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Short-Term Effects of Air Pollution on Hospital Admissions in Korea

Son, Ji-Young; Lee, Jong-Tae; Park, Yoon Hyeong; Bell, Michelle L.

doi: 10.1097/EDE.0b013e3182953244
Air Pollution

Background: Numerous studies have identified short-term effects of air pollution on morbidity in North America and Europe. The effects of air pollution may differ by region of the world. Evidence on air pollution and morbidity in Asia is limited.

Methods: We investigated associations between ambient air pollution and hospital admissions in eight Korean cities for 2003–2008. We applied a two-stage Bayesian hierarchical model to estimate city-specific effects and the overall effects across the cities. We considered lagged effects of pollutants by cause (allergic disease, asthma, selected respiratory disease, and cardiovascular disease), sex, and age (0–14, 15–64, 65–74, and ≥75 years).

Results: We found evidence of associations between hospital admissions and short-term exposure to air pollution. An interquartile range (IQR) increase in PM10 (30.7µg/m3) was associated with an overall increase of 2.2% (95% posterior interval = 0.5%–3.9%), 2.8% (1.3%–4.4%), 1.7% (0.9%–2.6%), and 0.7% (0.0%–1.4%) in allergic, asthma, selected respiratory, and cardiovascular admissions, respectively. For NO2 (IQR 12.2 ppb), the corresponding figures were 2.3% (0.6%–4.0%), 2.2% (0.3%–4.1%), 2.2% (0.6%–3.7%), and 2.2% (1.1%–3.4%). For O3, we found positive associations for all the studied diagnoses except cardiovascular disease. SO2 was associated with hospital admissions for selected respiratory or cardiovascular causes, whereas O3 was negatively associated with cardiovascular admissions. We found suggestive evidence for stronger associations in younger and older age groups. Associations were similar for men and women.

Conclusions: Ambient air pollution was associated with increased risk of hospital admissions in Korea. Results suggest increased susceptibility among the young or the elderly for pollution effects on specific diseases.

Supplemental Digital Content is available in the text.

From the aSchool of Forestry & Environmental Studies, Yale University, CT; bDepartment of Environmental Health, College of Health Science, Korea University, Seoul, Korea; and cDepartment of Preventive Medicine, College of Medicine, Soonchunhyang University, Asan, Korea.

Supported by NIEHS (R01ES015028, R21ES020152, R21ES021427, R01ES019560) and EPA (RD83479801).

The authors declare no competing interests.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article ( This content is not peer-reviewed or copy-edited; it is the sole responsibility of the author.

Correspondence: Michelle L. Bell, School of Forestry & Environmental Studies, Yale University, 195 Prospect Street, New Haven CT 06511. E-mail:

Received April 16, 2012

Accepted November 20, 2012

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.