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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
  • 12,318 View
  • 179 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary 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, PM2.5, SO2, NO2, CO, O3의 2년평균 노출량을 각각 로지스틱회귀모형으로 분석한 결과 PM10, PM2.5, 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, PM2.5, 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  
  • Joint effect of long-term exposure to ambient air pollution on the prevalence of chronic obstructive pulmonary disease using the Korea National Health and Nutrition Examination Survey 2010–2019
    Eunjin Kwon, Taiyue Jin, Young-Ah You, Byungmi Kim
    Chemosphere.2024; 358: 142137.     CrossRef
  • PM10-bound microplastics and trace metals: A public health insight from the Korean subway and indoor environments
    Debananda Roy, Jayun Kim, Minjoo Lee, Seunga Kim, Joonhong Park
    Journal of Hazardous Materials.2024; 477: 135156.     CrossRef
  • Association between exposure to ambient particulate matter and high sensitivity C-reactive protein: A nationwide study in South Korea, 2015–2018
    Seong-Uk Baek, Jong-Uk Won, Yu-Min Lee, Jin-Ha Yoon
    Atmospheric Environment.2024; 339: 120856.     CrossRef
  • Association between humidity and respiratory health: the 2016–2018 Korea National Health and Nutrition Examination Survey
    Jinwoo Seok, Bo Young Lee, Hee-Young Yoon
    Respiratory Research.2024;[Epub]     CrossRef
  • 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
  • 18,538 View
  • 221 Download
  • 14 Web of Science
  • 14 Crossref
AbstractAbstract 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

Citations to this article as recorded by  
  • COPD in females- Seeing through the smoke
    S R Sreedevi, Ramesh Holla, A. K Vishak, Bhaskaran Unnikrishnan, T Rekha, P Prasanna Mithra, Nithin Kumar, Mithun Rao
    Lung India.2025; 42(1): 40.     CrossRef
  • Exploring the links between indoor air pollutants and health outcomes in South Asian countries: a systematic review
    Laiba Rafiq, Syeda Hamayal Zahra Naqvi, Laila Shahzad, Syed Mustafa Ali
    Reviews on Environmental Health.2023; 38(4): 741.     CrossRef
  • Unmasking the Silent Threat: Periodontal Health’s Impact on COPD Severity and Hospitalization
    Anitha Subbappa, Komarla Sundararaja Lokesh, Sindaghatta Krishnarao Chaya, Mohammed Kaleem Ullah, Jayaraj Biligere Siddaiah, Nandlal Bhojraj, Padukudru Anand Mahesh
    Journal of Personalized Medicine.2023; 13(12): 1714.     CrossRef
  • Associations of Vitamin D, chronic obstructive pulmonary disease and acute exacerbations of COPD with anxiety and depression: a nested case control study
    Komarla Sundararaja Lokesh, Ananya Ananth Rao, Sindaghatta Krishnarao Chaya, Biligere Siddaiah Jayaraj, Attahalli Shivanarayanprasad Praveena, Murali Krishna, Purnima Madhivanan, Mahesh Padukudru Anand
    Wellcome Open Research.2022; 7: 86.     CrossRef
  • Calcifediol for Use in Treatment of Respiratory Disease
    Marta Entrenas-Castillo, Lourdes Salinero-González, Luis M. Entrenas-Costa, Rubén Andújar-Espinosa
    Nutrients.2022; 14(12): 2447.     CrossRef
  • Occupational Impact on The Respiratory Health & Function of Women, Working in The Glass Bangle Industry
    Arshad Sattar Lakho , Akbar Gohar Abro , Abdul Hafeez Thebo, Khalil Kazi , Saba Bashir, Ghulam Shahar Bano
    Pakistan BioMedical Journal.2022; : 107.     CrossRef
  • Vitamin D deficiency is associated with chronic obstructive pulmonary disease and exacerbation of COPD
    Komarla Sundararaja Lokesh, Sindaghatta Krishnarao Chaya, Biligere Siddaiah Jayaraj, Attahalli Shivanarayanprasad Praveena, Murali Krishna, Purnima Madhivanan, Padukudru Anand Mahesh
    The Clinical Respiratory Journal.2021; 15(4): 389.     CrossRef
  • Use of Exposomic Methods Incorporating Sensors in Environmental Epidemiology
    Brett T. Doherty, Jeremy P. Koelmel, Elizabeth Z. Lin, Megan E. Romano, Krystal J. Godri Pollitt
    Current Environmental Health Reports.2021; 8(1): 34.     CrossRef
  • Inflammatory Biomarkers Interleukin 1 Beta (IL-1β) and Tumour Necrosis Factor Alpha (TNF-α) Are Differentially Elevated in Tobacco Smoke Associated COPD and Biomass Smoke Associated COPD
    Bellipady Shyam Prasad Shetty, Sindaghatta Krishnarao Chaya, Sravan Kumar V, Maheswarappa Mahendra, Biligere Siddaiah Jayaraj, Komarla Sundararaja Lokesh, Koustav Ganguly, Padukudru Anand Mahesh
    Toxics.2021; 9(4): 72.     CrossRef
  • Prevalence of COPD among population above 30 years in India: A systematic review and meta-analysis
    Ashwani Verma, Nachiket Gudi, Uday N Yadav, Manas Pratim Roy, Amreen Mahmood, Ravishankar Nagaraja, Pradeepa Nayak
    Journal of Global Health.2021;[Epub]     CrossRef
  • Household air pollution in India and respiratory diseases: current status and future directions
    Surinder K. Jindal, Ashutosh N. Aggarwal, Aditya Jindal
    Current Opinion in Pulmonary Medicine.2020; 26(2): 128.     CrossRef
  • Methodology of Seasonal Waves of Respiratory Disorders survey conducted at respiratory outpatient clinics across India
    BharatBhushan Sharma, Sheetu Singh, KrishnaKumar Sharma, KP Suraj, Tariq Mahmood, KumarUtsav Samaria, Surya Kant, Nishtha Singh, Tejraj Singh, Aradhna Singh, Rajeev Gupta, ParvaizA Koul, Sundeep Salvi, Virendra Singh, SWORD Study Group
    Lung India.2020; 37(2): 100.     CrossRef
  • Clinical, Epidemiological and Experimental Approaches to Assess Adverse Health Outcomes of Indoor Biomass Smoke Exposure: Conclusions from An Indo-Swedish Workshop in Mysuru, January 2020
    Mahesh Padukudru Anand, Kjell Larsson, Gunnar Johanson, Harish C. Phuleria, P. Veeranna Ravindra, Lena Ernstgård, Ulaganathan Mabalirajan, Murali Krishna, Lena Palmberg, Krystal J. Godri Pollitt, Swapna Upadhyay, Koustav Ganguly
    Toxics.2020; 8(3): 68.     CrossRef
  • Putative Systemic Biomarkers of Biomass Smoke-Induced Chronic Obstructive Pulmonary Disease among Women in a Rural South Indian Population
    Sangeetha Vishweswaraiah, Tania Ahalya Thimraj, Leema George, Chaya Sindaghatta Krishnarao, Komarla Sundararaja Lokesh, Jayaraj Biligere Siddaiah, Kjell Larsson, Swapna Upadhyay, Lena Palmberg, Mahesh Padukudru Anand, Koustav Ganguly
    Disease Markers.2018; 2018: 1.     CrossRef
Epidemiologic Investigation
Epidemiologic research on lung damage caused by humidifier disinfectants
Moo-Song Lee, Hwa Jung Kim
Epidemiol Health. 2016;38:e2016031.   Published online July 20, 2016
DOI: https://doi.org/10.4178/epih.e2016031
  • 20,043 View
  • 282 Download
  • 6 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
In April 2011 a tertiary hospital located in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults. To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. A hospital based case-control study was conducted to indicate that humidifier detergent use was the cause of the outbreak. This information led the Ministry of Health and Welfare of Korea issued an order that humidifier detergents should be withdrawn from the market. Here, we describe the major events of planning, execution, and interpretation of the study, and discussions between researchers and public authorities following the decision to perform an epidemiologic study, chronologically.
Summary
Korean summary
본 역학조사는 일개 병원에서 신고한 질병 유행에 대해 다학제적 연구 결과로써, 질병의 임상적 특성과 역학적 원인 파악 후 정책적 대책으로 이어진 사례이다. 향후 가습기 살균제 이외에도 일반국민의 건강에 영향을 미칠 수 있는 다양한 생활환경요인에 관심을 가지고, 필요 시 적극적인 조사와 대응이 필요할 것이다.

Citations

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  • Prenatal and Childhood Exposure to Humidifier Disinfectants and Attention-Deficit/Hyperactivity Disorder (ADHD): Insights from a Retrospective Cohort Design
    Hyowon Choi, Hunju Lee, Yeon-Soon Ahn
    Toxics.2025; 13(2): 78.     CrossRef
  • Is Polyhexamethylene Guanidine and Oligo(2-(2-Ethoxy) Ethoxyethyl Guanidium Chloride Exposure Related to Gestational Diabetes?
    Hyowon Choi, Nam-Yun Kim, Nalai Kim, Yeon-Soon Ahn
    Toxics.2024; 12(12): 841.     CrossRef
  • Evaluation of polyhexamethylene guanidine-induced lung injuries by chest CT, pathologic examination, and RNA sequencing in a rat model
    Cherry Kim, Sang Hoon Jeong, Jaeyoung Kim, Ki Yeol Lee, Jaehyung Cha, Chang Hyun Lee, Eun-Kee Park, Ju-Han Lee
    Scientific Reports.2021;[Epub]     CrossRef
  • Comparison of Long Term Follow-up Chest CT Imaging in Adult and Pediatric Patients with Humidifier Disinfectant-related Lung Injury
    Soyeoun Lim, Jong Han Leem, Young-Seoub Hong, Jungwon Kim, Soyoung Park, Joon-Sung Joh, Woon-Jung Kwon, Yangho Kim
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
  • Guanidine-based disinfectants, polyhexamethylene guanidine-phosphate (PHMG-P), polyhexamethylene biguanide (PHMB), and oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) induced epithelial-mesenchymal transition in A549 alveolar epithelial cells
    Yong Joo Park, Mi Ho Jeong, In Jae Bang, Ha Ryong Kim, Kyu Hyuck Chung
    Inhalation Toxicology.2019; 31(4): 161.     CrossRef
  • Development of QSAR Model for Subchronic Inhalation Toxicity Using Random Forest Regression Method
    Jae Hong Shin, Byeong Hun Lee, Sung Kwang Lee
    Bulletin of the Korean Chemical Society.2019; 40(8): 819.     CrossRef
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