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Climate Change: Original Article
Association Between Air Conditioning Use and Self-reported Symptoms During the 2018 Heat Wave in Korea
Yong-Han Lee, Sanghyuk Bae, Seung-sik Hwang, Jong-Hun Kim, Kyoung-Nam Kim, Youn-Hee Lim, Miji Kim, Sohwa Jung, Ho-Jang Kwon
J Prev Med Public Health. 2020;53(1):15-25.   Published online November 26, 2019
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  • 223 Download
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
The purpose of this study was to investigate the health effects of air conditioning use during the 2018 heat wave in Korea, included the highest temperature ever recorded in the nation.
The participants in this study were 1000 adults aged 19 years and older recruited from across Korea. The participants were asked about their experience of symptoms of various diseases, disruptions of their daily lives, and use of air conditioning during the heat wave. The associations between air conditioning use during the heat wave and health outcomes were analyzed using the chi-square test and multiple logistic regression models.
Among participants who lacked air conditioning in the main space where they spent time outside the home, 33.9%, 8.1%, 43.5%, and 19.4% experienced symptoms of heat-related, cardiovascular, nervous system diseases, and air-conditioningitis, respectively. In comparison, participants who did have air conditioning outside the home experienced the same symptoms at proportions of 21.0%, 1.9%, 26.8%, and 34.2%, respectively (p=0.027, 0.007, 0.007, and 0.023, respectively). Among participants who had no air conditioner at home, 10.0% were absent from school or work due to the heat wave. In contrast, among participants who had an air conditioner at home, only 3.7% were absent as a result of the heat wave (p=0.007).
When air conditioning was not used at home or in the main space where participants spent time outside the home during the 2018 heat wave, adverse health effects were more prevalent, but the risk of air-conditioningitis was reduced.
Korean summary
본 연구는 한국 기상관측사상 가장 더웠던 2018년 한국의 폭염 기간 동안, 에어컨 사용이 건강에 미치는 영향에 대해 조사하였다. 가정 외 주 생활공간에 에어컨이 가동되지 않거나 가정에 에어컨이 없으면 폭염 기간 동안의 건강 및 일상생활에 좋지 않은 영향을 줄 수 있으나, 냉방병 위험은 낮아질 수 있다.


Citations to this article as recorded by  
  • Integration and Optimal Control of MicroCSP with Building HVAC Systems: Review and Future Directions
    Mohamed Toub, Chethan R. Reddy, Rush D. Robinett, Mahdi Shahbakhti
    Energies.2021; 14(3): 730.     CrossRef
  • Climate Change and Health: More Research Is Still Needed
    Ho-Jang Kwon
    Journal of Preventive Medicine and Public Health.2020; 53(1): 1.     CrossRef
Original Articles
The Effects of Temperature on Heat-related Illness According to the Characteristics of Patients During the Summer of 2012 in the Republic of Korea
Wonwoong Na, Jae-Yeon Jang, Kyung Eun Lee, Hyunyoung Kim, Byungyool Jun, Jun-Wook Kwon, Soo-Nam Jo
J Prev Med Public Health. 2013;46(1):19-27.   Published online January 31, 2013
  • 11,375 View
  • 116 Download
  • 29 Crossref
AbstractAbstract PDF

This study was conducted to investigate the relationship between heat-related illnesses developed in the summer of 2012 and temperature.


The study analyzed data generated by a heat wave surveillance system operated by the Korea Centers for Disease Control and Prevention during the summer of 2012. The daily maximum temperature, average temperature, and maximum heat index were compared to identify the most suitable index for this study. A piecewise linear model was used to identify the threshold temperature and the relative risk (RR) above the threshold temperature according to patient characteristics and region.


The total number of patients during the 3 months was 975. Of the three temperature indicators, the daily maximum temperature showed the best goodness of fit with the model. The RR of the total patient incidence was 1.691 (1.641 to 1.743) per 1℃ after 31.2℃. The RR above the threshold temperature of women (1.822, 1.716 to 1.934) was greater than that of men (1.643, 1.587 to 1.701). The threshold temperature was the lowest in the age group of 20 to 64 (30.4℃), and the RR was the highest in the ≥65 age group (1.863, 1.755 to 1.978). The threshold temperature of the provinces (30.5℃) was lower than that of the metropolitan cities (32.2℃). Metropolitan cities at higher latitudes had a greater RR than other cities at lower latitudes.


The influences of temperature on heat-related illnesses vary according to gender, age, and region. A surveillance system and public health program should reflect these factors in their implementation.



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    Scientific Reports.2018;[Epub]     CrossRef
  • Effect of Socioeconomic Status and Underlying Disease on the Association between Ambient Temperature and Ischemic Stroke
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    Yonsei Medical Journal.2018; 59(5): 686.     CrossRef
  • Heatwave and health impact research: A global review
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    Health & Place.2018; 53: 210.     CrossRef
  • Short-term effect of heat waves on hospital admissions in Madrid: Analysis by gender and comparision with previous findings
    J. Díaz, I.A. López, R. Carmona, I.J. Mirón, M.Y. Luna, C. Linares
    Environmental Pollution.2018; 243: 1648.     CrossRef
  • Factors affecting heat-related diseases in outdoor workers exposed to extreme heat
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  • Current and Projected Burden of Disease From High Ambient Temperature in Korea
    Soo Eun Chung, Hae-Kwan Cheong, Jae-Hyun Park, Jong-Hun Kim, Hyunjin Han
    Epidemiology.2017; 28: S98.     CrossRef
  • Heat-related illness in China, summer of 2013
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    Telemedicine and e-Health.2014; 20(3): 272.     CrossRef
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    Environmental Research.2014; 132: 212.     CrossRef
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Summertime Heat Waves and Ozone : an Interaction on Cardiopulmonary Mortality? - Based on the 1994 Heat Wave in Korea -.
Joohon Sung, Ho Kim, Soo Hun Cho
Korean J Prev Med. 2001;34(4):316-322.
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  • 23 Download
AbstractAbstract PDF
To explore the possible effect of an interaction between summertime heat waves and ozone on cardiopulmonary mortality during the 1994 heat wave in Korea. METHODS: The unusually hot summer of 1994 in Korea was defined as the heat wave in this study. We examined the associations of air pollutants with daily cardiopulmonary deaths between 1991-1995, considering the product term of the heat wave and each pollutant, weather and time trends. RESULTS: During the heat wave, while temperatures were uniformly higher than those of other summers, the within-heat-wave difference in mortality paralleled that in the regional ozone levels. In terms of the influence of the heat wave, the results of ozone were different to those of total suspended particles (TSP) and sulfur dioxide (SO2). The ozone association (relative risk (RR) =1.036; 95% confidence interval (CI) = 1.018-1.054) was observed only under heat wave conditions, while the TSP (RR =1.006, 95% CI = 0.999-1.012) and the SO2 (RR =1.018, 95% CI = 1.011-1.024) associations were found under normal weather conditions (per interquartile increase of each pollutant; results of three pollutants model). The ozone association under heat wave was attributable to the statistical interaction between the heat wave and ozone. CONCLUSIONS: These results support the possibility of a biological synergy between the heat wave and ozone, one that is not evident between the heat wave and other major pollutants like particles or SO2.
Comparative Study
The Impact of High Apparent Temperature on the Increase of Summertime Disease-related Mortality in Seoul: 1991-2000.
Gwang yong Choi, Jong nam Choi, Ho Jang Kwon
J Prev Med Public Health. 2005;38(3):283-290.
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  • 67 Download
AbstractAbstract PDF
The aim of this paper was to examine the relationship between the summertime (June to August) heat index, which quantifies the bioclimatic apparent temperature in sultry weather, and the daily disease-related mortality in Seoul for the period from 1991 to 2000. METHODS: The daily maximum (or minimum) summertime heat indices, which show synergetic apparent temperatures, were calculated from the six hourly temperatures and real time humidity data for Seoul from 1991 to 2000. The disease-related daily mortality was extracted with respect to types of disease, age and sex, etc. and compared with the time series of the daily heat indices. RESULTS: The summertime mortality in 1994 exceeded the normal by 626 persons. Specifically, blood circulation-related and cancer-related mortalities increased in 1994 by 29.7% (224 persons) and 15.4% (107 persons), respectively, compared with those in 1993. Elderly persons, those above 65 years, were shown to be highly susceptible to strong heat waves, whereas the other age and sex-based groups showed no significant difference in mortality. In particular, a heat wave episode on the 22nd of July 2004 (> 45 degree C daily heat index) resulted in double the normal number of mortalities after a lag time of 3 days. Specifically, blood circulation-related mortalities, such as cerebral infraction, were predominant causes. Overall, a critical mortality threshold was reached when the heat index exceeded approximately 37 degrees C, which corresponds to human body temperature. A linear regression model based on the heat indices above 37 degrees C, with a 3 day lag time, accounted for 63% of the abnormally increased mortality (> or = +2 standard deviations). CONCLUSIONS: This study revealed that elderly persons, those over 65 years old, are more vulnerable to mortality due to abnormal heat waves in Seoul, Korea. When the daily maximum heat index exceeds approximately 37 degrees C, blood circulation-related mortality significantly increases. A linear regression model, with respect to lag-time, showed that the heat index based on a human model is a more dependable indicator for the prediction of hot weatherrelated mortality than the ambient air temperature.

JPMPH : Journal of Preventive Medicine and Public Health