Ewha Med J.  2024 Jul;47(3):e38. 10.12771/emj.2024.e38.

Air pollution, including PM₁₀ , as a potential risk factor for the development of appendicitis in Korea: a case-crossover study

• Jee Y
• Nam JH
• Oh J
• Noh GT
• Ha E
• Lee RA

• KMID: 2558575
• DOI: http://doi.org/10.12771/emj.2024.e38

Abstract

Objectives
Interest in the association between particulate air pollution and appendicitis risk has been increasing in recent years, and previous studies have suggested a link between particulate matter ≤ 10 μm in diameter (PM₁₀ ) and appendicitis. However, robust evidence is currently lacking. This study explored the association between short-term PM₁₀ exposure and appendicitis using data from Ewha Womans University Mokdong Hospital, Seoul, Korea, between January 1, 2001 and December 31, 2018.
Methods
We employed a time-stratified case-crossover design using data from 6,526 appendicitis patients taken from the hospital’s electronic medical records system. We analyzed the data using a conditional logistic regression model adjusted for daily mean temperature and relative humidity. The effect size of PM₁₀ was estimated in terms of each 10 μm/m³ increase in PM₁₀ concentration. Sex, season, and age group were analyzed as subgroups.
Results
Appendicitis patients had been exposed to higher levels of PM₁₀ concentrations 3 days (OR 1.045, 95% CI : 1.007–1.084) and 7 days (OR, 1.053; 95% CI, 1.005–1.103) before hospital admission. The case-crossover analysis stratified by sex, age, and season showed that the male sex, being aged under 10, and the cold season were associated with a significantly stronger association between appendicitis and PM₁₀ concentrations.
Conclusion
Our study found that PM₁₀ concentrations were associated with appendicitis in boys aged under 10. The cold season was also a risk factor. Further research with a larger sample size and with other pollutants is required to clarify the association between PM₁₀ and appendicitis.

Keyword

Air pollution; Appendicitis; Cross-over studies; Particulate matter; Republic of Korea

Figure

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  Fig. 1. Identification of appendicitis cases at Ewha Womans University Mokdong Hospital during 2001–2018.

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  Fig. 2. Risk of appendicitis during various reference time intervals with associated interquartile ranges of PM10 using case-crossover analysis, among total patients, patients 0–9 years of age, male patients, and cases that occurred during the cold season. PM10, particulate matter ≤10 μm in diameter.

Reference

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