Abstract
Meniere’s disease is thought to be a disorder of the inner ear function, affected by genetic and environmental factors. Several recent studies have shown that air pollution could affect middle and inner ear diseases. The purpose of this study was to investigate the relationship between the Meniere’s disease occurrence and air pollution status in Korea. This study used a time-stratified case-crossover design. Hospital visit data by Meniere’s disease were collected from the Korea National Health Insurance Service-National Sample Cohort (NHIS-NSC) database. Daily air pollution data for sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), and particulate matter (PM10: ≤ 10 μm in diameter, and PM2.5: ≤ 2.5 μm in diameter) were collected from the National Ambient air quality Monitoring Information System (NAMIS) database. We used two-stage analysis to assess the association between degree of air pollution and the occurrence of Meniere’s disease. In the first stage, region-specific analysis was conducted to estimate the odds ratios (ORs) of Meniere’s disease risk associated with each air pollutant exposure by using conditional logistic regression for matched case–control sets in 16 regions. In the second stage, region-specific ORs from the first stage were combined and the pooled effect estimates were derived through fixed and random effect meta-analysis. Subgroup analysis was conducted for age, sex, seasonality, and urbanization of residence. In total, 29,646 (32.1% males and 67.9% females) Meniere’s disease cases were identified from Korea NHIS-NSC database between 2008 and 2015. Overall, SO2, NO2, CO, and PM10 showed significant correlation with Meniere’s disease risk at immediate lags, and weaker correlation at delayed lags, whereas O3 showed slightly negative correlation at the immediate lag (lag0) and PM2.5 did not show strong correlation (SO2: 1.04 [95% confidence interval: 1.01, 1.06]; NO2: 1.08 [1.06, 1.11]; CO: 1.04 [1.02, 1.06]; O3: 0.96 [0.93, 0.99]: statistically significant ORs at lag0 are listed). These positive and negative associations between Meniere’s disease and each air pollutant were generally stronger in the age of 40–64, female, summer (June–August) season, and urban subgroups. Our results showed that hospital visits for Meniere’s disease were associated with the measured concentrations of ambient air pollutants SO2, NO2, CO, and PM10. Further studies are required to confirm these associations and find their mechanisms.
Highlights
Meniere’s disease is a chronic illness of the inner ear characterized by episodic vertigo, fluctuating sensorineural hearing loss, ear fullness, and tinnitus, all of which decrease quality of life and could lead to permanent hearing loss
The Korea National Health Insurance database provides health services with big data related to medical care, and we can integrate these data and air pollution data from the Korea Environment Corporation to analyze the association between the frequency of Meniere’s disease hospital visits and the level of environmental pollution
29,646 (32.1% males and 67.9% females) Meniere’s disease cases were identified from Korea NHIS-NSC database between 2008 and 2015; 4464 (33.6% males and 66.4% females) cases were included in 2015 in the analysis of association with P M2.5, and 3972 (33.6% males and 66.4% females) were included in the subgroup analysis of association with PM2.5 (Table 1)
Summary
Meniere’s disease is a chronic illness of the inner ear characterized by episodic vertigo, fluctuating sensorineural hearing loss, ear fullness, and tinnitus, all of which decrease quality of life and could lead to permanent hearing loss. According to a recent study in the UK, the annual health care costs associated with Meniere’s disease were estimated between USD 829.9 and 934.2 million, equating to $5112–$5748 per person per y ear[4]. Since it was first described in 1 8615, Meniere’s disease has been believed to be caused by the over-accumulation of endolymphatic fluid in the membranous labyrinth and subsequent membrane rupture[6,7]. Identifying the relationship between air pollution and Meniere’s disease can help understand the pathophysiology of the disease and manage it. The purpose of this study was to investigate the relationship between the Meniere’s disease and air pollution
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