Epidemiology and Health

Original Article

Effects of exposure to ambient air pollution on pulmonary function impairment in Korea: the 2007-2017 Korea National Health and Nutritional Examination Survey: Soo Beom Choi, Sungha Yun, Sun-Ja Kim, Yong Bum Park, Kyungwon Oh; Epidemiol Health. 2021;43:e2021082. Published online October 18, 2021; DOI: https://doi.org/10.4178/epih.e2021082

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to investigate the association between pulmonary function and air pollution using 2007-2017 data from the Korea National Health and Nutrition Examination Survey, a nationwide cross-sectional representative survey.

METHODS

A total of 27,378 participants that had sampling weights from a complex sample survey were included in this study. Using the data for forced expiratory volume in 1 second and forced vital capacity, the participants with pulmonary function impairment were classified according to the criteria of restrictive lung disease and chronic obstructive pulmonary disease (COPD). Exposure to ambient air pollution was estimated using the Community Multiscale Air Quality model. Multivariate linear and logistic regression analyses with complex samples were used to determine the associations between pulmonary function and air pollution after adjusting for covariates.

RESULTS

In total, 13.2% of the participants aged >40 years had COPD, and 10.7% were classified as being in the restrictive lung disease group. According to the multivariate logistic regression model, the odds ratios for the fourth quartiles of particulate matter less than 10 μm in diameter (PM10), particulate matter less than 2.5 μm in diameter (PM2.5) and carbon monoxide (CO) with a 2-year lag period were 1.203 (95% confidence interval [CI], 1.036 to 1.396), 1.283 (95% CI, 1.101 to1.495), and 1.292 (95% CI, 1.110 to 1.504), respectively, using the restrictive lung disease group as an event after adjusting for covariates in the complex sample.

CONCLUSIONS

Long-term exposure to PM10, PM2.5, and CO was significantly associated with pulmonary function, especially restrictive lung disease.

Summary

Korean summary
대기오염이 폐기능에 미치는 영향을 조사하기 위해 2007년부터 2017년까지 국민건강영양조사자료와 대기질 자료를 연계하여 참여자 27,378명의 대기오염 노출량을 추정하여 분석하였다. 나이, 성별, 거주지 동/읍면 구분, 교육수준, 소득수준, 흡연, 비만, 기온, 상대습도 변수들을 보정 후 PM₁₀, PM_2.5, SO2, NO2, CO, O3의 2년평균 노출량을 각각 로지스틱회귀모형으로 분석한 결과 PM₁₀, PM_2.5, CO 와 제한성 환기장애가 연관성을 보였다. 대기오염의 노출은 만성폐쇄성폐질환보다는 제한성 환기장애와 연관이 있었으며 제한성 환기장애는 사망원인과도 연관이 있었다.

Key Message
This study aimed to investigate the association between pulmonary function and air pollution using 2007-2017 data from the Korea National Health and Nutrition Examination Survey. Long-term exposure to PM₁₀, PM_2.5, and CO was significantly associated with pulmonary function, especially restrictive lung disease. Although the COPD criteria do not include the restrictive lung disease group, restrictive lung disease needs to be controlled and managed based on its mortality risk. Reducing air pollution is also necessary to enhance pulmonary function.

Citations

Citations to this article as recorded by

Airborne Exposure of the Cornea to PM10 Induces Oxidative Stress and Disrupts Nrf2 Mediated Anti-Oxidant Defenses
Mallika Somayajulu, Sharon A. McClellan, Robert Wright, Ahalya Pitchaikannu, Bridget Croniger, Kezhong Zhang, Linda D. Hazlett
International Journal of Molecular Sciences.2023; 24(4): 3911. CrossRef

Cohort Profile

The Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA), India: Padukudru Anand Mahesh, Komarla Sundararaja Lokesh, Purnima Madhivanan, Sindaghatta Krishnarao Chaya, Biligere Siddaiah Jayaraj, Koustav Ganguly, Murali Krishna; Epidemiol Health. 2018;40:e2018027. Published online June 23, 2018; DOI: https://doi.org/10.4178/epih.e2018027

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Abstract PDF

Abstract

Between 2006 and 2010, in 16 randomly selected villages in rural areas of Mysore district, in south India, 8,457 subjects aged 30 and above were screened for symptoms of chronic respiratory disease. Of the 8,457 subjects, 1,692 were randomly invited for further evaluation of lung function and chronic obstructive pulmonary disease (COPD) by spirometry, and 1,085 of these subjects underwent lung function assessments for prevalent COPD and its risk factors. These 1,085 subjects, who were then aged between 35 and 80 years, constituted the Mysuru stUdies of Determinants of Health in Rural Adults (MUDHRA) cohort. Among other findings, threshold of biomass fuel smoke exposure suitable for use as a dichotomous risk factor for the diagnosis of chronic bronchitis was established, with a minimum biomass smoke exposure index of 60 found to be significantly associated with an elevated risk of developing chronic bronchitis. Five years later (between 2014 and 2016), 869 of the 1,085 participants were followed up with repeat lung function assessments for incident COPD and all-cause mortality. A subset of these participants (n=200) underwent blood tests for vitamin D levels, antioxidant activity, an assessment for anxiety and depression, and another subset (n=98) underwent a bioplex assay for 40 serum cytokines.

Summary

Citations

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