Particular matter influences the incidence of acute otitis media in children

Mina Park,Jiyeon Han,Jiwon Park,Myoung-Jin Jang,Moo Kyun Park

doi:10.1038/s41598-021-99247-3

Mina Park, Jiyeon Han + Show 3 more

Open Access

https://doi.org/10.1038/s41598-021-99247-3

Copy DOI

Abstract

Particulate matter (PM) is the main component of air pollution. Children are vulnerable to PM and acute otitis media (AOM), which is one of the most common diseases in children. However, studies on the relationship between AOM in children and PM are rare and their results are inconsistent. The aim of this study is to investigate the effect of PM on AOM in children on the basis of the Korea National Health Insurance service (NHIS) claims data. NHIS claim data from 2008 to 2015 was used to identify outpatient visits, antibiotic use to treat AOM, and demographic data. This data was combined with the data on PM2.5 (≤ 2.5 μm) and PM10 (≤ 10 μm according to its aerodynamic diameter) level extracted from air pollution data from Korean National Institute of Environmental Research for 16 administrative regions. The children with AOM were divided into three age groups (< 2, 2–4, 5–10 years). Generalized linear Poisson regression model was used to estimate the association between AOM and PM using daily counts of AOM and daily mean PM concentrations. It was adjusted to temperature, wind, humidity, season, year, age, and region. With an increase in PM2.5 of 10 μg/m3, the relative risk of OM increased by 4.5% in children under 2 years of age. The effect of PM2.5 was strongest influence on the day of exposure. The exposure to PM10 was related to the incidence of AOM on the day of exposure and the following seven days in all three age groups. The PM concentrations did not strongly affect either AOM duration or the use of antibiotics to cure AOM. The RR in the each lag day after exposure to PM10 was diverse according to the age groups. Regardless of PM size and children’s age, the PM levels are positively related to the incidence of AOM. Both PM2.5 and PM10 have the most adverse effects on children under 2 years of age and on the day of exposure.

Highlights

Identification and control of risk factors for OM are important for global healthcare in terms of quality of life and medical costs
The treatment choices for AOM comprise the use of antibiotics and ‘careful waiting’, which was first introduced by the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) in 200421
The pooled result of 16 region-specific effect estimates was a 1.045 increase in AOM case numbers over the 8 days for each 10 μg/m3 increase in PM2.5 (RR = 1.045, 95% CI = 1.021–1.070) (Table 2), and region-specific effect estimates ranged from 0.952 to 1.229 with a heterogeneity of 25%

Summary

Introduction

Identification and control of risk factors for OM are important for global healthcare in terms of quality of life and medical costs. That study had weekly temporal resolution because there were not enough cases for daily analysis, and spatial resolution for different urban and rural areas was low. It did not include children younger than 5 years of age. In South Korea, the ‘Korean clinical practice guidelines: otitis media in children’ were developed in 2010 and revised in 2014 by the Korean Otology S ociety[22] In both the America and South Korea, the guidelines have been modified to increase the proportion of careful waiting and to limit the use of antibiotics only to severe cases[17]. We used NHIS claim data for the whole country to include younger children and to investigate the daily incidence and improve spatial resolution of different areas.

Objectives

Methods

Results

Conclusion