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Effects of Particulate Matter on the Developments of Community-Acquired Pneumonia: A Nationwide Population-Based Cohort Study
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A4461 - Effects of Particulate Matter on the Developments of Community-Acquired Pneumonia: A Nationwide Population-Based Cohort Study
Author Block: W. Ji1, Y. Park2, H. Kim1, H. Kim3, J. Lee4, S. Song5, C. Choi1; 1Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Korea, Republic of, 2Clinical Research Center, Asan Institute of Life Sciences, Asan Medical Center, Seoul, Korea, Republic of, 3Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Korea, Republic of, 4Oncology, Asan Medical Center, Seoul, Korea, Republic of, 5Personalized Health Management System Group, Ministry of Trade, Industry and Energy, Seoul, Korea, Republic of.
Rationale Increased exposure to particulate matter (PM) is a possible risk factor for respiratory diseases. This study aims to investigate the effect of PM on the developments of community-acquired pneumonia (CAP). Methods We analyzed claim data of the nationwide sampled cohort which comprised one million random subjects from the Korean National Health Insurance Sharing Service. The subjects were defined as those who received ICD 10 code for pneumonia (J100, J110, J12-18, J69 and J851) and took chest images within 2 weeks. People who had been hospitalized within a month were excluded. The regional daily levels of PM with diameters less than 10μm (PM10) and PM 2.5 were obtained from the Korean Ministry of Environment. We used a Poisson regression analysis to analyze the relevance of 16 regions in South Korea, and employed a meta-analysis with random effect model to investigate the overall associations. Results We detected 35,699 cases of CAP from Jan to Dec 2015. Annual incidence rates of CAP were 33.68 per one thousand person-year. A 10 μm/m3 increase of PM2.5 concentration showed a significant association with the incidence of pneumonia at immediate (OR 1.04, 95% CI 1.01-1.07, p=0.002), delayed 2 weeks (OR 1.07, 95% CI 1.01-1.13, p=0.02) and cumulative 1 week (OR 1.04, 95% CI 1.01-1.06, p=0.01). This pattern was more prominent in people who was younger than 18 and older than 65. The association of PM10 and CAP was not significant in any time point. In two pollutant model, the effect of PM 2.5 on the occurrence of CAP persisted during 4 weeks cumulative period (OR 1.05, 95% CI 1.01-1.08, p=0.005). The concentration of PM2.5 and the incidence of pneumonia showed a statistically significant linear dose-concentration relationship between PM2.5 concentrations of 22.5 and 32.5 μm/m3. Conclusion Increased concentration of PM 2.5 was associated with a development of pneumonia in South Korea. Moreover, the effects of PM 2.5 exposure lasted up to 4 weeks and were prominent in young and older people.
Author Block: W. Ji1, Y. Park2, H. Kim1, H. Kim3, J. Lee4, S. Song5, C. Choi1; 1Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Korea, Republic of, 2Clinical Research Center, Asan Institute of Life Sciences, Asan Medical Center, Seoul, Korea, Republic of, 3Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Korea, Republic of, 4Oncology, Asan Medical Center, Seoul, Korea, Republic of, 5Personalized Health Management System Group, Ministry of Trade, Industry and Energy, Seoul, Korea, Republic of.
Rationale Increased exposure to particulate matter (PM) is a possible risk factor for respiratory diseases. This study aims to investigate the effect of PM on the developments of community-acquired pneumonia (CAP). Methods We analyzed claim data of the nationwide sampled cohort which comprised one million random subjects from the Korean National Health Insurance Sharing Service. The subjects were defined as those who received ICD 10 code for pneumonia (J100, J110, J12-18, J69 and J851) and took chest images within 2 weeks. People who had been hospitalized within a month were excluded. The regional daily levels of PM with diameters less than 10μm (PM10) and PM 2.5 were obtained from the Korean Ministry of Environment. We used a Poisson regression analysis to analyze the relevance of 16 regions in South Korea, and employed a meta-analysis with random effect model to investigate the overall associations. Results We detected 35,699 cases of CAP from Jan to Dec 2015. Annual incidence rates of CAP were 33.68 per one thousand person-year. A 10 μm/m3 increase of PM2.5 concentration showed a significant association with the incidence of pneumonia at immediate (OR 1.04, 95% CI 1.01-1.07, p=0.002), delayed 2 weeks (OR 1.07, 95% CI 1.01-1.13, p=0.02) and cumulative 1 week (OR 1.04, 95% CI 1.01-1.06, p=0.01). This pattern was more prominent in people who was younger than 18 and older than 65. The association of PM10 and CAP was not significant in any time point. In two pollutant model, the effect of PM 2.5 on the occurrence of CAP persisted during 4 weeks cumulative period (OR 1.05, 95% CI 1.01-1.08, p=0.005). The concentration of PM2.5 and the incidence of pneumonia showed a statistically significant linear dose-concentration relationship between PM2.5 concentrations of 22.5 and 32.5 μm/m3. Conclusion Increased concentration of PM 2.5 was associated with a development of pneumonia in South Korea. Moreover, the effects of PM 2.5 exposure lasted up to 4 weeks and were prominent in young and older people.
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