Lee Hyun, Kim Sang Hyuk, Lee Sun-Kyung, Moon Ji-Yong, Min Kyung Hoon, Yoon Ho Joo, Kim Sang-Heon
Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea.
Allergy Asthma Immunol Res. 2025 May;17(3):349-358. doi: 10.4168/aair.2025.17.3.349.
Safety thresholds for air quality levels have been proposed to protect people from the harmful effects of air pollutants. However, the impacts of air pollutants on asthma, particularly at levels below these safe thresholds, remain unclear.
We analyzed the associations between air pollutants (particulate matter of 10 μm or less in diameter [PM₁₀], particulate matter of 2.5 μm or less in diameter, sulfur dioxide [SO₂], carbon monoxide, ozone [O₃], and nitrogen dioxide) and healthcare utilization in 23,498 individuals with asthma in Seoul during the 2015-2017 season. The relative risk for healthcare utilization was assessed based on quantitative comparison (upper quartile vs. lower quartile) and non-linear concentration-response curves. Safety thresholds for air quality levels were determined according to the World Health Organization and Korean standards.
In quantitative analysis, healthcare utilization risk decreased for PM₁₀ and SO₂ but increased for O₃ on lag day 0, with no significant associations observed for other air pollutants. Non-linear analyses revealed significant concentration-response associations for all air pollutants, indicating increased risks of healthcare utilization on lag day 0. Notably, these increased risks occurred below proposed safety thresholds, with a steeper rise observed for asthma-related healthcare utilization within these ranges.
Exposure to 6 air pollutants was associated with an increased risk of healthcare utilization among individuals with asthma, with no safe exposure levels identified. The impact was more pronounced below current safety thresholds.
已提出空气质量水平的安全阈值，以保护人们免受空气污染物的有害影响。然而，空气污染物对哮喘的影响，尤其是在低于这些安全阈值的水平下，仍不清楚。
我们分析了2015 - 2017年期间首尔23498名哮喘患者中空气污染物（直径10μm或更小的颗粒物[PM₁₀]、直径2.5μm或更小的颗粒物、二氧化硫[SO₂]、一氧化碳、臭氧[O₃]和二氧化氮）与医疗保健利用之间的关联。基于定量比较（上四分位数与下四分位数）和非线性浓度 - 反应曲线评估医疗保健利用的相对风险。空气质量水平的安全阈值根据世界卫生组织和韩国标准确定。
在定量分析中，在滞后第0天，PM₁₀和SO₂的医疗保健利用风险降低，而O₃的风险增加，其他空气污染物未观察到显著关联。非线性分析显示所有空气污染物均存在显著的浓度 - 反应关联，表明在滞后第0天医疗保健利用风险增加。值得注意的是，这些增加的风险发生在提议的安全阈值以下，并且在这些范围内哮喘相关医疗保健利用的上升更为陡峭。
暴露于6种空气污染物与哮喘患者医疗保健利用风险增加相关，未确定安全暴露水平。在当前安全阈值以下影响更为明显。
