Dataset Information

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea.

ABSTRACT:

Objectives

A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than 10 ?m in aerodynamic diameter, nitrogen dioxide [NO2], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009.

Methods

The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants.

Results

Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of NO2 was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of NO2 at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291).

Conclusions

The results of our study suggest that ambient air pollution, specifically NO2, is associated with ED visits for diabetic coma.

SUBMITTER: Kim H

PROVIDER: S-EPMC6283743 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea.

Kim Hyunmee H Kim Woojin W Choi Jee Eun JE Kim Changsoo C Sohn Jungwoo J

Journal of preventive medicine and public health = Yebang Uihakhoe chi 20181029 6

<h4>Objectives</h4>A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with ...[more]

PMID: 30514056

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Project description:BackgroundPrevious studies of short-term ambient air pollution exposure and asthma morbidity in the United States have been limited to a small number of cities and/or pollutants and with limited consideration of effects across ages.ObjectivesTo estimate acute age group-specific effects of fine and coarse particulate matter (PM), major PM components, and gaseous pollutants on emergency department (ED) visits for asthma during 2005-2014 across the United States.MethodsWe acquired ED visit and air quality data in regions surrounding 53 speciation sites in 10 states. We used quasi-Poisson log-linear time-series models with unconstrained distributed exposure lags to estimate site-specific acute effects of air pollution on asthma ED visits overall and by age group (1-4, 5-17, 18-49, 50-64, and 65+ y), controlling for meteorology, time trends, and influenza activity. We then used a Bayesian hierarchical model to estimate pooled associations from site-specific associations.ResultsOur analysis included 3.19 million asthma ED visits. We observed positive associations for multiday cumulative exposure to all air pollutants examined [e.g., 8-d exposure to PM2.5: rate ratio of 1.016 with 95% credible interval (CI) of (1.008, 1.025) per 6.3-μg/m3 increase, PM10-2.5: 1.014 (95% CI: 1.007, 1.020) per 9.6-μg/m3 increase, organic carbon: 1.016 (95% CI: 1.009, 1.024) per 2.8-μg/m3 increase, and ozone: 1.008 (95% CI: 0.995, 1.022) per 0.02-ppm increase]. PM2.5 and ozone showed stronger effects at shorter lags, whereas associations of traffic-related pollutants (e.g., elemental carbon and oxides of nitrogen) were generally stronger at longer lags. Most pollutants had more pronounced effects on children (<18 y old) than adults; PM2.5 had strong effects on both children and the elderly (>64 y old); and ozone had stronger effects on adults than children.ConclusionsWe reported positive associations between short-term air pollution exposure and increased rates of asthma ED visits. We found that air pollution exposure posed a higher risk for children and older populations. https://doi.org/10.1289/EHP11661.

Project description:Various temporal metrics of daily pollution levels have been used to examine the relationships between air pollutants and acute health outcomes. However, daily metrics of the same pollutant have rarely been systematically compared within a study. In this analysis, we describe the variability of effect estimates attributable to the use of different temporal metrics of daily pollution levels. We obtained hourly measurements of ambient particulate matter (PM?.?), carbon monoxide (CO), nitrogen dioxide (NO?), and ozone (O?) from air monitoring networks in 20-county Atlanta for the time period 1993-2004. For each pollutant, we created (1) a daily 1-h maximum; (2) a 24-h average; (3) a commute average; (4) a daytime average; (5) a nighttime average; and (6) a daily 8-h maximum (only for O?). Using Poisson generalized linear models, we examined associations between daily counts of respiratory emergency department visits and the previous day's pollutant metrics. Variability was greatest across O? metrics, with the 8-h maximum, 1-h maximum, and daytime metrics yielding strong positive associations and the nighttime O? metric yielding a negative association (likely reflecting confounding by air pollutants oxidized by O?). With the exception of daytime metric, all of the CO and NO? metrics were positively associated with respiratory emergency department visits. Differences in observed associations with respiratory emergency room visits among temporal metrics of the same pollutant were influenced by the diurnal patterns of the pollutant, spatial representativeness of the metrics, and correlation between each metric and copollutant concentrations. Overall, the use of metrics based on the US National Ambient Air Quality Standards (for example, the use of a daily 8-h maximum O? as opposed to a 24-h average metric) was supported by this analysis. Comparative analysis of temporal metrics also provided insight into underlying relationships between specific air pollutants and respiratory health.

Dataset Information

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea.

Objectives

Methods

Results

Conclusions

Publications

Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea.

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