Department of Otorhinolaryngology-Head and Neck Surgery, Seoul Medical Center, Seoul, South Korea.
Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea.
PLoS One. 2018 Jun 28;13(6):e0199296. doi: 10.1371/journal.pone.0199296. eCollection 2018.
Otitis media (OM) is a major reason for children's visits to physicians and a major cause of their being treated with antibiotics. It not only causes economic burdens but also influences hearing, speech, and education. To our knowledge, no nationwide population-based study has assessed the association between air pollution and OM. Therefore, this study evaluated the association between air pollution levels and the incidence of OM.
We identified cases of OM that occurred in South Korea between January 2011 and December 2012 from the Korea National Health Insurance Service-National Sample Cohort database, and evaluated its relationship with five air pollutants: particulate matter (PM10, particulates ≤10 μm in diameter), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide, and carbon monoxide. Associations between the weekly incidence of OM and the five air pollutants were analyzed using generalized estimating equations. Conditional logistic regression analysis was used to obtain odds ratios (ORs) and their 99.9% Bonferroni-corrected confidence intervals after adjusting for gender, age, season, and region.
We based our analysis on 160,875 hospital visits for OM by children aged <15 years. Correlations with higher concentrations of the five pollutants showed higher ORs than did the reference values at most time lags. PM10 had the largest influence on the OM incidence at a time lag of 0 weeks, whereas NO2 and O3 had the largest impacts on OM incidence at time lags of 1 and 4 weeks, respectively.
These findings support the notion that the incidence of OM is associated with ambient air pollution.
中耳炎（OM）是儿童就诊和使用抗生素治疗的主要原因之一。它不仅造成经济负担，还会影响听力、言语和教育。据我们所知，尚无全国性的基于人群的研究评估过空气污染与 OM 之间的关系。因此，本研究评估了空气污染水平与 OM 发病之间的关系。
我们从韩国国家健康保险服务-国家抽样队列数据库中确定了 2011 年 1 月至 2012 年 12 月期间发生的韩国 OM 病例，并评估了它与五种空气污染物之间的关系：颗粒物（PM10，直径≤10μm 的颗粒）、二氧化氮（NO2）、臭氧（O3）、二氧化硫和一氧化碳。使用广义估计方程分析 OM 每周发病率与五种空气污染物之间的关联。调整性别、年龄、季节和地区后，使用条件 logistic 回归分析获得比值比（OR）及其 99.9%Bonferroni 校正置信区间。
我们的分析基于 160875 名<15 岁儿童因 OM 就诊的病例。与较高浓度五种污染物的相关性表明，在大多数时间滞后下，OR 值高于参考值。PM10 对 OM 发病的影响最大，在 0 周的时间滞后下，而 NO2 和 O3 对 OM 发病的影响最大，分别在 1 周和 4 周的时间滞后下。
这些发现支持了 OM 发病率与环境空气污染有关的观点。
