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Evaluation of an air quality warning system for vulnerable and susceptible individuals in Korea: an interrupted time series analysis

 YouHyun Park  ;  Jun Hyuk Koo  ;  Hoyeon Jeong  ;  Ji Ye Jung  ;  Changsoo Kim  ;  Dae Ryong Kang 
 EPIDEMIOLOGY AND HEALTH, Vol.45 : e2023020, 2023-02 
Journal Title
Issue Date
Air Pollutants* / analysis ; Air Pollution* / adverse effects ; Air Pollution* / analysis ; Environmental Exposure / adverse effects ; Humans ; Interrupted Time Series Analysis ; Particulate Matter / adverse effects ; Republic of Korea / epidemiology
Air quality ; Alert system ; Environmental policy
OBJECTIVES: This study was conducted to elucidate the effects of an air quality warning system (AQWS) implemented in January 2015 in Korea by analyzing changes in the incidence and exacerbation rates of environmental diseases.

METHODS: Data from patients with environmental diseases were extracted from the National Health Insurance Service-National Sample Cohort database from 2010 to 2019, and data on environmental risk factors were acquired from the AirKorea database. Patient and meteorological data were linked based on residential area. An interrupted time series analysis with Poisson segmented regression was used to compare the rates before and after AQWS introduction. Adjustment variables included seasonality, air pollutants (carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter less than 10 μm in diameter, and ozone), temperature, and humidity.

RESULTS: After AQWS implementation, the incidence of asthma gradually decreased by 20.5%. Cardiovascular disease and stroke incidence also significantly decreased (by 34.3 and 43.0%, respectively). However, no immediate or gradual decrease was identified in the exacerbation rate of any environmental disease after AQWS implementation. Sensitivity analyses were performed according to age, disability, and health insurance coverage type. Overall, the AQWS effectively mitigated the occurrence of most environmental diseases in Korea. However, the relationships between alarm system implementation and reduced incidence differed among diseases based on the characteristics of vulnerable and sensitive individuals.

CONCLUSIONS: Our results suggest that by tailoring the AQWS to demographic and sociological characteristics and providing enhanced education about the warning system, interventions can become an efficient policy tool to decrease air pollution- related health risks.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
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