Disease In Seoul Research Articles

예측과정을 이용한 연령별 시차 분포 모형

Interest in mental disease is increasing. Recently a positive association between elevated temperature and mental disease has been reported. However, there was a limitation in that detailed interaction with age could not be confirmed. In this study, to overcome such limitations, the association between emergency room visits due to mental disease and mean temperature was explored by using the age-specific distributed lag model. The age-specific distributed lag model is a model in which a coefficient of age and lagged temperature are integrated into the existing distributed lag model. Accordingly the dimension of the parameter space was reduced by expressing the increased parameters as a linear combination of prediction process basis functions and the accuracy of parameter estimation was increased using information on the total age. The degree of borrowing information over age was estimated through variogram modeling. From 2014 to 2020, 906,958 patients visited the emergency room due to mental disease in Seoul. The age groups with a positive cumulative association over the lag period of 0-3 days between mean temperature and emergency room visits due to mental disease were 15 to 24, 40 to 59 and 80 to 84. As the effects of climate change become a reality, understanding detailed vulnerabilities will become very important for public health planning and intervention.

Impact of ambient temperature on respiratory disease: a case-crossover study in Seoul.

Respiratory diseases contribute to global morbidity and mortality, and temperature is a significant factor. We investigated the association between ambient temperature and emergency department (ED) visits for various respiratory diseases in Seoul, South Korea. Using data from the National Emergency Department Information System (2008-2017), we analysed 1,616,644 ED visits for respiratory diseases, categorised according to the Korean Standard Classification of Diseases 7th revision codes (J00-J99). Using a time-stratified case-crossover design and a distributed lag nonlinear model, we investigated the effect of temperature exposure on ED visits for respiratory diseases, calculating the relative risk (RR) for the maximum risk temperature (MaxRT) of both cold and hot extremes compared to the minimum risk temperature (MinRT). Cold temperatures (MaxRT: -9.0°C) resulted in a 2.68-fold increase (RR = 2.68, 95% CI = 2.26-3.14) in ED visits for total respiratory diseases, while hot temperatures (MaxRT: 29.4°C) led to a 1.26-fold increase (RR = 1.26, 95% CI = 1.11-1.42) compared to the MinRT (24.8°C). Cold temperatures increased the risk of most respiratory diseases, except interstitial lung disease, whereas hot temperatures increased ED visits for acute upper respiratory infections and influenza. Cold temperatures increased ED visits for all age groups, especially those aged 18-64 (RR = 3.54, 95% CI = 2.90-4.33), while hot temperatures significantly affected those < 18 (RR = 1.45, 95% CI = 1.27-1.66). The risk levels were similar in both males and females, regardless of hot and cold temperatures. Our findings underscore the significant impact of both cold and heat exposure on ED visits for respiratory diseases, with varying intensities and risk profiles across different population groups.

Long-term exposure to high perceived temperature and risk of mortality among patients with chronic kidney disease

Health risks due to climate change are emerging, particularly from high-temperature exposure. The perceived temperature is an equivalent temperature based on the complete heat budget model of the human body. Therefore, we aimed to analyze the effect of perceived temperature on overall mortality among patients with chronic kidney disease. In total, 32,870 patients with chronic kidney disease in Seoul participated in this retrospective study (2001–2018) at three medical centers. The perceived temperature during the summer season was calculated using meteorological factors, including the air temperature near the automated weather station, dew point temperature, wind velocity, and total cloud amount. We assessed the association between perceived temperature using Kriging spatial interpolation and mortality in patients with CKD in the time-varying Cox proportional hazards model that was adjusted for sex, age, body mass index, hypertension, diabetes mellitus, estimated glomerular filtration rate, smoking, alcohol consumption, and educational level. During the 6.14 ± 3.96 years of follow-up, 3863 deaths were recorded. In multivariable analysis, the average level of perceived temperature and maximum level of perceived temperature demonstrated an increased risk of overall mortality among patients with chronic kidney disease. The concordance index for mortality of perceived temperature was higher than temperature, discomfort index, and heat index. When stratified by age, diabetes mellitus, and estimated glomerular filtration rate, patients with chronic kidney disease with young age (age <65 years) showed higher hazard ratio for mortality (interaction P = 0.049). Moreover, the risk of death in the winter and spring seasons was more significant compared to that of the summer and autumn seasons. Therefore, long-term exposure to high perceived temperature during summer increases the risk of mortality among patients with chronic kidney disease.

Association between diurnal temperature range and emergency department visits for multiple sclerosis: A time-stratified case-crossover study

Although multiple sclerosis (MS) has been the leading cause of neurologically-induced disability in young adults, risk factors for the relapse and acute aggravation of MS remain unclear. A few studies have suggested a possible role of temperature changes on the relapse and acute aggravation of MS. We investigated the association between short-term exposure to wide diurnal temperature ranges (DTRs) and acute exacerbation of MS requiring an emergency department (ED) visit. A total of 1265 patients visited EDs for acute aggravation of MS as the primary disease in Seoul between 2008 and 2014 from the national emergency database. We conducted a conditional logistic regression analysis of the time-stratified case-crossover design to compare DTRs on the ED visit days for MS and those on control days matched according to the day of the week, month, and year. We examined possible associations with other temperature-related variables (ambient temperature, between-day temperature change, and sunlight hours). Short-term exposure to wide DTRs immediately increased the risk of ED visits for MS. Especially, 2-day average (lag0–1) DTR levels on the day of and one day prior to ED visits exhibited the strongest association (an 8.81% [95% CI: 3.46%–14.44%] change in the odds ratio per 1 °C increase in the DTR). Other temperature-related variables were not associated with MS aggravation. Our results suggest that exposure to wider DTR may increase the risk of acute exacerbation of MS. Given the increasing societal burden of MS and the increasing temperature variability due to climate change, further studies are required.

Application of Testing-Tracing-Treatment Strategy in Response to the COVID-19 Outbreak in Seoul, Korea.

BackgroundFollowing the coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China, a total of 637 patients had been diagnosed with the disease in Seoul as of May 2, 2020. Our study aimed to describe the impact of the 3T strategies (preemptive testing, prompt tracing and proper treatment) on the epidemiological characteristics of COVID-19 in Seoul.MethodsThe descriptive and explanatory analysis was carried out on critical indicators such as epidemiological characteristics and key duration of patient status change from January 24 to May 2 in Seoul before and after preemptive testing for patients under investigation associated with COVID-19 clusters.ResultsPreemptive testing increased the positive test rate (3.9% to 4.2%), an asymptomatic case at diagnosis (16.9% to 30.6%), and reduced the time from symptom onset to quarantine (4.0 to 3.0 days). Prompt tracing decreased unknown sources of infection (6.9% to 2.8%), the mean number of contacts (32.2 to 23.6), and the time-varying reproduction number R(t) (1.3 to 0.6). With proper treatment, only 2 cases of mortality occurred, resulting in a fatality rate of just 0.3%.ConclusionIn the first wave of the COVID-19 pandemic lasting 100 days, the effect of the 3T strategies flattened the curve and decreased the time during which infected individuals were contagious, thereby lowering the R(t) below 1 in Seoul.

Assessing the Impact of Ozone and Particulate Matter on Mortality Rate from Respiratory Disease in Seoul, Korea

The evidence linking ozone and particulate matter with adverse health impacts is increasing. The goal of this study was to assess the impact of air pollution on the mortality rate from respiratory disease in Seoul, Korea, between 2008 and 2017. The analysis was conducted using a decision tree model in two ways: using 24-h average concentrations and using 1-h maximum values to compare any health impacts from the different times of exposure to pollution. Results show that in spring an elevated level of ozone is one of the most important factors, but in summer temperature has a greater impact than air pollution. Nitrogen dioxide is one of the most important factors in fall, while high levels of particles less than 2.5 μm (PM2.5) and 10 μm in size (PM10) and cooler temperatures are key factors in winter. We checked the accuracy of our results through a 10-fold cross validation method. Error rates using 24-h average and 1-h maximum concentrations were in the ranges of 24.9–42% and 27.6–42%, respectively, indicating that 24-h average concentrations are slightly more directly related with mortality rate. These results could be useful for policy makers in determining the temporal scale of predicted pollutant concentrations for an air quality warning system to help minimize the adverse impacts of air pollution.

The Effects of PM10 on the Hospital Admission of Patients with Respiratory Disease in Seoul, Korea

This cohort study aimed to identify the effects of daily PM10 exposure on the hospital admission of patients with respiratory diseases, during the nine-year period (2002–2010), in Seoul, Korea. The research subjects were 13,974 patients who had been hospitalized with respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia. During the follow-up period, an increase of 10 ug/m3 in PM10 under the threshold of 50 ug/m3 of PM10 led to hospital admission in 1.38% of the age group younger than 15 years, 1.62% in those 65 years or older, 2.87% in patients 75 years or older and in 1.50% of pneumonia patients, 1.51% of COPD patients, and 1.55% of pneumonia and asthma patients. Under the threshold of 80 ug/m3 of PM10, there was a 3.71% increase in new patients admitted in the age group 65 years or older and 4.25% in those at least 75 years old. Our study found that high PM10 was associated with increased risk of admission of respiratory patients, especially in the elderly. People who already have a respiratory disease should refrain from exposure to particulate matter when there is a high concentration of PM10, especially older patients.

Short-term PM2.5 exposure and emergency hospital admissions for mental disease

Epidemiologic studies regarding the relationship between short-term exposure to particulate matter with a median aerodynamic diameter < 2.5 µm (PM2.5) and mental disease are limited. This study examined the effects of short-term exposure to PM2.5 on emergency admissions to the hospital for mental disease in Seoul, Korea.Data regarding 80,634 emergency admissions for mental diseases were collected from a nationally centralized healthcare claims database in Seoul during 2003–2013. Generalized linear models with climate variables were used to examine associations between short-term PM2.5 exposure and mental disease admissions. To comprehensively assess PM2.5 effects, we used single- and two-pollutant models, which considered other pollutants in combination with PM2.5.The relative risk (RR) of emergency admissions for mental disease was 1.008 (95% confidence interval, 1.001–1.015) for each 10 μg/m3 increase in 2-day average PM2.5 concentration. This effect persisted or became slightly stronger in the two-pollutant models that included carbon monoxide, nitrogen dioxide, ozone, or sulfur dioxide (RR, 1.01–1.021), but association appeared to be limited to individuals < 65 years of age. Significant association was estimated only during the warm season (RR, 1.021–1.023) in the two-pollutant models. The exposure–response curve was steeper at lower concentrations, suggesting that the risk of mental disease at lower concentrations of pm2.5 (0–30 µg/m3). PM2.5 was associated with increased admissions even when it was below the World Health Organization's Air Quality Guidelines (25 μg/m3), but the association was not statistically significant.Thus, based on the data from a large database, exposure to PM2.5 was associated with increases in emergency admissions for mental diseases, and this association was significant during the warm season. PM2.5 may even affect mental disease at levels below the current air quality guidelines. These results provide substantial insight regarding the effects of air pollutants and have important implications for policy makers.

Ambient air pollution exposure and risk of migraine: Synergistic effect with high temperature

BackgroundMigraine is a chronic and agonizing neurological disorder prevalent worldwide. Although its pathogenesis remains unclear, limited evidence exists on the role of air pollution. ObjectiveWe aimed to assess the association of short-term air pollution exposure with migraine in conjunction with the synergistic effect of temperature. MethodsWe identified 18,921 patients who visited emergency departments (EDs) for migraine as a primary disease in Seoul from the national emergency database between 2008 and 2014. We conducted a time-stratified, case-crossover analysis to compare levels of particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) on ED visit days and those on the control days matched to day of the week, month, and year. We evaluated the synergistic effects of air pollution and temperature using an interaction term. ResultsHigher air pollution levels were significantly associated with risk of migraine over various lag structures. In the best fitting lags, the odds ratio (OR) associated with an interquartile range increase of PM2.5, PM10, NO2, O3, and CO was 1.031 (95% CI: 1.010–1.053), 1.032 (95% CI: 1.007–1.057), 1.053 (95% CI: 1.022–1.085), 1.034 (95% CI: 1.001–1.067), and 1.029 (95% CI: 1.005–1.053), respectively. The SO2 effect was positive but not significant (OR 1.019 [95% CI: 0.991–1.047]). The PM effect was significantly stronger on high-temperature days (above the 75th percentile) than on low-temperature days (PM2.5, high: OR 1.068, low: OR 1.021, Pinteract = 0.03; PM10, high: OR 1.066, low: OR 1.014, Pinteract = 0.02). ConclusionOur study provides new evidence that air pollution exposure may trigger migraine especially on high-temperature days, and this finding may contribute in establishing preventive measures against migraine.

Assessing the impact of air pollution on mortality rate from cardiovascular disease in Seoul, Korea

Assessing the impact of air pollution on mortality rate from cardiovascular disease in Seoul, Korea

The effects of PM10 on the admission of patients with respiratory disease in Seoul, Korea

Background This study aimed to identify the effects of daily PM10 exposure on the admission of patients with respiratory diseases in Seoul, the capital city of Korea. Methods We analyzed the Nation...

Short-term exposure to PM10 and emergency admissions for Parkinson's disease in Seoul, Korea

Short-term exposure to PM10 and emergency admissions for Parkinson's disease in Seoul, Korea

Susceptibility to ambient particulate matter on emergency care utilization for ischemic heart disease in Seoul, Korea.

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 5years 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 ≥80years 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 ≥80years 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 ≥80years. Identification of populations susceptible to air pollution is of paramount importance to establishing recommendations or guidelines for high-risk individuals.

GIS-based Association Between PM10 and Allergic Diseases in Seoul: Implications for Health and Environmental Policy

GIS-based Association Between PM10 and Allergic Diseases in Seoul: Implications for Health and Environmental Policy

GIS-based Association Between PM10 and Allergic Diseases in Seoul: Implications for Health and Environmental Policy.

PurposeThe role of PM10 in the development of allergic diseases remains controversial among epidemiological studies, partly due to the inability to control for spatial variations in large-scale risk factors. This study aims to investigate spatial correspondence between the level of PM10 and allergic diseases at the sub-district level in Seoul, Korea, in order to evaluate whether the impact of PM10 is observable and spatially varies across the subdistricts.MethodsPM10 measurements at 25 monitoring stations in the city were interpolated to 424 sub-districts where annual inpatient and outpatient count data for 3 types of allergic diseases (atopic dermatitis, asthma, and allergic rhinitis) were collected. We estimated multiple ordinary least square regression models to examine the association of the PM10 level with each of the allergic diseases, controlling for various sub-district level covariates. Geographically weighted regression (GWR) models were conducted to evaluate how the impact of PM10 varies across the sub-districts.ResultsPM10 was found to be a significant predictor of atopic dermatitis patient count (P<0.01), with greater association when spatially interpolated at the sub-district level. No significant effect of PM10 was observed on allergic rhinitis and asthma when socioeconomic factors were controlled for. GWR models revealed spatial variation of PM10 effects on atopic dermatitis across the sub-districts in Seoul. The relationship of PM10 levels to atopic dermatitis patient counts is found to be significant only in the Gangbuk region (P<0.01), along with other covariates including average land value, poverty rate, level of education and apartment rate (P<0.01).ConclusionsOur findings imply that PM10 effects on allergic diseases might not be consistent throughout Seoul. GIS-based spatial modeling techniques could play a role in evaluating spatial variation of air pollution impacts on allergic diseases at the sub-district level, which could provide valuable guidelines for environmental and public health policymakers.

Epidemiological and Clinical Features of Canine Ophthalmic Diseases in Seoul from 2009 to 2013

This study aimed to investigate the epidemiology of canine ophthalmic diseases in Seoul, Korea using data for new canine patients examined from January 2009 through December 2013 at an ophthalmic referral center (WooSung Animal Medical Center, Seoul). The study included 1253 dogs with an average age of 7.93 years (SD, 4.06). Shih Tzu (29.4%) was the most common breed, followed by Maltese, Yorkshire Terrier, Cocker Spaniel, and toy Poodle (P < 0.01). Lens diseases (28.3%) were the most common, followed by eyelid, corneal, retinal, and glaucomatous diseases (P < 0.01). Lens, eyelid, retinal, nasolacrimal, uveal, vitreous, and neuro-ophthalmic diseases more frequently showed a bilateral occurrence (P < 0.01) than a unilateral occurrence. In the Shih Tzu breed, corneal disease was the most frequent, followed by lens, eyelid, retinal, and glaucomatous diseases. The most frequent diseases in the Maltese breed were lens, eyelid, retinal, and corneal diseases. In the Yorkshire Terrier, Cocker Spaniel, and toy Poodle breeds, lens disease was the most common (P < 0.01). The most frequent ophthalmic patients belonged to small breeds such as Shih Tzu, Maltese, and Yorkshire Terrier. Moreover, the most common ophthalmic diseases were not traumatic diseases, but breed-inherited diseases such as lens diseases.

Assessment of Total/Specific IgE Levels Against 7 Inhalant Allergens in Children Aged 3 to 6 Years in Seoul, Korea

PurposeChildhood allergies are a serious problem, as they may lead to lifetime chronic disease. Determination of total and specific IgE levels is known to be a diagnostic tool for allergic sensitization; however, IgE levels are affected by various factors, such as age, sex, ethnicity, and geographic area. Thus, we evaluated the distribution of total and specific serum IgE levels against seven inhalant allergens in preschool children and examined their association with allergic diseases in Seoul, Korea.MethodsTotal/specific serum IgE determination and skin prick tests for seven common allergens were performed on 509 children aged 3 to 6 years from 16 child care centers in Seoul, Korea. Demographic characteristics were surveyed from parents using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. A diagnosis of atopic dermatitis was made by physicians.ResultsThe geometric mean of total IgE was 80.48±3.80 kU/L in preschool children. IgE levels were higher in boys (boys, 102.34±3.52 kU/L; girls, 62.37±3.93 kU/L; P<0.001) and atopic subjects (atopic, 158.00±3.35 kU/L; non-atopic, 52.75±3.44 kU/L; P<0.001). An increased prevalence of atopy was associated with a high monthly household income (P=0.004) and higher maternal education level (above university-level education; P=0.009), as well as increased total IgE levels (P=0.036). Physician-diagnosed atopic dermatitis was associated with sensitization to inhalant allergens.ConclusionsTotal IgE levels were very high as compared with those in previous reports from other countries. The most common sensitized allergen was Dermatophagoides farinae, and the positive response rate peaked at age 3 years and was maintained thereafter, particularly in boys. Specific IgE levels for seven inhalant allergens varied with age in preschool children. Although further investigations are needed with a broad range of ages and various allergens, the distribution of the total and specific serum IgE levels in preschool children might help to serve as a reference value to diagnose atopy.

Regional prevalence of non-alcoholic fatty liver disease in Seoul and Gyeonggi-do, Korea

Background/AimsThe prevalence of nonalcoholic fatty liver disease (NAFLD) in Korea has increased recently. The aim of the present study was to determine the regional differences in the prevalence and characteristics of NAFLD.MethodsFrom January 2009 to December 2010, 161,891 Seoul and Gyeonggi-do residents receiving a health examination at our institution were enrolled in this cross-sectional study. After applying exclusion criteria, the data of 141,610 subjects (80,943 males, 60,667 females) were analyzed. The presence of NAFLD was established by ultrasound examination.ResultsThe overall prevalence of NAFLD was 27.3% (38.3% in men, 12.6% in women). When standardized according to age, area, and sex, the prevalence of NAFLD was 25.2%. The age and area standardized prevalence of NAFLD was higher for men (34.4%) than for women (12.2%; P<0.001). The overall prevalence of NAFLD was higher in Gyeonggi-do (27.7%) than in Seoul (26.9%; P<0.001). Among the men, the prevalence of NAFLD was higher in Gyeonggi-do (39.2%) than in Seoul (37.4%; P<0.001), while for the women it was higher in Seoul (13.2%) than in Gyeonggi-do (12.0%; P<0.001).ConclusionsThe regional prevalence of NAFLD differed between Seoul and Gyeonggi-do. Further studies are needed to establish the etiology of this difference.

The Prevalence of Atopic Dermatitis, Asthma, and Allergic Rhinitis and the Comorbidity of Allergic Diseases in Children

ObjectivesChildhood allergic diseases are a major concern because they lead to a heavy economic burden and poor quality of life. The purpose of this study was to investigate the prevalence of childhood atopic dermatitis, asthma, allergic rhinitis, and the comorbidity of allergic diseases in Seoul, Korea.MethodsWe conducted a cross-sectional survey between May and October 2010 to evaluate the prevalence of childhood allergic diseases, including atopic dermatitis, asthma, and allergic rhinitis, using a questionnaire from the International Study of Asthma and Allergies in Childhood group. Each questionnaire was completed by the parent or guardian of a child.ResultsIn the 31,201 children studied, the prevalence of atopic dermatitis symptoms in the past 12 months was 19.3% in children 0 to 3 years of age, 19.7% in children 4 to 6 years of age, 16.7% in children 7 to 9 years of age, and 14.5% in children 10 to 13 years of age (p for trend < 0.001). The prevalence of asthma in these age groups was 16.5%, 9.8%, 6.5%, and 5.4%, respectively (p for trend < 0.001). The prevalence of allergic rhinitis in these age groups was 28.5%, 38.0%, 38.5%, and 35.9%, respectively (p for trend = 0.043). The percentage of subjects with both atopic dermatitis and asthma, both asthma and allergic rhinitis, or both atopic dermatitis and allergic rhinitis was 2.5%, 4.7%, and 8.7%, respectively. The prevalence of comorbid allergic diseases decreased with age (p for trend < 0.001).ConclusionsOur study revealed that the prevalence of some allergic diseases, such as atopic dermatitis and asthma, was relatively high in very young children and that all of the principal allergic diseases in children often co-exist.

황사현상이 천식질환에 미치는 영향도 분석: 2005년부터 2008년 서울지역을 중심으로

This study investigates the relationship between Asian dust and asthma disease in Seoul, using data of Asian dust occurrences and the number of treatments for asthma between 2005 and 2008. The data include the number of treatments for asthma on the basic day paired with the average number of treatments for asthma on the compared days. The compared day is defined by the day of no Asian dust in same month and day of the week as the basic day, when Asian dust occurs. Also, the basic day is expanded to the day after three days from the day of Asian dust. The paired two sample t-test for the number of treatments for asthma on the basic day and the compared days revealed that the Asian dust occurrences are correlated with the asthma disease. The number of treatments for asthma is significantly increased on the one and two days after Asian dust occurs. On the other hand, there's no significant difference in the number of treatments for asthma between the days of Asian dust occurrence and the days of no Asian dust, which implies that people usually try not to go out when Asian dust occurs.