Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Preventive Medicine and Public Health, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
Int Arch Occup Environ Health. 2021 Oct;94(7):1605-1615. doi: 10.1007/s00420-021-01724-9. Epub 2021 Jun 5.
We aimed to investigate the association between air pollution concentration levels and hospital admissions for heart failure (HF) among older adults in metropolitan cities in South Korea.
We used hospital admission data of 1.8 million older adults in seven metropolitan cities from 2008 to 2016, derived from the National Health Insurance Service of South Korea. Daily HF admission data were linked to air pollutants concentrations for the respective dates, including particulate matter less than 2.5 μm in size (PM), 10 μm (PM), sulfur dioxide (SO), nitrogen dioxide (NO), carbon monoxide (CO), and ozone. We estimated the association between air pollutants and daily HF admissions using quasi-Poisson generalized additive models for each city.
During the study period, 142,490 hospital admissions for HF were noted. Increases of 10 μg/m of PM and PM, and 10 ppb of SO, NO, and CO were associated with an increased risk of HF admission by 0.93% ([95% confidence intervals 0.51-1.36], 0.55% [0.31-0.80], 6.04% [2.15-10.08], 1.10% [0.38-1.82], and 0.05% [0.01-0.09]), respectively, on the same day. Increases in mean exposure to PM, PM, and SO for 8 days from the concurrent day were also significantly associated with HF admissions. During the warm season, the risk of HF admissions increased shortly after an increase in PM, whereas prolonged effects were observed during the cold season.
Our study suggests the adverse effects of air pollution on HF. Moreover, the evidence of seasonality may help tailor protection guidelines for older adults.
我们旨在研究韩国大都市地区空气污染浓度水平与老年人心力衰竭（HF）住院之间的关联。
我们使用了韩国国家健康保险服务提供的 2008 年至 2016 年期间来自七个大都市地区的 180 万名老年人的住院数据。每日 HF 入院数据与相应日期的空气污染物浓度相关联，包括小于 2.5μm 的颗粒物（PM）、10μm（PM）、二氧化硫（SO）、二氧化氮（NO）、一氧化碳（CO）和臭氧。我们使用每个城市的准泊松广义加性模型来估计空气污染物与每日 HF 入院之间的关联。
在研究期间，注意到 142490 例 HF 住院。PM 和 PM 每增加 10μg/m，SO、NO 和 CO 每增加 10ppb，与 HF 入院风险增加 0.93%（[95%置信区间 0.51-1.36]）、0.55%（[0.31-0.80]）、6.04%（[2.15-10.08]）、1.10%（[0.38-1.82]）和 0.05%（[0.01-0.09]）相关。在同日的 8 天内，PM、PM 和 SO 的平均暴露量增加也与 HF 入院显著相关。在温暖季节，PM 增加后 HF 入院的风险会立即增加，而在寒冷季节则会观察到长期影响。
我们的研究表明空气污染对 HF 有不利影响。此外，季节性证据可能有助于为老年人量身定制保护指南。
