• 한국대기환경학회지
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• 제22권5호
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• pp.554-563
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• 2006

Numerous epidemiological studies have shown stronger associations between $PM_{2.5}$ and both mortality and morbidity than $PM_{10}$. The association of $PM_{2.5}$ with respiratory mortality was examined in Seoul, during the period of $1996{\sim}2002$. Because $PM_{2.5}$ data were available for only 10% of this time period, a prediction regression model was developed to estimate $PM_{2.5}$ concentration. Death count due to respiratory-related diseases(total respiratory mortality; ICD-10, J00-J98) and death counts(cause-specific mortality) due to pneumonia(ICD-10, J12-J18), COPD(ICD-10, J40-J44) and asthma(ICD-10, J45-J46) were considered in this study. Averaged daily mortality was 5.6 for total respiratory mortality and 1.1 to 1.6 for cause-specific mortality. Generalized additive Poisson models controlling for confounders were used to evaluate the acute effects of particle exposures on total respiratory mortality and cause-specific mortality. An IQR increase in 5-day moving average of $PM_{2.5}(22.6{\mu}g/m^3)$ was associated with an 8.2%(95% CI: 4.5 to 12.1%) increase in total respiratory mortality The association of $PM_{2.5}$ was stronger for the elderly ($\geq$65 years old, 10.1%, 95% CI: 5.8 to 14.5%) and for males(8.9%, 95% CI: 2.1 to 11.3%). A $10{\mu}g/m^3$ increase in 5-day moving average of $PM_{2.5}$ was strongly associated with total respiratory mortality in winter(9.5%, 95% CI: 6.6 to 12.4%), followed by spring(3.1%, 95% CI: -1.2 to 7.5%), which was a different pattern with the finding in North American cities. However, our results are generally consistent with those observed in recent epidemiological studies, and suggest that $PM_{2.5}$ has a stronger effect on respiratory mortality in Seoul.

• Tuberculosis and Respiratory Diseases
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• 제78권2호
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• pp.85-91
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• 2015

Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation. Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU. Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups. Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2877-2881
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• 2016

Background: Lung cancer is one of the most common causes of death that is rising in many countries including Iran. This study aimed to determine the impact of factors on survival of lung cancer patients at a referral center of lung diseases in Tehran, Iran. Materials and Methods: A retrospective study was conducted on adult lung cancer cases admitted to a referral center for lung diseases from 2011 to 2015. Multivariate analysis was performed to determine the risk factors for all-cause mortality. Results: Of a total 933 patients with lung cancer, 53.4% died, 49.3% of them at the hospital. Overall median follow-up time was 7 months. The most common histological type of cancer was adenocarcinoma with a 13 month median survival time. Age ${\geq}55$ and smoking remained significant for all-cause mortality on Cox analysis, whereas gender was not. Conclusions: The survival of lung cancer patients is poor and the patients with history of smoking and age${\geq}55$ are at increased risk of death. Having a large hospital-based registry provides a good measurement of prognostic statistics for lung cancer. Further investigations are necessary to establish reasons for mortality.

• 대한임상독성학회지
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• 제18권2호
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• pp.116-122
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• 2020

Acute respiratory failure is an important risk factor for mortality in patients with acute pesticide poisoning. Therefore, it is necessary to investigate the risk factors to predict respiratory failure in these patients. This study retrospectively investigated the clinical features of respiratory failure among patients with acute pesticide poisoning requiring mechanical ventilation. This study included patients who were admitted with intentional poisoning by pesticide ingestion from January 2017 to December 2019. Paraquat intoxication was excluded. Among 469 patients with acute pesticide poisoning, 398 patients were enrolled in this study. The respiratory failure rate was 30.4%. The rate of respiratory failure according to the type of pesticide was carbamate (75.0%), organophosphate (52.6%), glufosinate (52.1%), glyphosate (23%), pyrethroid (8.9%), and others (17%). The mortality was 25.6% in the respiratory failure group. The risk factors for respiratory failure were old age, low body mass index, and ingestion of more than 300 mL. In conclusion, respiratory failure is a risk factor for mortality in pesticide poisoning. Old age, low body mass index, and ingestion of more than 300 mL are the risk factors for predicting respiratory failure.

• Journal of Preventive Medicine and Public Health
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• 제52권5호
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• pp.308-315
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• 2019

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.

• 한국산업보건학회지
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• 제25권3호
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• pp.346-354
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• 2015

Objectives: This study was conducted to evaluate the changes and regional differences of mortality and morbidity particularly respiratory system diseases in the area of exposure to coal dust(Ansim area, Dong-gu, Daegu). Methods: The authors analyzed secondary data(cancer registration data, mortality data, and health insurance data) for respiratory system diseases. We calculated age standardized incidence ratio(SIR), mortality ratio(SMR), and health care utilization ratio(SHR) using those data. Results: There were no significant differences between Ansim area(or Dong-gu, Daegu) and the control area for cancer registration data and mortality data. In the results for the health insurance data, significant increased SHR in asthma was observed compared to the control area. Conclusions: Although confounders such as selection bias were not clearly ruled out, our findings reveal increased asthma SHR in the area of exposure to coal dust. Further prospective studies are required to clarify the increasing respiratory disease due to exposure to coal dust.

• Tuberculosis and Respiratory Diseases
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• 제81권3호
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• pp.256-257
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• 2018

• Journal of the Korean Data and Information Science Society
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• 제22권1호
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• pp.125-136
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• 2011

Ground-level ozone, an air pollutant that is monitored by the Environmental Protection Agency (EPA), damages human health by irritating the respiratory system, reducing lung function, damaging lung cells, and aggravating asthma and other chronic conditions. In March 2008, the EPA strengthened ozone standards by lowering acceptable limits from 84 parts per billion to 75 parts per billion. Here epidemiologic data is used to study the effects of ozone regulation on human health and assessed how various regulatory standards for ozone may affect nonaccidental mortality, including respiratory-related deaths during ozone season. The assessment uses statistical methods based on hierarchical Bayesian models to predict the potential effects of the different regulatory standards. It also analyzes the variability of the results and ho they are impacted by different modeling assumptions. We focused on the technical an statistical approach to assessing relationship between new ozone regulations and mortality while other researches have detailed the relationship between ozone and human mortality. We shows a statistical correlation between ozone regulations and mortality, with lower limits of acceptable ozone linked to a decrease in deaths, and projects that mortality is expected to decrease by reducing ozone regulatory standards.

• 한국환경과학회지
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• 제30권7호
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• pp.573-584
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• 2021

To analyze the effects of PM₁₀ and PM_2.5 on daily mortality cases, the relations of death counts from natural causes, respiratory diseases, and cardiovascular diseases with PM₁₀ and PM_2.5 concentrations were applied to the generalized additive model (GAM) in this study. From the coefficients of the GAM model, the excessive mortality risks due to an increase of 10 ㎍/m³ in daily mean PM₁₀ and PM_2.5 for each cause were calculated. The excessive risks of deaths from natural causes, respiratory diseases, and cardiovascular diseases were 0.64%, 1.69%, and 1.16%, respectively, owing to PM₁₀ increase and 0.42%, 2.80%, and 0.91%, respectively, owing to PM_2.5 increase. Our result showed that particulate matter posed a greater risk of death from respiratory diseases and is consistent with the cases in Europe and China. The regional distribution of excessive risk of death is 0.24%-0.81%, 0.34%-2.6%, and 0.62%-1.94% from natural causes, respiratory diseases, and cardiovascular diseases, respectively, owing to PM₁₀ increase, and 0.14%-1.02%, 1.07%-3.92%, and 0.22%-1.73% from natural causes, respiratory diseases, and cardiovascular diseases, respectively, owing to PM_2.5 increase. Our results represented a different aspect from the regional concentration distributions. Thus, we saw that the concentration distributions of air pollutants differ from the affected areas and identified the need for a policy to reduce damage rather than reduce concentrations.

• 한국대기환경학회지
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• 제23권5호
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• pp.563-574
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• 2007

There seems to be a consensus among most people that visibility impairment is the most obvious indicator of air pollution. While considerable evidence on the association between air pollution and health outcomes including death and disease have been established, based on industrial complex areas or huge urban cities, time-series, case-crossover and cohort studies, scarce literature exists on the direct evidence for the association between visibility and adverse health outcomes. Our study is assessed the effect of air pollution measured by visibility impairment on respiratory mortality over a period of six years. Relative risks in respiratory deaths were estimated by a Poisson regression model of daily deaths between $1999{\sim}2004$. Daily counts of respiratory deaths as dependent variable was modelled with daily 24-hr mean visibility measurements (kilometers) as independent variable by means of Poisson regression. This model is controlled for confounding factors such as day of weeks, weather variables, seasonal variables and $PM_{10}$. The results in this study is observed the statistically significant association between an inverse health effect and visibility during the study period for respiratory mortality (percentage change in the relative risk for all aged -0.57%, 95% Cl, $-1.01%{\sim}-0.12%$; for $0{\sim}15$ aged -7.12%, 95% Cl, $-13.29%{\sim}-0.51%$; for 65+ aged -0.43%, 95% Cl, $-0.93%{\sim}-0.06%$ per 1 km increased in visibility). The effect size was much reduced during warm season. Visibility impairment resulting from air pollution is strongly associated with respiratory mortality, especially for children may be spent at outdoor. Our result provides a quick and useful indicator for eliciting the contribution of air pollution to the excess risk of respiratory mortality in Seoul, Korea.