The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study

Abstract

ObjectivesAir pollution is a growing concern in Korea because of transboundary air pollution from mainland China. A panel study was conducted to clarify the effects of air pollution on respiratory symptoms and health-related quality of life (HR-QoL) in outpatients with and without chronic obstructive pulmonary disease (COPD) in Korea.MethodsPatients filled out a questionnaire including self-reported HR-QoL in February and were followed up in May and July. The study was conducted from 2013 to 2015, with different participants each year. Air quality parameters were applied in a generalized estimating equation as independent variables to predict factors affecting HR-QoL.ResultsLower physical fitness scores were associated with Asian sand dust events. Daily activity scores were worse when there were high concentrations of particulate matter (PM) less than 10 μm in diameter (PM10). Lower social functioning scores were associated with high PM less than 2.5 μm in diameter and nitrogen dioxide (NO2) concentrations. High NO2 concentrations also showed a significant association with mental health scores. Weather-related cough was prevalent when PM10, NO2, or ozone (O3) concentrations were high, regardless of COPD severity. High PM10 concentrations were associated with worsened wheezing, particularly in COPD patients.ConclusionsThe results suggest that PM, NO2, and O3 cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.

Associations Between Dust Storms and Intensive Care Unit Admissions in the United States, 2000–2015

“…Studies have been carried out in many regions of the world, including southern Europe (Díaz et al, 2012;Faustini et al, 2015;Karanasiou et al, 2012;Mallone et al, 2011;Middleton et al, 2008;Neophytou et al, 2013;Perez et al, 2008;Reyes et al, 2014;Stafoggia et al, 2016;Tobías et al, 2011;Trianti et al, 2017), east Asia (Chiu et al, 2008;Higashi et al, 2014;Kanatani et al, 2010;Kurai et al, 2017;Lee et al, 2008;Lee, 2013Lee, , 2014Nakamura et al, 2016;Nakao et al, 2018;Watanabe et al, 2015Watanabe et al, , 2016Yoo et al, 2008), the Middle East (Al-Taiar & Thalib, 2014;Khaniabadi et al, 2017;Neisi et al, 2017;Thalib & Al-Taiar, 2012;Vodonos et al, 2014Vodonos et al, , 2015, the Caribbean (Cadelis et al, 2014;Gyan et al, 2005;Prospero et al, 2008), and Australia (Barnett et al, 2012;Johnston et al, 2011;Merrifield et al, 2013;Rutherford et al, 1999). However, despite high dust activity in many U.S. states, the United States has lagged behind other regions in the study of dust storms and their health effects.…”

Asian Sand Dust Particles Increased Pneumococcal Biofilm Formation in vitro and Colonization in Human Middle Ear Epithelial Cells and Rat Middle Ear Mucosa

“…However, the interaction, colonization, and virulence of S. pneumoniae in the presence of ASD are not known. Previous reports suggested that PM alters host immune defense (Becker and Soukup, 1999;Zelikoff et al, 2002;Watanabe et al, 2016) and induces OM (Bowatte et al, 2018;Nakao et al, 2018;Park et al, 2018); therefore, we hypothesized that the presence of a small quantity of ASD may increase pneumococcal in vitro biofilms, colonization to epithelial cells and middle ear mucosa, and the risk factor for pneumococcus-mediated OM. In this study, we evaluated the effect of ASD on S. pneumoniae in vitro biofilm growth, colonization on HMEECs, and rat middle ear using the rat OM model.…”

“…A seasonal episode of Asian sand dust (ASD), which originates from arid areas of Mongolia and the Gobi desert, and affects the Korean peninsula, Japan, and China, is a major source of pollution in the East and Northeast Asia (Jung, 2016). In recent years, a growing number of reports have suggested that ASD exposure negatively affects human health, leading to respiratory diseases (Jung et al, 2012;Yu et al, 2012;Watanabe et al, 2016;Nakao et al, 2018) and significant mortality annually (Chen et al, 2004;Lee et al, 2014;Al et al, 2018). In addition, ASD contains PM of diameters < 10 µm (PM 10 ) along with inhalable hazardous chemical components such as sulfate (SO 4 2− ) and nitrate (NO 3 − ) and microbes such as bacteria, viruses, and fungi (Chen et al, 2010).…”

“…In the nasopharynx, pneumococci and PM interact, and PM exposure increases the risk of infections and alters the function of native immune cells, impairs mucociliary clearance, and decreases phagocytosis by macrophages (Becker and Soukup, 1999;Zelikoff et al, 2002;Watanabe et al, 2016). PM including environmental tobacco smoke increases the risk of OM in children and changed the middle ear histology and eustachian tube mucosa (Kong et al, 2009;Jones et al, 2012;Bowatte et al, 2018;Nakao et al, 2018;Park et al, 2018). Previously, our group identified a potential biomarker and a signaling pathway related to OM induced by diesel exhaust particles (Kim et al, 2016).…”

Progression of physical inactivity in COPD patients: the effect of time and climate conditions – a multicentre prospective cohort study

“…13 Currently, evidence of the specific effect of environmental conditions on PA among COPD patients is limited. [14][15][16][17] In these studies, season and temperature were established as the most significant climate predictors of daily step count. Nevertheless, the relatively small patient cohort, 12 wide variations in the follow-up period 14 and the lack of objective indices to define seasons 15,16 are some of the factors which limit the interpretation of these results.…”