Epidemiology and Health

Data Profile

Integrated dataset of the Korean Genome and Epidemiology Study cohort with estimated air pollution data: Hae Dong Woo, Dae Sub Song, Sun Ho Choi, Jae Kyung Park, Kyoungho Lee, Hui-Young Yun, Dae-Ryun Choi, Youn-Seo Koo, Hyun-Young Park; Epidemiol Health. 2022;44:e2022071. Published online September 7, 2022; DOI: https://doi.org/10.4178/epih.e2022071

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Abstract

Public concern about the adverse health effects of air pollution has grown rapidly in Korea, and there has been increasing demand for research on ways to minimize the health effects of air pollution. Integrating large epidemiological data and air pollution exposure levels can provide a data infrastructure for studying ambient air pollution and its health effects. The Korean Genome and Epidemiology Study (KoGES), a large population-based study, has been used in many epidemiological studies of chronic diseases. Therefore, KoGES cohort data were linked to air pollution data as a national resource for air pollution studies. Air pollution data were produced using community multiscale air quality modeling with additional adjustment of monitoring data, satellite-derived aerosol optical depth, normalized difference vegetation index, and meteorological data to increase the accuracy and spatial resolution. The modeled air pollution data were linked to the KoGES cohort based on participants’ geocoded residential addresses in grids of 1 km (particulate matter) or 9 km (gaseous air pollutants and meteorological variables). As the integrated data become available to all researchers, this resource is expected to serve as a useful infrastructure for research on the health effects of air pollution.

Summary

Korean summary
대기오염이 건강에 미치는 정도를 파악하고 이를 최소화하는 과학적 근거 생산 마련을 위하여 한국인유전체역학조사사업(KoGES) 자료와 대기오염 및 기상 자료를 연계하여 연구 기반을 마련하고자 하였다. 배출량, 기상자료 및 공기의 확산 등을 고려하는 화학수송모델(CMAQ)을 통하여 2005년에서 2017년 사이의 대기오염 및 기상자료를 예측하였으며, 이후 관측소 자료 및 인공위성자료인 에어로졸 광화학두께(AOD)를 추가 적용하여 최종 생산하였다. 미세먼지 자료는 1 km 격자로 기체상 오염물질 및 기상 자료는 9 km 격자 단위로 구성되었다. 생산된 자료는 KoGES 참여자의 주소를 기반으로 연계하여 최종 KoGES-대기오염 연계DB를 구축하였으며, 구축된 자료를 이용하여 KoGES 참여자의 대기오염 노출 수준을 공간적 시간적 분포로 살펴보았다. 구축된 자료는 내외부 연구자에게 공개가 되고 있어 대기오염에 의한 건강영향평가 및 피해를 최소화하는 방안 마련 연구를 위한 좋은 기반 자료가 될 것으로 기대된다.

Key Message
The Korean Genome and Epidemiology Study (KoGES) cohort were linked to air pollution data as a national resource for studying air pollution and its health effect. Air pollution data (2005~2017) were produced using community multiscale air quality modeling with additional adjustment of monitoring data, satellite-derived aerosol optical depth, normalized difference vegetation index, and meteorological data to increase the accuracy and spatial resolution. The modelled air pollution data were linked to the cohort based on participants’ geocoded residential addresses in grids of 1 km (particulate matter) or 9 km (gaseous air pollutants and meteorological variables).

Citations

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Association between short-term exposure to ambient air pollutants and biomarkers indicative of inflammation and oxidative stress: a cross-sectional study using KoGES-HEXA data
Ji Hyun Kim, Hae Dong Woo, Jane J Lee, Dae Sub Song, Kyoungho Lee
Environmental Health and Preventive Medicine.2024; 29: 17. CrossRef
Edible mushroom intake and risk of all-cause and cause-specific mortality: results from the Korean Genome and Epidemiology Study (KoGES) Cohort
Hyein Jung, JiAe Shin, Kyungjoon Lim, Sangah Shin
Food & Function.2023; 14(19): 8829. CrossRef
Association between ambient particulate matter levels and hypertension: results from the Korean Genome and Epidemiology Study
Sewhan Na, Jong-Tae Park, Seungbeom Kim, Jinwoo Han, Saemi Jung, Kyeongmin Kwak
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef

Original Articles

Effect modification of consecutive high concentration days on the association between fine particulate matter and mortality: a multi-city study in Korea: Hyungryul Lim, Sanghyuk Bae, Jonghyuk Choi, Kyung-Hwa Choi, Hyun-Joo Bae, Soontae Kim, Mina Ha, Ho-Jang Kwon; Epidemiol Health. 2022;44:e2022052. Published online June 9, 2022; DOI: https://doi.org/10.4178/epih.e2022052

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Although there is substantial evidence for the short-term effect of fine particulate matter (PM2.5) on daily mortality, few epidemiological studies have explored the effect of prolonged continuous exposure to high concentrations of PM2.5. This study investigated how the magnitude of the mortality effect of PM2.5 exposure is modified by persistent exposure to high PM2.5 concentrations.
METHODS
We analyzed data on the daily mortality count, simulated daily PM2.5 level, mean daily temperature, and relative humidity level from 7 metropolitan cities from 2006 to 2019. Generalized additive models (GAMs) with quasi-Poisson distribution and random-effects meta-analyses were used to pool city-specific effects. To investigate the effect modification of continuous exposure to prolonged high concentrations, we applied categorical consecutive-day variables to the GAMs as effect modification terms for PM2.5.
RESULTS
The mortality risk increased by 0.33% (95% confidence interval [CI], 0.16 to 0.50), 0.47% (95% CI, -0.09 to 1.04), and 0.26% (95% CI, -0.08 to 0.60) for all-cause, respiratory, and cardiovascular diseases, respectively, with a 10 μg/m3 increase in PM2.5 concentration. The risk of all-cause mortality per 10 μg/m3 increase in PM2.5 on the first and fourth consecutive days significantly increased by 0.63% (95% CI, 0.20 to 1.06) and 0.36% (95% CI, 0.01 to 0.70), respectively.
CONCLUSIONS
We found increased risks of all-cause, respiratory, and cardiovascular mortality related to daily PM2.5 exposure on the day when exposure to high PM2.5 concentrations began and when exposure persisted for more than 4 days with concentrations of ≥35 μg/m3. Persistently high PM2.5 exposure had a stronger effect on seniors.; Summary

Korean summary
한국의 7개 대도시를 배경으로 수행한 본 시계열 연구를 통하여 2006년부터 2019년까지의 기간 동안에 초미세먼지의 단기 노출이 일별 사망률을 증가시키며, 교호작용모형을 통해 일평균 35 μg/m3 이상의 고농도 지속기간이 처음 시작되는 날과 넷째 지속일에 이러한 사망효과가 커짐을 보고하였다. 이러한 고농도 지속기간의 교호작용은 65세 이상 연령군에서 더욱 두드러졌다.

Key Message
With our Korean multi-city study design from 2006 to 2019, the short-term effects of PM2.5 on mortality were greater when the high PM2.5 concentration duration began during the day and lasted for approximately 4 days, and the elderly may be more affected by persistently high PM2.5.

Effects of exposure to ambient air pollution on pulmonary function impairment in Korea: the 2007-2017 Korea National Health and Nutritional Examination Survey: Soo Beom Choi, Sungha Yun, Sun-Ja Kim, Yong Bum Park, Kyungwon Oh; Epidemiol Health. 2021;43:e2021082. Published online October 18, 2021; DOI: https://doi.org/10.4178/epih.e2021082

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Abstract

OBJECTIVES
This study aimed to investigate the association between pulmonary function and air pollution using 2007-2017 data from the Korea National Health and Nutrition Examination Survey, a nationwide cross-sectional representative survey.

METHODS

A total of 27,378 participants that had sampling weights from a complex sample survey were included in this study. Using the data for forced expiratory volume in 1 second and forced vital capacity, the participants with pulmonary function impairment were classified according to the criteria of restrictive lung disease and chronic obstructive pulmonary disease (COPD). Exposure to ambient air pollution was estimated using the Community Multiscale Air Quality model. Multivariate linear and logistic regression analyses with complex samples were used to determine the associations between pulmonary function and air pollution after adjusting for covariates.

RESULTS

In total, 13.2% of the participants aged >40 years had COPD, and 10.7% were classified as being in the restrictive lung disease group. According to the multivariate logistic regression model, the odds ratios for the fourth quartiles of particulate matter less than 10 μm in diameter (PM10), particulate matter less than 2.5 μm in diameter (PM2.5) and carbon monoxide (CO) with a 2-year lag period were 1.203 (95% confidence interval [CI], 1.036 to 1.396), 1.283 (95% CI, 1.101 to1.495), and 1.292 (95% CI, 1.110 to 1.504), respectively, using the restrictive lung disease group as an event after adjusting for covariates in the complex sample.

CONCLUSIONS

Long-term exposure to PM10, PM2.5, and CO was significantly associated with pulmonary function, especially restrictive lung disease.

Summary

Korean summary
대기오염이 폐기능에 미치는 영향을 조사하기 위해 2007년부터 2017년까지 국민건강영양조사자료와 대기질 자료를 연계하여 참여자 27,378명의 대기오염 노출량을 추정하여 분석하였다. 나이, 성별, 거주지 동/읍면 구분, 교육수준, 소득수준, 흡연, 비만, 기온, 상대습도 변수들을 보정 후 PM₁₀, PM_2.5, SO2, NO2, CO, O3의 2년평균 노출량을 각각 로지스틱회귀모형으로 분석한 결과 PM₁₀, PM_2.5, CO 와 제한성 환기장애가 연관성을 보였다. 대기오염의 노출은 만성폐쇄성폐질환보다는 제한성 환기장애와 연관이 있었으며 제한성 환기장애는 사망원인과도 연관이 있었다.

Key Message
This study aimed to investigate the association between pulmonary function and air pollution using 2007-2017 data from the Korea National Health and Nutrition Examination Survey. Long-term exposure to PM₁₀, PM_2.5, and CO was significantly associated with pulmonary function, especially restrictive lung disease. Although the COPD criteria do not include the restrictive lung disease group, restrictive lung disease needs to be controlled and managed based on its mortality risk. Reducing air pollution is also necessary to enhance pulmonary function.

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Airborne Exposure of the Cornea to PM10 Induces Oxidative Stress and Disrupts Nrf2 Mediated Anti-Oxidant Defenses
Mallika Somayajulu, Sharon A. McClellan, Robert Wright, Ahalya Pitchaikannu, Bridget Croniger, Kezhong Zhang, Linda D. Hazlett
International Journal of Molecular Sciences.2023; 24(4): 3911. CrossRef

Data Profile

Establishment of the Korea National Health and Nutrition Examination Survey air pollution study dataset for the researchers on the health impact of ambient air pollution: Myung-Jae Hwang, Jisun Sung, Miryoung Yoon, Jong-Hun Kim, Hui-Young Yun, Dae-Ryun Choi, Youn-Seo Koo, Kyungwon Oh, Sungha Yun, Hae-Kwan Cheong; Epidemiol Health. 2021;43:e2021015. Published online February 8, 2021; DOI: https://doi.org/10.4178/epih.e2021015

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Abstract

To provide a nationwide representative dataset for the study on health impact of air pollution, we combined the data from the Korea National Health and Nutrition Examination Survey with the daily air quality and weather data by matching the date of examination and the residential address of the participants. The database of meteorological factors and air quality as sources of exposure data were estimated using the Community Multiscale Air Quality model. The linkage dataset was merged by three ways; administrative district, si-gun-gu (city, county, and district), and geocode (in latitude and longitude coordinate units) based on the participants’ residential address, respectively. During the study period, the exposure dataset of 85,018 individuals (38,306 men and 46,712 women) whose examination dates were recorded were obtained. According to the definition of exposure period, the dataset was combined with the data on short-term, mid-term, and long-term exposure to air pollutants and the meteorological indices. Calculation of the daily merged dataset’s average air pollution linked by si-gun-gu and geocode units showed similar results. This study generated a daily average of meteorological indices and air pollution exposure dataset for all regions including rural and remote areas in Korea for 11 years. It is expected to provide a platform for the researchers studying the health impact of air pollution and climate change on the representative population and area, which may facilitate the establishment of local health care plans by understanding the residents’ health status at the local as well as national level.

Summary

Korean summary
-2007년부터 2017년까지 11년간 국민건강영양조사의 검진조사 대상자의 검진일자와 지리정보를 기준으로 85,018명에 대해 기상 및 대기오염 모델링 자료를 결합하여 조사 대상자의 거주지주소를 이용하여 시·군·구 단위와 주소 기반 위경도 좌표를 기준으로 각각 노출자료를 결합함. -대기오염의 단기노출, 중기노출, 장기노출의 건강영향을 평가하기 위해 지연효과(lag effect)를 적용하여 각 건강자료와 결합함. -기상 및 대기오염 모델링 자료와 연계된 국민건강영양조사의 활용을 위한 data profile을 제시함.

Key Message
-We built a dataset for air pollution research by combining meteorological and air pollution modeling data through CMAQ for 85,018 individuals based on the date of examination and geographic information of the Korea National Health and Nutrition Examination Survey participants for 11 years, from 2007 to 2017. -Each exposure data was combined based on si-gun-gu (city, county, and district) and geocode (in latitude and longitude coordinate units) based on the participants’ residential address. -To evaluate the health effects of short-, medium- and long-term air pollution exposure, the lag values of days, months, and years was applied and combined with each health data. -A data profile was presented for the Korea National Health and Nutrition Examination Survey linked to meteorological and air pollution modeling data.

Citations

Citations to this article as recorded by

Association between ambient particulate matter levels and hypertension: results from the Korean Genome and Epidemiology Study
Sewhan Na, Jong-Tae Park, Seungbeom Kim, Jinwoo Han, Saemi Jung, Kyeongmin Kwak
Annals of Occupational and Environmental Medicine.2023;[Epub] CrossRef
Effect of Short- to Long-Term Exposure to Ambient Particulate Matter on Cognitive Function in a Cohort of Middle-Aged and Older Adults: KoGES
Jane J. Lee, Ji Hyun Kim, Dae Sub Song, Kyoungho Lee
International Journal of Environmental Research and Public Health.2022; 19(16): 9913. CrossRef
Long-Term Effects of Ambient Particulate and Gaseous Pollutants on Serum High-Sensitivity C-Reactive Protein Levels: A Cross-Sectional Study Using KoGES-HEXA Data
Ji Hyun Kim, Hae Dong Woo, Sunho Choi, Dae Sub Song, Jung Hyun Lee, Kyoungho Lee
International Journal of Environmental Research and Public Health.2022; 19(18): 11585. CrossRef
Effects of exposure to ambient air pollution on pulmonary function impairment in Korea: the 2007-2017 Korea National Health and Nutritional Examination Survey
Soo Beom Choi, Sungha Yun, Sun-Ja Kim, Yong Bum Park, Kyungwon Oh
Epidemiology and Health.2021; 43: e2021082. CrossRef

Original Article

Modification of the effect of ambient air temperature on cardiovascular and respiratory mortality by air pollution in Ahvaz, Iran: Sohrab Iranpour, Soheila Khodakarim, Abbas Shahsavani, Ardeshir Khosravi, Koorosh Etemad; Epidemiol Health. 2020;42:e2020053. Published online July 18, 2020; DOI: https://doi.org/10.4178/epih.e2020053

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Abstract

OBJECTIVES
This study investigated the modification of temperature effects on cardiovascular and respiratory mortality by air pollutants (particulate matter less than 2.5 and 10 µm in diameter [respectively], ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide).

METHODS

Poisson additive models with a penalized distributed lag non-linear model were used to assess the association of air temperature with the daily number of deaths from cardiovascular and respiratory diseases in Ahvaz, Iran from March 21, 2014 to March 20, 2018, controlling for day of the week, holidays, relative humidity, wind speed, air pollutants, and seasonal and long-term trends. Subgroup analyses were conducted to evaluate the effect modification for sex and age group. To assess the modification of air pollutants on temperature effects, the level of each pollutant was categorized as either greater than the median value or less than/equal to the median value.

RESULTS

We found no significant associations between temperature and cardiovascular and respiratory mortality. In the subgroup analyses, however, high temperatures were significantly associated with an increased risk of cardiovascular mortality among those 75 years old and older, with the strongest effect observed on day 0 relative to exposure. The results revealed a lack of interactive effects between temperature and air pollutants on cardiovascular and respiratory mortality.

CONCLUSIONS

A weak but significant association was found between high temperature and cardiovascular mortality, but only in elderly people. Air pollution did not significantly modify the effect of ambient temperature on cardiovascular and respiratory mortality.

Summary

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Associations between ambient temperature and suicide: а systematic review
Andrej М. Grjibovski, Ivan М. Kobelev, Natalia N. Kukalevskaya, Yulia A. Popova, Alexander V. Baranov
Ekologiya cheloveka (Human Ecology).2023; 30(6): 399. CrossRef
Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States
Richard V. Remigio, Hao He, Jochen G. Raimann, Peter Kotanko, Frank W. Maddux, Amy Rebecca Sapkota, Xin-Zhong Liang, Robin Puett, Xin He, Amir Sapkota
Science of The Total Environment.2022; 812: 152481. CrossRef

Brief Communication

Effects of particulate air pollution on tuberculosis development in seven major cities of Korea from 2010 to 2016: methodological considerations involving long-term exposure and time lag: Honghyok Kim, Sarah Yu, Hongjo Choi; Epidemiol Health. 2020;42:e2020012. Published online March 12, 2020; DOI: https://doi.org/10.4178/epih.e2020012

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Abstract Summary PDF

Abstract

OBJECTIVES
Epidemiological evidence of associations between ambient particulate matter (PM) and tuberculosis (TB) risk is accumulating. Two previous studies in Korea found associations between air pollution—especially sulfur dioxide (SO2)—and TB. In this study, we conducted an annual time-series cross-sectional study to assess the effect of PM with an aerodynamic diameter less than 10 μm (PM10) on TB risk in seven major cities of Korea from 2010 to 2016, taking into account time lag and long-term cumulative exposure.

METHODS

Age-standardized TB notification rates were derived using the Korea National TB Surveillance System. Annual average PM10 concentrations were obtained from annual Korean air quality reports. We applied a generalized linear mixed model with unconstrained distributed lags of exposure to PM10. We adjusted for potential confounders such as age, health behaviors, and area-level characteristics.

RESULTS

Both average annual PM10 concentrations and age-standardized TB notification rates decreased over time. The association between cumulative exposure to PM10 and TB incidence became stronger as a longer exposure duration was considered. An increase of one standard deviation (5.63 μg/m3) in PM10 exposure for six years was associated with a 1.20 (95% confidence interval, 1.17 to 1.22) times higher TB notification rate. The marginal association of exposure duration with the TB notification rate was highest at four and five years prior to TB notification. This association remained consistent even after adjusting it for exposure to SO2.

CONCLUSIONS

The findings of this study suggest that cumulative exposure to PM10 may affect TB risk, with a potential lag effect.

Summary

Korean summary
국외 연구에서 미세먼지와 결핵발생의 관련성이 종종 보고되지만, 기존의 국내 연구에서는 관련성이 없는 것으로 알려져 있다. 본 연구는 미세먼지 노출의 누적효과와 결핵발생과의 시차에 주목하여 수행했다. 연구결과 미세먼지의 누적 노출 효과가 시간적 격차는 결핵발생률과 관련이 확인되었으며, 향후 연구에서도 이와 같은 방법론적 고려가 필요하겠다

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Original Article

Ambient air quality and subjective stress level using Community Health Survey data in Korea: Myung-Jae Hwang, Hae-Kwan Cheong, Jong-Hun Kim, Youn Seo Koo, Hui-Young Yun; Epidemiol Health. 2018;40:e2018028. Published online June 28, 2018; DOI: https://doi.org/10.4178/epih.e2018028

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Abstract

OBJECTIVES
Air pollution causes various disease in exposed populations, and can lead to premorbid health effects manifested as both physical and psychological functional impairment. The present study investigated the subjective stress level in daily life in relation to the level of air pollution.

METHODS

Data from the Community Health Survey (2013), comprising 99,162 men, and 121,273 women residing in 253 healthcare administrative districts, were combined with air pollutant concentration modelling data from the Korean Air Quality Forecasting System, and were stratified by subjective stress levels into five strata for multiple logistic regression. Levels of exposure were divided into five quintiles according to the annual concentration of nitrogen dioxide (NO2), and were analyzed using a single-pollutant model using NO2 concentration only, and a multi-pollutant model adjusted for the concentration of particulate matter <10 μm in diameter.

RESULTS

Analysis of men and women in various age groups showed the highest odds ratio (OR) for subjective stress level at the highest NO2 concentration quintile in men and women aged 30–64 years (men: 2.91; 95% confidence interval [CI], 2.12 to 4.01; women: 1.82; 95% CI, 1.32 to 2.51). As the NO2 concentration quintile increased, the OR increased. Men showed higher ORs than women in all strata.

CONCLUSIONS

In the present study, annual NO2 concentrations were found to be associated with subjective stress levels. This association was especially clear among socioeconomically active men and women aged 30-64 years.

Summary

Korean summary
2013년 지역사회건강조사를 이용하여 253개 보건행정지역단위로 Korean Air Quality Forecasting System (KAQFS) 대기물질농도 모델링자료를 결합하여 주관적 스트레스 정도에 따라 5분위로 범주화하여 다항로지스틱회귀을 하였다. 본 연구에서는 연평균 NO2농도와 주관적 스트레스 정도가 관련이 있는 것으로 나타났다. 특히, 사회 경제적 활동이 활발한30세 이상 65세 미만의 남성과 여성에서 관련성이 뚜렷하게 나타났다.

Citations

Citations to this article as recorded by

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