title: Physical Activity- and Alcohol-dependent Association Between Air Pollution Exposure and Elevated Liver Enzyme Levels: An Elderly Panel Study.
abstract: OBJECTIVE
  The deleterious effects of air pollution on various health outcomes have been demonstrated. However, few studies have examined the effects of air pollution on liver enzyme levels.
  
  
  METHODS
  Blood samples were drawn up to three times between 2008 and 2010 from 545 elderly individuals who regularly visited a community welfare center in Seoul, Korea. Data regarding ambient air pollutants (particulate matter ≤2.5 μm [PM2.5], nitrogen dioxide [NO2], ozone [O3], carbon monoxide, and sulfur dioxide) from monitoring stations were used to estimate air pollution exposure. The effects of the air pollutants on the concentrations of three liver enzymes (aspartate aminotransferase [AST], alanine aminotransferase [ALT], and γ-glutamyltranspeptidase [γ-GTP)]) were evaluated using generalized additive and linear mixed models.
  
  
  RESULTS
  Interquartile range increases in the concentrations of the pollutants showed significant associations of PM2.5 with AST (3.0% increase, p=0.0052), ALT (3.2% increase, p=0.0313), and γ-GTP (5.0% increase, p=0.0051) levels; NO2 with AST (3.5% increase, p=0.0060) and ALT (3.8% increase, p=0.0179) levels; and O3 with γ-GTP (5.3% increase, p=0.0324) levels. Significant modification of these effects by exercise and alcohol consumption was found (p for interaction <0.05). The effects of air pollutants were greater in non-exercisers and heavy drinkers.
  
  
  CONCLUSIONS
  Short-term exposure to air pollutants such as PM2.5, NO2, and O3 is associated with increased liver enzyme levels in the elderly. These adverse effects can be reduced by exercising regularly and abstinence from alcohol.
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyoung-Nam
authors.initials: KN
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyemi
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Environmental Health, Graduate School of Public Health, Seoul National University, Seoul, Korea.
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Seoul Metropolitan Institute of Public Health and Environment, Seoul, Korea.
authors.forename: Kweon
authors.initials: K
authors.lastname: Jung
authors.affiliation: Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea ; Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Youn-Hee
authors.initials: YH
authors.lastname: Lim
authors.affiliation: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea ; Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea ; Environmental Health Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Yun-Chul
authors.initials: YC
authors.lastname: Hong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking; D001219:Aspartate Aminotransferases / Q000097:blood; D004781:Environmental Exposure; D015444:Exercise; D005260:Female; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D008297:Male; D009585:Nitrogen Dioxide / Q000737:chemistry / Q000633:toxicity; D010126:Ozone / Q000737:chemistry / Q000633:toxicity; D052638:Particulate Matter / Q000032:analysis / Q000633:toxicity; D013458:Sulfur Dioxide / Q000737:chemistry / Q000633:toxicity; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D013458:Sulfur Dioxide; D010126:Ozone; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D009585:Nitrogen Dioxide
keywords: Air pollution; Liver; Nitrogen dioxide; Ozone; Particulate matter