Journal of Preventive Medicine and Public Health

Original Articles

Estimating Influenza-associated Mortality in Korea: The 2009-2016 Seasons: Kwan Hong, Sangho Sohn, Byung Chul Chun; J Prev Med Public Health. 2019;52(5):308-315. Published online August 23, 2019; DOI: https://doi.org/10.3961/jpmph.19.156

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Objectives
Estimating influenza-associated mortality is important since seasonal influenza affects persons of all ages, causing severe illness or death. This study aimed to estimate influenza-associated mortality, considering both periodic changes and age-specific mortality by influenza subtypes.
Methods
Using the Microdata Integrated Service from Statistics Korea, we collected weekly mortality data including cause of death. Laboratory surveillance data of respiratory viruses from 2009 to 2016 were obtained from the Korea Centers for Disease Control and Prevention. After adjusting for the annual age-specific population size, we used a negative binomial regression model by age group and influenza subtype.
Results
Overall, 1 859 890 deaths were observed and the average rate of influenza virus positivity was 14.7% (standard deviation [SD], 5.8), with the following subtype distribution: A(H1N1), 5.0% (SD, 5.8); A(H3N2), 4.4% (SD, 3.4); and B, 5.3% (SD, 3.7). As a result, among individuals under 65 years old, 6774 (0.51%) all-cause deaths, 2521 (3.05%) respiratory or circulatory deaths, and 1048 (18.23%) influenza or pneumonia deaths were estimated. Among those 65 years of age or older, 30 414 (2.27%) all-cause deaths, 16 411 (3.42%) respiratory or circulatory deaths, and 4906 (6.87%) influenza or pneumonia deaths were estimated. Influenza A(H3N2) virus was the major contributor to influenza-associated all-cause and respiratory or circulatory deaths in both age groups. However, influenza A(H1N1) virus–associated influenza or pneumonia deaths were more common in those under 65 years old.
Conclusions
Influenza-associated mortality was substantial during this period, especially in the elderly. By subtype, influenza A(H3N2) virus made the largest contribution to influenza-associated mortality.

Summary

Korean summary
계절 인플루엔자는 심각한 호흡기 합병증으로 진행할 수 있어 질병 부담의 추산이 중요한 질병이다. 현재까지는 연령별, 인플루엔자 연관 사망을 정확하게 추산하기 어려웠으나, 본 연구에서는 이를 추산하기 위해 고안된 다양한 방법 중 음이항 회귀 분석을 이용하여 2009년부터 2016년간 인플루엔자 아형별 연관 사망을 추산하였다. 그 결과, 전체 사망자 중 65세 미만에서 약 6,774명, 65세 이상에서 약 30,414명의 연간 인플루엔자 사망이 추산되었고, 이는 특히 인플루엔자 아형 중 전체 연령에서 A(H3N2) 연관 사망이 가장 많은 비율을 차지했다.

Citations

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‘Pneumonia Weather’: Short-term Effects of Meteorological Factors on Emergency Room Visits Due to Pneumonia in Seoul, Korea: Sangho Sohn, Wonju Cho, Jin A Kim, Alaa Altaluoni, Kwan Hong, Byung Chul Chun; J Prev Med Public Health. 2019;52(2):82-91. Published online February 11, 2019; DOI: https://doi.org/10.3961/jpmph.18.232

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216 Download
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Abstract Summary PDF

Objectives
Many studies have explored the relationship between short-term weather and its health effects (including pneumonia) based on mortality, although both morbidity and mortality pose a substantial burden. In this study, the authors aimed to describe the influence of meteorological factors on the number of emergency room (ER) visits due to pneumonia in Seoul, Korea.
Methods
Daily records of ER visits for pneumonia over a 6-year period (2009-2014) were collected from the National Emergency Department Information System. Corresponding meteorological data were obtained from the National Climate Data Service System. A generalized additive model was used to analyze the effects. The percent change in the relative risk of certain meteorological variables, including pneumonia temperature (defined as the change in average temperature from one day to the next), were estimated for specific age groups.
Results
A total of 217 776 ER visits for pneumonia were identified. The additional risk associated with a 1°C increase in pneumonia temperature above the threshold of 6°C was 1.89 (95% confidence interval [CI], 1.37 to 2.61). Average temperature and diurnal temperature range, representing within-day temperature variance, showed protective effects of 0.07 (95% CI, 0.92 to 0.93) and 0.04 (95% CI, 0.94 to 0.98), respectively. However, in the elderly (65+ years), the effect of pneumonia temperature was inconclusive, and the directionality of the effects of average temperature and diurnal temperature range differed.
Conclusions
The term ‘pneumonia temperature’ is valid. Pneumonia temperature was associated with an increased risk of ER visits for pneumonia, while warm average temperatures and large diurnal temperature ranges showed protective effects.

Summary

Korean summary
본 연구에서는 기온 등 다양한 기상요인의 건강영향을 나타내는 표현 중 하나로 알려진 'pneumonia weather'가 역학적으로 가진 의미를 파악하고자 하였다. 이를 위해 국가응급진료정보망의 폐렴 진료기록과 기상자료개방포털 일기자료를 일반화가법모형을 이용해 분석하였다. 그 결과 pneumonia weather는 연속된 양일간 평균기온의 차이를 의미하며, 일정 수준 이상의 일간 기온차는 단기간 이후 폐렴으로 인한 응급실 내원 위험을 증가시킨다는 사실을 확인하였다.

Citations

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