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1Department of Biostatistics, Graduate School of Yonsei University, Seoul, Korea
2National Health Big Data Clinical Research Institute, Yonsei University Wonju Industry-Academic Cooperation Foundation, Wonju, Korea
3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
4Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
5Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
© 2023, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest to declare for this study.
FUNDING
This work was supported by the Korea Environmental Industry & Technology Institute (KEITI) through the Development of a Personalized Service Model for Management of Exposure to Environmental Risk Factors among Vulnerable and Susceptible Individuals program, funded by the Korean Ministry of Environment (MOE) (2021003340003).
AUTHOR CONTRIBUTIONS
Conceptualization: Park YH. Data curation: Park YH. Formal analysis: Park YH. Funding acquisition: Park YH, Kang DR. Methodology: Park YH. Project administration: Kang DR, Kim C. Visualization: Park YH. Writing – original draft: Park YH, Koo JH. Writing – review & editing: Kim C, Jeong H, Jung JY, Kang DR.
Variables | Total 2010-2019 | Before 2010-2014 | After 2015-2019 | p-value | |
---|---|---|---|---|---|
Incidence rate | |||||
COPD | 82.87 (64.9, 109.04) | 91.21 (70.85, 119.03) | 76.64 (60.19, 100.18) | <0.001 | |
Asthma | 433.92 (335.01, 543.34) | 516.56 (417.19, 621.35) | 362.92 (289.56, 447.73) | <0.001 | |
Cardiovascular disease | 75.16 (60.02, 97.39) | 72.95 (58.49, 94.98) | 78.32 (61.56, 99.73) | <0.001 | |
Stroke | 115.65 (88.2, 139.31) | 121.63 (93.43, 142.81) | 110.68 (82.87, 133.46) | <0.001 | |
Digestive disease3 | 2,794.03 (2,530.3, 3,100.62) | 2,802.58 (2,530.3, 3,145.03) | 2,787.8 (2,530.06, 3,070.66) | 0.017 | |
Exacerbation rate | |||||
COPD | 42.45 (24.86, 63.81) | 42.88 (25.22, 66.79) | 41.61 (24.48, 62.3) | 0.013 | |
Asthma | 89.63 (58.25, 133.34) | 97.86 (67.3, 145.81) | 80.94 (49.66, 119.25) | <0.001 | |
Cardiovascular disease | 48.41 (34.97, 67.07) | 46.36 (33.69, 62.51) | 50.61 (36.06, 71.15) | <0.001 | |
Stroke | 185.36 (147.56, 224.16) | 186.64 (147.13, 222.37) | 183.67 (148.24, 226.94) | 0.255 | |
Digestive disease3 | 680.48 (561.43, 825.40) | 626.84 (511.25, 750.71) | 737.97 (631.86, 876.53) | <0.001 | |
Covariates | |||||
CO | 532.87 (447.44, 647.42) | 543.23 (461.66, 662.35) | 524.02 (431.6, 638.99) | <0.001 | |
NO2 | 36.34 (27.55, 46.46) | 38.51 (29.27, 48.49) | 34.47 (26.00, 44.85) | <0.001 | |
SO2 | 11.40 (8.54, 14.63) | 12.76 (9.37, 16.48) | 10.52 (7.92, 12.98) | <0.001 | |
PM10 | 44.00 (34.94, 53.00) | 45.69 (36.50, 55.51) | 42.22 (33.45, 50.95) | <0.001 | |
O3 | 53.08 (39.370, 67.70) | 49.43 (37.60, 64.98) | 56.13 (41.19, 71.37) | <0.001 | |
Meteorological variables | |||||
Temperature | 14.00 (5.30, 21.80) | 13.60 (4.60, 21.90) | 14.40 (5.75, 21.60) | 0.143 | |
Relative humidity | 72.00 (63.00, 80.00) | 72.00 (64.00, 79.50) | 73.00 (63.00, 81.00) | 0.210 |
Values are presented as median (interquartile range).
AQWS, air quality warning system; COPD, chronic obstructive pulmonary disease; CO, carbon monoxide; NO2, nitrogen dioxide; SO2, sulfur dioxide; PM10, particulate matter with a diameter less than 10 μm; O3, ozone.
1 Monthly mean concentration of respiratory diseases in Hong Kong, age-standardized based on the World Health Organization standard population per 1,000,000. Hong Kong’s population at the end of 2013 was 7.2 million.
2 Environmental diseases: COPD, asthma, heart failure, stroke.
3 Digestive disease: control disease for the study, excluding peptic ulcer diseases.
Environmental disease2 |
Incidence rate |
Exacerbation rate |
||
---|---|---|---|---|
Immediate effects | Gradual effects | Immediate effects | Gradual effects | |
COPD | 0.78 (0.42, 1.44) | 0.98 (0.95, 1.00) | 1.76 (0.79, 3.93) | 0.97 (0.94, 1.01) |
Asthma | 0.23 (0.05, 1.22) | 0.80 (0.73, 0.87)*** | 0.97 (0.21, 4.47) | 0.94 (0.85, 1.04) |
Cardiovascular disease | 0.66 (0.47, 0.92)*** | 1.01 (0.99, 1.03) | 1.10 (0.75, 1.61) | 1.01 (0.99, 1.04) |
Stroke | 0.57 (0.34, 0.94)*** | 0.98 (0.95, 1.02) | 1.79 (0.40, 8.06) | 1.00 (0.94, 1.07) |
Digestive disease3 | 0.50 (0.00, 1.00) | 0.77 (0.57, 1.05) | 0.50 (0.00, 1.00) | 1.07 (0.85, 1.34) |
Values are presented as relative risk (95% confidence interval).
COPD, chronic obstructive pulmonary disease.
1 Age-standardized based on the Korean standard population in 2005; Adjusted for seasonality, temperature, humidity, time trend, and concentrations of carbon monoxide, sulfur dioxide, nitrogen dioxide, particulate matter with a diameter less than 10 μm, and ozone.
2 Environmental diseases: COPD, asthma, heart failure, stroke.
3 Digestive disease: control disease for the study, excluding peptic ulcer diseases.
*** p<0.001.
Variables | Total 2010-2019 | Before 2010-2014 | After 2015-2019 | p-value | |
---|---|---|---|---|---|
Incidence rate | |||||
COPD | 82.87 (64.9, 109.04) | 91.21 (70.85, 119.03) | 76.64 (60.19, 100.18) | <0.001 | |
Asthma | 433.92 (335.01, 543.34) | 516.56 (417.19, 621.35) | 362.92 (289.56, 447.73) | <0.001 | |
Cardiovascular disease | 75.16 (60.02, 97.39) | 72.95 (58.49, 94.98) | 78.32 (61.56, 99.73) | <0.001 | |
Stroke | 115.65 (88.2, 139.31) | 121.63 (93.43, 142.81) | 110.68 (82.87, 133.46) | <0.001 | |
Digestive disease |
2,794.03 (2,530.3, 3,100.62) | 2,802.58 (2,530.3, 3,145.03) | 2,787.8 (2,530.06, 3,070.66) | 0.017 | |
Exacerbation rate | |||||
COPD | 42.45 (24.86, 63.81) | 42.88 (25.22, 66.79) | 41.61 (24.48, 62.3) | 0.013 | |
Asthma | 89.63 (58.25, 133.34) | 97.86 (67.3, 145.81) | 80.94 (49.66, 119.25) | <0.001 | |
Cardiovascular disease | 48.41 (34.97, 67.07) | 46.36 (33.69, 62.51) | 50.61 (36.06, 71.15) | <0.001 | |
Stroke | 185.36 (147.56, 224.16) | 186.64 (147.13, 222.37) | 183.67 (148.24, 226.94) | 0.255 | |
Digestive disease |
680.48 (561.43, 825.40) | 626.84 (511.25, 750.71) | 737.97 (631.86, 876.53) | <0.001 | |
Covariates | |||||
CO | 532.87 (447.44, 647.42) | 543.23 (461.66, 662.35) | 524.02 (431.6, 638.99) | <0.001 | |
NO2 | 36.34 (27.55, 46.46) | 38.51 (29.27, 48.49) | 34.47 (26.00, 44.85) | <0.001 | |
SO2 | 11.40 (8.54, 14.63) | 12.76 (9.37, 16.48) | 10.52 (7.92, 12.98) | <0.001 | |
PM10 | 44.00 (34.94, 53.00) | 45.69 (36.50, 55.51) | 42.22 (33.45, 50.95) | <0.001 | |
O3 | 53.08 (39.370, 67.70) | 49.43 (37.60, 64.98) | 56.13 (41.19, 71.37) | <0.001 | |
Meteorological variables | |||||
Temperature | 14.00 (5.30, 21.80) | 13.60 (4.60, 21.90) | 14.40 (5.75, 21.60) | 0.143 | |
Relative humidity | 72.00 (63.00, 80.00) | 72.00 (64.00, 79.50) | 73.00 (63.00, 81.00) | 0.210 |
Environmental disease |
Incidence rate |
Exacerbation rate |
||
---|---|---|---|---|
Immediate effects | Gradual effects | Immediate effects | Gradual effects | |
COPD | 0.78 (0.42, 1.44) | 0.98 (0.95, 1.00) | 1.76 (0.79, 3.93) | 0.97 (0.94, 1.01) |
Asthma | 0.23 (0.05, 1.22) | 0.80 (0.73, 0.87) |
0.97 (0.21, 4.47) | 0.94 (0.85, 1.04) |
Cardiovascular disease | 0.66 (0.47, 0.92) |
1.01 (0.99, 1.03) | 1.10 (0.75, 1.61) | 1.01 (0.99, 1.04) |
Stroke | 0.57 (0.34, 0.94) |
0.98 (0.95, 1.02) | 1.79 (0.40, 8.06) | 1.00 (0.94, 1.07) |
Digestive disease |
0.50 (0.00, 1.00) | 0.77 (0.57, 1.05) | 0.50 (0.00, 1.00) | 1.07 (0.85, 1.34) |
Values are presented as median (interquartile range). AQWS, air quality warning system; COPD, chronic obstructive pulmonary disease; CO, carbon monoxide; NO2, nitrogen dioxide; SO2, sulfur dioxide; PM10, particulate matter with a diameter less than 10 μm; O3, ozone. Monthly mean concentration of respiratory diseases in Hong Kong, age-standardized based on the World Health Organization standard population per 1,000,000. Hong Kong’s population at the end of 2013 was 7.2 million. Environmental diseases: COPD, asthma, heart failure, stroke. Digestive disease: control disease for the study, excluding peptic ulcer diseases.
Values are presented as relative risk (95% confidence interval). COPD, chronic obstructive pulmonary disease. Age-standardized based on the Korean standard population in 2005; Adjusted for seasonality, temperature, humidity, time trend, and concentrations of carbon monoxide, sulfur dioxide, nitrogen dioxide, particulate matter with a diameter less than 10 μm, and ozone. Environmental diseases: COPD, asthma, heart failure, stroke. Digestive disease: control disease for the study, excluding peptic ulcer diseases. p<0.001.