서울지역 미세먼지 농도가 호흡기계 및 심혈관계의 외래 방문 및 입원과 진료비에 미치는 영향
Hospital Visits, Admissions and Hospital Costs among Patients with Respiratory and Cardiovascular Diseases according to Particulate Matter in Seoul
2
조회
0
다운로드
6
인용
0
참고문헌
키워드
초록
Objectives: The annual average of PM10 in Seoul was 45 μ/m3, which surpasses the WHO annual guidelines(20 μ/m3). Most previous analyses of the effects of PM exposure have been retrospective studies using singlehospital data, and fewer studies have attempted to address the relationship of PM10 and hospital costs. This studywas conducted to investigate the effects of the concentration of PM10 on hospital visits, admissions and hospitalcosts in patients with respiratory and cardiovascular diseases. Methods: Medical data from the National Health Insurance Service and the monthly average of PM10 fromNational Institute of Environmental Research were used to identify the effects of PM10 on hospital visits,admissions and hospital costs. We applied Poisson regression and linear regression to perform the analysis. Results: The relative risks for admissions per 10 μ/m3 increase in PM10 were 23.11%, 10.2% and 6.9% increasesfor acute bronchiolitis, asthma and bronchitis, respectively. The relative risk for hospital visits per 10 μ/m3 increasein PM10 were 10.4%, 6.7% and 5.9% for chronic obstructive pulmonary disease, asthma and chronic sinusitis,respectively. For cardiovascular disease, the relative risk for admissions per 10 μ/m3 increase in PM10 were 2.2%and 2.1% increases in angina and acute myocardial infarction, respectively. A 10 μ/m3 increase in the monthlyaverage of PM10 corresponded to 170,723,000 won (95% CI: 125,587,000-215,860,000 won), 123,636,000 won(95% CI: 47,784,000-199,487,000 won) and 78,571,000 won (95% CI: 29,062,000-128,081,000 won) increasesin hospital costs for asthma, acute tonsillitis and chronic sinusitis, respectively. Conclusion: Hospital admissions for respiratory and cardiovascular disease were associated with PM10 levels. PM10 exposure is also associated with increased costs for respiratory diseases.
Abstract
Objectives: The annual average of PM10 in Seoul was 45 μ/m3, which surpasses the WHO annual guidelines(20 μ/m3). Most previous analyses of the effects of PM exposure have been retrospective studies using singlehospital data, and fewer studies have attempted to address the relationship of PM10 and hospital costs. This studywas conducted to investigate the effects of the concentration of PM10 on hospital visits, admissions and hospitalcosts in patients with respiratory and cardiovascular diseases. Methods: Medical data from the National Health Insurance Service and the monthly average of PM10 fromNational Institute of Environmental Research were used to identify the effects of PM10 on hospital visits,admissions and hospital costs. We applied Poisson regression and linear regression to perform the analysis. Results: The relative risks for admissions per 10 μ/m3 increase in PM10 were 23.11%, 10.2% and 6.9% increasesfor acute bronchiolitis, asthma and bronchitis, respectively. The relative risk for hospital visits per 10 μ/m3 increasein PM10 were 10.4%, 6.7% and 5.9% for chronic obstructive pulmonary disease, asthma and chronic sinusitis,respectively. For cardiovascular disease, the relative risk for admissions per 10 μ/m3 increase in PM10 were 2.2%and 2.1% increases in angina and acute myocardial infarction, respectively. A 10 μ/m3 increase in the monthlyaverage of PM10 corresponded to 170,723,000 won (95% CI: 125,587,000-215,860,000 won), 123,636,000 won(95% CI: 47,784,000-199,487,000 won) and 78,571,000 won (95% CI: 29,062,000-128,081,000 won) increasesin hospital costs for asthma, acute tonsillitis and chronic sinusitis, respectively. Conclusion: Hospital admissions for respiratory and cardiovascular disease were associated with PM10 levels. PM10 exposure is also associated with increased costs for respiratory diseases.
참고문헌 (17)
- Devos S, "Cost saving potential in cardiovascular hospital costs due to reduction in air pollution", Science of Total Environment, 527, pp.413~419 (2015)
- Dominici F, "Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases", Journal of American Medical Association, 295(10), pp.1127~1134 (2006)
- "Integrated Science Assessment for Particulate Matter"[URL]
- Pope CA, "Cardiovascular mortality and long-term exposure to particulate air pollution epidemiological evidence of general pathophysiological pathways of disease", Circulation, 109(1), pp.71~77 (2004)
- Pope CA, "Synoptic weather modeling and estimates of the exposure-response relationship between daily mortality and particulate air pollution", Environmental Health Perspectives, 104(4), pp.414~420 (1996)
- "Ambient (outdoor) air quality and health"[URL]
- "Enforcement Decree of the Clean Air Conservation Act"[URL]
- Kim, YP., "Air pollution in Seoul caused by aerosols", Journal of Korean Society for Atmospheric Environment, 22(5), pp.535~553 (2006)
- Park RS, "Contribution of long-range transported air pollution from China to particulate matter over Korean Peninsula", Journal of Korean Society of Hazard Mitigation, 14(2), pp.26~36 (2014)
- 박희진, "여수시의 대기오염과 일별 사망의 상관성에 관한 연구 - 미세먼지와 이산화황을 대상으로 -", 환경영향평가, 24(1), pp.66~77 (2015), 한국환경영향평가학회[DOI]
- 배현주, "서울시 미세먼지(PM10)와 초미세먼지(PM2.5)의 단기노출로 인한 사망영향", 한국환경보건학회지, 40(5), pp.346~354 (2014), 한국환경보건학회[DOI]
- 오인보, "울산지역 초등학생 알레르기 질환 유병률: 지역적 차이와 환경위험인자", 한국환경보건학회지, 38(6), pp.472~481 (2012), 한국환경보건학회[DOI]
- 장안수, "대기오염에 따른 천식, 만성폐쇄성 폐질환, 심장질환 환자의 병원 방문 및 입원", 천식 및 알레르기, 26(3), pp.233~238 (2006), 대한천식알레르기학회
- "International status of air pollution"[URL]
- 이병재, "Air Pollution Exposure and Cardiovascular Disease", 한국독성학회지, 30(2), pp.71~75 (2014), 한국독성학회[DOI]
- Perez L, "Associations of daily levels of PM10 and NO2 with emergency hospital admissions and mortality in Switzerland: trends and missed prevention potential over the last decade", Environmental Research, 140, pp.554~561 (2015)
- Zanobetti A, "The temporal pattern of respiratory and heart disease mortality in response to air pollution", Environmental Health Perspectives, 111(9), pp.1188~1193 (2003)