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Original Articles
Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea
Hyunmee Kim, Woojin Kim, Jee eun Choi, Changsoo Kim, Jungwoo Sohn
J Prev Med Public Health. 2018;51(6):265-274.   Published online October 29, 2018
DOI: https://doi.org/10.3961/jpmph.18.153
  • 6,398 View
  • 234 Download
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than 10 μm in aerodynamic diameter, nitrogen dioxide [NO2], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009.
Methods
The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants.
Results
Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of NO2 was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of NO2 at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291).
Conclusions
The results of our study suggest that ambient air pollution, specifically NO2, is associated with ED visits for diabetic coma.
Summary
Korean summary
본 연구에서는 대기오염물질의 단기적인 영향을 확인하기 위하여 당뇨병성 혼수로 인한 응급실 내원을 시계열적으로 분석하였다. 분석 결과 이산화질소 상승이 노출 1일 후의 응급실 방문을 1.25% 상승시켰다(RR, 1.125; 95% CI 1.039-1.219). 또한, 노출 3일 후까지 누적 결과도 유의한 상관관계를 보였다(RR 1.092; 95% CI, 1.005-1.186).

Citations

Citations to this article as recorded by  
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    Atmospheric Environment.2021; 244: 117907.     CrossRef
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    Ling Chao, Mengxue Lu, Zhen An, Juan Li, Yuchun Li, Qian Zhao, Yinbiao Wang, Yue Liu, Weidong Wu, Jie Song
    Environmental Geochemistry and Health.2021; 43(9): 1.     CrossRef
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    Abhishek Dutta, Wanida Jinsart
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Short-term Effects of Ambient Air Pollution on Emergency Department Visits for Asthma: An Assessment of Effect Modification by Prior Allergic Disease History
Juhwan Noh, Jungwoo Sohn, Jaelim Cho, Seong-Kyung Cho, Yoon Jung Choi, Changsoo Kim, Dong Chun Shin
J Prev Med Public Health. 2016;49(5):329-341.   Published online September 8, 2016
DOI: https://doi.org/10.3961/jpmph.16.038
  • 9,929 View
  • 242 Download
  • 29 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients’ prior history of allergic diseases.
Methods
Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [NO2], ozone [O3], sulfur dioxide [SO2], and particulate matter with an aerodynamic diameter <10 μm [PM10]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season.
Results
A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in O3 concentration. IQR changes in NO2 and PM10 concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in PM10 concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history.
Conclusions
Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.
Summary

Citations

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    Monika Ścibor, Bartosz Balcerzak, Andrzej Galbarczyk, Grazyna Jasienska
    International Journal of Environmental Research and Public Health.2022; 19(8): 4852.     CrossRef
  • Spatial autocorrelation may bias the risk estimation: An application of eigenvector spatial filtering on the risk of air pollutant on asthma
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    Science of The Total Environment.2022; 843: 157053.     CrossRef
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Medical Care Expenditure in Suicides From Non-illness-related Causes
Jungwoo Sohn, Jaelim Cho, Ki Tae Moon, Mina Suh, Kyoung Hwa Ha, Changsoo Kim, Dong Chun Shin, Sang Hyuk Jung
J Prev Med Public Health. 2014;47(6):327-335.   Published online November 4, 2014
DOI: https://doi.org/10.3961/jpmph.14.038
  • 9,375 View
  • 91 Download
  • 2 Crossref
AbstractAbstract PDF
Objectives
Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated.
Methods
Suicides motivated by non-illness-related factors were identified using the investigator’s note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status.
Results
Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women.
Conclusions
Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.
Summary

Citations

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  • Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence
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Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses
Jaelim Cho, Won Joon Lee, Ki Tae Moon, Mina Suh, Jungwoo Sohn, Kyoung Hwa Ha, Changsoo Kim, Dong Chun Shin, Sang Hyuk Jung
J Prev Med Public Health. 2013;46(3):147-154.   Published online May 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.3.147
  • 9,695 View
  • 95 Download
  • 20 Crossref
AbstractAbstract PDF
Objectives

Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses.

Methods

Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status.

Results

Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p=0.021) after adjustment for residence, socioeconomic status, and morbidity.

Conclusions

Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

Summary

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