Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study
Objectives This study explored the effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder (ASD), a proxy for symptom aggravation, among Korean children aged 5–14 years.Design Time-series study.Setting, participants and outcome measures We used data from t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/9/e058286.full |
| _version_ | 1811181825004929024 |
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| author | Kyoung-Nam Kim Soontae Kim Yun-Chul Hong Ji Hoon Sohn Sung Joon Cho Hwo Yeon Seo |
| author_facet | Kyoung-Nam Kim Soontae Kim Yun-Chul Hong Ji Hoon Sohn Sung Joon Cho Hwo Yeon Seo |
| author_sort | Kyoung-Nam Kim |
| collection | DOAJ |
| description | Objectives This study explored the effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder (ASD), a proxy for symptom aggravation, among Korean children aged 5–14 years.Design Time-series study.Setting, participants and outcome measures We used data from the National Health Insurance Service (2011–2015). Daily concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3) levels in each region were used as exposures. ASD cases were defined based on a principal admission diagnosis of the claims data. We applied distributed lag non-linear models and a generalised difference-in-differences method to the quasi-Poisson models to estimate the causal effects of air pollution for up to 6 days. We also performed weighted quantile sum regression analyses to assess the combined effects of air pollution mixtures.Results PM2.5 levels at lag day 1, NO2 levels at lag day 5 and O3 levels at lag day 4 increased the risks of hospital admissions for ASD (relative risk (RR)=1.17, 95% CI 1.10 to 1.25 for PM2.5; RR=1.09, 95% CI 1.01 to 1.18 for NO2 and RR=1.03, 95% CI 1.00 to 1.06 for O3). The mean daily count of hospital admissions for ASD was 8.5, and it would be 7.3, 7.8 and 8.3 when the PM2.5 levels would be decreased by 10.0 µg/m3, NO2 by 10 ppb and O3 by 10 ppb, respectively. The weighted quantile sum index, constructed from PM2.5, NO2 and O3 levels, was associated with a higher risk of hospital admissions for ASD (RR 1.29, 95% CI 1.14 to 1.46), where NO2 was found to contribute to the effects most (the weight of 0.80).Conclusions These results emphasise that reduction of air pollution exposure should be considered for ASD symptom management, with important implications for the quality of life and economic costs. |
| first_indexed | 2024-04-11T09:23:27Z |
| format | Article |
| id | doaj.art-441843732dbd4af1b177b722abb2d919 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-11T09:23:27Z |
| publishDate | 2022-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-441843732dbd4af1b177b722abb2d9192022-12-22T04:32:05ZengBMJ Publishing GroupBMJ Open2044-60552022-09-0112910.1136/bmjopen-2021-058286Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series studyKyoung-Nam Kim0Soontae Kim1Yun-Chul Hong2Ji Hoon Sohn3Sung Joon Cho4Hwo Yeon Seo51 Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea (the Republic of)6 Department of Environmental and Safety Engineering, Ajou University, Suwon, Korea (the Republic of)2 Institute of Public Health and Medical Care, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)2 Institute of Public Health and Medical Care, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)5 Department of Psychiatry, Kangbuk Samsung Hospital, Jongno-gu, Korea (the Republic of)2 Institute of Public Health and Medical Care, Seoul National University Hospital, Jongno-gu, Korea (the Republic of)Objectives This study explored the effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder (ASD), a proxy for symptom aggravation, among Korean children aged 5–14 years.Design Time-series study.Setting, participants and outcome measures We used data from the National Health Insurance Service (2011–2015). Daily concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3) levels in each region were used as exposures. ASD cases were defined based on a principal admission diagnosis of the claims data. We applied distributed lag non-linear models and a generalised difference-in-differences method to the quasi-Poisson models to estimate the causal effects of air pollution for up to 6 days. We also performed weighted quantile sum regression analyses to assess the combined effects of air pollution mixtures.Results PM2.5 levels at lag day 1, NO2 levels at lag day 5 and O3 levels at lag day 4 increased the risks of hospital admissions for ASD (relative risk (RR)=1.17, 95% CI 1.10 to 1.25 for PM2.5; RR=1.09, 95% CI 1.01 to 1.18 for NO2 and RR=1.03, 95% CI 1.00 to 1.06 for O3). The mean daily count of hospital admissions for ASD was 8.5, and it would be 7.3, 7.8 and 8.3 when the PM2.5 levels would be decreased by 10.0 µg/m3, NO2 by 10 ppb and O3 by 10 ppb, respectively. The weighted quantile sum index, constructed from PM2.5, NO2 and O3 levels, was associated with a higher risk of hospital admissions for ASD (RR 1.29, 95% CI 1.14 to 1.46), where NO2 was found to contribute to the effects most (the weight of 0.80).Conclusions These results emphasise that reduction of air pollution exposure should be considered for ASD symptom management, with important implications for the quality of life and economic costs.https://bmjopen.bmj.com/content/12/9/e058286.full |
| spellingShingle | Kyoung-Nam Kim Soontae Kim Yun-Chul Hong Ji Hoon Sohn Sung Joon Cho Hwo Yeon Seo Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study BMJ Open |
| title | Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study |
| title_full | Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study |
| title_fullStr | Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study |
| title_full_unstemmed | Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study |
| title_short | Effects of short-term exposure to air pollution on hospital admissions for autism spectrum disorder in Korean school-aged children: a nationwide time-series study |
| title_sort | effects of short term exposure to air pollution on hospital admissions for autism spectrum disorder in korean school aged children a nationwide time series study |
| url | https://bmjopen.bmj.com/content/12/9/e058286.full |
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