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Purpose: The prevalence of asthma is increasing globally as the world population increases; however, and the prevalence and mortality of asthma have not been extensively investigated. Also, the effects of severity and aging on asthma prevalence and mortality are unknown. We aimed to investigate trends of the prevalence and mortality of asthma as well as health care uses and costs over 14 years according to disease severity by using real-world data in Korea. Methods: Using the National Health Insurance Sharing Service database, we extracted asthmatic patients having diagnosis codes of asthma and prescription records of antiasthmatic medications from 2002 to 2015 and categorized them according to asthma exacerbation and regular treatment. We defined asthma-associated death in terms of patients' prescription records within 3 months before all-cause death, then linked with the Cause of Death Statistics. The annual asthma-related health care uses and costs were analyzed. Results: The prevalence rates of asthma (1.6% to 2.2%) and severe asthma (SA; 3.5% to 6.1% among total asthmatics) have increased steadily over the decade in Korea, where the proportion of elderly asthmatics having increased. The asthma-related health care uses and costs had increased during the study period with the highest uses/costs in SA. The asthma mortality had a steady rising trend from 16.2 to 28.0 deaths per 100,000 with the highest mortality in SA. Conclusions: The prevalence and mortality of asthma as well as SA increases along with the burden of health care uses/costs. More active interventions, including changes in health care policies, are needed to reduce the prevalence and mortality of asthma, especially SA.

An ozone treatment system was introduced as an alternative method for municipal sludge treatment and disposal. A pilot-scale facility was built to investigate the feasibility of the ozonation for sludge reduction and recycle. The system consists of three main parts; advanced wastewater treatment, sludge ozone treatment and belt press dewatering. Ozonation of wastewater sludge resulted in mass reduction by mineralization as well as volume reduction by improvement of dewatering characteristics. The supernatant of the ozonated sludge, consisting of solubilized organics and micro-particles, proved to be an effective carbon source for denitrification. A simple economic assessment reveals that the ozonation process can be more economical than incineration for sludge treatment and disposal at small- and medium-sized wastewater treatment plants.