Journal of Environmental Health Sciences (한국환경보건학회지)

Korean Society of Environmental Health (한국환경보건학회)
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Effects of Reduced Ambient PM10 Levels on the Health of Children in Lower-income Families

대기질 개선과 저소득계층 어린이 건강보호 효과

  • Bae, Hyun-Joo (Institute of Health and Environment, Seoul National University)
  • 배현주 (서울대학교 보건환경연구소)
  • Received : 2010.05.08
  • Accepted : 2010.06.22
  • Published : 2010.06.30
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Abstract

We examined the association of particulate matter with an aerodynamic diameter < $10\;{\mu}m$ ($PM_{10}$) with asthma-related hospitalization, stratified by socioeconomic status (SES), among children less than 15 years of age in Seoul, Korea, between 2003 and 2005. In addition, we estimated the reduction in the number of asthma-related hospitalizations that would result from implementing the World Health Organization (WHO) guideline. SES was defined based on data concerning health insurance premium grades, and grouped into two levels: lower-income group and control group. The lower-income group was classified as having an accumulated income which did not exceed the 50th percentile of the median income. Time-series analysis was performed to evaluate the association between $PM_{10}$ and asthma-related hospitalization. The Environmental Benefits Mapping and Analysis Program was used to analyze the impact on children's health. Based upon an increase of $10\;{\mu}g/m^3$ of $PM_{10}$, the asthma-related hospitalization risk for the lower-income group was increased by 1.78% (95% confidence intervals (CI) = 0.79-2.78%), while the risk for the control group was increased by 0.83% (95% CI = 0.34-1.32%). Attaining the WHO guideline, relative to the concentration in 2007, would result in a reduction in asthma-related hospitalizations of 18 cases per 100,000 of the children population in the lower-income group, and 7 cases in the control group. The health benefits of improved air quality for children in the lower-income group were thus 2.5 times greater than for children in the control group. Our results show that the lower-income group is disproportionately burdened with asthma-related hospitalization arising from air pollution. Therefore, biologically- and socioeconomically-disadvantaged populations should be considered in public health interventions in order to protect the children's health.

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References

  1. Zanobetti, A., Schwartz, J. and Gold, D. : Are there sensitive subgroups for the effects of airborne particles? Environmental Health Perspectives, 108(9), 841-845, 2000. https://doi.org/10.1289/ehp.00108841
  2. Zanobetti, A. and Schwartz, J. : Race, gender, and social status as modifiers of the effects of $PM_{10}$ on mortality. Journal of Occupational and Environmental Medicine, 42(5), 469-474, 2000. https://doi.org/10.1097/00043764-200005000-00002
  3. Bae, H. J., Ha, J. S., Lee, A. K. and Park, J. I. : Age dependencies in air pollution-associated asthma hospitalization. Korean Journal of Environmental Health, 34(2), 124-130, 2008. https://doi.org/10.5668/JEHS.2008.34.2.124
  4. Bell, M. L. and Dominici, F. : Effect modification by community characteristics on the short-term effects of ozone exposure and mortality in 98 US communities. American Journal of Epidemiology, 167(8), 986-997, 2008. https://doi.org/10.1093/aje/kwm396
  5. Wong, C. M., Ou, C. Q., Chan, K. P., Chau, Y. K., Thach, T. Q., Yang, L., Chung, R. Y., Thomas, G. N., Peiris, J. S., Wong, T. W., Hedley, A. J. and Lam, T. H. : The effects of air pollution on mortality in socially deprived urban areas in Hong Kong, China. Environmental Health Perspectives, 116(9), 1189-1194, 2008. https://doi.org/10.1289/ehp.10850
  6. O'Neill, M. S., Jerrett, M., Kawachi, I., Levy, J. I., Cohen, A. J., Gouveia, N., Wilkinson, P., Fletcher, T., Cifuentes, L. and Schwartz, J. : Health, wealth, and air pollution: advancing theory and methods. Environmental Health Perspectives, 111(16), 1861-1870, 2003. https://doi.org/10.1289/ehp.6334
  7. Ou, C. Q., Hedley, A. J., Chung, R. Y., Thach, T. Q., Chau, Y. K., Chan, K. P., Yang, L., Ho, S. Y., Wong, C. M. and Lam, T. H. : Socioeconomic disparities in air pollution-associated mortality. Environmental Research, 107(2), 237-244, 2008. https://doi.org/10.1016/j.envres.2008.02.002
  8. National Health Insurance Corporation : Statistical analysis in health insurance, 2008.
  9. Wissow, L. S., Gittelsohn, A. M., Szklo, M., Starfield, B. and Mussman, M. : Poverty, race, and hospitalization for childhood asthma. American Journal of Public Health. 78(7), 777-782, 1998.
  10. Basagana, X., Sunyer, J., Kogevinas, M., Zock, J. P., Duran-Tauleria, E., Jarvis, D., Burney, P., Anto, J. M. and European Community Respiratory Health Survey : Socioeconomic status and asthma prevalence in young adults- the European Community Respiratory Health Survey. American Journal of Epidemiology, 160(2), 178-188, 2004. https://doi.org/10.1093/aje/kwh186
  11. Lin, M., Chen, Y., Villeneuve, P. J., Burnett, R. T., Lemyre, L., Hertzman, C., McGrail, K. M. and Krewski, D. : Gaseous air pollutants and asthma hospitalization of children with low household income in Vancouver, British Columbia, Canada. American Journal of Epidemiology, 159(3), 294-303, 2004. https://doi.org/10.1093/aje/kwh043
  12. Burra, T. A., Moineddin, R., Agha, M. M. and Glazier, R. H. : Social disadvantage, air pollution, and asthma physician visits in Toronto, Canada. Environmental Research, 109(5), 567-574, 2009. https://doi.org/10.1016/j.envres.2009.03.004
  13. Wong, E. Y., Gohlke, J., Griffith, W. C., Farrow, S. and Faustman, E. M. : Assessing the health benefits of air pollution reduction for children. Environmental Health Perspectives, 112(2), 226-232, 2004.
  14. Ministry of Environment : Environmental health policy plan 10 years, 2005.
  15. World Health Organization : WHO air quality guidelines for particulate matter, ozone, nitrogen, dioxide and sulfur dioxide, 2005.
  16. Statistics Korea : Population and housing census report, 2006.
  17. Kang, H. C., Park, E. C., Lee, K. S., Park, T. K., Chung, W. J. and Kim, H. J. : Changes in distributive equity of health insurance contribution burden. Journal of Preventive Medicine and Public Health, 38(1), 107-116, 2005.
  18. Korea Development Institute : Pro-poor Growth, 2008.
  19. Dominici, F., McDermott, A., Zeger, S. L. and Samet, J. M. : On the use of generalized additive models in time-series studies of air pollution and health. American Journal of Epidemiology, 156(3), 193-203, 2002. https://doi.org/10.1093/aje/kwf062
  20. Atkinson, R. W., Anderson, H. R., Sunyer, J., Ayres, J., Baccini, M., Vonk, J. M., Boumghar, A., Forastiere, F., Forsberg, B., Touloumi, G., Schwartz, J. and Katsouyanni, K. : Acute effects of particulate air pollution on respiratory admissions: results from APHEA 2 project. Air Pollution and Health: a European Approach. American Journal of Respiratory and Critical Care Medicine, 164(10), 1860-1866, 2001. https://doi.org/10.1164/ajrccm.164.10.2010138
  21. Zanobetti, A., Schwartz, J. and Dockery, D. W. : Airborne particles are a risk factor for hospital admissions for heart and lung disease. Environmental Health Perspectives, 108(11), 1071-1077, 2000. https://doi.org/10.1289/ehp.001081071
  22. Dominici, F., Peng, R. D., Bell, M. L., Pham, L., McDermott, A., Zeger, S. L. and Samet, J. M. : Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. Journal of the American Medical Association, 295(10), 1127-1134, 2006. https://doi.org/10.1001/jama.295.10.1127
  23. Akaike, K. : Information theory and an extension of the maximum likelihood principle, 1973.
  24. Park, J. I. and Bae, H. J. : Assessing the Health Benefits of the Seoul Air Quality Management Plan Using BenMAP. Korean Journal of Environmental Health, 32(6), 571-577, 2006.
  25. Bae, H. J., Kim, M. H., Lee, A. K. and Park, J. I. : Acute effects of $PM_{10}$ on asthma hospitalization among children and benefit analysis at four major cities in Korea. Korean Journal of Environmental Health, 35(1), 1-10, 2009. https://doi.org/10.5668/JEHS.2009.35.1.001
  26. Abt Associates Inc. : BenMAP Environmental Benefits Mapping and Analysis Program user's manual, 2008.
  27. Davidson, K., Hallberg, A., McCubbin, D. and Hubbell, B. : Analysis of $PM_{2.5}$ using the Environmental Benefits Mapping and Analysis Program (BenMAP). Journal of Toxicology and Environmental Health. Part A, 70(3-4), 332-346, 2007. https://doi.org/10.1080/15287390600884982
  28. Nauenberg, E. and Basu, K. : Effect of insurance coverage on the relationship between asthma hospitalizations and exposure to air pollution. Public Health Reports, 114(2), 135-148, 1999.
  29. Kim, S. Y., O'Neill, M. S., Lee, J. T., Cho, Y., Kim, J. and Kim, H. : Air pollution, socioeconomic position, and emergency hospital visits for asthma in Seoul, Korea. International Archives of Occupational and Environmental Health A, 80(8), 701-710, 2007. https://doi.org/10.1007/s00420-007-0182-3
  30. Lee, J. T., Kim, H. and Schwartz, J. : Bidirectional case-crossover studies of air pollution: bias from skewed and incomplete waves. Environmental Health Perspectives, 108(12), 1107-1111, 2000. https://doi.org/10.1289/ehp.001081107
  31. Forastiere, F., Stafoggia, M., Tasco, C., Picciotto, S., Agabiti, N., Cesaroni, G. and Perucci, C. A. : Socioeconomic status, particulate air pollution, and daily mortality: differential exposure or differential susceptibility. American Journal of Industrial Medicine, 50(3), 208-216, 2007. https://doi.org/10.1002/ajim.20368
  32. Zeka, A., Zanobetti, A. and Schwartz, J. : Individuallevel modifiers of the effects of particulate matter on daily mortality. American Journal of Epidemiology, 163(9), 849-859, 2006. https://doi.org/10.1093/aje/kwj116
  33. Ostro, B. D., Tran, H. and Levy, J. I. : The health benefits of reduced tropospheric ozone in California. Journal of the Air & Waste Management Association, 56(7), 1007-1021, 2006. https://doi.org/10.1080/10473289.2006.10464511
  34. Bell, M. L., Davis, D. L., Gouveia, N., Borja-Aburto, V. H. and Cifuentes, L. A. : The avoidable health effects of air pollution in three Latin American cities: Santiago, So Paulo, and Mexico City. Environmental Research, 100(3), 431-440, 2006. https://doi.org/10.1016/j.envres.2005.08.002
  35. Environmental Protection Agency : The Benefits and Costs of the Clean Air Act Amendments of 1990-2010, 1999.
  36. Park, C, S., Kang, H. Y., Kwon, I., Kang, D. R. and Jung, H. Y. : Cost-of-illness study of asthma in Korea: estimated from the Korea National Health insurance claims database. Journal of Preventive Medicine and Public Health, 39(5), 397-403, 2006.

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