Journal of Preventive Medicine and Public Health

Original Articles

Environmental Health Literacy Regarding Fine Particulate Matter and Related Factors Among Village Health Volunteers in Upper Northern Thailand: Nattapon Pansakun, Warangkana Naksen, Waraporn Boonchieng, Parichat Ong-artborirak, Tippawan Prapamontol; J Prev Med Public Health. 2024;57(2):138-147. Published online February 10, 2024; DOI: https://doi.org/10.3961/jpmph.23.434

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Abstract PDF: Objectives
Fine particulate matter pollution has emerged as a significant life-threatening issue in Thailand. Recognizing the importance of environmental health literacy (EHL) in disease prevention is crucial for protecting public health. This study investigated EHL levels and aimed to identify associated factors among village health volunteers (VHVs) in the upper northern region of Thailand.
Methods
A cross-sectional study was conducted to collect data from 710 VHVs using the EHL assessment tool developed by the Department of Health, Thailand.
Results
The overall EHL score was moderate (mean, 3.28 out of a possible 5.0), with the highest and lowest domain-specific mean score for the ability to make decisions (3.52) and the ability to access (3.03). Multiple linear regression revealed that the factors associated with EHL score were area of residence (urban areas in Chiang Mai: B=0.254; urban areas in Lampang: B=0.274; and rural areas in Lampang: B=0.250 compared to rural areas in Chiang Mai), higher education levels (senior high school: B=0.212; diploma/high vocational certificate: B=0.350; bachelor’s degree or above: B=0.528 compared to elementary school or lower), having annual health checkups compared to not having annual health check-ups (B=0.142), monthly family income (B=0.004), and individuals frequently facing air pollution issues around their residence (B=0.199) compared to those who reported no such issues.
Conclusions
The VHVs exhibited moderate EHL associated with residence area, education, health check-ups, family income, and residential air pollution. Considering these factors is vital for enhancing VHVs’ EHL through strategic interventions.; Summary

The Association Between PM_2.5 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

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Abstract Summary PDF Supplementary Material

Objectives
This study investigated the association between baseline exposures to particulate matter with a diameter < 2.5 microns (PM_2.5) and subsequent temporal changes in PM_2.5 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., PM_2.5-baseline) and subsequent changes (i.e., PM_2.5-change) in PM_2.5 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 PM_2.5 baseline and PM_2.5-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 PM_2.5-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 PM_2.5-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 PM_2.5 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

Associations of Ambient Air Pollutant Concentrations With Respiratory Symptoms and Perceived Health Status in Japanese Adults With and Without Chronic Respiratory Diseases: A Panel Study: Motoyuki Nakao, Keiko Yamauchi, Satoshi Mitsuma, Tetsuro Odaira, Hideto Obata, Yoichi Chijimatsu, Yoko Ishihara; J Prev Med Public Health. 2019;52(6):416-426. Published online November 13, 2019; DOI: https://doi.org/10.3961/jpmph.19.180

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Abstract PDF Supplementary Material

Objectives
In recent years, transboundary air pollution from mainland East Asia has led to growing concerns about air pollution in Japan. Air pollution is reportedly associated with the exacerbation of respiratory diseases. In this study, we assessed the effects of air pollution on respiratory symptoms and the health status of participants with and without chronic respiratory diseases.
Methods
Participants (n=2753) with and without chronic respiratory diseases who visited healthcare facilities in Japan during February from 2010 to 2015 filled out a self-report questionnaire regarding their symptoms and perceived health status. Participants were followed up during April-May and June-July.
Results
Oxidant concentrations were associated with respiratory symptoms, overall health, and quality of life (QoL). Suspended particulate matter (SPM) and particulate matter <2.5 μm levels were associated with physical fitness; SPM was also associated with QoL. Recent experience of an Asian sand dust event had a significant effect on allergic symptoms, change in health, and QoL.
Conclusions
Respiratory symptoms were more strongly affected by oxidants than by other pollutants. Significant associations of air pollutants were found with a comprehensive range of items related to perceived health status, including overall health and QoL. Although the effects of air pollutants on respiratory symptoms and health status were more apparent among patients with respiratory diseases, the adverse effects of air pollutants were significant even among participants without such conditions.

Summary

Citations

Citations to this article as recorded by

Loranthus tanakae Franch. and Sav. Attenuates Respiratory Inflammation Caused by Asian Sand Dust
Se-Jin Lee, So-Won Pak, A Yeong Lee, Woong-Il Kim, Sung-Wook Chae, Young-Kwon Cho, Je-Won Ko, Tae-Won Kim, Jong-Choon Kim, Byeong Cheol Moon, Yun-Soo Seo, In-Sik Shin
Antioxidants.2024; 13(4): 419. CrossRef
Evaluation of the impact of energy utilization and PM on respiratory health in China
Changfeng Shi, Xinhui Liu, Min Gu, Qinghua Pang, Zhen Shi
Energy & Environment.2021; 32(3): 380. CrossRef
Respiratory Effects of Exposure to Traffic-Related Air Pollutants During Exercise
Giuseppe Morici, Fabio Cibella, Annalisa Cogo, Paolo Palange, Maria R. Bonsignore
Frontiers in Public Health.2020;[Epub] CrossRef

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea: Hyunmee Kim, Woojin Kim, Jee eun Choi, Changsoo Kim, Jungwoo Sohn; J Prev Med Public Health. 2018;51(6):265-274. Published online October 29, 2018; DOI: https://doi.org/10.3961/jpmph.18.153

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Abstract Summary PDF Supplementary Material

Objectives
A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than 10 μm in aerodynamic diameter, nitrogen dioxide [NO2], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009.
Methods
The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants.
Results
Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of NO2 was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of NO2 at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291).
Conclusions
The results of our study suggest that ambient air pollution, specifically NO2, is associated with ED visits for diabetic coma.

Summary

Korean summary
본 연구에서는 대기오염물질의 단기적인 영향을 확인하기 위하여 당뇨병성 혼수로 인한 응급실 내원을 시계열적으로 분석하였다. 분석 결과 이산화질소 상승이 노출 1일 후의 응급실 방문을 1.25% 상승시켰다(RR, 1.125; 95% CI 1.039-1.219). 또한, 노출 3일 후까지 누적 결과도 유의한 상관관계를 보였다(RR 1.092; 95% CI, 1.005-1.186).

Citations

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Criteria air pollutants and diabetes mortality classified by different subtypes and complications: A nationwide, case-crossover study
Peng Yin, Huihuan Luo, Ya Gao, Wei Liu, Su Shi, Xinyue Li, Xia Meng, Haidong Kan, Maigeng Zhou, Guanglin Li, Renjie Chen
Journal of Hazardous Materials.2023; 460: 132412. CrossRef
Comparison of different hybrid modeling methods to estimate intraurban NO2 concentrations
Inbo Oh, Mi-Kyoung Hwang, Jin-Hee Bang, Wonho Yang, Soontae Kim, Kiyoung Lee, SungChul Seo, Jiho Lee, Yangho Kim
Atmospheric Environment.2021; 244: 117907. CrossRef
Short-term effect of NO2 on outpatient visits for dermatologic diseases in Xinxiang, China: a time-series study
Ling Chao, Mengxue Lu, Zhen An, Juan Li, Yuchun Li, Qian Zhao, Yinbiao Wang, Yue Liu, Weidong Wu, Jie Song
Environmental Geochemistry and Health.2021; 43(9): 1. CrossRef
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Judy S. LaKind, Carol J. Burns, Lynn H. Pottenger, Daniel Q. Naiman, Julie E. Goodman, Satori A. Marchitti
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Perspective

Necessity of Epigenetic Epidemiology Studies on the Carcinogenesis of Lung Cancer in Never Smokers: Jong-Myon Bae; J Prev Med Public Health. 2018;51(5):263-264. Published online July 8, 2018; DOI: https://doi.org/10.3961/jpmph.18.076

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Abstract PDF Supplementary Material: Based on epidemiological and genomic characteristics, lung cancer in never smokers (LCNS) is a different disease from lung cancer in smokers. Based on current research, the main risk factor for LCNS may be air pollution. A recent case-control study in Koreans reported that nitrogen dioxide (NO2) may be a risk factor for LCNS. Additionally, a cohort study showed that exposure to NO2 was associated with significant hypomethylation. Thus, epigenetic epidemiology studies are needed in the near future to evaluate the carcinogenesis of LCNS according to chronic exposure to air pollution and/or viral infections.; Summary

Original Articles

Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014): Pouran Raeissi, Touraj Harati-Khalilabad, Aziz Rezapour, Seyed Yaser Hashemi, Abdoreza Mousavi, Saeed Khodabakhshzadeh; J Prev Med Public Health. 2018;51(3):140-147. Published online May 14, 2018; DOI: https://doi.org/10.3961/jpmph.17.153

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Abstract PDF

Objectives
Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures.
Methods
This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships.
Results
Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term.
Conclusions
The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.

Summary

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Reza Bayat, Khosro Ashrafi, Majid Shafiepour Motlagh, Mohammad Sadegh Hassanvand, Rajabali Daroudi, Günther Fink, Nino Künzli
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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

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Abstract PDF Supplementary 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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Short-term Effects of Ambient Air Pollution on Emergency Department Visits for Asthma: An Assessment of Effect Modification by Prior Allergic Disease History: Juhwan Noh, Jungwoo Sohn, Jaelim Cho, Seong-Kyung Cho, Yoon Jung Choi, Changsoo Kim, Dong Chun Shin; J Prev Med Public Health. 2016;49(5):329-341. Published online September 8, 2016; DOI: https://doi.org/10.3961/jpmph.16.038

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Abstract PDF Supplementary Material

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 [NO2], ozone [O3], sulfur dioxide [SO2], and particulate matter with an aerodynamic diameter <10 μm [PM10]), 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 O3 concentration. IQR changes in NO2 and PM10 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 PM10 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.

Summary

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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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Abstract PDF Supplementary 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 [PM_2.5], 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 PM_2.5 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 PM_2.5, 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

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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

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Abstract 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

Review

Air Pollution Exposure and Health Effects in Fetus.: Bo Eun Lee, Hye sook Park, Young Ju Kim, Eun Ae Park, Yun Chul Hong, Eun Hee Ha; J Prev Med Public Health. 2004;37(4):291-299. Published online November 30, 2004

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Abstract PDF: As there have been growing concerns about the adverse effects of air pollution on birth outcome, studies for this area has been carried out in different populations and sites. We reviewed the epidemiologic studies that evaluated the effects of air pollution on birth outcome such as low birth weight and preterm births. We identified the air pollution exposure during pregnancy was related with low birth weight and preterm birth, although there are differences among studies for the critical period of vulnerability. The biological mechanisms whereby air pollution might influence health of fetus are not clearly established. The exposure to carbon monoxide (CO) during pregnancy could increase fetal carboxyhemoglobin and result in tissue hypoxia. On the other hand, ambient particles less than 10 micrometer in aerodynamic diameter (PM10) could lead to inflammation and increase blood viscosity. Controlling for potential confounders and valid assessment of exposure are the methodological issues remained in these epidemiologic studies. In the future, more studies are needed to investigate the effect of air pollution on preterm birth or stillbirths, considering the various exposure period and the biological mechanism.; Summary

English Abstracts

Environmental Health Surveillance of Low Birth Weight in Seoul using Air Monitoring and Birth Data.: Ju Hee Seo, Eun Hee Ha, Ok Jin Kim, Byung Mi Kim, Hye Sook Park, Jong Han Leem, Yun Chul Hong, Young Ju Kim; J Prev Med Public Health. 2007;40(5):363-370.; DOI: https://doi.org/10.3961/jpmph.2007.40.5.363

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Abstract PDF

OBJECTIVES
The principal objective of this study was to determine the relationship between maternal exposure to air pollution and low birth weight and to propose a possible environmental health surveillance system for low birth weight. METHODS: We acquired air monitoring data for Seoul from the Ministry of Environment, the meteorological data from the Korean Meteorological Administration, the exposure assessments from the National Institute of Environmental Research, and the birth data from the Korean National Statistical Office between January 1, 2002 and December 31, 2003. The final birth data were limited to singletons within 37~44 weeks of gestational age. We defined the Low Birth Weight (LBW) group as infants with birth weights of less than 2500g and calculated the annual LBW rate by district. The air monitoring data were measured for CO, SO2, NO2, and PM10 concentrations at 27 monitoring stations in Seoul. We utilized two models to evaluate the effects of air pollution on low birth weight: the first was the relationship between the annual concentration of air pollution and low birth weight (LBW) by individual and district, and the second involved a GIS exposure model constructed by Arc View 3.1. RESULTS: LBW risk (by Gu, or district) was significantly increased to 1.113(95% CI=1.111~1.116) for CO, 1.004 (95% CI=1.003~1.005) for NO2, 1.202(95% CI=1.199~ 1.206) for SO2, and 1.077(95% CI=1.075~1.078) for PM10 with each interquartile range change. Personal LBW risk was significantly increased to 1.081(95% CI=1.002~1.166) for CO, 1.145(95% CI=1.036~1.267) for SO2, and 1.053(95% CI=1.002~1.108) for PM10 with each interquartile range change. Personal LBW risk was increased to 1.003(95% CI=0.954~1.055) for NO2, but this was not statistically significant. The air pollution concentrations predicted by GIS positively correlated with the numbers of low birth weights, particularly in highly polluted regions. CONCLUSIONS: Environmental health surveillance is a systemic, ongoing collection effort including the analysis of data correlated with environmentally-associated diseases and exposures. In addition, environmental health surveillance allows for a timely dissemination of information to those who require that information in order to take effective action. GIS modeling is crucially important for this purpose, and thus we attempted to develop a GIS-based environmental surveillance system for low birth weight.

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Abstract PDF

OBJECTIVES
We aimed to assess the relationship between long-term exposure to air pollution and lung cancer in the Republic of Korea. METHODS: Using the Annual Report of Ambient Air Quality in Korea, Annual Report of National Cancer Registration, and Annual Report on the Cause of Death Statistics, we calculated the standardized mortality ratio (SMR) and standardized incidence ratio (SIR) of lung cancer for both sexes in 74 areas from 7 Korean metropolitan cities. We performed random intercept, Poisson regression using empirical Bayes method. RESULTS: Both SMRs and SIRs in the 7 metropolitan cities were higher in women than in men. Mean SIRs were 99.0 for males and 107.0 for females. The association between PM(10) and lung cancer risk differed according to gender. PM(10) was not associated with the risk of lung cancer in males, but both incidence and mortality of lung cancer were positively associated with PM(10) in females. The estimated percentage increases in the rate of female lung cancer mortality and incidence were 27% and 65% at the highest PM(10) category (> or = 70 microgram/m(3)), compared to the referent category (<50 microgram/m(3)). CONCLUSIONS: Long-term exposure to PM(10) was significantly associated with female lung cancer incidence in 7 Korean metropolitan cities. Further study is undergoing to estimate the relative risk of PM(10) using multi-level analysis for controlling individual and regional confounders such as smoking and socioeconomic position.

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Original Articles

Associations between Air Pollution and Asthma-related Hospital Admissions in Children in Seoul, Korea: A Case-crossover Study.: Jong Tae Lee; Korean J Prev Med. 2003;36(1):47-53.

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Abstract PDF: OBJECTIVES
I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea METHODS: I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. RESULTS: Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3) ; 1.05 (95% CI, 1.00-1.09) for nitrogen dioxide (IQR=14.6ppb) ; 1.02 (95% CI, 0.97-1.06) for sulfur dioxide (IQR=4.4ppb) ; 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb) ; and 1.03 (95% CI, 0.99-1.08) for carbon monoxide (IQR=1.0ppm). CONCLUSIONS: This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution, at levels below the current ambient air quality standards of Korea, is harmful to sensitive subjects, such as asthmatic children.; Summary

Quantifying the Burden of Cardiovascular Disease Attributable to Total Suspended Particulate and Sulfur Dioxide Using Years Lived with Disability.: Seok Jun Yoon, Beom Man Ha, Jong Won Kang, Ho Jang Kwon; Korean J Prev Med. 2002;35(2):92-98.

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Abstract PDF: OBJECTIVE
To estimate the burden of cardiovascular disease attributable to the total suspended particulates (TSP) and sulfur dioxide (SO2) in Korea using the YLD (years lived with disability) measurement. METHODS: Congestive heart failure(CHF) and myocardial infarction (MI) were chosen as the main cardiovascular diseases whose causes are attributable to the TSP and SO2 levels. In order to calculate the YLD (years lived with a disability), the following parameters in the formula were estimated. : the incidence rate, the case fatality rate, The expected duration of a disability and the average age of onset were estimated. The expected duration of a disability and the average age of onset were calculated using the DISMOD method, as developed by the GBD researchers. The burden of cardiovascular disease due to TSP and SO2 was estimated using the number of years that the patient lived with a disability. RESULTS: The YLD of the CHF due to the TSP and SO2 was attributed to the TSP (94.4 person-year) and SO2 levels (35.0 person-year). The YLD of the MI due to the TSP and SO2 was attributed to the TSP (148.4 person-year) and SO2 levels(27.6 person-year). CONCLUSION: The YLD method employed in this study was appropriate for quantifying the burden of cardiovascular disease. Therefore, it would provide a rational basis for planning a national health policy regarding the disease burden of the risk factors in Korea.; Summary

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