Korean J Med.  2010 Apr;78(4):450-456.

Effect of air pollution on acute exacerbation of adult asthma in Seoul, Korea: A case-crossover study

  • 1Department of Internal Medicine, Hanyang University College of Medicine, Korea. hjyoon@hanyang.ac.kr
  • 2Department of Health Management, Graduate School, Hanyang University College of Medicine, Korea.
  • 3Department of Environmental Health, Korea University College of Health Science, Korea.
  • 4Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Korea.
  • 5Department of Internal Medicine, Seoul National University College of Medicine, Korea.
  • 6Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea.


Outdoor air pollution is an important risk factor for developing asthma and acute exacerbation. Although some epidemiologic studies have shown that increased levels of air pollutants are linked with acute exacerbations of asthma, few have estimated the effects of individual air pollutant on the exacerbation of asthma in adult patients in Korea.
We evaluated the relative risk of acute exacerbation of asthma due to an increase in air pollutant levels. We enrolled patients with asthma who were living in Seoul, and who had visited the emergency department (ED) of three University Hospitals in Seoul, Korea, for aggravated asthmatic symptoms over 12 months. The daily average levels of air pollutants were retrieved from data collected by routine monitoring for gaseous air pollutants (sulfur dioxide [SO2], nitrogen dioxide [NO2], ozone [O3], carbon monoxide [CO]) and for airborne particles less than or equal to 10 micrometer in diameter (PM10)]. A case-crossover analysis was performed using levels of air pollutants at 2 weeks before and after ED visits of controls.
For the 1 year study period, 297 ED visits were made by 237 adult patients with asthma. There were no significant increases in the relative risk for ED visits for air pollutants including SO2, NO2, O3, CO, and PM10.
These findings suggest that there was no significant impact of air pollution on ED visits for acute exacerbation of asthma in adult patients living in Seoul. Further large scale studies are needed to confirm the effects of these air pollutants on the exacerbation of asthma.


Asthma; Air pollution; Acute exacerbation; Emergency department visit
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