Association between long-term PM 2.5 exposure and risk of Kawasaki disease in children: A nationwide longitudinal cohort study
Based on previous studies suggesting air pollution as a potential risk factor for Kawasaki Disease (KD), we examined the association of long-term exposure to childhood fine particulate matter (PM ) with the risk of KD. We used National Health Insurance Service-National Sample Cohort data from 2002 t...
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Veröffentlicht in: | Environmental research 2024-03, Vol.244, p.117823 |
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Sprache: | eng |
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Zusammenfassung: | Based on previous studies suggesting air pollution as a potential risk factor for Kawasaki Disease (KD), we examined the association of long-term exposure to childhood fine particulate matter (PM
) with the risk of KD.
We used National Health Insurance Service-National Sample Cohort data from 2002 to 2019, which included beneficiaries aged 0 years at enrollment and followed-up until the onset of KD or age 5 years. The onset of KD was defined as the first hospital visit record with a primary diagnostic code of M30.3, based on the 10th revision of the International Classification of Diseases, and with an intravenous immunoglobulin (IVIG) prescription. We assigned PM
concentrations to 226 districts, based on mean annual predictions from a machine learning-based ensemble prediction model. We performed Cox proportional-hazards modeling with time-varying exposures and confounders.
We identified 134,634 individuals aged five or less at enrollment and, of these, 1220 individuals who had a KD onset and an IVIG prescription during study period. The average annual concentration of PM
exposed to the entire cohort was 28.2 μg/m³ (Standard Deviation 2.9). For each 5 μg/m³ increase in annual PM
concentration, the hazard ratio of KD was 1.21 (95% CI 1.05-1.39).
In this nationwide, population-based, cohort study, long-term childhood exposure to PM
was associated with an increased incidence of KD in children. The study highlights plausible mechanisms for the association between PM
and KD, but further studies are needed to confirm our findings. |
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ISSN: | 1096-0953 |