Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Department of Human Systems Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea; Integrated Major in Innovative Medical Science, Seoul National University Graduate School, Republic of Korea.
Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Environ Res. 2024 Jul 1;252(Pt 2):118916. doi: 10.1016/j.envres.2024.118916. Epub 2024 Apr 16.
The increasing prevalence of precocious puberty (PP) has emerged as a significant medical and social problem worldwide. However, research on the relationship between long-term air pollution exposure and PP has been relatively limited. We thus investigated the association between long-term air pollution exposure and the onset of PP in South Korea.
We investigated a retrospective cohort using the Korea National Health Insurance Database. Six-year-old children born from 2007 to 2009 were examined (2013-2015). We included boys ≤10 years and girls aged ≤9 years who visited hospitals for early pubertal development, were diagnosed with PP per the ICD-10 (E228, E301, and E309), and received gonadotropin-releasing hormone agonist treatment. We analyzed data for boys up until 10 years old (60-month follow-up) and for girls up to 9 years old (48-month follow-up). We assessed the association between long-term air pollution exposure and the onset of PP using a Cox proportional hazard model. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) per 1 μg/m increase in fine particulate matter (PM) and particulate matter (PM) and per 1 ppb increase in sulfur dioxide (SO), nitrogen dioxide (NO), and ozone (O).
This study included 1,205,784 children aged six years old between 2013 and 2015. A positive association was found between the 48-month moving average PM (HR: 1.019; 95% CI: 1.012, 1.027), PM (HR: 1.009; 95% CI: 1.006, 1.013), SO (HR: 1.037; 95% CI: 1.018, 1.055), and O (HR: 1.006; 95% CI: 1.001, 1.010) exposure and PP in girls but not boys.
This study provides valuable insights into the harmful effects of air pollution during childhood and adolescence, emphasizing that air pollution is a risk factor that should be managed and reduced.
性早熟（PP）的发病率不断上升，已成为全球范围内一个重大的医学和社会问题。然而，有关长期暴露于空气污染与 PP 之间关系的研究相对较少。因此，我们调查了长期暴露于空气污染与韩国性早熟发病之间的关联。
我们利用韩国国家健康保险数据库进行了回顾性队列研究。研究对象为 2007 年至 2009 年出生的 6 岁儿童（2013-2015 年）。我们纳入了≤10 岁的男孩和≤9 岁的女孩，这些儿童因早期青春期发育到医院就诊，根据 ICD-10（E228、E301 和 E309）诊断为 PP，并接受促性腺激素释放激素激动剂治疗。我们对男孩的随访时间截至 10 岁（60 个月），对女孩的随访时间截至 9 岁（48 个月）。我们使用 Cox 比例风险模型评估长期空气污染暴露与 PP 发病之间的关联。我们每增加 1μg/m³细颗粒物（PM）和颗粒物（PM），以及每增加 1ppb 二氧化硫（SO）、二氧化氮（NO）和臭氧（O），估计危险比（HR）和 95%置信区间（CI）。
本研究纳入了 2013 年至 2015 年期间 1205784 名 6 岁儿童。研究发现，48 个月移动平均 PM（HR：1.019；95%CI：1.012，1.027）、PM（HR：1.009；95%CI：1.006，1.013）、SO（HR：1.037；95%CI：1.018，1.055）和 O（HR：1.006；95%CI：1.001，1.010）暴露与女孩的 PP 呈正相关，但与男孩无关。
本研究提供了有关儿童和青少年时期空气污染有害影响的有价值的见解，强调空气污染是一个应加以管理和减少的风险因素。
