Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study

  • Nakao, Motoyuki (Department of Public Health, Kurume University School of Medicine) ;
  • Ishihara, Yoko (Department of Public Health, Kurume University School of Medicine) ;
  • Kim, Cheol-Hong (Department of Internal Medicine, Respiratory Health Center, Hallym University Dongtan Sacred Heart Hospital) ;
  • Hyun, In-Gyu (Department of Internal Medicine, Respiratory Health Center, Hallym University Dongtan Sacred Heart Hospital)
  • Received : 2018.01.25
  • Accepted : 2018.04.17
  • Published : 2018.05.31
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Abstract

Objectives: Air pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea. Methods: Patients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL. Results: Lower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than $10{\mu}m$ in diameter ($PM_{10}$). Lower social functioning scores were associated with high PM less than $2.5{\mu}m$ in diameter and nitrogen dioxide ($NO_2$) concentrations. High $NO_2$ concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when $PM_{10}$, $NO_2$, or ozone ($O_3$) concentrations were high, regardless of COPD severity. High $PM_{10}$ concentrations were associated with worsened wheezing, particularly in COPD patients. Conclusions: The results suggest that PM, $NO_2$, and $O_3$ cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.

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References

  1. Coulibaly S, Minami H, Abe M, Hasei T, Oro T, Funasaka K, et al. Long-range transport of mutagens and other air pollutants from mainland East Asia to western Japan. Genes Environ 2015;37:25. https://doi.org/10.1186/s41021-015-0025-5
  2. Guan WJ, Zheng XY, Chung KF, Zhong NS. Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action. Lancet 2016;388(10054):1939-1951. https://doi.org/10.1016/S0140-6736(16)31597-5
  3. Kim HS, Chung YS, Yoon MB. An analysis on the impact of large-scale transports of dust pollution on air quality in East Asia as observed in central Korea in 2014. Air Qual Atmos Health 2016;9(1):83-93. https://doi.org/10.1007/s11869-014-0312-5
  4. Heo JB, Hopke PK, Yi SM. Source apportionment of PM2.5 in Seoul, Korea. Atmos Chem Phys 2009;9:4957-4971. https://doi.org/10.5194/acp-9-4957-2009
  5. Lee HJ, Son YS. Spatial variability of AERONET aerosol optical properties and satellite data in South Korea during NASA DRAGON-Asia campaign. Environ Sci Technol 2016;50(7): 3954-3964. https://doi.org/10.1021/acs.est.5b04831
  6. Vadrevu KP, Ohara T, Justice C. Air pollution in Asia. Environ Pollut 2014;195:233-235. https://doi.org/10.1016/j.envpol.2014.09.006
  7. Kim HS, Chung YS, Choi HJ. On air pollutant variations in the cases of long-range transport of dust particles observed in central Korea in the leeside of China in 2010. Air Qual Atmos Health 2014;7(3):309-323. https://doi.org/10.1007/s11869-014-0238-y
  8. Wang Z, Pan X, Uno I, Chen X, Yamamoto S, Zheng H, et al. Importance of mineral dust and anthropogenic pollutants mixing during a long-lasting high PM event over East Asia. Environ Pollut 2018;234:368-378. https://doi.org/10.1016/j.envpol.2017.11.068
  9. Lee S, Choi B, Yi SM, Ko G. Characterization of microbial community during Asian dust events in Korea. Sci Total Environ 2009;407(20):5308-5314. https://doi.org/10.1016/j.scitotenv.2009.06.052
  10. Liu R, Zeng J, Jiang X, Chen J, Gao X, Zhang L, et al. The relationship between airborne fine particle matter and emergency ambulance dispatches in a southwestern city in Chengdu, China. Environ Pollut 2017;229:661-667. https://doi.org/10.1016/j.envpol.2017.06.098
  11. Liu H, Tian Y, Xu Y, Zhang J. Ambient particulate matter concentrations and hospitalization for stroke in 26 Chinese cities: a case-crossover study. Stroke 2017;48(8):2052-2059. https://doi.org/10.1161/STROKEAHA.116.016482
  12. Health Effects Institute. Special report: revised analysis of time- series studies of air pollution and health. Boston: Health Effects Institute; 2003, p. 85-89, 165-172.
  13. Pope CA 3rd. Epidemiology of fine particulate air pollution and human health: biologic mechanisms and who's at risk? Environ Health Perspect 2000;108 Suppl 4:713-723. https://doi.org/10.1289/ehp.00108s4713
  14. Samet J, Buist S, Bascom R, Garcia J, Lipsett M, Mauderly J, et al. What constitutes an adverse health effect of air pollution? Am J Respir Crit Care Med 2000;161(2 Pt 1):665-673. https://doi.org/10.1164/ajrccm.161.2.ats4-00
  15. Yamazaki S, Nitta H, Murakami Y, Fukuhara S. Association between ambient air pollution and health-related quality of life in Japan: ecological study. Int J Environ Health Res 2005;15(5): 383-391. https://doi.org/10.1080/09603120500292279
  16. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2017 report) [cited 2018 Jan 6]. Available from: http://goldcopd.org/download/ 326/.
  17. Van Weel C. Functional status in primary care: COOP/WONCA charts. Disabil Rehabil 2009;15(2):96-101.
  18. Han CW, Lee EJ, Iwaya T, Kataoka H, Kohzuki M. Development of the Korean version of Short-Form 36-Item Health Survey: health related QOL of healthy elderly people and elderly patients in Korea. Tohoku J Exp Med 2004;203(3):189-194. https://doi.org/10.1620/tjem.203.189
  19. Stavem K, Jodalen H. Reliability and validity of the COOP/WONCA health status measure in patients with chronic obstructive pulmonary disease. Qual Life Res 2002;11(6):527-533. https://doi.org/10.1023/A:1016345428638
  20. Suh SY, Im YS, Lee SH, Park MS, Yoo T. A study for the development of Korean version of the Duke-UNC functional social support questionnaire. J Korean Acad Fam Med 1997;18(3): 250-260 (Korean).
  21. Fukuhara S, Suzukamo Y. Manual of SF-36v2 Japanese version. Kyoto: Institute for Health Outcomes & Process Evaluation Research; 2004, p. 55-75 (Japanese).
  22. Gyeonggi-do Institute of Health & Environment. Air Gyeonggi-do [cited 2018 Jan 8]. Available from: http://air.gg.go.kr/airgg/ (Korean).
  23. US Department of Commerce. NNDC climate data online [cited 2018 Mar 12]. Available from: https://www7.ncdc.noaa.gov/CDO/cdo.
  24. National Institute of Environmental Research. Case analysis of the Asian sand dust event 2015 [cited 2018 Mar 12]. Available from http://webbook.me.go.kr/DLi-File/NIER/09/021/5621763.pdf (Korean).
  25. Zeger SL, Liang KY. Longitudinal data analysis for discrete and continuous outcomes. Biometrics 1986;42(1):121-130. https://doi.org/10.2307/2531248
  26. Air Korea. Air quality standards [cited 2018 Jan 6]. Available from: https://www.airkorea.or.kr/eng/information/airQualityStandards.
  27. Li MH, Fan LC, Mao B, Yang JW, Choi AM, Cao WJ, et al. Short-term exposure to ambient fine particulate matter increases hospitalizations and mortality in COPD: a systematic review and meta-analysis. Chest 2016;149(2):447-458. https://doi.org/10.1378/chest.15-0513
  28. Yamazaki S, Nitta H, Fukuhara S. Associations between exposure to ambient photochemical oxidants and the vitality or mental health domain of the health related quality of life. J Epidemiol Community Health 2006;60(2):173-179. https://doi.org/10.1136/jech.2005.039560
  29. Nakao M, Yamauchi K, Ishihara Y, Solongo B, Ichinnorov D. Effects of air pollution and seasonality on the respiratory symptoms and health-related quality of life (HR-QoL) of outpatients with chronic respiratory disease in Ulaanbaatar: pilot study for the comparison of the cold and warm seasons. Springerplus 2016;5(1):1817. https://doi.org/10.1186/s40064-016-3481-x
  30. Nakao M, Yamauchi K, Ishihara Y, Omori H, Ichinnorov D, Solongo B. Effects of air pollution and seasons on health-related quality of life of Mongolian adults living in Ulaanbaatar: cross-sectional studies. BMC Public Health 2017;17(1):594. https://doi.org/10.1186/s12889-017-4507-1
  31. Kamimura A, Armenta B, Nourian M, Assasnik N, Nourian K, Chernenko A. Perceived environmental pollution and its impact on health in China, Japan, and South Korea. J Prev Med Public Health 2017;50(3):188-194. https://doi.org/10.3961/jpmph.17.044
  32. Wise RA, Calverley PM, Carter K, Clerisme-Beaty E, Metzdorf N, Anzueto A. Seasonal variations in exacerbations and deaths in patients with COPD during the $TIOSPIR^{(R)}$ trial. Int J Chron Obstruct Pulmon Dis 2018;13:605-616. https://doi.org/10.2147/COPD.S148393
  33. Donaldson GC, Wedzicha JA. The causes and consequences of seasonal variation in COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2014;9:1101-1110.
  34. Miravitlles M, Ferrer M, Pont A, Zalacain R, Alvarez-Sala JL, Masa F, et al. Effect of exacerbations on quality of life in patients with chronic obstructive pulmonary disease: a 2 year follow up study. Thorax 2004;59(5):387-395. https://doi.org/10.1136/thx.2003.008730
  35. Watanabe M, Noma H, Kurai J, Sano H, Mikami M, Yamamoto H, et al. Effect of Asian dust on pulmonary function in adult asthma patients in western Japan: a panel study. Allergol Int 2016;65(2):147-152. https://doi.org/10.1016/j.alit.2015.10.002
  36. Han S, Bian H, Feng Y, Liu A, Li X, Zeng F, et al. Analysis of the relationship between O3, NO and NO2 in Tianjin, China. Aerosol Air Qual Res 2011;11(2):128-139. https://doi.org/10.4209/aaqr.2010.07.0055
  37. Snipes MB. Biokinetics of inhaled radionuclides. In: Raabe OG, editor. Internal radiation-dosimetry. Madison: Medical Physics Publishing; 1994, p. 181-204.
  38. McClellan RO. Particle interactions with the respiratory tract. In: Gehr P, Hyder J, editors. Particle-lung interactions. Boca Raton: CRC Press; 2000, p. 3-63.

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