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1.  Air Pollution and Symptoms of Depression in Elderly Adults 
Environmental Health Perspectives  2012;120(7):1023-1028.
Background: Although the effect of air pollution on various diseases has been extensively investigated, few studies have examined its effect on depression.
Objectives: We investigated the effect of air pollution on symptoms of depression in an elderly population.
Methods: We enrolled 537 participants in the study who regularly visited a community center for the elderly located in Seoul, Korea. The Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) was used to evaluate depressive symptomatology during a 3-year follow-up study. We associated ambient air pollutants with SGDS-K results using generalized estimating equations (GEE). We also conducted a factor analysis with items on the SGDS-K to determine which symptoms were associated with air pollution.
Results: SGDS-K scores were positively associated with interquartile range (IQR) increases in the 3-day moving average concentration of particulate matter with an aerodynamic diameter ≤ 10 μm (PM10) [17.0% increase in SGDS-K score, 95% confidence interval (CI): 4.9%, 30.5%], the 0–7 day moving average of nitrogen dioxide [NO2; 32.8% (95% CI: 12.6%, 56.6%)], and the 3-day moving average of ozone [O3; 43.7% (95% CI: 11.5%, 85.2%)]. For these three pollutants, factor analysis showed that air pollution was more strongly associated with emotional symptoms such as feeling happy and satisfied than with somatic or affective symptoms.
Conclusions: Our study suggests that increases in PM10, NO2, and O3 may increase depressive symptoms among the elderly. Of the symptoms evaluated, ambient air pollution was most strongly associated with emotional symptoms.
PMCID: PMC3404652  PMID: 22514209
air pollution; depressive symptoms; elderly; factor analysis; panel study
2.  Effect of Previous-Winter Mortality on the Association between Summer Temperature and Mortality in South Korea 
Environmental Health Perspectives  2011;119(4):542-546.
It has recently been postulated that low mortality levels in the previous winter may increase the proportion of vulnerable individuals in the pool of people at risk of heat-related death during the summer months.
We explored the sensitivity of heat-related mortality in summer (June–August) to mortality in the previous winter (December–February) in Seoul, Daegu, and Incheon in South Korea, from 1992 through 2007, excluding the summer of 1994.
Poisson regression models adapted for time-series data were used to estimate associations between a 1°C increase in average summer temperature (on the same day and the previous day) above thresholds specific for city, age, and cause of death, and daily mortality counts. Effects were estimated separately for summers preceded by winters with low and high mortality, with adjustment for secular trends.
Temperatures above city-specific thresholds were associated with increased mortality in all three cities. Associations were stronger in summers preceded by winters with low versus high mortality levels for all nonaccidental deaths and, to a lesser extent, among persons ≥ 65 years of age. Effect modification by previous-winter mortality was not evident when we restricted deaths to cardiovascular disease outcomes in Seoul.
Our results suggest that low winter all-cause mortality leads to higher mortality during the next summer. Evidence of a relation between increased summer heat-related mortality and previous wintertime deaths has the potential to inform public health efforts to mitigate effects of hot weather.
PMCID: PMC3080938  PMID: 21233056
high temperature; mortality; preventive heath services; South Korea; weather
3.  Exposures to Particulate Matter and Polycyclic Aromatic Hydrocarbons and Oxidative Stress in Schoolchildren 
Environmental Health Perspectives  2009;118(4):579-583.
Air pollution is known to contribute to respiratory and cardiovascular mortality and morbidity. Oxidative stress has been suggested as one of the main mechanisms for these effects on health.
The aim of this study was to analyze the effects of exposure to particulate matter (PM) with aerodynamic diameters ≤ 10 μm (PM10) and ≤ 2.5 μm (PM2.5) and polycyclic aromatic hydrocarbons (PAHs) on urinary malondialdehyde (MDA) levels in schoolchildren.
The study population consisted of 120 schoolchildren. The survey and measurements were conducted in four cities—two in China (Ala Shan and Beijing) and two in Korea (Jeju and Seoul)—between 4 and 9 June 2007. We measured daily ambient levels of PM and their metal components at the selected schools during the study period. We also measured urinary 1-hydroxypyrene (1-OHP) and 2-naphthol, to assess PAH exposure, and MDA, to assess oxidative stress. Measurements were conducted once a day for 5 consecutive days. We constructed a linear mixed model after adjusting for individual variables to estimate the effects of PM and PAH on oxidative stress.
We found statistically significant increases in urinary MDA levels with ambient PM concentrations from the current day to the 2 previous days (p < 0.0001). Urinary 1-OHP level also showed a positive association with urinary MDA level, which was statistically significant with or without PM in the model (p < 0.05). Outdoor PM and urinary 1-OHP were synergistically associated with urinary MDA levels. Some metals bound to PM10 (aluminum, iron, strontium, magnesium, silicon, arsenic, barium, zinc, copper, and cadmium) and PM2.5 (magnesium, iron, strontium, arsenic, cadmium, zinc, aluminum, mercury, barium, and copper) also had significant associations with urinary MDA level.
Exposure to PM air pollution and PAHs was associated with oxidative stress in schoolchildren.
PMCID: PMC2854738  PMID: 20368125
children; metal; oxidative stress; PAH; panel study; particulate matter
4.  Effects of air pollutants on acute stroke mortality. 
Environmental Health Perspectives  2002;110(2):187-191.
The relationship between stroke and air pollution has not been adequately studied. We conducted a time-series study to examine the evidence of an association between air pollutants and stroke over 4 years (January 1995-December 1998) in Seoul, Korea. We used a generalized additive model to regress daily stroke death counts for each pollutant, controlling for seasonal and long-term trends and meteorologic influences, such as temperature, relative humidity, and barometric pressure. We observed an estimated increase of 1.5% [95% confidence interval (CI), 1.3-1.8%] and 2.9% (95% CI, 0.3-5.5%) in stroke mortality for each interquartile range increase in particulate matter < 10 microm aerodynamic diameter (PM(10)) and ozone concentrations in the same day. Stroke mortality also increased 3.1% (95% CI, 1.1-5.1%) for nitrogen dioxide, 2.9% (95% CI, 0.8-5.0%) for sulfur dioxide, and 4.1% (95% CI, 1.1-7.2%) for carbon monoxide in a 2-day lag for each interquartile range increase in single-pollutant models. When we examined the associations among PM(10) levels stratified by the level of gaseous pollutants and vice versa, we found that these pollutants are interactive with respect to their effects on the risk of stroke mortality. We also observed that the effects of PM(10) on stroke mortality differ significantly in subgroups by age and sex. We conclude that PM(10) and gaseous pollutants are significant risk factors for acute stroke death and that the elderly and women are more susceptible to the effect of particulate pollutants.
PMCID: PMC1240734  PMID: 11836148

Results 1-4 (4)