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Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea
Jongmin Oh, Youn-Hee Lim, Changwoo Han, Dong-Wook Lee, Jisun Myung, Yun-Chul Hong, Soontae Kim, Hyun-Joo Bae
J Prev Med Public Health. 2024;57(2):185-196.   Published online March 29, 2024
DOI: https://doi.org/10.3961/jpmph.23.514
  • 2,229 View
  • 150 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Excess mortality associated with long-term exposure to fine particulate matter (PM2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM2.5 by considering the potential non-linear concentration–response relationship in Korea.
Methods
Daily cause-specific mortality rates and PM2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM2.5 concentrations below 15 μg/m3. Overall deaths attributable to short-term PM2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM2.5 exposure.
Results
Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM2.5. The estimated number of all-cause excess deaths due to short-term PM2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472).
Conclusions
Our findings indicate an association between short-term PM2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM2.5.
Summary
Korean summary
본 연구는 2010~2019년 한국의 초미세먼지 단기 노출로 인한 사망 부담을 추정하였으며 2010~2019년간, 초미세먼지 단기노출로 인한 전체원인 사망은 10,814명, 비사고 사망은 7,855명, 심혈관 사망은 1,642명, 호흡기 사망은 708명으로 추정하였다. 본 연구 결과는 대기오염 관리, 규제, 정책 수립에 있어 도움을 줄 것으로 예상한다.
Key Message
- We estimated mortality burden attributable to short-term exposure to PM 2.5 in Korea from 2010 to 2019 - Over the 10-years study period, the estimated excess deaths due to short-term exposure to PM 2.5 totaled 10,814 for all-causes, 7,855 for non-accidental, 1,642 for cardiovascular disease, and 708 for respiratory disease. - Our findings can assist in air pollution management, regulation, and policy-making.
The Association Between PM2.5 Exposure and Diabetes Mellitus Among Thai Army Personnel
Apisorn Laorattapong, Sarun Poobunjirdkul, Thanapoom Thanapoom, Wiroj Jiamjarasrangsi
J Prev Med Public Health. 2023;56(5):449-457.   Published online September 26, 2023
DOI: https://doi.org/10.3961/jpmph.23.292
  • 2,037 View
  • 123 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated the association between baseline exposures to particulate matter with a diameter < 2.5 microns (PM2.5) and subsequent temporal changes in PM2.5 exposure with the incidence of type 2 diabetes among Royal Thai Army personnel.
Methods
A retrospective cohort study was conducted using nationwide health check-up data from 21 325 Thai Army personnel between 2018 and 2021. Multilevel mixed-effects parametric survival statistics were utilized to analyze the relationship between baseline (i.e., PM2.5-baseline) and subsequent changes (i.e., PM2.5-change) in PM2.5 exposure and the occurrence of type 2 diabetes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were employed to assess this association while considering covariates.
Results
There was a significant association between both PM2.5 baseline and PM2.5-change and the incidence of type 2 diabetes in a dose-response manner. Compared to quartile 1, the HRs for quartiles 2 to 4 of PM2.5-baseline were 1.11 (95% CI, 0.74 to 1.65), 1.51 (95% CI, 1.00 to 2.28), and 1.77 (95% CI, 1.07 to 2.93), respectively. Similarly, the HRs for quartiles 2 to 4 of PM2.5-change were 1.41 (95% CI, 1.14 to 1.75), 1.43 (95% CI, 1.13 to 1.81) and 2.40 (95% CI, 1.84 to 3.14), respectively.
Conclusions
Our findings contribute to existing evidence regarding the association between short-term and long-term exposure to PM2.5 and the incidence of diabetes among personnel in the Royal Thai Army.
Summary
Key Message
We simultaneously investigated the impact of the baseline and temporal variations in the exposure to particulate matter (PM) with a diameter <2.5 microns (PM2.5) on type 2 diabetes risk among the Royal Thai Army personnel. We found stronger evidence on the impact of the temporal variation in PM2.5 exposure on the disease risk than that of the baseline variation. This finding may reflect the shorter time frame between the increased PM2.5 exposure and changes in fasting plasma glucose level.

Citations

Citations to this article as recorded by  
  • Influence of Air Pollution Exposures on Cardiometabolic Risk Factors: a Review
    Li-Hao Guo, Mohammed Zeeshan, Guo-Feng Huang, Duo-Hong Chen, Min Xie, Jun Liu, Guang-Hui Dong
    Current Environmental Health Reports.2023; 10(4): 501.     CrossRef
Trends in the Prevalence of Childhood Asthma in Seoul Metropolitan City, Korea: The Seoul Atopy ∙ Asthma-friendly School Project
Yong Min Cho, Chea-Bong Kim, Kyung Nam Yeon, Eun Sun Lee, KyooSang Kim
J Prev Med Public Health. 2018;51(6):275-280.   Published online October 8, 2018
DOI: https://doi.org/10.3961/jpmph.18.090
  • 7,975 View
  • 160 Download
  • 14 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
The project Seoul Atopy ∙ Asthma-friendly School investigated the current status of childhood asthma to enable formulation of a preventative policy. We evaluated the current prevalence of childhood asthma in Seoul and its trends and related factors.
Methods
The project was conducted annually from 2011 to 2016 and involved around 35 000 children aged 1-13 years. Based on the International Study of Asthma and Allergies in Childhood guidelines, the survey involved parents. The associations of the particulate matter (PM10) concentration, and the number of days on which the daily air quality guidance level was exceeded in the 25 districts of Seoul, with the prevalence of asthma were assessed.
Results
The age-standardized asthma prevalence in 2011 and 2016 was 6.74 and 4.02%, respectively. The prevalence of lifetime asthma treatment and treatment during the last 12 months tended to decrease from 2011 to 2016. Asthma treatment was significantly correlated with the number of days on which the daily air quality guidance level was exceeded, but not with the PM10 concentration.
Conclusions
This study reports the prevalence of asthma among children in Seoul and confirmed the relationship between childhood asthma and known risk factors in a large-scale survey.
Summary
Korean summary
서울시 아토피 천식 안심학교 사업을 통하여 2011년부터 2016년까지 약 25만명의 아동들을 대상으로 천식 유병률을 파악하고 관련 요인을 분석하였다. 천식의 연령표준화 유병률은 2011년 6.745에서 2016년 4.02%로 감소 추세를 보였다. 미세먼지(PM10)의 농도가 기준을 초과한 일수는 천식으로 인한 병원 치료 건 수와 상관성을 보였다.

Citations

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The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study
Motoyuki Nakao, Yoko Ishihara, Cheol-Hong Kim, In-Gyu Hyun
J Prev Med Public Health. 2018;51(3):130-139.   Published online May 9, 2018
DOI: https://doi.org/10.3961/jpmph.18.021
  • 9,306 View
  • 250 Download
  • 29 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Air pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea.
Methods
Patients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL.
Results
Lower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than 10 μm in diameter (PM10). Lower social functioning scores were associated with high PM less than 2.5 μm in diameter and nitrogen dioxide (NO2) concentrations. High NO2 concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when PM10, NO2, or ozone (O3) concentrations were high, regardless of COPD severity. High PM10 concentrations were associated with worsened wheezing, particularly in COPD patients.
Conclusions
The results suggest that PM, NO2, and O3 cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.
Summary

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Review
Short-term Effect of Fine Particulate Matter on Children’s Hospital Admissions and Emergency Department Visits for Asthma: A Systematic Review and Meta-analysis
Hyungryul Lim, Ho-Jang Kwon, Ji-Ae Lim, Jong Hyuk Choi, Mina Ha, Seung-Sik Hwang, Won-Jun Choi
J Prev Med Public Health. 2016;49(4):205-219.   Published online July 14, 2016
DOI: https://doi.org/10.3961/jpmph.16.037
  • 15,259 View
  • 291 Download
  • 55 Crossref
AbstractAbstract PDF
Objectives
No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter (PM2.5) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies.
Methods
Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger’s test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3.
Results
We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of PM2.5 on children’s hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children’s hospital admissions and emergency department visits for asthma were positively associated with a short-term 10 μg/m3 increase in PM2.5 (relative risk, 1.048; 95% CI, 1.028 to 1.067; I2=95.7%). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe.
Conclusions
We strengthened the evidence on the short-term effect of PM2.5 on children’s hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.
Summary

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Original Article
Physical Activity- and Alcohol-dependent Association Between Air Pollution Exposure and Elevated Liver Enzyme Levels: An Elderly Panel Study
Kyoung-Nam Kim, Hyemi Lee, Jin Hee Kim, Kweon Jung, Youn-Hee Lim, Yun-Chul Hong
J Prev Med Public Health. 2015;48(3):151-169.   Published online May 15, 2015
DOI: https://doi.org/10.3961/jpmph.15.014
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  • 47 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The deleterious effects of air pollution on various health outcomes have been demonstrated. However, few studies have examined the effects of air pollution on liver enzyme levels.
Methods
Blood samples were drawn up to three times between 2008 and 2010 from 545 elderly individuals who regularly visited a community welfare center in Seoul, Korea. Data regarding ambient air pollutants (particulate matter ≤2.5 μm [PM2.5], nitrogen dioxide [NO2], ozone [O3], carbon monoxide, and sulfur dioxide) from monitoring stations were used to estimate air pollution exposure. The effects of the air pollutants on the concentrations of three liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and γ-glutamyltranspeptidase [γ-GTP)]) were evaluated using generalized additive and linear mixed models.
Results
Interquartile range increases in the concentrations of the pollutants showed significant associations of PM2.5 with AST (3.0% increase, p=0.0052), ALT (3.2% increase, p=0.0313), and γ-GTP (5.0% increase, p=0.0051) levels; NO2 with AST (3.5% increase, p=0.0060) and ALT (3.8% increase, p=0.0179) levels; and O3 with γ-GTP (5.3% increase, p=0.0324) levels. Significant modification of these effects by exercise and alcohol consumption was found (p for interaction <0.05). The effects of air pollutants were greater in non-exercisers and heavy drinkers.
Conclusions
Short-term exposure to air pollutants such as PM2.5, NO2, and O3 is associated with increased liver enzyme levels in the elderly. These adverse effects can be reduced by exercising regularly and abstinence from alcohol.
Summary

Citations

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Special Article
Environmental Source of Arsenic Exposure
Jin-Yong Chung, Seung-Do Yu, Young-Seoub Hong
J Prev Med Public Health. 2014;47(5):253-257.   Published online September 11, 2014
DOI: https://doi.org/10.3961/jpmph.14.036
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AbstractAbstract PDF
Arsenic is a ubiquitous, naturally occurring metalloid that may be a significant risk factor for cancer after exposure to contaminated drinking water, cigarettes, foods, industry, occupational environment, and air. Among the various routes of arsenic exposure, drinking water is the largest source of arsenic poisoning worldwide. Arsenic exposure from ingested foods usually comes from food crops grown in arsenic-contaminated soil and/or irrigated with arsenic-contaminated water. According to a recent World Health Organization report, arsenic from contaminated water can be quickly and easily absorbed and depending on its metabolic form, may adversely affect human health. Recently, the US Food and Drug Administration regulations for metals found in cosmetics to protect consumers against contaminations deemed deleterious to health; some cosmetics were found to contain a variety of chemicals including heavy metals, which are sometimes used as preservatives. Moreover, developing countries tend to have a growing number of industrial factories that unfortunately, harm the environment, especially in cities where industrial and vehicle emissions, as well as household activities, cause serious air pollution. Air is also an important source of arsenic exposure in areas with industrial activity. The presence of arsenic in airborne particulate matter is considered a risk for certain diseases. Taken together, various potential pathways of arsenic exposure seem to affect humans adversely, and future efforts to reduce arsenic exposure caused by environmental factors should be made.
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Original Article
Prenatal Exposure to PM10 and Preterm Birth between 1998 and 2000 in Seoul, Korea.
Eun Hee Ha, Bo Eun Lee, Hye Sook Park, Yun Sang Kim, Ho Kim, Young Ju Kim, Yun Chul Hong, Eun Ae Park
J Prev Med Public Health. 2004;37(4):300-305.   Published online November 30, 2004
  • 2,403 View
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AbstractAbstract PDF
OBJECTIVES
The exposure to particulate air pollution during the pregnancy has reported to result in adverse pregnancy outcome such as low birth weight, preterm birth, still birth, and intrauterine growth retardation (IUGR). We aim to assess whether prenatal exposure of particulate matter less than 10 (m in diameter (PM10) is associated with preterm birth in Seoul, South Korea. METHODS: We included 382, 100 women who delivered a singleton at 25-42 weeks of gestation between 1998 and 2000. We calculated the average PM10 exposures for each trimester period and month of pregnancy, from the first to the ninth months, based on the birth date and gestational age. We used three different models to evaluate the effect of air pollution on preterm birth; the logistic regression model, the generalized additive logistic regression model, and the proportional hazard model. RESULTS: The monthly analysis using logistic regression model suggested that the risks of preterm birth increase with PM10 exposure between the sixth and ninth months of pregnancy and the highest risk was observed in the seventh month (adjusted odds ratio=1.07, 95% CI=1.01- 1.14). We also found the similar results using generalized additive model. In the proportional hazard model, the adjusted odds ratio for preterm births due to PM10 exposure of third trimester was 1.04 (95% CI=0.96-1.13) and PM10 exposure between the seventh month and ninth months of pregnancy was associated with the preterm births. CONCLUSIONS: We found that there were consistent results when we applied the three different models. These findings suggest that air pollution exposure during the third trimester pregnancy has an adverse effect on preterm birth in South Korea.
Summary
English Abstract
Effects of the Severe Asian Dust Events on Daily Mortality during the Spring of 2002, in Seoul, Korea.
Seung Sik Hwang, Soo Hun Cho, Ho Jang Kwon
J Prev Med Public Health. 2005;38(2):197-202.
  • 2,392 View
  • 57 Download
AbstractAbstract PDF
OBJECTIVES
During the spring of 2002, an unprecedented 2 Asian dust events were experienced in Seoul. On those days, the PM10 was surprisingly increased, with daily PM10 averages exceeding 600 and 700 microgram/m3 on March 21 and April 8, respectively. Accordingly, public concern relating to the possible adverse health effects of these dust events has increased, as the dust arrives in Korea after having flown over heavily industrialized eastern China. We investigated the effects of these Asian dust events on the mortality during the spring of 2002, in Seoul, Korea. METHODS: The total number of deaths per day during the spring of 2002 in Seoul was extracted form the mortality records of the National Statistical Office. We constructed 14 Asian dust days (March 17-March 23, April 7-April 13) and 42 control days during the 56 day study period (March 3-April 27) with respect to the days of the week. The daily average numbers of deaths between the Asian dust and control days were analyzed, with adjustment for meteorological variables and pollutants. RESULTS: The daily PM10 average during the Asian dust weeks was 295.2 microgram/m3, which was significantly higher than during the control days (P< 0.001). The daily average number of deaths from all causes during the Asian dust days was 109.9; 65.6 for those aged 65 years and older, 6.7 from respiratory causes (J00-J99) and 25.6 from cardiovascular causes (I00-I99). The estimated percentage increases in the rate of deaths were 2.5% (95% CI=-5.0- 10.6) from all causes; 2.2% (95% CI=-7.4-12.8) for those aged 65 years and older, and 36.5% (95% CI=0.7-85.0) from respiratory causes, but with a 6.1% (95% CI=-19.7- 9.7) decrease in deaths from cardiovascular causes. CONCLUSION: The Asian dust events were found to be weakly associated with the risk of death from all causes. However, the association between dust events and deaths from respiratory causes was stronger. This suggests that persons with advanced respiratory diseases may be susceptible to Asian dust events.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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