Journal of Preventive Medicine and Public Health

Original Articles

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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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

Citations

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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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Abstract PDF: OBJECTIVES
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.; Summary

Case Report

Short-term Effect of Air Pollution on Respiratory Disease in Seoul : A Case-Crossover Study.: Young Ju Lee, Jong Tae Lee, Young Su Ju, Dong Chun Shin, Hyoung June Im, Soo Hun Cho; Korean J Prev Med. 2001;34(3):253-261.

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Abstract PDF: OBJECTIVES
To evaluate the hypothesis that air pollution could increase emergency room visits for respiratory diseases, and if so, to quantify the strength of association between those. METHODS: We compiled daily records of hospital emergency room visits for respiratory diseases in Seoul, from November 1. 1995 to October 31. 1996, by using medical utilization data of unscheduled visits. In addition, air quality and weather data for the same period was collected. And a case-crossover design was applied by adopting conditional logistic regression analysis to determine the relationship between air pollutants and emergency room visits for respiratory diseases. In particular, the control periods were chosen by a bidirectional paired matching technique 7, 14, and 21days before and after the case periods. RESULTS: Only ozone was associated with the increased number of emergency room visits for respiratory diseases. The relative risk according to a 30ppb increase of ozone concentration (24hr mean, lagged 1day) was 1.91 (95% confidence interval = 1.78-2.05). CONCLUSION: There was a statistically significant association between the ambient ozone and daily emergency room visits for respiratory diseases.; Summary

Original Article

Effect of Air Pollution on Emergency Room Visits for Asthma: a Time Series Analysis.: Young Su Ju, Soo Hun Cho; Korean J Prev Med. 2001;34(1):61-72.

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Abstract PDF: OBJECTIVES
To evaluate the hypothesis that increasing ambient levels of ozone or particulate matter are associated with increased emergency room visits for asthma and to quantify the strength of association, if any, between these. METHODS: Daily counts of emergency room visits for asthma, air quality, and weather data were collected from hospitals with over 200 beds and from monitoring stations in Seoul, Korea from 1994 through 1997. Daily counts of emergency room visits for asthma attack were analyzed using a general additive Poisson model, with adjustment for the effects of secular trend, seasonal variation, Sunday and holiday, temperature, and humidity, according to levels of ozone and particulate matter. RESULTS: The association between daily counts of emergency room visits for asthma attack and ozone levels was statistically significant in summer(from June to August), and the RR by unit increment of 100 ppb ozone was 1.30(95% CI = 1.11-1.52) without lag time. With restriction of the period from April to September in 1996, the RR was 1.37(95% CI = 1.06-1.76), and from June to August in 1995, the RR was 1.62(95% CI = 1.12-2.35). In the data for children(5?14 yr), the RR was 2.57(95% CI = 1.31-5.05) with restriction of the period from April to September in 1997. There was no significant association between TSP levels and asthma attacks, but a slight association was seen between PM10 levels and asthma attacks in a very restricted period. CONCLUSION: There was a statistically significant association between ambient levels of ozone and daily counts of emergency room visits for asthma attack. Therefore, we must make efforts to effectively minimize air pollution, in order to protect public health.; Summary

English Abstract

Relationship between the Exposure to Ozone in Seoul and the Childhood Asthma-related Hospital Admissions according to the Socioeconomic Status.: Ji Young Son, Ho Kim, Jong Tae Lee, Sun Young Kim; J Prev Med Public Health. 2006;39(1):81-86.

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Abstract PDF: BACKGROUND
A number of studies have reported associations between the ambient air pollution concentrations and various health outcomes. Especially, ozone is well known for primary risk factor of asthma attacks. The results of a recent study indicate that the size of the effect on health outcomes due to air pollution varied according to several conditions, including age, gender, race and the socioeconomic status. Therefore, this study was conducted to examine the associations of ozone with the childhood asthma hospitalizations as stratified by the socioeconomic status (SES) at the community level in Seoul, Korea, 2002. METHODS: SES at aggregated levels was measured on the basis of average regional health-insurance rate per citizen in the area. We applied the generalized additive model to analyze the effect of ozone on asthma after controlling for the potential confounding variables that were capable of influencing the results. RESULTS: Our analysis showed that the number of children who were hospitalized for asthma increased as the SES of the residence area decreased. The estimated relative risks of hospitalization for asthma, as stratified by the SES of the community level, were 1.12 (95% confidence interval 1.00-1.25) in districts with the highest SES levels, 1.24 (95% CI=1.08-1.43) within the moderate SES levels, and 1.32 (95% CI=1.11-1.58) in the districts with the lowest SES levels. CONCLUSIONS: Our analysis showed that exposure to air pollution did not equally affect the health status of individuals. This suggests that not only the biological-sensitivity markers, but also the SES of the subjects should be considered as potentially confounding factors.; Summary

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