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Korean Journal of Preventive Medicine 2003;36(1): 47-53.
Associations between Air Pollution and Asthma-related Hospital Admissions in Children in Seoul, Korea: A Case-crossover Study.
Jong Tae Lee
Department of Preventive Medicine, College of Medicine, Ewha Womans University, Korea. jonglee@ewha.ac.kr
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.
Key words: Air pollution; Case-crossover studies; Epidemiologic methods; Asthma; Child
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