Winter Season Temperature Drops and Sulfur Dioxide Levels Affect on Exacerbation of Refractory Asthma in South Korea: A Time-Trend Controlled Case-Crossover Study Using Soonchunhyang Asthma Cohort Data

Kim, Sungroul; Kim, Yongbae; Lee, Mee-Ri; Kim, Junhyung; Jung, Ara; Park, Jong Suk; Jang, An‐Soo; Park, Sung Woo; Uh, Soo‐Taek; Choi, Jae Sung; Kim, Young Hoon; Buckley, Timothy J.; Park, Choon-Sik

doi:10.3109/02770903.2012.702839

Cited by 27 publications

(15 citation statements)

References 38 publications

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“…However, the reported relationship between asthma exacerbations and air pollution during 'natural' exposure is inconsistent, and air pollution-related asthma aggravations are expected to be dependent largely on the atmospheric conditions during such natural exposure 528. Several time-series analyses have reported that air pollution is related to asthma exacerbation 2930.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department Visits for Asthma Exacerbation due to Weather Conditions and Air Pollution in Chuncheon, Korea: A Case-Crossover Analysis

Kwon

Han

et al. 2016

Allergy Asthma Immunol Res

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PurposeThis retrospective study was conducted to estimate the effects of climate factors and air pollution on asthma exacerbations using a case-crossover analysis.MethodsPatients who visited the emergency department (ED) of 2 university hospitals in Chuncheon for asthma exacerbations from January 1, 2006, to December 31, 2011, were enrolled. Daily average data for meteorological factors (temperature, daily temperature range, relative humidity, wind speed, atmospheric pressure, presence of rain, solar irradiation, and presence of fog) and the daily average levels of gaseous air pollutants (SO2, NO2, O3, CO, and PM10) were obtained. A case-crossover analysis was performed using variables about the weather and air pollution at 1-week intervals between cases and controls before and after ED visits.ResultsThere were 660 ED visits by 583 patients with asthma exacerbations. Low relative humidity (lag 1 and 2) and high wind speed (lag 1, 2, and 3) were associated with ED visits for asthma. Fog (lag 2) showed protective effects against asthma exacerbations in Chuncheon (risk increase: -29.4% [95% CI=-46.3% to -7.2%], P=0.013). These relationships were stronger in patients ≤19 years old than in those >60 years old. High levels of ambient CO (lag 1, 2, and 3) and NO2 (lag 2 and 3) were associated with decreased ED visits for asthma. However, there were no significant relationships among levels of ambient CO or NO2 and asthma exacerbations after adjusting for wind speed and relative humidity.ConclusionsHigh wind speed and low humidity were associated with an increased risk of asthma ED visits. Fog was associated with a decreased risk of asthma ED visits after controlling for seasonal variations in weather and air pollution.

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Section: Discussionmentioning

confidence: 99%

Emergency Department Visits for Asthma Exacerbation due to Weather Conditions and Air Pollution in Chuncheon, Korea: A Case-Crossover Analysis

Kwon

Han

et al. 2016

Allergy Asthma Immunol Res

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“…Supplementary Table S2 presents the quality scores and main characteristics of the eligible studies. [12, 19-101] The outcomes were asthma exacerbations related to outpatient visits (9 studies), ER visits (44 studies), hospitalizations (29 studies), deaths (2 studies), and other events (7 studies). Additionally, one study did not specify separate data regarding ER visits and hospitalizations[96]; consequently, it was classified as ER visits or hospitalization outcomes.…”

Section: Resultsmentioning

confidence: 99%

Outdoor air pollution and the risk of asthma exacerbations in single lag0 and lag1 exposure patterns: A systematic review and meta-analysis

Huang

Yang

Fan

et al. 2021

Preprint

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Background: Asthma exacerbations accelerate the disease progression, as well as increases the incidence of hospitalizations and deaths. There have been studies on the effects of outdoor air pollution and asthma exacerbations; however, evidence regarding single lag0 and lag1 exposure patterns is inconclusive. Objective To synthesize evidence regarding the relationship between outdoor air pollution and the asthma exacerbation risk in single lag0 and lag1 exposure patterns. Methods We performed a systematic literature search using PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Internet, Chinese BioMedical, and Wanfang databases until August 1st, 2020. Additionally, we reviewed the reference lists of the relevant articles. Two authors independently evaluated the eligible articles and performed structured extraction of relevant information. Pooled relative risks (RRs) and 95% confidence intervals (CIs) of lag0 and lag1 exposure patterns were estimated using the random-effect models. Results: Eighty-four studies met the eligibility criteria and provided sufficient information for meta-analysis. Outdoor air pollutants were associated with significantly increased risks of asthma exacerbations in both single lag0 and lag1 exposure patterns [lag0: RR (95%CI) (pollutants), 1.057(1.011, 1.103) (air quality index; AQI), 1.007(1.005, 1.010) (PM2.5), 1.009(1.005, 1.012) (PM10), 1.010(1.006, 1.014) (NO2), 1.030(1.011, 1.048) (CO), 1.005(1.002, 1.009) (O3); lag1: RR (95%CI) (pollutants), 1.064(1.022, 1.106) (AQI), 1.005(1.002, 1.008) (PM2.5), 1.007(1.004, 1.011) (PM10), 1.008(1.004, 1.012) (NO2), 1.025(1.007, 1.042) (CO), 1.010(1.006, 1.013) (O3)], except SO2 [lag0: RR (95%CI), 1.004(1.000, 1.007); lag1: RR (95%CI), 1.003(0.999, 1.006)]. Subgroup analyses revealed stronger effects in children and asthma exacerbations associated with other events (including symptoms, lung function changes, and medication use as required). Conclusion These findings demonstrate that outdoor air pollution significantly increases the asthma exacerbation risk in single lag0 and lag1 exposure patterns.

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“…Meteorological data, including mean daily temperature, relative humidity, and air pressure, were obtained at national monitoring sites closest to the hospital [ 20 ]. Air pollution measurements were obtained from the national ambient monitoring station located closest to homes of the patients, as previously described [ 20 ]. Daily (24-h) averages for PM 10 , sulfur dioxide (SO 2 ), and nitrogen dioxide (NO 2 ) levels were used, whereas 8-h running averages were used for ozone (O 3 ) and carbon monoxide (CO) levels.…”

Section: Methodsmentioning

confidence: 99%

Association between the Ratio of FEV1 to FVC and the Exposure Level to Air Pollution in Neversmoking Adult Refractory Asthmatics Using Data Clustered by Patient in the Soonchunhyang Asthma Cohort Database

Park

et al. 2018

IJERPH

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Using real-world cases, asthma-related clinical data were clustered by patient; 5% of all asthmatics were found to have refractory asthma (RA) with a relatively low lung function (forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) less than 80%). Using a multilevel study design for clustered spirometry data observed between 2005 and 2014, we evaluated the association between changes in the ratio of FEV1 to FVC and variations in acute exposure to air pollution. We analyzed 2310 episodes of RA from 214 neversmoking patients. In spring, a 1 µg/m³ increase in concentration of particles ≤10 μm (PM10) on Lag 1 significantly reduced the ratio by 0.4% (95% confidence interval (CI): 0.1–0.7%) after adjusting for sex, age, body mass index (BMI), and total Immunoglobulin E (IgE) level. Unit (ppb) increase in SO2 concentration on Lag 3 and 4 in fall and on Lag 6 in winter significantly reduced the ratio by 2 to 3% (p < 0.05). We found that acute exposure to PM10 in spring or SO2 in fall or winter were positively associated with lung function drop indicating necessity of control strategies of target air pollutant source by season to protect susceptible population.

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Winter Season Temperature Drops and Sulfur Dioxide Levels Affect on Exacerbation of Refractory Asthma in South Korea: A Time-Trend Controlled Case-Crossover Study Using Soonchunhyang Asthma Cohort Data

Cited by 27 publications

References 38 publications

Emergency Department Visits for Asthma Exacerbation due to Weather Conditions and Air Pollution in Chuncheon, Korea: A Case-Crossover Analysis

Emergency Department Visits for Asthma Exacerbation due to Weather Conditions and Air Pollution in Chuncheon, Korea: A Case-Crossover Analysis

Outdoor air pollution and the risk of asthma exacerbations in single lag0 and lag1 exposure patterns: A systematic review and meta-analysis

Association between the Ratio of FEV1 to FVC and the Exposure Level to Air Pollution in Neversmoking Adult Refractory Asthmatics Using Data Clustered by Patient in the Soonchunhyang Asthma Cohort Database

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