title: Susceptibility to ambient particulate matter on emergency care utilization for ischemic heart disease in Seoul, Korea.
abstract: Many epidemiological studies have reported associations between ambient particulate matter (PM) and cardiovascular diseases. However, the effects associated with PM that promote cardiovascular events among susceptible populations who may respond differently than the general population to the same ambient air pollutants remain unclear. We conducted a time-series study with generalized additive models to assess the association between ambient PM10 and emergency department (ED) visits for ischemic heart disease (IHD) in Seoul, Republic of Korea from 2005 to 2009. The ED data and previous medical records within the 5 years of each IHD event to examine the effect of PM10 in a susceptible population were obtained from Health Insurance Review and Assessment Service. Overall, the adjusted relative risks (RRs) of ED visits for IHD were not statistically significant for PM10, but significant positive RRs were found for groups with hypertension (1.018; 95 % confidence interval [CI] 1.002-1.035) and those who are ≥80 years of age (1.019; 1.002-1.037) for same-day exposure and with diabetes (1.019; 1.002-1.037) for single-lag models. Subgroup analyses revealed gender differences in ED visits for IHD in hypertensive patients and those who are ≥80 years of age; positive correlations were found only in males with the lag models. Our study suggests that ambient PM10 is significantly associated with ED visits for IHD, especially in males with hypertension, diabetes mellitus, or who are aged ≥80 years. Identification of populations susceptible to air pollution is of paramount importance to establishing recommendations or guidelines for high-risk individuals.
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Jungwoo
authors.initials: J
authors.lastname: Sohn
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Seng Chan
authors.initials: SC
authors.lastname: You
authors.affiliation: Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea.
authors.forename: Jaelim
authors.initials: J
authors.lastname: Cho
authors.affiliation: Health Insurance Review & Assessment Service, 267 Hyoyeong-ro, Seocho-gu, Seoul, 137-706, Republic of Korea.
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea. cby6908@yuhs.ac.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea. preman@yuhs.ac.
authors.forename: Changsoo
authors.initials: C
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000032:analysis; D000397:Air Pollution / Q000032:analysis / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003920:Diabetes Mellitus; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017202:Myocardial Ischemia; D052638:Particulate Matter / Q000032:analysis; D056910:Republic of Korea / Q000453:epidemiology; D066106:Seoul
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Air pollutants; Ischemic heart disease; Particulate matter; Susceptible population