Associations of Particulate Matter Exposures With Brain Gray Matter Thickness and White Matter Hyperintensities: Effect Modification by Low-Grade Chronic Inflammation

Cho Jaelim,Jang Heeseon,Noh Young,Lee Seung-Koo,Koh Sang-Baek,Kim Sun-Young,Kim Changsoo 대한의학회 2023 Journal of Korean medical science Vol.38 No.16

Background: Numerous studies have shown the effect of particulate matter exposure on brain imaging markers. However, little evidence exists about whether the effect differs by the level of low-grade chronic systemic inflammation. We investigated whether the level of c-reactive protein (CRP, a marker of systemic inflammation) modifies the associations of particulate matter exposures with brain cortical gray matter thickness and white matter hyperintensities (WMH). Methods: We conducted a cross-sectional study of baseline data from a prospective cohort study including adults with no dementia or stroke. Long-term concentrations of particulate matter ≤ 10 µm in diameter (PM10) and ≤ 2.5 µm (PM2.5) at each participant’s home address were estimated. Global cortical thickness (n = 874) and WMH volumes (n = 397) were estimated from brain magnetic resonance images. We built linear and logistic regression models for cortical thickness and WMH volumes (higher versus lower than median), respectively. Significance of difference in the association between the CRP group (higher versus lower than median) was expressed as P for interaction. Results: Particulate matter exposures were significantly associated with a reduced global cortical thickness only in the higher CRP group among men (P for interaction = 0.015 for PM10 and 0.006 for PM2.5). A 10 μg/m3 increase in PM10 was associated with the higher volumes of total WMH (odds ratio, 1.78; 95% confidence interval, 1.07–2.97) and periventricular WMH (2.00; 1.20–3.33). A 1 μg/m3 increase in PM2.5 was associated with the higher volume of periventricular WMH (odds ratio, 1.66; 95% confidence interval, 1.08–2.56). These associations did not significantly differ by the level of high sensitivity CRP. Conclusion: Particulate matter exposures were associated with a reduced global cortical thickness in men with a high level of chronic inflammation. Men with a high level of chronic inflammation may be susceptible to cortical atrophy attributable to particulate matter exposures.

Ambient ozone concentrations and emergency department visits for panic attacks

Jaelim Cho(조재림),Changsoo Kim(김창수) 환경독성보건학회 2014 한국독성학회 심포지움 및 학술발표회 Vol.2014 No.11

Air pollution and brain health: Epidemiological approaches

Jaelim Cho(조재림),Changsoo Kim(김창수) 환경독성보건학회 2021 한국독성학회 심포지움 및 학술발표회 Vol.2021 No.5

It is now established that exposure to air pollution affects human brains as numerous animal experiments and epidemiological studies have suggested during the last 15 years. The underlying mechanism is brain inflammation by ultrafine particles travelling directly to the brain, as well as by cytokines traversing the blood-brain barrier (secondary to systemic inflammation). Additionally, particulate matter is a mixture of pollutants, of which neurotoxic substances such as lead and mercury contribute to the adverse effect of particulate matter on the brain. Epidemiological studies have linked air pollution to a variety of outcomes related to brain health. There have been a substantial number of epidemiological studies on the short-term and long-term effects of air pollution on psychiatric outcomes (depression, anxiety, psychosis, and suicide). There is also mounting evidence on the association between long-term exposure to air pollution and neurological outcomes. In addition to clinical outcomes such as cognitive decline, mild cognitive impairment, and dementia, studies have increasingly targeted preclinical outcomes with the advancement of tools to analyze brain images. Neuroimaging studies on air pollution to date have explored several brain imaging markers (vascular markers, cortical volume, and cortical thickness) associated with air pollution in a cross-sectional manner. Future studies are warranted to improve methodologies (e.g., follow-up imaging studies) and to look into cross-talks between the brain and other body systems with a view to better understanding of the mechanism that underlies the relation between air pollution and brain health.

Medical Care Utilization During 1 Year Prior to Death in Suicides Motivated by Physical Illnesses

Cho, Jaelim,Lee, Won Joon,Moon, Ki Tae,Suh, Mina,Sohn, Jungwoo,Ha, Kyoung Hwa,Kim, Changsoo,Shin, Dong Chun,Jung, Sang Hyuk The Korean Society for Preventive Medicine 2013 예방의학회지 Vol.46 No.3

Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

Medical Care Expenditure in Suicides From Non-illness-related Causes

Sohn, Jungwoo,Cho, Jaelim,Moon, Ki Tae,Suh, Mina,Ha, Kyoung Hwa,Kim, Changsoo,Shin, Dong Chun,Jung, Sang Hyuk The Korean Society for Preventive Medicine 2014 예방의학회지 Vol.47 No.6

Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

The effect of exposure to Polycyclic aromatic hydrocarbons on amnestic mild cognitive impairment and Alzheimer’s disease: A matched case-control study

Heeseon Jang,Jaelim Cho,Sang Won Seo,Changsoo Kim 환경독성보건학회 2022 한국독성학회 심포지움 및 학술발표회 Vol.2022 No.10

Blood cadmium level and serum triglyceride concentration in Korean men

Jungwoo Sohn,Jaelim Cho,Juhwan Noh,Hye Lim Kim,Inseok Kye,Eunjoo Lee,Changsoo Kim 환경독성보건학회 2015 한국독성학회 심포지움 및 학술발표회 Vol.2015 No.6

Study on brain volume and thickness according to heavy-metal exposure shown in Brain MRI

Shinyoung Woo(우신영),Jaelim Cho(조재림),Munjoo Bae(배문주),Changsoo Kim(김창수) 환경독성보건학회 2022 한국독성학회 심포지움 및 학술발표회 Vol.2022 No.5

Short-term Effects of Ambient Air Pollution on Emergency Department Visits for Asthma: An Assessment of Effect Modification by Prior Allergic Disease History

Noh, Juhwan,Sohn, Jungwoo,Cho, Jaelim,Cho, Seong-Kyung,Choi, Yoon Jung,Kim, Changsoo,Shin, Dong Chun The Korean Society for Preventive Medicine 2016 Journal of Preventive Medicine and Public Health Vol.49 No.5

Objectives: The goal of this study was to investigate the short-term effect of ambient air pollution on emergency department (ED) visits in Seoul for asthma according to patients' prior history of allergic diseases. Methods: Data on ED visits from 2005 to 2009 were obtained from the Health Insurance Review and Assessment Service. To evaluate the risk of ED visits for asthma related to ambient air pollutants (carbon monoxide [CO], nitrogen dioxide [$NO_2$], ozone [$O_3$], sulfur dioxide [$SO_2$], and particulate matter with an aerodynamic diameter <$10{\mu}m$ [$PM_{10}$]), a generalized additive model with a Poisson distribution was used; a single-lag model and a cumulative-effect model (average concentration over the previous 1-7 days) were also explored. The percent increase and 95% confidence interval (CI) were calculated for each interquartile range (IQR) increment in the concentration of each air pollutant. Subgroup analyses were done by age, gender, the presence of allergic disease, and season. Results: A total of 33 751 asthma attack cases were observed during the study period. The strongest association was a 9.6% increase (95% CI, 6.9% to 12.3%) in the risk of ED visits for asthma per IQR increase in $O_3$ concentration. IQR changes in $NO_2$ and $PM_{10}$ concentrations were also significantly associated with ED visits in the cumulative lag 7 model. Among patients with a prior history of allergic rhinitis or atopic dermatitis, the risk of ED visits for asthma per IQR increase in $PM_{10}$ concentration was higher (3.9%; 95% CI, 1.2% to 6.7%) than in patients with no such history. Conclusions: Ambient air pollutants were positively associated with ED visits for asthma, especially among subjects with a prior history of allergic rhinitis or atopic dermatitis.

Residential radon and environmental burden of disease among Non-smokers

Juhwan Noh,Jungwoo Sohn,Jaelim Cho,Dae Ryong Kang,Sowon Joo,Changsoo Kim,Dong Chun Shin 대한직업환경의학회 2016 대한직업환경의학회지 Vol.28 No.-

Background: Lung cancer was the second highest absolute cancer incidence globally and the first cause of cancer mortality in 2014. Indoor radon is the second leading risk factor of lung cancer after cigarette smoking among ever smokers and the first among non-smokers. Environmental burden of disease (EBD) attributable to residential radon among non-smokers is critical for identifying threats to population health and planning health policy. Methods: To identify and retrieve literatures describing environmental burden of lung cancer attributable to residential radon, we searched databases including Ovid-MEDLINE, -EMBASE from 1980 to 2016. Search terms included patient keywords using ‘lung’ , ‘neoplasm’ , exposure keywords using ‘residential’ , ‘radon’ , and outcomes keywords using ‘years of life lost’ , ‘years of life lost due to disability’ , ‘burden’. Searching through literatures identified 261 documents; further 9 documents were identified using manual searching. Two researchers independently assessed 271 abstracts eligible for inclusion at the abstract level. Full text reviews were conducted for selected publications after the first assessment. Ten studies were included in the final evaluation. Review: Global disability‐adjusted life years (DALYs)(95 % uncertainty interval) for lung cancer were increased by 35.9 % from 23,850,000(18,835,000-29,845,000) in 1900 to 32,405,000(24,400,000-38,334,000) in 2000. DALYs attributable to residential radon were 2,114,000(273,000-4,660,000) DALYs in 2010. Lung cancer caused 34,732,900(33,042,600 ~ 36,328,100) DALYs in 2013. DALYs attributable to residential radon were 1,979,000(1,331,000-2,768,000) DALYs for in 2013. The number of attributable lung cancer cases was 70-900 and EBD for radon was 1,000-14,000 DALYs in Netherland. The years of life lost were 0.066 years among never-smokers and 0.198 years among ever-smoker population in Canada. Conclusion: In summary, estimated global EBD attributable to residential radon was 1,979,000 DALYs for both sexes in 2013. In Netherlands, EBD for radon was 1,000–14,000 DALYs. Smoking population lost three times more years than never-smokers in Canada. There was no study estimating EBD of residential radon among never smokers in Korea and Asian country. In addition, there were a few studies reflecting the age of building, though residential radon exposure level depends on the age of building. Further EBD study reflecting Korean disability weight and the age of building is required to estimate EBD precisely.