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Lamichhane DK, Ha E, Hong YC, Lee DW, Park MS, Song S, Kim S, Kim WJ, Bae J, Kim HC. Ambient particulate matter and surrounding greenness in relation to sleep quality among pregnant women: A nationwide cohort study. Heliyon 2024; 10:e26742. [PMID: 38434397 PMCID: PMC10904245 DOI: 10.1016/j.heliyon.2024.e26742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Particulate air pollution and residential greenness are associated with sleep quality in the general population; however, their influence on maternal sleep quality during pregnancy has not been assessed. Objective This cross-sectional study investigated the individual and interactive effects of exposure to particulate matter (PM) air pollution and residential greenness on sleep quality in pregnant women. Methods Pregnant women (n = 4933) enrolled in the Korean Children's Environmental Health Study with sleep quality information and residential address were included. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The average concentrations of PM (PM2.5 and PM10) during pregnancy were estimated through land use regression, and residential greenness in a 1000 m buffer area around participants' residences was estimated using the Normalized Difference Vegetation Index (NDVI1000-m). Modified Poisson regression models were used to estimate the associations between PM and NDVI and poor sleep quality (PSQI >5) after controlling for a range of covariates. A four-way mediation analysis was conducted to examine the mediating effects of PM. Results After adjusting for confounders, each 10 μg/m3 increase in PM2.5 and PM10 exposure was associated with a higher risk of poor sleep quality (relative risk [RR]: 1.06; 95% confidence interval [CI]: 1.01, 1.11; and RR: 1.09; 95% CI: 1.06, 1.13, respectively), and each 0.1-unit increase in NDVI1000-m was associated with a lower risk of poor sleep quality (RR: 0.97; 95% CI: 0.95, 0.99). Mediation analysis showed that PM mediated approximately 37%-56% of the association between residential greenness and poor sleep quality. Conclusions This study identified a positive association between residential greenness and sleep quality. Furthermore, these associations are mediated by a reduction in exposure to particulate air pollution and highlight the link between green areas, air pollution control, and human health.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Dong-Wook Lee
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Myung-Sook Park
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Sanghwan Song
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Suejin Kim
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
| | - Woo Jin Kim
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea
| | - Jisuk Bae
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Ko-CHENS Study Group
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
- Environmental Health Research Division, Department of Environmental Health Research, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea
- Department of Internal Medicine and Environmental Health Center, Kangwon National University, Chuncheon, Republic of Korea
- Department of Preventive Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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Lamichhane DK, Shrestha S, Kim HC. District-Level Risk Factors for COVID-19 Incidence and Mortality in Nepal. Int J Environ Res Public Health 2022; 19:ijerph19052659. [PMID: 35270351 PMCID: PMC8910479 DOI: 10.3390/ijerph19052659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023]
Abstract
The recent global pandemic of the novel coronavirus disease 2019 (COVID-19) is affecting the entire population of Nepal, and the outcome of the epidemic varies from place to place. A district-level analysis was conducted to identify socio-demographic risk factors that drive the large variations in COVID-19 mortality and related health outcomes, as of 22 January 2021. Data on COVID-19 extracted from relevant reports and websites of the Ministry of Health and Population of Nepal, and the National Population and Housing Census and the Nepal Demographic and Health Survey were the main data sources for the district-level socio-demographic characteristics. We calculated the COVID-19 incidence, recovered cases, and deaths per 100,000 population, then estimated the associations with the risk factors using regression models. COVID-19 outcomes were positively associated with population density. A higher incidence of COVID-19 was associated with districts with a higher percentage of overcrowded households and without access to handwashing facilities. Adult literacy rate was negatively associated with the COVID-19 incidence. Increased mortality was significantly associated with a higher obesity prevalence in women and a higher smoking prevalence in men. Access to health care facilities reduced mortality. Population density was the most important driver behind the large variations in COVID-19 outcomes. This study identifies critical risk factors of COVID-19 outcomes, including population density, crowding, education, and hand hygiene, and these factors should be considered to address inequities in the burden of COVID-19 across districts.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon 22212, Korea;
- Correspondence:
| | - Sabina Shrestha
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon 22212, Korea;
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Lamichhane DK, Jung DY, Shin YJ, Lee KS, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Association between ambient air pollution and perceived stress in pregnant women. Sci Rep 2021; 11:23496. [PMID: 34873215 PMCID: PMC8648786 DOI: 10.1038/s41598-021-02845-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Air pollution may influence prenatal maternal stress, but research evidence is scarce. Using data from a prospective cohort study conducted on pregnant women (n = 2153), we explored the association between air pollution and perceived stress, which was assessed using the 14-item Perceived Stress Scale (PSS), among pregnant women. Average exposures to particulate matter with an aerodynamic diameter of < 2.5 µm (PM2.5) or < 10 µm (PM10), nitrogen dioxide (NO2), and ozone (O3) for each trimester and the entire pregnancy were estimated at maternal residential addresses using land-use regression models. Linear regression models were applied to estimate associations between PSS scores and exposures to each air pollutant. After adjustment for potential confounders, interquartile-range (IQR) increases in whole pregnancy exposures to PM2.5, PM10, and O3 in the third trimester were associated with 0.37 (95% confidence interval [CI] 0.01, 0.74), 0.54 (95% CI 0.11, 0.97), and 0.30 (95% CI 0.07, 0.54) point increases in prenatal PSS scores, respectively. Furthermore, these associations were more evident in women with child-bearing age and a lower level of education. Also, the association between PSS scores and PM10 was stronger in the spring. Our findings support the relationship between air pollution and prenatal maternal stress.
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Affiliation(s)
- Dirga Kumar Lamichhane
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dal-Young Jung
- grid.202119.90000 0001 2364 8385Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yee-Jin Shin
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sook Lee
- grid.444037.00000 0000 9208 7123Department of Rehabilitation, Hanshin University, Osan, Gyeonggi-do Republic of Korea
| | - So-Yeon Lee
- grid.413967.e0000 0001 0842 2126Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- grid.414964.a0000 0001 0640 5613Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea ,grid.414964.a0000 0001 0640 5613Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- grid.15444.300000 0004 0470 5454Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- grid.413793.b0000 0004 0624 2588Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- grid.31501.360000 0004 0470 5905Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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Lamichhane DK, Jung DY, Shin YJ, Lee KS, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Association of ambient air pollution with depressive and anxiety symptoms in pregnant women: A prospective cohort study. Int J Hyg Environ Health 2021; 237:113823. [PMID: 34364017 DOI: 10.1016/j.ijheh.2021.113823] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Air pollution is associated with depressive and anxiety symptoms in the general population. However, this relationship among pregnant women remains largely unknown. OBJECTIVE To evaluate the association between pregnancy air pollution exposure and maternal depressive and anxiety symptoms during the third trimester assessed using the Center for Epidemiologic Studies-Depression and State-Trait Anxiety Inventory scales, respectively. METHODS We analyzed 1481 pregnant women from a cohort study in Seoul. Maternal exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and <10 μm (PM10), as well as to nitrogen dioxide (NO2) and ozone (O3) for each trimester and the entire pregnancy was assessed at participant's residential address by land use regression models. We estimated the relative risk (RR) and corresponding confidence interval (CI) of the depressive and anxiety symptoms associated with an interquartile range (IQR) increase in PM2.5, PM10, NO2, and O3 using modified Poisson regression. RESULTS In single-pollutant models, an IQR increase in PM2.5, PM10, and NO2 during the second trimester was associated with an increased risk of depressive symptoms (PM2.5 RR = 1.15, 95% CI: 1.04, 1.27; PM10 RR = 1.13, 95% CI: 1.04, 1.23; NO2 RR = 1.15, 95% CI: 1.03, 1.29) after adjusting for relevant covariates. Similarly, an IQR increase in O3 during the third trimester was associated with an increased risk of depressive symptoms (RR = 1.09, 95% CI: 1.01, 1.18), while the IQR increase in O3 during the first trimester was associated with a decreased risk (RR = 0.89, 95% CI: 0.82, 0.96). Exposure to PM2.5, PM10, and NO2 during the second trimester was significantly associated with anxiety symptoms. The associations with PM2.5 and O3 in single-and multi-pollutant models were consistent. CONCLUSIONS Our findings indicate that increased levels of particulate matter, NO2, and O3 during pregnancy may elevate the risk of depression or anxiety in pregnant women.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Dal-Young Jung
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Yee-Jin Shin
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sook Lee
- Department of Rehabilitation, Hanshin University, Gyeonggi-do, Republic of Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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Lamichhane DK, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Quantile regression analysis of the socioeconomic inequalities in air pollution and birth weight. Environ Int 2020; 142:105875. [PMID: 32590283 DOI: 10.1016/j.envint.2020.105875] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/02/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND An association between maternal exposure to air pollution and the birth weight distribution has been reported, but the extent to which this relationship varies according to socioeconomic status (SES) is unknown. This study examined the relationship using the data from a Korean birth cohort. METHODS Data for singleton births in Seoul from 2007 to 2017 (n = 1739) were analyzed. Maternal exposures to particulate matter with an aerodynamic diameter <10 µm (PM10) and <2.5 µm (PM2.5), as well as to nitrogen dioxide (NO2) and ozone (O3) for each trimester and the entire pregnancy were estimated using residential address, gestational age, and the birth date. The associations between the interquartile range (IQR) increases in pollutant concentrations and the changes in birth weight were examined using linear regression and quantile regression models. The socioeconomic disparities in the associations were investigated using a derived SES variable based on the composite of parental education and occupation. This SES variable was then interacted with the air pollutant. RESULTS In the gestational age-adjusted models, particulate air pollutants (PM10 and PM2.5) and O3 were associated with birth weight decreases for the lower birth weight percentiles. For example, the decrease in mean birthweight per IQR increase in PM2.5 during second trimester was -21.1 g (95% confidence interval (CI) = -41.8, -0.4), whereas the quantile-specific associations were: 10th percentile -27.0 g (95% CI = -46.6, -7.3); 50th percentile -22.2 g (95% CI = -39.6, -4.8); and 90th percentile -22.9 g (95% CI = -45.5, -0.2). Particulate air pollutants and O3 showed a pattern of socioeconomic inequalities; the reduced birth weight was of greater magnitude for children from a low SES group. CONCLUSIONS Negative associations between particulate air pollutants and O3 and birth weight were consistently greater at the lower quantiles of the birth weight distribution, especially in lower SES group.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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Abstract
This study investigated whether the association between household air pollution (HAP) and nutritional status (stunting, underweight, or wasting) among children differ by caste/ethnicity. Child anthropometry data for 9,914 children aged 0-59 months were analyzed linearly as Z scores and as dichotomous categories. Exposure to HAP was significantly associated with a decrease in child height-for-age and child weight-for-age, as well as with stunting and underweight. Children in low caste (Dalits) had higher prevalence of stunting (odds ratio [OR] = 1.21; 95% confidence intervals [CI] = 1.01, 1.44), underweight (OR = 1.47; 95% CI = 1.24, 1.75), and wasting (OR = 1.53; 95% CI = 1.21, 1.92) than those children in upper caste group. This association was modestly attenuated with adjustment for HAP. Exposure to HAP partly explained the caste-ethnic difference in undernutrition among children in Nepal.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, South Korea
| | - Jong Han Leem
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon, South Korea
| | - Hwan Cheol Kim
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Incheon, South Korea
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Lamichhane DK, Leem JH, Lee SM, Yang HJ, Kim J, Lee JH, Ko JK, Kim HC, Park DU, Cheong HK. Family-based case-control study of exposure to household humidifier disinfectants and risk of idiopathic interstitial pneumonia. PLoS One 2019; 14:e0221322. [PMID: 31487292 PMCID: PMC6728032 DOI: 10.1371/journal.pone.0221322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/06/2019] [Indexed: 11/19/2022] Open
Abstract
Background In Korea, several household humidifier disinfectants (HDs) were clinically confirmed to cause HD-associated lung injury (HDLI). Polyhexamethylene guanidine (PHMG) phosphate is the main ingredient of the HDs found to be associated with lung disease. However, the association of HDs with other interstitial lung disease including idiopathic interstitial pneumonia (IIP) is not clear. We examined the relationship between HD exposure and IIP in a family-based study. Methods This case-control study included 244 IIP cases and 244 family controls who lived with the IIP patients. The IIP cases were divided into two groups, HDLI and other IIP, and were matched to family controls based on age and gender. Information on exposure to HDs was obtained from a structured questionnaire and field investigations. Conditional logistic regression was used to estimate odds ratio (ORs) and their corresponding 95% confidence interval (CI), investigating the association of HD-related exposure characteristics with IIP risk. Results The risks of IIP increased two-fold or more in the highest compared with the lowest quartile of several HD use characteristics, including average total use hours per day, cumulative sleep hours, use of HD during sleep, and cumulative exposure level. In analyses separated by HDLI and other IIP, the risks of HDLI were associated with airborne HD concentrations (adjusted OR = 3.01, 95% CI = 1.34–6.76; Q4 versus Q1) and cumulative exposure level (adjusted OR = 3.57, 95% CI = 1.59–8.01; Q4 versus Q1), but this relationship was not significant in the patients with other IIP. In comparison between HDLI and other IIP, the odds ratios of average total use hours, cumulative use hours, and cumulative sleeps hours was higher for other IIP. Conclusion The use of household HDs is associated not only with HDLI but also with other IIP.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Korea
| | - Jong-Han Leem
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Inha University, Incheon, Korea
- * E-mail:
| | - Sang-Min Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University, College of Medicine, Seoul, Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University Hospital, Soonchunhyang University, College of Medicine, Seoul, Korea
| | - Jaiyong Kim
- Health and Society Institute, Hanyang University, College of Medicine, Seoul, Korea
| | | | - Jung Keun Ko
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Korea
| | - Hwan Cheol Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Inha University, Incheon, Korea
| | - Dong-Uk Park
- Department of Environmental Health, Korea National Open University, Seoul, Korea
| | - Hae-Kwan Cheong
- Department of Social Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
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Abstract
Depression is a leading cause of reduced work ability and absence due to sickness. The objective of this study was to investigate how depressive symptoms are prospectively associated with subsequent absence, whether caused by illness or accidents, among manufacturing workers. This prospective study was conducted on 2,349 male and female employees that underwent a regular health examination at a university hospital. Depressive symptoms were measured at baseline using the Center for Epidemiologic Studies Depression (CES-D) Scale. Data on self-reported absence due to illness and accidents were obtained during a follow up of 1 yr. The incidences of sickness absence were 6.0% for men and 17.3% for women. Men and women with depressive symptoms (CES-D ≥16) were found to have higher odds of sickness absence during follow up (men: OR=4.06; 95% CI: 2.32-7.11; women: OR=1.75; 95% CI: 1.02-2.98), after adjustment for demographic and occupational factors. When depressive symptoms were divided into quartiles, significantly higher ORs of sickness absence were observed only among employees with the highest quartile of depressive symptoms. The study shows that depressive symptoms are a risk factor for future absence due to illness or accidents among manufacturing workers.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, School of Medicine, Inha University, Republic of Korea
| | - Yong Seok Heo
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Republic of Korea
| | - Hwan Cheol Kim
- Department of Occupational and Environmental Medicine, School of Medicine, Inha University, Republic of Korea
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Lamichhane DK, Ryu J, Leem JH, Ha M, Hong YC, Park H, Kim Y, Jung DY, Lee JY, Kim HC, Ha EH. Air pollution exposure during pregnancy and ultrasound and birth measures of fetal growth: A prospective cohort study in Korea. Sci Total Environ 2018; 619-620:834-841. [PMID: 29734629 DOI: 10.1016/j.scitotenv.2017.11.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/19/2017] [Accepted: 11/06/2017] [Indexed: 05/04/2023]
Abstract
Few studies have examined the effects of air pollution on fetal growth based on ultrasound measures during pregnancy. More data is needed to evaluate the windows of special vulnerability. Our aim was to investigate the association of ambient air pollution during pregnancy with fetal and neonatal characteristics in a cohort of Korean women. Maternal exposure to particulate matter with an aerodynamic diameter<10μm (PM10) and nitrogen dioxide (NO2) was estimated using land-use regression models based on residential address. The biparietal diameter (BPD), abdominal circumference (AC), femur length (FL), and estimated fetal weight (EFW) were evaluated via ultrasonography, and birth weight (BW), birth length (BL), and head circumference at birth (BHC) were obtained from medical records. The multiple linear regression model was used to adjust for confounders, and the mixed-effect model was used to evaluate longitudinal effect. The negative effects for NO2 and PM10 were estimated; in the adjusted analyses the decreases of BPD were -0.26mm (95% confidence interval [CI]=-0.41 to -0.11, with a 10μg/m3 increase) in the second trimester for NO2, and -0.30mm (95% CI=-0.59 to -0.03, with a 10μg/m3 increase) in the third trimester for PM10. Both NO2 and PM10 levels (10μg/m3) during third trimester were inversely associated with BHC, and NO2 level was inversely associated with BL in all exposure windows. No significant associations for AC, FL, and EFW were observed. The longitudinal analyses showed inverse association of NO2 exposure with head and length growth (P<0.001). Our findings suggest that ambient air pollution is associated with impaired fetal head size from mid-gestation onwards.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jia Ryu
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jong-Han Leem
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea; Department of Environmental and Occupational Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyesook Park
- Department of Preventive Medicine and Ewha Medical Research Center, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Dal-Young Jung
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Ji-Young Lee
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea; Department of Environmental and Occupational Medicine, Inha University Hospital, Incheon, Republic of Korea.
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, Ewha Womans University, Seoul, Republic of Korea; Ewha Institute of Convergence Medicine, Ewha Womans University, Seoul, Republic of Korea; Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.
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Lamichhane DK, Leem JH, Park CS, Ha M, Ha EH, Kim HC, Lee JY, Ko JK, Kim Y, Hong YC. Associations between prenatal lead exposure and birth outcomes: Modification by sex and GSTM1/GSTT1 polymorphism. Sci Total Environ 2018; 619-620:176-184. [PMID: 29145054 DOI: 10.1016/j.scitotenv.2017.09.159] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 09/14/2017] [Accepted: 09/16/2017] [Indexed: 06/07/2023]
Abstract
Maternal lead exposure is associated with poor birth outcomes. However, modifying effects of polymorphism in glutathione S-transferases (GST) gene and infant sex remain unexplored. Our aim was to evaluate whether associations between prenatal lead and birth outcomes differed by maternal GST genes and infant sex. Prospective data of 782 mother-child pairs from Mothers and Children's Environmental Health (MOCEH) study were used. The genotyping of GST-mu 1 (GSTM1) and theta-1 (GSTT1) polymorphisms was carried out using polymerase chain reaction. Multivariable linear regression was used to examine whether the association between blood lead (BPb) level and birth outcomes (birthweight, length, and head circumference) varied by maternal GST genes and sex. We did not find a statistically significant association between prenatal BPb levels and birth outcomes; in stratified analyses, the association between higher BPb level during early pregnancy and lower birthweight (β=-224 per square root increase in BPb; 95% confidence interval (CI): -426, -21; false discovery rate p=0.036) was significant in males of mothers with GSTM1 null. Results were similar for head circumference model (β=-0.78 per square root increase in BPb; 95% CI: -1.69, 0.14, p=0.095), but the level of significance was borderline. Head circumference model showed a significant three-way interaction among BPb during early pregnancy, GSTM1, and sex (p=0.046). For combined analysis with GSTM1 and GSTT1, GSTM1 null and GSTT1 present group showed a significant inverse association of BPb with birthweight and head circumference in males. Our findings of the most evident effects of BPb on the reduced birthweight and head circumference in male born to the mother with GSTM1 null may suggest a biological interaction among lead, GST genes and sex in detoxification process during fetal development.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Jong-Han Leem
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea; Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea.
| | - Chang-Shin Park
- Department of Pharmacology, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Eun-Hee Ha
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Hwan-Cheol Kim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea; Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, Republic of Korea
| | - Ji-Young Lee
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jung Keun Ko
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, University of Ulsan, College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
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Lamichhane DK, Leem JH, Kim HC. Associations between Ambient Particulate Matter and Nitrogen Dioxide and Chronic Obstructive Pulmonary Diseases in Adults and Effect Modification by Demographic and Lifestyle Factors. Int J Environ Res Public Health 2018; 15:E363. [PMID: 29463050 PMCID: PMC5858432 DOI: 10.3390/ijerph15020363] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/10/2018] [Accepted: 02/16/2018] [Indexed: 01/07/2023]
Abstract
This study was undertaken to investigate the associations between chronic exposure to particulate matter of medium aerodynamic diameter ≤10 or ≤2.5 µm (PM10 or PM2.5) and nitrogen dioxide (NO₂) levels and lung function and to examine a possible change in these relationships by demographic and lifestyle factors. Chronic obstructive pulmonary disease (COPD) was defined using the Global Initiative for COPD criteria (forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70%). Associations of lung function and COPD with PM10 or PM2.5 or NO₂ were examined using linear and logistic regression analyses among 1264 Korean adults. The highest tertiles of PM2.5 (≥37.1 μg/m³) and NO₂ (≥53.8 μg/m³) exposure were significantly associated with COPD (highest versus lowest tertile of PM2.5: adjusted odds ratio (OR) = 1.79, 95% CI: 1.02-3.13; highest versus lowest tertile of NO₂: adjusted OR = 1.83, 95% CI: 1.04-3.21). A 10 μg/m³ increase in PM10 concentration was associated with a 1.85 L (95% CI -3.65 to -0.05) decrease in FEV1 and a 1.73 L (95% CI -3.35 to -0.12) decrease in FVC, with the strongest negative association among older people and those with less education. Reduced lung function was associated with PM2.5 exposure in subjects with no physical activity. This study provides evidence that exposure to ambient air pollution has adverse effects on lung function in adults.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon 22212, South Korea.
| | - Jong Han Leem
- Department of Occupational and Environmental Medicine, College of Medicine, Inha University, Incheon 22212, South Korea.
| | - Hwan Cheol Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Inha University, Incheon 22212, South Korea.
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Lee JY, Leem JH, Kim HC, Lamichhane DK, Hwang SS, Kim JH, Park MS, Jung DY, Ko JK, Kwon HJ, Hong SJ. Effects of traffic-related air pollution on susceptibility to infantile bronchiolitis and childhood asthma: A cohort study in Korea. J Asthma 2017; 55:223-230. [PMID: 29257909 DOI: 10.1080/02770903.2017.1313270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study examined the role of exposure to traffic-related air pollution (TRAP) on susceptibility to asthma in children with past episodes of bronchiolitis. METHODS The baseline data included 2,627 school children aged 6-14 years who had participated in the longitudinal follow-up survey of the Children's Health and Environmental Research of Korea. Lifetime wheezing, past episodes of bronchiolitis, and doctor-diagnosed asthma were evaluated using an International Study of Asthma and Allergies in Childhood questionnaire. We used generalized linear regression with binomial distribution to calculate the relative risk (RR) between TRAP, assessed by proximity to a main road and the total length of roads, and asthma. RESULTS Compared with the subjects who had less than 100 m of road length within 200-m radius from their home, those with more than 500 m of road length had significantly increased odds for infantile bronchiolitis (adjusted OR [aOR]: 1.57, 95% confidence interval [CI]: 1.01-2.42). Positive exposure-response relationships were found between residential proximity to the main road and asthma (aOR: 1.79, 95% CI: 1.05-3.06; <75 m vs. >700 m from a main road, P for the trend = 0.02). Closer residential proximity to the main road (<75 m) and bronchiolitis combined increased the risks of newly diagnosed asthma (adjusted RR: 3.62, 95% CI: 1.07-12.26) compared with those without bronchiolitis and living ≥ 75 m away from the main road. CONCLUSIONS TRAP appeared to be associated with an increased asthma among children with bronchiolitis, indicating the importance of modifying effects of bronchiolitis in asthma pathogenesis.
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Affiliation(s)
- Ji-Young Lee
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea.,b Department of Occupational and Environmental Medicine , Ewha Womans University College of Medicine , Seoul , Korea
| | - Jong-Han Leem
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea.,c Department of Occupational and Environmental Medicine , College of Medicine, Inha University , Incheon , Korea
| | - Hwan-Cheol Kim
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea.,c Department of Occupational and Environmental Medicine , College of Medicine, Inha University , Incheon , Korea
| | - Dirga Kumar Lamichhane
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Seung-Sik Hwang
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Jeong-Hee Kim
- d Department of Pediatrics, College of Medicine , Inha University , Incheon , Korea
| | - Myung-Sook Park
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Dal-Young Jung
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Jung-Keun Ko
- a Department of Social and Preventive Medicine, College of Medicine , Inha University , Incheon , Korea
| | - Ho-Jang Kwon
- e Department of Preventive Medicine, College of Medicine , Dankook University , Cheonan , Korea
| | - Soo-Jong Hong
- f Department of Pediatrics, Asan Medical Center, College of Medicine , University of Ulsan , Seoul , Korea
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Lamichhane DK, Kim HC, Choi CM, Shin MH, Shim YM, Leem JH, Ryu JS, Nam HS, Park SM. Lung Cancer Risk and Residential Exposure to Air Pollution: A Korean Population-Based Case-Control Study. Yonsei Med J 2017; 58:1111-1118. [PMID: 29047234 PMCID: PMC5653475 DOI: 10.3349/ymj.2017.58.6.1111] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/10/2017] [Accepted: 07/24/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the association between long-term exposure to ambient air pollution and lung cancer incidence in Koreans. MATERIALS AND METHODS This was a population-based case-control study covering 908 lung cancer patients and 908 controls selected from a random sample of people within each Korean province and matched according to age, sex, and smoking status. We developed land-use regression models to estimate annual residential exposure to particulate matter (PM₁₀) and nitrogen dioxide (NO₂) over a 20-year exposure period. Logistic regression was used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CI). RESULTS Increases in lung cancer incidence (expressed as adjusted OR) were 1.09 (95% CI: 0.96-1.23) with a ten-unit increase in PM₁₀ (μg/m³) and 1.10 (95% CI: 1.00-1.22) with a ten-unit increase in NO₂ (ppb). Tendencies for stronger associations between air pollution and lung cancer incidence were noted among never smokers, among those with low fruit consumption, and among those with a higher education level. Air pollution was more strongly associated with squamous cell and small cell carcinomas than with adenocarcinoma of the lung. CONCLUSION This study provides evidence that PM10 and NO₂ contribute to lung cancer incidence in Korea.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hwan Cheol Kim
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea.
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myung Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Young Mog Shim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Han Leem
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jeong Seon Ryu
- Center for Lung Cancer, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Hae Seong Nam
- Center for Lung Cancer, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Sung Min Park
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
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Lamichhane DK, Leem JH, Kim HC, Park MS, Lee JY, Moon SH, Ko JK. Association of infant and young child feeding practices with under-nutrition: evidence from the Nepal Demographic and Health Survey. Paediatr Int Child Health 2016; 36:260-269. [PMID: 26863233 DOI: 10.1080/20469047.2015.1109281] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Childhood undernutrition remains a highly influential risk factor in terms of the global burden of disease. Increasing evidence links infant and young child feeding (IYCF) practices to undernutrition. However, the results are inconsistent, and more country-specific studies are needed. OBJECTIVES To determine the associations between IYCF practices and nutritional outcomes among children aged 0-23 months using a nationally representative dataset. METHODS The study used data from the 2011 Nepal Demographic and Health Survey, and the data were analysed for children aged 0-23.9 months who had corresponding data for the outcome variables of interest (n = 890). Multiple linear and logistic regressions were undertaken and adjusted for the complex design of the survey, controlling for child, maternal, household and community characteristics. RESULTS Of the 890 children included in the study, 83% received age-appropriate breastfeeding but only 48% were breastfed within 1 hour of birth. Exclusive breastfeeding under 6 months of age was associated with a higher weight-for-age Z-score (WAZ) and a lower probability of wasting, but the estimated effects were of borderline significance. A significant negative association was found between continued breastfeeding at 1 year and WAZ and weight-for-height Z-score (WHZ). Timely introduction of complementary feeding in children aged 6-8 months was associated with a higher WAZ [effect size (ES) 0.6, P < 0.01] and higher WHZ (ES 0.6, P < 0.05). Higher dietary diversity index (DDI) was associated with higher height-for-age Z-score (ES 0.1, P < 0.05 for each DDI point). Children who achieved minimum meal frequency had a higher WAZ (ES 0.3, P < 0.05). CONCLUSION This is the first study to relate the wide ranges of IYCF indicators with child nutritional outcomes in Nepal, and it underscores the need to improve age-appropriate complementary feeding practices with a sustained focus on exclusive breastfeeding to reduce undernutrition in infants and young children.
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Affiliation(s)
- Dirga Kumar Lamichhane
- a Departments of Social and Preventive Medicine , School of Medicine, Inha University , Incheon , Korea
| | - Jong Han Leem
- a Departments of Social and Preventive Medicine , School of Medicine, Inha University , Incheon , Korea.,b Departments of Occupational and Environmental Medicine , School of Medicine, Inha University , Incheon , Korea
| | - Hwan Cheol Kim
- a Departments of Social and Preventive Medicine , School of Medicine, Inha University , Incheon , Korea.,b Departments of Occupational and Environmental Medicine , School of Medicine, Inha University , Incheon , Korea
| | - Myung Sook Park
- a Departments of Social and Preventive Medicine , School of Medicine, Inha University , Incheon , Korea
| | - Ji Young Lee
- a Departments of Social and Preventive Medicine , School of Medicine, Inha University , Incheon , Korea
| | - So Hyun Moon
- b Departments of Occupational and Environmental Medicine , School of Medicine, Inha University , Incheon , Korea
| | - Jung Keun Ko
- a Departments of Social and Preventive Medicine , School of Medicine, Inha University , Incheon , Korea
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Lamichhane DK, Leem JH, Park M, Kim JA, Kim HC, Kim JH, Hong YC. Increased prevalence of some birth defects in Korea, 2009-2010. BMC Pregnancy Childbirth 2016; 16:61. [PMID: 27006092 PMCID: PMC4802851 DOI: 10.1186/s12884-016-0841-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 03/07/2016] [Indexed: 11/10/2022] Open
Abstract
Background Birth defects are a leading cause of neonatal and infant mortality, and several studies have indicated an increase in the prevalence of birth defects; more recent investigations have suggested that the trends of some defects are increasing in rapidly industrialized areas. This study estimates the prevalence rate and types of birth defects in Korea. Methods This study used medical insurance benefit data of 403,250 infants aged less than one year from the National Health Insurance Corporation from seven metropolitan areas in Korea for 2009 and 2010. Results The prevalence rate of birth defects was 548.3 per 10,000 births (95 % CI: 541.1–555.6), 306.8 among boys and 241.5 among girls. Anomalies of the circulatory system (particularly septal defects) were the most common (180.8 per 10,000), followed by defects of the genitourinary tract (130.1 per 10,000) (particularly obstructive genitourinary and undescended testis), musculoskeletal system (105.7 per 10,000), digestive system (24.7 per 10,000), and central nervous system (15.6 per 10,000). Conclusions Relatively higher rates of some birth defects were found in the metropolitan areas. The high differences of birth prevalences for septal heart defects and undescended testis are probably due in part to progress in clinical management and more frequent prenatal diagnosis. Environmental exposure might play a critical role in the development of some birth defects. In attempting to describe the prevalence and spatio-temporal variations of birth defects in Korea, establishment of a registry system of birth defects and environmental surveillance are needed.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, Korea
| | - Jong-Han Leem
- Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, Korea. .,Department of Occupational and Environmental Medicine, School of Medicine, Inha University, 7-206 3rd St. Shinhung Dong, Jung Gu, Incheon, Korea.
| | - Myungsook Park
- Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, Korea
| | - Jung Ae Kim
- Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, Korea
| | - Hwan Cheol Kim
- Department of Social and Preventive Medicine, School of Medicine, Inha University, Incheon, Korea.,Department of Occupational and Environmental Medicine, School of Medicine, Inha University, 7-206 3rd St. Shinhung Dong, Jung Gu, Incheon, Korea
| | - Jin Hee Kim
- Department of Integrative Bioscience & Biotechnology, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul, 05006, Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Korea
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16
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Lamichhane DK, Leem JH, Kim HC, Park MS, Lee JY, Moon SH, Ko JK. Association of infant and young child feeding practices with undernutrition in children: evidence from the Nepal Demographic and Health Survey. Paediatr Int Child Health 2015:2046905515Y0000000049. [PMID: 26216364 DOI: 10.1179/2046905515y.0000000049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Childhood undernutrition remains a highly influential risk factor in terms of the global burden of disease. Increasing evidence links infant and young child feeding (IYCF) practices to undernutrition. However, the results are inconsistent, and more country-specific studies are needed. OBJECTIVES To determine the associations between IYCF practices and nutritional outcomes among children aged 0-23 months using a nationally representative dataset. METHODS The study used data from the 2011 Nepal Demographic and Health Survey, and the data were analysed for children aged 0-23.9 months who had corresponding data for the outcome variables of interest (n = 890). Multiple linear and logistic regressions were undertaken and adjusted for the complex design of the survey, controlling for child, maternal, household and community characteristics. RESULTS Of the 890 children included in the study, 83% received age-appropriate breastfeeding but only 48% were breastfed within 1 hour of birth. Exclusive breastfeeding under 6 months of age was associated with a higher weight-for-age Z-score (WAZ) and a lower probability of wasting, but the estimated effects were of borderline significance. A significant negative association was found between continued breastfeeding at 1 year and WAZ and weight-for-height Z-score (WHZ). Timely introduction of complementary feeding in children aged 6-8 months was associated with a higher WAZ [effect size (ES) 0.6, P < 0.01] and higher WHZ (ES 0.6, P < 0.05). Higher dietary diversity index (DDI) was associated with higher height-for-age Z-score (ES 0.1, P < 0.05 for each DDI point). Children who achieved minimum meal frequency had a higher WAZ (ES 0.3, P < 0.05). CONCLUSION This is the first study to relate the wide ranges of IYCF indicators with child nutritional outcomes in Nepal, and it underscores the need to improve age-appropriate complementary feeding practices with a sustained focus on exclusive breastfeeding to reduce undernutrition in infants and young children.
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Lamichhane DK, Leem JH, Lee JY, Kim HC. A meta-analysis of exposure to particulate matter and adverse birth outcomes. Environ Health Toxicol 2015; 30:e2015011. [PMID: 26796890 PMCID: PMC4722965 DOI: 10.5620/eht.e2015011] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 11/02/2015] [Indexed: 05/20/2023]
Abstract
OBJECTIVES The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. METHODS We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to 2.5μm and 10.0 μm in diameter, PM2.5 and PM10, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. RESULTS In random effects meta-analyses, BW as a continuous outcome was negativelyassociated with 10 μg/m(3) increase in PM10 (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=0.947) and PM2.5 (-22.17 g; 95% CI, -37.93 to -6.41 g; I-squared=92.3%, p <0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per 10 μg/m(3) increase in PM10 (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p =0.977) and PM2.5 (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p <0.001) exposure during entire pregnancy was observed. Effect size of change in BW per 10 μg/m(3) increase in PM tended to report stronger associations after adjustment for maternal smoking. CONCLUSIONS While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Jong-Han Leem
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
- Correspondence: Jong-Han Leem 27 Inhang-ro Jung-gu, Incheon 22332,Korea Tel: +82-32-890-3539 Fax: +82-32-890-2859 E-mail:
| | - Ji-Young Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Korea
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Redding L, Chetri DK, Lamichhane DK, Chay Y, Aldinger L, Ferguson J. Animal production systems of small farms in the Kaski district of Nepal. Trop Anim Health Prod 2012; 44:1605-13. [DOI: 10.1007/s11250-012-0114-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2012] [Indexed: 10/28/2022]
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Lamichhane DK, Mangyo E. Water accessibility and child health: use of the leave-out strategy of instruments. J Health Econ 2011; 30:1000-1010. [PMID: 21802755 DOI: 10.1016/j.jhealeco.2011.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Revised: 06/29/2011] [Accepted: 07/05/2011] [Indexed: 05/31/2023]
Abstract
This paper investigates the leave-out strategy of instruments by using the leave-out community ratio of household access to in-yard water sources and community water infrastructure as instruments for hours in fetching water time, and the data on disease symptoms. The results show that community-level access to clean water is significantly associated with both water-relevant and irrelevant disease symptoms, which suggests that the correlation between community-level access to clean water and child health is at least partially due to endogenous project placement potentially with respect to unobserved community wealth. The paper concludes that the OLS estimates have a potential endogeneity bias problem and that IV estimates under this strategy is subject to endogenous project placement and is not valid. A policy implication of this study is that careful attention should be paid to both self-selection and endogenous project placement in studying the effect of water accessibility on child health.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Graduate School of International Relations, International University of Japan (IDP 2009), Japan.
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