2001; 164(10 Pt 1): 1860-1866 https://doi.org/10.1164/ajrccm.164.10.2010138
  18. Kwon JH, Cho, SH, Nyberg F, Pershagen G. Effects of ambient air pollution on daily mortality in a cohort of patients with congestive heart failure. Epidemiology 2001; 21(4): 413-419
  19. Park JK, Kim KS, Kim CB, Lee TY, Lee KS, Lee DH, Lee S, lee SH, Suh I, Koh KW, Ryu SY, Park KH, Park W, Wang S, Lee H, Chae Y, Hong H, Suh JS. The accuracy of ICD codes for cerebrovascular diseases in medical insurance claims. Korean J Prev Med 2000; 33(1): 76-82 (Korean)
  20. Dixon JK. Kids need clean air: air pollution and children's health. Fam Community Health 2002; 24(4): 9-26 https://doi.org/10.1097/00003727-200201000-00004
  21. Lee JT, Kim H Epidemiologic methods and study designs for investigating adverse health effects of ambient air pollution. Korean J Prev Med 2001; 34(2): 119-126 (Korean)
  22. Hong YC, Leem JH, He EH, Christiani DC. PM10 exposure, gaseous pollutants, and daily mortality in Inchon, South Korea. Environ Health Perspect 1999; 107(11): 873-878 https://doi.org/10.1289/ehp.99107s6873
  23. Kwon HJ, Cho SH Air pollution and daily mortality in Seoul. Korean J Prev Med 1999; 32(2): 191-199 (Korean)
  24. Lee JT, Shin D, Chung Y. Air pollution and daily mortality in Seoul and Ulsan, Korea. Environ Health Perspect 1999; 107(2): 149-154 https://doi.org/10.1289/ehp.99107149
  25. Lee JT. Schwartz J. Reanalysis of the effects of air pollution and daily mortality in Seoul, Korea: a case-crossover design. Environ Health Perspect 1999; 107(8): 633-636 https://doi.org/10.1289/ehp.99107633
  26. Hong YC, Rha JH, Lee JT, Ha EH, Kwon HJ, Kim H. Ischemic stroke associated with decrease in temperature. Epidemiology 2003; 14(4): 473-478
  27. Lee JT, Kim H, Son H, Hong YC, Cho YS, Shin SY, Hyun YJ, Kim YS. Air pollution and asthma among children in Seoul, Korea. Epidemiology 2002; 13(4):481-484 https://doi.org/10.1097/00001648-200207000-00018
  28. Schwartz J, Marcus A. Mortality and air pollution in London: a time series analysis. Am J Epidemiol 1990; 131(1): 185-194 https://doi.org/10.1093/oxfordjournals.aje.a115473
  29. Schwartz J. Air pollution and daily mortality in Birmingham, Alabama Am J Epidemiol 1993; 137(10): 1136-1147 https://doi.org/10.1093/oxfordjournals.aje.a116617
  30. Li Y, Roth HD. Daily mortality analysis by using different regression models in Philadelphia county, 1973-1990. Inhal Toxicol 1995; 7: 45-58 https://doi.org/10.3109/08958379509014270
  31. Moolgavkar S, Luebeck EG, Hall TA, Anderson EL. Air pollution and daily mortality in Philadelphia. Epidemiology 1995; 6(5): 476-484 https://doi.org/10.1097/00001648-199509000-00003
  32. Styer P, McMillan N, Gao F, Davis J, Sacks J. Effects of outdoor airborne particulate matter on daily death counts. Environ Health Perspeet 1995; 103(5): 490-497 https://doi.org/10.2307/3432588
  33. Woodruff TJ, Grillo J, Schoendorf KC. The relationship between selected causes of postneonatal infant mortality and particulate air pollution in the United States. Environ Health Perspeet 1997; 105(6): 608-612 https://doi.org/10.2307/3433606
  34. Ramsay TO. Burnett RT, Krewski D. The effect of concurvity in generalized additive models linking mortality to ambient particulate matter. Epidemiology 2003; 14(1): 18-23 https://doi.org/10.1097/00001648-200301000-00009
  35. Maclure M. The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol 1991; 133(2): 144-153 https://doi.org/10.1093/oxfordjournals.aje.a115853
  36. Bateson TF, Schwartz J. Control for seasonal variation and time trend in case-crossover studies of acute effects of environmental exposures. Epidemiology 1999; 10(5): 539-544 https://doi.org/10.1097/00001648-199909000-00013
  37. Neas LN, Schwartz J, Dockery D. A casecrossover analysis of air pollution and mortality in Philadelphia. Environ Health Perspeet 1999; 107(8): 629-631 https://doi.org/10.1289/ehp.99107629
  38. Tsai SS. Huang CH. Goggins WB. Wu TN, Yang CY. Relationship between air pollution and daily mortality in a tropical city: Kaohsiung, Taiwan. J Toxicol Environ Health 2003; 66(14): 1341-1349 https://doi.org/10.1080/15287390306389
  39. Janes H, Sheppard L, Lumley T. Casecrossover analyses of air pollution exposure data: referent selection strategies and their implications for bias. Epidemiology 2005; 16(6): 717-726 https://doi.org/10.1097/01.ede.0000181315.18836.9d