Effects of Air Pollution on Acute and Chronic Kidney Disease: Using the National Health Insurance Service - National Sample Cohort (NHIS-NSC) Data in Korea

摘要

In order to prevent and manage the environmental and health hazards caused by air pollution, the preparation of the scientific evidenced data is very important. However, the health impact assessment of kidney diseases caused by air pollution is very limited. Kidney disease is a disease that is likely to have co-existing with cardiovascular disease, and air pollution has a great effect on vascular disease, so it is expected that it will adversely affect kidney disease. In this study, we investigated the relationship between air pollutants and kidney disease exacerbations in Seoul using national sample cohort data from National Health Insurance Service in Korea. The data includes about 1 million subjects and the period is from 2002 to 2013. It includes medical examination details, medical history, prescription history, and personal information for all members of the health insurance scheme and the beneficiaries. The analyzed areas were Seoul, and persons including N17 and N18 of the Korean Standardized Disease Code in the main disease / injuries on the medical service statement were selected as the study subjects. Because of the nature of the illness, we excludes all cases such as reserved medical care. Therefore, this study limited the subjects to emergency hospitalization to confirm the short - term effect of air pollution on kidney disease. Air pollution data are on the following five substances: carbon monoxide (CO), ozone (O3), fine dust (PM10), nitrogen dioxide (NO2), idealized sulfur (SO2). We used case-crossover analysis. The control day was selected for the same day of the month (28) as the case day for exposure to air pollution. Acute kidney disease was affected by air pollution but relatively chronic kidney disease was less affected by air pollution. Especially, in case of acute renal disease, the risk of emergency hospitalization increased with increasing SO2, and the delayed effect showed that the risk increased with lag.