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KMID : 1142920180020010057
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Public Health Affairs
2018 Volume.2 No. 1 p.57 ~ p.71
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Association between hourly differences of Particulate matters concentration and Emergency department visits in Seoul
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Kim Ja-Yeun
Kim Ho
Jung Kweon
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Abstract
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Purpose: High particulate matter (PM) levels is known to cause cardio-respiratory symptoms exacerbation. We aimed to investigate the association between PM levels and cause-specific emergency department (ED) visits according to different size fractions (PM10, PM10-2.5, and PM2.5) of PM at an hourly timescale.
Methods: In this study, cause-specific ED visits; asthmaticus, chronic obstructive pulmonary disease (COPD), myocardial infarction (MI), and arrhythmia were analyzed for the relationship with an hourly increase of PM concentrations in different size fractions among 29 hospitals in Seoul, Korea in 2008?2011. The lag between an interquartile range increase in PM concentration and cardio-respiratory symptoms exacerbation was stratified as 1?6, 7?12, 13?18, 19?24, and 25?48 hours. Effect size [odds ratio (OR), 95% confidence interval (CI)] of increased PM levels on ED visits was investigated according to season and age after adjusting for meteorological variables.
Results: Of 8,274 asthmaticus, 6,760 COPD, 7,216 MI, and 17,088 arrhythmia were 1,805 (21.8%), 2,807 (41.5%), 3,431 (47.6%), and 8,110 (47.5%) by age ≥ 65 years respectively. The highest adverse effect [OR, (95% CI)] was of 2.5?10 μm diameter PM (PM10-2.5) after 1?6 h [1.06, (1.01?1.12)] for asthmaticus, and after 7?12 h [1.06, (1.00?1.11)] for COPD in multi pollutant model. Among the four seasons, highest effect of PM10 was in spring for asthmaticus and arrhythmia and summer for COPD and MI. Effect of PM was age-modified and increased adverse effect was observed among age ≥ 65 years in COPD and arrhythmia-related ED visits.
Conclusions: Comprehensive data is presented for differential effects of different PM size fractions in terms of the lag after which an increase in the levels of PM is likely to cause cardio-respiratory symptoms exacerbations. In addition, it suggested the modifications in the effects size according to seasons and age.
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KEYWORD
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Acute effect, Case-crossover, Emergency Department, Effect modification, Particulate matters
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