Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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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

  • Noh, Juhwan (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Sohn, Jungwoo (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Cho, Jaelim (Department of Occupational and Environmental Medicine, Gachon University Gil Hospital) ;
  • Cho, Seong-Kyung (Department of Medical Informatics and Biostatistics, Yonsei University College of Medicine) ;
  • Choi, Yoon Jung (Health Insurance Review and Assessment Service) ;
  • Kim, Changsoo (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Shin, Dong Chun (Department of Preventive Medicine, Yonsei University College of Medicine)
  • Received : 2016.04.09
  • Accepted : 2016.09.08
  • Published : 2016.09.30
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Abstract

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 [$NO_2$], ozone [$O_3$], sulfur dioxide [$SO_2$], and particulate matter with an aerodynamic diameter <$10{\mu}m$ [$PM_{10}$]), 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 $O_3$ concentration. IQR changes in $NO_2$ and $PM_{10}$ 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 $PM_{10}$ 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.

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References

  1. Oh IH, Yoon SJ, Kim EJ. The burden of disease in Korea. J Korean Med Assoc 2011;54(6):646-652 (Korean). https://doi.org/10.5124/jkma.2011.54.6.646
  2. OECD. Health at a glance 2013: OECD indicators [cited 2016 Sep 16]. Available from: http://apps.who.int/medicinedocs/documents/s21725en/s21725en.pdf.
  3. Korean Academy of Asthma, Allergy and Clinical Immunology; Korean Academy of Pediatric Allergy and Respiratory Disease; National Strategic Coordinating Center for Clinical Research. Korean guideline for asthma; 2015 [cited 2016 Sep 16]. Available from: http://www.allergy.or.kr/file/150527_01.pdf.
  4. Kim SY, Jung JY, Park MS, Kang YA, Kim EY, Kim SK, et al. Increased prevalence of self-reported asthma among Korean adults: an analysis of KNHANES I and IV data. Lung 2013; 191(3):281-288. https://doi.org/10.1007/s00408-013-9453-9
  5. Clark NA, Demers PA, Karr CJ, Koehoorn M, Lencar C, Tamburic L, et al. Effect of early life exposure to air pollution on development of childhood asthma. Environ Health Perspect 2010; 118(2):284-290. https://doi.org/10.1289/ehp.0900916
  6. Jacquemin B, Sunyer J, Forsberg B, Aguilera I, Briggs D, García-Esteban R, et al. Home outdoor NO2 and new onset of self-reported asthma in adults. Epidemiology 2009;20(1):119-126. https://doi.org/10.1097/EDE.0b013e3181886e76
  7. Jerrett M, Shankardass K, Berhane K, Gauderman WJ, Künzli N, Avol E, et al. Traffic-related air pollution and asthma onset in children: a prospective cohort study with individual exposure measurement. Environ Health Perspect 2008;116(10):1433-1438. https://doi.org/10.1289/ehp.10968
  8. Bowatte G, Lodge C, Lowe AJ, Erbas B, Perret J, Abramson MJ, et al. The influence of childhood traffic-related air pollution exposure on asthma, allergy and sensitization: a systematic review and a meta-analysis of birth cohort studies. Allergy 2015;70(3):245-256. https://doi.org/10.1111/all.12561
  9. Peden D. Air pollution and asthma. In: Nadadur SS, Hollingsworth JW, editors. Air pollution and health effects. Heidelberg: Humana Press; 2015, p. 93-117.
  10. Weinmayr G, Romeo E, De Sario M, Weiland SK, Forastiere F. Short-term effects of PM10 and NO2 on respiratory health among children with asthma or asthma-like symptoms: a systematic review and meta-analysis. Environ Health Perspect 2010;118(4):449-457. https://doi.org/10.1289/ehp.0900844
  11. Schildcrout JS, Sheppard L, Lumley T, Slaughter JC, Koenig JQ, Shapiro GG. Ambient air pollution and asthma exacerbations in children: an eight-city analysis. Am J Epidemiol 2006; 164(6):505-517. https://doi.org/10.1093/aje/kwj225
  12. Slaughter JC, Lumley T, Sheppard L, Koenig JQ, Shapiro GG. Effects of ambient air pollution on symptom severity and medication use in children with asthma. Ann Allergy Asthma Immunol 2003;91(4):346-353. https://doi.org/10.1016/S1081-1206(10)61681-X
  13. Gent JF, Triche EW, Holford TR, Belanger K, Bracken MB, Beckett WS, et al. Association of low-level ozone and fine particles with respiratory symptoms in children with asthma. JAMA 2003;290(14):1859-1867. https://doi.org/10.1001/jama.290.14.1859
  14. Bantz SK, Zhu Z, Zheng T. The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma. J Clin Cell Immunol 2014;5(2):202.
  15. Oh JW, Kim JH, Chang YS, Sohn KT. Development of binary forecast models of asthma exacerbation: asthma index. Eur Respir J 2014;44(Suppl 58):P4056.
  16. Hastie T, Tibshirani R. Generalized additive models. London: Chapman and Hall; 1990, p. 82-103.
  17. Wood SN. Generalized additive models : an introduction with R. Boca Raton: CRC Press; 2006, p.121-140.
  18. Qiu H, Yu IT, Tian L, Wang X, Tse LA, Tam W, et al. Effects of coarse particulate matter on emergency hospital admissions for respiratory diseases: a time-series analysis in Hong Kong. Environ Health Perspect 2012;120(4):572-576. https://doi.org/10.1289/ehp.1104002
  19. Curriero FC, Heiner KS, Samet JM, Zeger SL, Strug L, Patz JA. Temperature and mortality in 11 cities of the eastern United States. Am J Epidemiol 2002;155(1):80-87. https://doi.org/10.1093/aje/155.1.80
  20. Altman DG, Bland JM. Interaction revisited: the difference between two estimates. BMJ 2003;326(7382):219. https://doi.org/10.1136/bmj.326.7382.219
  21. Kim J, Kim H, Kweon J. Hourly differences in air pollution on the risk of asthma exacerbation. Environ Pollut 2015;203:15-21. https://doi.org/10.1016/j.envpol.2015.03.040
  22. Strickland MJ, Klein M, Flanders WD, Chang HH, Mulholland JA, Tolbert PE, et al. Modification of the effect of ambient air pollution on pediatric asthma emergency visits: susceptible subpopulations. Epidemiology 2014;25(6):843-850. https://doi.org/10.1097/EDE.0000000000000170
  23. Burra TA, Moineddin R, Agha MM, Glazier RH. Social disadvantage, air pollution, and asthma physician visits in Toronto, Canada. Environ Res 2009;109(5):567-574. https://doi.org/10.1016/j.envres.2009.03.004
  24. Lavigne E, Villeneuve PJ, Cakmak S. Air pollution and emergency department visits for asthma in Windsor, Canada. Can J Public Health 2012;103(1):4-8.
  25. Clougherty JE. A growing role for gender analysis in air pollution epidemiology. Environ Health Perspect 2010;118(2):167-176. https://doi.org/10.1289/ehp.0900994
  26. Becklake MR, Kauffmann F. Gender differences in airway behaviour over the human life span. Thorax 1999;54(12):1119-1138. https://doi.org/10.1136/thx.54.12.1119
  27. Zheng XY, Ding H, Jiang LN, Chen SW, Zheng JP, Qiu M, et al. Association between air pollutants and asthma emergency room visits and hospital admissions in time series studies: a systematic review and meta-analysis. PLoS One 2015;10(9): e0138146. https://doi.org/10.1371/journal.pone.0138146
  28. Stieb DM, Szyszkowicz M, Rowe BH, Leech JA. Air pollution and emergency department visits for cardiac and respiratory conditions: a multi-city time-series analysis. Environ Health 2009;8:25. https://doi.org/10.1186/1476-069X-8-25
  29. Yi O, Hong YC, Kim H. Seasonal effect of PM(10) concentrations on mortality and morbidity in Seoul, Korea: a temperature- matched case-crossover analysis. Environ Res 2010; 110(1):89-95. https://doi.org/10.1016/j.envres.2009.09.009
  30. Son JY, Lee JT, Park YH, Bell ML. Short-term effects of air pollution on hospital admissions in Korea. Epidemiology 2013; 24(4):545-554. https://doi.org/10.1097/EDE.0b013e3182953244
  31. Kim C, Jung SH, Kang DR, Kim HC, Moon KT, Hur NW, et al. Ambient particulate matter as a risk factor for suicide. Am J Psychiatry 2010;167(9):1100-1107. https://doi.org/10.1176/appi.ajp.2010.09050706
  32. Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol 2013;132(5):1132-1138. https://doi.org/10.1016/j.jaci.2013.08.031
  33. Martin PE, Matheson MC, Gurrin L, Burgess JA, Osborne N, Lowe AJ, et al. Childhood eczema and rhinitis predict atopic but not nonatopic adult asthma: a prospective cohort study over 4 decades. J Allergy Clin Immunol 2011;127(6):1473-1479.e1. https://doi.org/10.1016/j.jaci.2011.02.041
  34. Kim SY, Kim H, Kim J. Effects of air pollution on asthma in Seoul: comparisons across subject characteristics. J Prev Med Public Health 2006;39(4):309-316 (Korean).
  35. 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).
  36. 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).
  37. Lee JT, Kim H, Song H, Hong YC, Cho YS, Shin SY, et al. Air pollution and asthma among children in Seoul, Korea. Epidemiology 2002;13(4):481-484. https://doi.org/10.1097/00001648-200207000-00018
  38. Winquist A, Kirrane E, Klein M, Strickland M, Darrow LA, Sarnat SE, et al. Joint effects of ambient air pollutants on pediatric asthma emergency department visits in Atlanta, 1998-2004. Epidemiology 2014;25(5):666-673. https://doi.org/10.1097/EDE.0000000000000146

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