Dataset Information

Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea.

ABSTRACT: Cancer survivors are at an increased risk for cardiovascular disease (CVD). However, the association between particulate matter (PM) and CVD risk among cancer survivors (alive >5 years since diagnosis) is unclear. We investigated the risk of CVD among 40,899 cancer survivors within the Korean National Health Insurance Service database. Exposure to PM was determined by assessing yearly average PM levels obtained from the Air Korea database from 2008 to 2011. PMs with sizes <2.5 (PM2.5), <10 (PM10), or 2.5-10 (PM2.5-10) ?m in diameter were compared, with each PM level exposure further divided into quintiles. Patients were followed up from January 2012 to date of CVD event, death, or December 2017, whichever came earliest. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated using Cox proportional hazards regression by PM exposure levels. Compared with cancer survivors in the lowest quintile of PM2.5 exposure, those within the highest quintile had a greater risk for CVD (aHR 1.31, 95% CI 1.07-1.59). Conversely, increasing PM10 and PM2.5-10 levels were not associated with increased CVD risk (p for trend 0.078 and 0.361, respectively). Cancer survivors who reduce PM2.5 exposure may benefit from lower risk of developing CVD.

SUBMITTER: Choi S

PROVIDER: S-EPMC7215375 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea.

Choi Seulggie S Kim Kyae Hyung KH Kim Kyuwoong K Chang Jooyoung J Kim Sung Min SM Kim Seong Rae SR Cho Yoosun Y Lee Gyeongsil G Son Joung Sik JS Park Sang Min SM

International journal of environmental research and public health 20200421 8

Cancer survivors are at an increased risk for cardiovascular disease (CVD). However, the association between particulate matter (PM) and CVD risk among cancer survivors (alive >5 years since diagnosis) is unclear. We investigated the risk of CVD among 40,899 cancer survivors within the Korean National Health Insurance Service database. Exposure to PM was determined by assessing yearly average PM levels obtained from the Air Korea database from 2008 to 2011. PMs with sizes <2.5 (PM2.5), <10 (PM10 ...[more]

PMID: 32326144

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Project description:BACKGROUND:While many studies reported the association between long-term exposure to particulate matter air pollution (PM) and cardiovascular disease (CVD), few studies focused on incidence with relatively high-dose exposure using a nationwide cohort. This study aimed to investigate the association between long-term exposure to PM10 and PM2.5 and incidence of CVD in a nationwide and population-based cohort in South Korea where the annual average concentration of PM2.5 is above 20??g/m3. METHODS:We selected 196,167 adults in the National Health Insurance Service-National Sample Cohort (NHIS-NSC) constructed based on the entire South Korean population. Incidence of four CVD subtypes including ischemic heart disease (IHD), myocardial infarction, heart failure, and stroke, and total CVD including all four was identified as the first diagnosis for 2007-2015. To assess individual exposures, we used annually-updated district-level residential addresses and district-specific PM concentrations predicted by a previously developed universal kriging prediction model. We computed individual-level long-term PM concentrations for four exposure windows: previous 1, 3, and 5?year(s) and 5?years before baseline. We applied time-dependent Cox proportional hazards models to estimate hazard ratios (HRs) of incident CVDs per 10??g/m3 increase in PM10 and PM2.5 after adjusting for individual- and area-level characteristics. RESULTS:During 1,578,846 person-year, there were 33,580 cases of total incident CVD. Average PM10 and PM2.5 concentrations for the previous 5?years were 52.3 and 28.1??g/m3, respectively. A 10??g/m3 increase in PM2.5 exposed for the previous 5?years was associated with 4 and 10% increases in the incidence of total CVD (95% confidence interval: 0-9%) and IHD (4-16%), respectively. HRs tended to be higher with earlier exposure for IHD and more recent exposure for stroke. The estimated shape of the concentration-response relationship showed non-linear patterns. We did not find evidence of the association for PM10. CONCLUSIONS:Using a population-based nationwide cohort exposed to relatively high PM concentration, this study confirmed the association between PM2.5 and CVD incidence that was reported in previous studies mostly with low-dose environments. The magnitude and the shape of the association were generally consistent with previous findings.

Project description:Given that fine particulate matter (? 2.5 ?m; PM2.5) is a mixture of multiple components, it has been of high interest to identify its specific health-relevant physical and/or chemical features.We conducted a time-series study of PM2.5 and cardiorespiratory emergency department (ED) visits in the St. Louis, Missouri-Illinois metropolitan area, using 2 years of daily PM2.5 and PM2.5 component measurements (including ions, carbon, particle-phase organic compounds, and elements) made at the St. Louis-Midwest Supersite, a monitoring site of the U.S. Environmental Protection Agency Supersites ambient air monitoring research program.Using Poisson generalized linear models, we assessed short-term associations between daily cardiorespiratory ED visit counts and daily levels of 24 selected pollutants. Associations were estimated for interquartile range changes in each pollutant. To allow comparison of relationships among multiple pollutants and outcomes with potentially different lag structures, we used 3-day unconstrained distributed lag models controlling for time trends and meteorology.Considering results of our primary models, as well as sensitivity analyses and models assessing co-pollutant confounding, we observed robust associations of cardiovascular disease visits with 17?(H),21?(H)-hopane and congestive heart failure visits with elemental carbon. We also observed a robust association of respiratory disease visits with ozone. For asthma/wheeze, associations were strongest with ozone and nitrogen dioxide; observed associations of asthma/wheeze with PM2.5 and its components were attenuated in two-pollutant models with these gases. Differential measurement error due to differential patterns of spatiotemporal variability may have influenced patterns of observed associations across pollutants.Our findings add to the growing field examining the health effects of PM2.5 components. Combustion-related components of the pollutant mix showed particularly strong associations with cardiorespiratory ED visit outcomes.

Project description:BackgroundNumerous studies have linked fine particles [? 2.5 µm in aerodynamic diameter (PM(2.5))] and health. Most studies focused on the total mass of the particles, although the chemical composition of the particles varies substantially. Which chemical components of fine particles that are the most harmful is not well understood, and research on the chemical composition of PM(2.5) and the components that are the most harmful is particularly limited in Asia.ObjectivesWe characterized PM(2.5) chemical composition and estimated the effects of cause-specific mortality of PM(2.5) mass and constituents in Seoul, Korea. We compared the chemical composition of particles to those of the eastern and western United States.MethodsWe examined temporal variability of PM(2.5) mass and its composition using hourly data. We applied an overdispersed Poisson generalized linear model, adjusting for time, day of week, temperature, and relative humidity to investigate the association between risk of mortality and PM(2.5) mass and its constituents in Seoul, Korea, for August 2008 through October 2009.ResultsPM(2.5) and chemical components exhibited temporal patterns by time of day and season. The chemical characteristics of Seoul's PM(2.5) were more similar to PM(2.5) found in the western United States than in the eastern United States. Seoul's PM(2.5) had lower sulfate (SO(4)) contributions and higher nitrate (NO(3)) contributions than that of the eastern United States, although overall PM(2.5) levels in Seoul were higher than in the United States. An interquartile range (IQR) increase in magnesium (Mg) (0.05 ?g/m³) was associated with a 1.4% increase (95% confidence interval: 0.2%, 2.6%) in total mortality on the following day. Several components that were among the largest contributors to PM(2.5) total mass--NO(3), SO(4), and ammonium (NH(4))--were moderately associated with same-day cardiovascular mortality at the p < 0.10 level. Other components with smaller mass contributions [Mg and chlorine (Cl)] exhibited moderate associations with respiratory mortality on the following day (p < 0.10).ConclusionsOur findings link PM(2.5) constituents with mortality and have implications for policy making on sources of PM(2.5) and on the relevance of PM(2.5) health studies from other areas to this region.

Dataset Information

Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea.

Publications

Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea.

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