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Susceptibility to air pollution effects on mortality in Seoul, Korea: A case-crossover analysis of individual-level effect modifiers

Journal of Exposure Science & Environmental Epidemiology volume 22, pages 227–234 (2012)Cite this article

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Abstract

Air pollution's mortality effects may differ by subpopulation; however, few studies have investigated this issue in Asia. We investigated susceptibility to air pollutants on total, cardiovascular, and respiratory mortality in Seoul, Korea for the period 2000–2007. We applied time-stratified case-crossover analysis, which allows direct modeling of interaction terms, to estimate susceptibility based on sex, age, education, marital status, and occupation. An interquartile range increase in pollution was associated with odds ratios of 0.94 (95% confidence interval, 0.25–1.62), 2.27 (1.03–3.53), 1.94 (0.80–3.09), and 2.21 (1.00–3.43) for total mortality and 1.95 (0.64–3.27), 4.82 (2.18–7.54), 3.64 (1.46–5.87), and 4.32 (1.77–6.92) for cardiovascular mortality for PM10, nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO), respectively. Ozone effect estimates were positive, but not statistically significant. Results indicate that some populations are more susceptible than others. For total or cardiovascular mortality, associations were higher for males, those 65–74 years, and those with no education or manual occupation for some pollutants. For example, the odds ratio for SO2 and cardiovascular mortality was 1.19 (1.03–1.37) times higher for those with manual occupations than professional occupations. Our findings provide evidence that some populations are more susceptible to the effects of air pollution than others, which has implications for public policy and risk assessment for susceptible subpopulations.

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Acknowledgements

This work was supported by the US National Institute of Environmental Health Sciences (R01 01ES015028).

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Authors and Affiliations

  1. School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA

    Ji-Young Son & Michelle L Bell

  2. Department of Environmental Health, College of Health Science, Korea University, Seoul, Korea

    Jong-Tae Lee

  3. Department of Epidemiology and Biostatistics, School of Public Health, Seoul National University, Seoul, Korea

    Ho Kim

  4. Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Korea

    Okhee Yi

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Correspondence to Michelle L Bell.

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Son, JY., Lee, JT., Kim, H. et al. Susceptibility to air pollution effects on mortality in Seoul, Korea: A case-crossover analysis of individual-level effect modifiers. J Expo Sci Environ Epidemiol 22, 227–234 (2012). https://doi.org/10.1038/jes.2012.6

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