Journal List > Kosin Med J > v.33(2) > 1122220

Lee, Lee, Hwang, and Odajima: The effect of short-term particular matter2.5 exposure on asthma attacks in asthma children in Fukuoka, Japan

Abstract

Objectives

We investigated whether asthma attacks in asthmatic children were caused by short-term exposure to particulate matter(PM)2.5.

Methods

Subjects were 411 patients who received inhalation therapy in National Fukuoka Hospital, from March to May 2013. All subjects were outpatients. We surveyed the air quality measurement results in the stations closest to the address of the patients. Data were used from the City of Fukuoka website data on air pollution. We carried out a case-crossover study and compared PM2.5 concentration between 7 days after asthma attack occurred and the day asthma attack occurred and 1, 2 and 3 days before asthma attack occurred.

Results

Highest hourly concentration of the day (OR 1.013, 95%CI 1.000-1.025) showed a significant association with 1 day before PM2.5 concentration statistically. And 0-1 year-old infants were more vulnerable to the highest concentration of 1 day before PM2.5 concentration(P < 0.05). Average concentration of NO2 and O3 and asthma attack also showed a significant association.

Conclusions

Maximal daily PM2.5 concentrations within 24 hours prior to the attack affect asthma exacerbation. 0-1 year-old infants are particularly vulnerable to PM2.5 concentration. Asthma exacerbation is aggravated by NO2 and O3 concentration on the day of the asthma attack.

REFERENCES

1.United States Environmental Protection Agency (2012). viewed April 17 2013. http://www.epa.gov.
2.Bateson TF., Schwartz J. Children's response to air pollutants. J Toxicol Environ Health A. 2008. 71:238–43.
crossref
3.Strickland MJ., Darrow LA., Klein M., Flanders WD., Sarnat JA., Waller LA, et al. Short-term associations between ambient air pollutants and pediatric asthma emergency department visits. Am J Respir Crit Care Med. 2010. 182:307–16.
crossref
4.Yamazaki S., Shima M., Ando M., Nitta H., Watanabe H., Nishimuta T. Effect of hourly concentration of particulate matter on peak expiratory flow in hospitalized children: a panel study. Environ Health. 2011. 10:15.
crossref
5.Kelly FJ., Fussell JC. Air pollution and airway disease. Clin Exp Allergy. 2011. 41:1059–71.
crossref
6.Nishimuta T., Kondo N., Hamasaki Y., Morikawa A., Nishima S. Japanese guideline for childhood asthma. Allergology International. 2011. 60:147–69.
crossref
7.Ueda K., Nitta H., Odajima H. The effects of weather, air pollutants, and Asian dust on hospitalization for asthma in Fukuoka. Environ Health Prev Med. 2010. 15:350–7.
crossref
8.Odajima H., Yamazaki S., Nitta H. Decline in peak expiratory flow according to hourly short-term concentration of particulate matter in asthmatic children. Inhal Toxicol. 2008. 20:1263–72.
crossref
9.Iskandar A. Andersen ZJ, Bonnelykke K, Ellermann T, Andersen KK, Bisgaard H. Coarse and fine particles but not ultrafine particles in urban air trigger hospital admission for asthma in children. Thorax. 2012. 67:252–7.
10.Lin S., Liu X., Le LH., Hwang SA. Chronic exposure to ambient ozone and asthma hospital admissions among children. Environ Health Perspect. 2008. 116:1725–30.
crossref
11.Meng YY., Rull RP., Wilhelm M., Lombardi C., Balmes J., Ritz B. Outdoor air pollution and uncontrolled asthma in the San Joaquin Valley, California. J Epidemiol Community Health. 2010. 64:142–7.
crossref
12.Lipsett M., Hurley S., Ostro B. Air pollution and emergency room visits for asthma in Santa Clara Country, California. Environ Health Perspect. 1997. 105:216–22.
13.Gauderman WJ., Avol E., Lurmann F., Kuenzli N., Gilliland F., Peters J, et al. Childhood asthma and exposure to traffic and nitrogen dioxide. Epidemiology. 2005. 16:737–43.
crossref
14.Selgrade MK., Plopper CG., Gilmour MI., Conolly RB., Foos BSP. Assessing the health effects and risks associated with children's inhalation exposures: asthma and allergy. J Toxicol Environ Health A. 2008. 71:196–207.
15.Trasande L., Thurston GD. The role of air pollution in asthma and other pediatric morbidities. J Allergy Clin Immunol. 2005. 115:689–99.
crossref
16.Gaudeman WJ., Avol E., Gilliland F., Vora H., Thomas D., Berhane K, et al. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med. 2004. 351:1057–67.
crossref
17.Song S., Lee K., Lee YM., Lee JH., Lee SI., Yu SD, et al. Acute health effects of urban fine and ultrafine particles on children with atopic dermatitis. Environ Res. 2011. 111:394–9.
crossref
18.Konishi S., Ng CFS., Stickley A., Nishihata S., Shinsugi C., Ueda K, et al. Particulate matter modifies the association between airborne pollen and daily medical consultations for pollinosis in Tokyo. Sci Total Environ. 2014. 499:125–32.
crossref
19.Lim JM., Jeong JH., Lee JH., Moon JH., Chung YS., Kim KH. The analysis of PM2.5 and associated elements and their indoor/outdoor pollution status in an urban area. Indoor Air. 2011. 2:145–55.

Fig. 1.
Map of monitoring stations in Fukuoka. The table on the left shows the names of monitoring stations, the number of asthma patients, and percentage.
kmj-33-171f1.tif
Table 1.
Characteristics of the study groups.
Number Percent
Total 411
Sex ratio (M:F) 1.45
Mean age(± SD) 5.58 ± 4.41
Age
0-1 97 23.6
2-5 142 34.5
6-12 136 33.1
13-15 30 7.3
Over 16 6 1.5
Table 2.
Comparison of maximal, average concentration of PM2.5 (μg/㎥).
D-3 Control day D-2§ Control day
Average(maximal) 35.65 36.50 35.52 33.91
Standard deviation 18.53 19.34 18.73 16.81
P 0.522 0.196
D-1 Control day D0 Control day
Average(maximal) 35.44 32.84 35.71 34.53
Standard deviation 18.22 15.63 18.19 18.23
P 0.029 0.352
D-3 Control day D-2§ Control day
Average(average) 22.21 22.92 21.81 21.47
Standard deviation 12.33 13.98 11.54 12.64
P 0.439 0.684
D-1 Control day D0 Control day
Average(average) 21.34 19.81 21.95 21.17
Standard deviation 11.89 11.00 13.06 12.43
P 0.057 0.382

* P < 0.01

P < 0.05 by t-test

D-3 : 3 days prior to day of attack

§ D-2 : 2 days prior to day of attack

D-1 : 1 day prior to day of attack

D0 : day of asthma attack

Table 3.
Odds ratios and 95% confidence intervals of asthma attack by maximal 1-hour concentration of each air pollutant.
D-3 D-2§
OR* 95%CI P OR* 95%CI P
PM2.5 Single-variant 0.998 0.990-1.005 0.522 1.005 0.997-1.013 0.196
Multi-variant 0.841 0.719-0.983 0.030 0.932 0.844-1.029 0.165
SPM Single-variant 0.993 0.986-1.000 0.067 0.998 0.990-1.006 0.579
Multi-variant 1.160 1.037-1.297 0.009 1.060 0.981-1.146 0.142
NO2 Single-variant 1.004 0.988-1.021 0.615 1.013 0.997-1.029 0.105
Multi-variant 0.973 0.885-1.069 0.564 1.101 1.012-1.197 0.026
O3 Single-variant 0.984 0.971-0.997 0.197 0.986 0.972-0.999 0.042
Multi-variant 1.174 1.089-1.264 0.000 1.043 0.995-1.094 0.081
D-1 D0
OR* 95%CI P OR* 95%CI P
PM2.5 Single-variant 1.009 1.001-1.017 0.030 1.004 0.996-1.011 0.352
Multi-variant 1.063 0.944-1.195 0.313 0.954 0.874-1.040 0.286
SPM Single-variant 1.004 0.996-1.012 0.318 1.002 0.995-1.009 0.598
Multi-variant 0.992 0.903-1.090 0.874 1.027 0.968-1.090 0.380
NO2 Single-variant 1.016 1.000-1.033 0.052 1.010 0.995-1.026 0.197
Multi-variant 1.001 0.922-1.086 0.984 1.111 0.944-1.308 0.207
O3 Single-variant 1.003 0.988-1.019 0.661 1.015 0.999-1.030 0.065
Multi-variant 0.920 0.860-0.985 0.016 1.011 0.965-1.056 0.646

* OR : odds ratio

CI : confidence interval

D-3 : 3 days prior to day of attack

§ D-2 : 2 days prior to day of attack

D-1 : 1 day prior to day of attack

D0 : day of asthma attack

Table 4.
Odds ratios and 95% confidence intervals of asthma attack by average daily concentration of each air pollutant.
D-3 D-2§
OR* 95%CI P OR* 95%CI P
PM2.5 Single-variant 0.996 0.986-1.006 0.439 1.002 0.991-1.014 0.683
Multi-variant 0.777 0.564-1.072 0.124 1.052 0.880-1.257 0.581
SPM Single-variant 0.992 0.981-1.002 0.133 0.994 0.983-1.005 0.304
Multi-variant 1.299 0.963-1.752 0.086 0.977 0.854-1.117 0.729
NO2 Single-variant 0.993 0.961-1.027 0.692 1.013 0.978-1.049 0.467
Multi-variant 0.815 0.601-1.103 0.185 1.271 1.027-1.572 0.027
O3 Single-variant 1.006 0.989-1.024 0.481 0.994 0.975-1.013 0.513
Multi-variant 1.475 1.179-1.846 0.001 1.128 1.031-1.234 0.009
D-1 D0
OR* 95%CI P OR* 95%CI P
PM2.5 Single-variant 1.012 1.000-1.024 0.057 1.005 0.994-1.016 0.382
Multi-variant 1.068 0.907-1.259 0.430 1.004 0.893-1.129 0.941
SPM Single-variant 1.009 0.997-1.020 0.133 1.004 0.993-1.014 0.506
Multi-variant 0.952 0.835-1.085 0.456 0.974 0.894-1.063 0.558
NO2 Single-variant 1.018 0.985-1.052 0.299 1.034 1.002-1.068 0.040
Multi-variant 1.078 0.926-1.255 0.331 1.103 0.942-1.292 0.224
O3 Single-variant 1.016 0.997-1.035 0.097 1.031 1.012-1.050 0.001
Multi-variant 1.037 0.960-1.120 0.359 1.058 0.990-1.131 0.098

* OR : odds ratio

CI : confidence interval

D-3 : 3 days prior to day of attack

§ D-2 : 2 days prior to day of attack

D-1 : 1 day prior to day of attack

D0 : day of asthma attack

Table 5.
Odds ratios and 95% confidence intervals of asthma attack by maximal 1-hour concentration of PM2.5 divided by age group.
Age group (years) Odds ratio 95% Confidence interval P-value
0-1 1.018 1.001-1.035 0.042
2-5 1.002 0.988-1.017 0.757
6-12 1.007 0.993-1.021 0.345
13-15 1.022 0.993-1.052 0.139
Over 16 0.987 0.879-1.108 0.822
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