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Short-term Effect of Ambient Air Pollution on Emergency Department Visits for Diabetic Coma in Seoul, Korea

Authors
 Hyunmee Kim  ;  Woojin Kim  ;  Jee Eun Choi  ;  Changsoo Kim  ;  Jungwoo Sohn 
Citation
 Journal of Preventive Medicine and Public Health, Vol.51(6) : 265-274, 2018 
Journal Title
 Journal of Preventive Medicine and Public Health 
ISSN
 1975-8375 
Issue Date
2018
Keywords
Air pollution ; Diabetic coma ; Diabetic ketoacidosis ; Hyperosmolar hyperglycemic status ; Nitrogen dioxide
Abstract
OBJECTIVES: A positive association between air pollution and both the incidence and prevalence of diabetes mellitus (DM) has been reported in some epidemiologic and animal studies, but little research has evaluated the relationship between air pollution and diabetic coma. Diabetic coma is an acute complication of DM caused by diabetic ketoacidosis or hyperosmolar hyperglycemic state, which is characterized by extreme hyperglycemia accompanied by coma. We conducted a time-series study with a generalized additive model using a distributed-lag non-linear model to assess the association between ambient air pollution (particulate matter less than 10 μm in aerodynamic diameter, nitrogen dioxide [NO2], sulfur dioxide, carbon monoxide, and ozone) and emergency department (ED) visits for DM with coma in Seoul, Korea from 2005 to 2009. METHODS: The ED data and medical records from the 3 years previous to each diabetic coma event were obtained from the Health Insurance Review and Assessment Service to examine the relationship with air pollutants. RESULTS: Overall, the adjusted relative risks (RRs) for an interquartile range (IQR) increment of NO2 was statistically significant at lag 1 (RR, 1.125; 95% confidence interval [CI], 1.039 to 1.219) in a single-lag model and both lag 0-1 (RR, 1.120; 95% CI, 1.028 to 1.219) and lag 0-3 (RR, 1.092; 95% CI, 1.005 to 1.186) in a cumulative-lag model. In a subgroup analysis, significant positive RRs were found for females for per-IQR increments of NO2 at cumulative lag 0-3 (RR, 1.149; 95% CI, 1.022 to 1.291). CONCLUSIONS: The results of our study suggest that ambient air pollution, specifically NO2, is associated with ED visits for diabetic coma.
Files in This Item:
T201804679.pdf.pdf Download
DOI
10.3961/jpmph.18.153
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Woojin(김우진) ORCID logo https://orcid.org/0000-0001-5520-4228
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166778
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