Abstract
Climate change, air pollution, and the rapidly aging population are important public health challenges. An understanding of air pollution impacts is imperative for preventing air-pollution-related deaths and illnesses, particularly in vulnerable subgroups such as the increasing population of older adults. To assess the effects of short-term air-pollution exposure on the elderly, we conducted a time-series analysis (1996–2015) of the associations between particulate matter with an aerodynamic diameter of <10 μm (PM10) and deaths among elderly residents of Seoul, South Korea, which has a rapidly aging population. We also investigated the synergistic effects of temperature and the lag structures of the effects by sex, cause of death, and season. A 10 μg/m3 rise in the 4-day moving average concentration of PM10 was associated with 0.31% (95% confidence interval (CI): 0.18% to 0.44%), 0.32% (95% CI: 0.09% to 0.55%), and 0.22% (95% CI: –0.23% to 0.66%) increases in non-accidental, cardiovascular, and respiratory mortalities, respectively. We found a significant and strong synergistic effect of PM10 concentration and ambient temperature on mortality in elderly people. PM10 posed an increased risk of non-accidental or cardiovascular mortality with increasing temperature, whereas the associated risk of respiratory death was highest on very cold days. The shape and length of the lag structure varied with the cause of death, sex, and season. Results indicate that elderly people exposed to PM10 are at increased risk of premature death. In the near future, these risks are likely to increase in step with the temperature rise associated with climate change and the continued population aging. Stronger emission controls will be needed to minimize the increased health risks associated with air pollution, especially in regions with high populations of elderly individuals.
Highlights
Air quality and its impact on health are major environmental health issues [1]
Because aging is associated with declines in adaptive and innate immunity, as well as with comorbidities, exposure to particulate matter (PM) may be fatal in elderly individuals [5,6]
We examined the effects of PM10 under different lag structures, because a delayed health effect is known to exist in the association between PM10 and mortality [13]
Summary
Air quality and its impact on health are major environmental health issues [1]. The high concentration of particulate matter (PM) is a rising socioenvironmental issue in South Korea owing to its large impacts on the health and lifestyle of residents [2]. It has been suggested that short-term exposure to PM affects vulnerable subpopulations, such as the elderly, who are at elevated risk of dying owing to their poor health [3,4]. Because aging is associated with declines in adaptive and innate immunity, as well as with comorbidities, exposure to PM may be fatal in elderly individuals [5,6]. In the last four decades, South Korea has shown the most extreme demographic shift among advanced economies, with its population aging at the fastest pace [7].
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