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Epidemiology and Health 2022;e2022002.
DOI: https://doi.org/10.4178/epih.e2022002    [Accepted] Published online Dec 28, 2021.
Age-specific effects of ozone on pneumonia in Korean children and adolescents: A nationwide time-series study
Kyoung-Nam Kim1  , Youn-Hee Lim2  , Sanghyuk Bae3  , In Gyu Song4  , Soontae Kim5  , Yun-Chul Hong1 
1Seoul National University Hospital, Seoul, Korea
2University of Copenhagen, Copenhagen, Denmark
3Catholic University of Korea, Seoul, Korea
4Korea University Guro Hospital, Seoul, Korea
5Ajou University, Suwon, Korea
Correspondence  Yun-Chul Hong ,Tel: 02-740-8394, Email: ychong1@snu.ac.kr
Received: Jul 31, 2021  Accepted after revision: Dec 8, 2021
To estimate the age-specific effects of 8-hour maximum ozone levels on pneumonia in children and adolescents.
We performed quasi-Poisson regression analyses at 0–4, 5–9, 10–14, and 15–19 years of age using nationwide time-series data from the Republic of Korea (2011–2015). We constructed distributed lag linear models employing a generalized difference-in-differences method and controlling for other air pollutants.
A 10.0-ppb increase in 8-hour maximum ozone levels was associated with a higher risk of hospital admissions due to pneumonia at 0–4 (relative risk [RR] = 1.02, 95% confidence interval [CI]: 1.01, 1.03) and 5–9 years of age (RR = 1.06, 95% CI: 1.04, 1.08) but not at 10–14 (RR = 1.01, 95% CI: 0.98, 1.04) or 15–19 years of age (RR = 1.01, 95% CI: 0.97, 1.06). The association between ozone and hospital admissions due to pneumonia was stronger was stronger in cool seasons (from November to April) than in warm seasons (from May to October) but was similar between boys and girls.
Short-term exposure to ozone was associated with a higher risk of pneumonia at 0–4 and 5–9 years of age but not at 10–14 or 15–19 years of age. Our findings can help identify vulnerable periods, determine the target populations for public health interventions, and establish air pollution standards.
Keywords: ozone; pneumonia; children; adolescent; time-series study
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