Skip Navigation
Skip to contents

KMJ : Kosin Medical Journal

OPEN ACCESS
SEARCH
Search
Advanced Search
mobile menu button

Articles

Page Path
HOME > Kosin Med J > Volume 33(2); 2018 > Article
Original Article
The effect of short-term particular matter2.5 exposure on asthma attacks in asthma children in Fukuoka, Japan
Song Han Lee1, Koh Woon Lee1, Yoon Ha Hwang1, Hiroshi Odajima2
Kosin Medical Journal 2018;33(2):171-180.
DOI: https://doi.org/10.7180/kmj.2018.33.2.171
Published online: January 19, 2018

1Department of Pediatrics, Busan St. Mary’s Hospital, Busan, Korea

2Department of Pediatrics, Fukuoka National Hospital, Japan, Korea

Corresponding Author: Lee Song Han, Department of Pediatrics, Busan St. Mary’s Hospital 25-14, Yongho-ro, 232 beon-gil, Nam-gu, Busan 48575, Korea Tel: +82-52-246-6113 Fax: +82-52-246-6113 E-mail: thdgks33@naver.com
• Received: September 21, 2016   • Accepted: October 24, 2016

Copyright © 2018 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 2,147 Views
  • 5 Download
  • 1 Crossref
prev next
Full Article

Download PDF Download PDF

  • 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.
  • Keywords: Air pollution; Asthma; Asthma attack; Japan
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.jpg
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
  • 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.ArticlePubMed
  • 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.ArticlePubMedPMC
  • 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.ArticlePubMedPMC
  • 5.Kelly FJ, Fussell JC. Air pollution and airway disease. Clin Exp Allergy 2011;41:1059–71.ArticlePubMed
  • 6.Nishimuta T, Kondo N, Hamasaki Y, Morikawa A, Nishima S. Japanese guideline for childhood asthma. Allergology International 2011;60:147–69.ArticlePubMed
  • 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.ArticlePubMedPMC
  • 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.ArticlePubMed
  • 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.ArticlePubMed
  • 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.ArticlePubMedPMC
  • 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.ArticlePubMed
  • 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.ArticlePubMedPMC
  • 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.ArticlePubMed
  • 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.ArticlePubMed
  • 15.Trasande L, Thurston GD. The role of air pollution in asthma and other pediatric morbidities. J Allergy Clin Immunol 2005;115:689–99.ArticlePubMed
  • 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.ArticlePubMed
  • 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.ArticlePubMed
  • 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.ArticlePubMed
  • 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.Article

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Annual changes in the prevalence of asthma may be related to air pollution in Fukuoka: 29 years of observation
      Hiroshi Odajima, Toshiaki Kawano, Masatoshi Wakatsuki, Yuko Akaminea, Koki Okabe, Tuyoshi Oki, Hiroshi Matsuzaki, Yoko Murakami, Mihoko Iwata, Naohiko Taba, Chikako Motomura, Satoshi Honjo, Takahito Ninomiya
      ERJ Open Research.2020; 6(2): 00166-2020.     CrossRef

    • PubReader PubReader
    • ePub LinkePub Link
    • Cite
      CITE
      export Copy
      Close
    • Download Citation
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      The effect of short-term particular matter2.5 exposure on asthma attacks in asthma children in Fukuoka, Japan
      Kosin Med J. 2018;33(2):171-180.   Published online January 19, 2018
      DOI: https://doi.org/10.7180/kmj.2018.33.2.171
      Close
    • XML DownloadXML Download
    Figure
    • 0
    The effect of short-term particular matter2.5 exposure on asthma attacks in asthma children in Fukuoka, Japan
    Image
    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.

    Fig. 1.

    The effect of short-term particular matter2.5 exposure on asthma attacks in asthma children in Fukuoka, Japan

    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

    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

    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

    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

    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
    Table 1. Characteristics of the study groups.

    Table 2. Comparison of maximal, average concentration of PM2.5 (μg/㎥).

    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.

    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.

    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.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

    KMJ : Kosin Medical Journal
    © Kosin University College of Medicine.
    TOP