[논문]지역간 상대위험도 변동을 고려한 미세먼지 기인 질병부담 및 사회경제적 비용 추정 연구

변가람; 최용수; 길준수; 차준일; 이미혜; 이종태

doi:10.5668/jehs.2021.47.5.486

지역간 상대위험도 변동을 고려한 미세먼지 기인 질병부담 및 사회경제적 비용 추정 연구
Health and Economic Burden Attributable to Particulate Matter in South Korea: Considering Spatial Variation in Relative Risk 원문보기

韓國環境保健學會誌 = Journal of environmental health sciences, v.47 no.5, 2021년, pp.486 - 495

변가람 (고려대학교 정밀보건과학융합전공) , 최용수 (고려대학교 일반대학원 보건과학과) , 길준수 (고려대학교 지구환경과학과) , 차준일 (고려대학교 지구환경과학과) , 이미혜 (고려대학교 지구환경과학과) , 이종태 (고려대학교 정밀보건과학융합전공)

Abstract ▼ AI-Helper

Background: Particulate matter (PM) is one of the leading causes of premature death worldwide. Previous studies in South Korea have applied a relative risk calculated from Western populations when estimating the disease burden attributable to PM. However, the relative risk of PM on health outcomes may not be the same across different countries or regions. Objectives: This study aimed to estimate the premature deaths and socioeconomic costs attributable to long-term exposure to PM in South Korea. We considered not only the difference in PM concentration between regions, but also the difference in relative risk. Methods: National monitoring data of PM concentrations was obtained, and missing values were imputed using the AERMOD model and linear regression model. As a surrogate for relative risk, hazard ratios (HRs) of PM for cardiovascular and respiratory mortality were estimated using the National Health Insurance Service-National Sample Cohort. The nation was divided into five areas (metropolitan, central, southern, south-eastern, and Gangwon-do Province regions). The number of PM attributable deaths in 2018 was calculated at the district level. The socioeconomic cost was derived by multiplying the number of deaths and the statistical value of life. Results: The average PM10 concentration for 2014~2018 was 45.2 ㎍/m3. The association between long-term exposure to PM10 and mortality was heterogeneous between areas. When applying area-specific HRs, 23,811 premature deaths from cardiovascular and respiratory disease in 2018 were attributable to PM10 (reference level 20 ㎍/m3). The corresponding socioeconomic cost was about 31 trillion won. These estimated values were higher than that when applying nationwide HRs. Conclusions: This study is the first research to estimate the premature mortality caused by long-term exposure to PM using relative risks derived from the national population. This study will help precisely identify the national and regional health burden attributed to PM and establish the priorities of air quality policy.

주제어

표/그림 (7)

표 Table 1. Characteristics of the study subjects in the NHIS-NSC
그림 Fig. 1. Mean concentration of PM₁₀ (A) and PM_2.5 (B) for 2014~2018 in South Korea
표 Table 2. Hazard Ratios* (95% CI) for mortality per 10 μg/m³ increase of PM₁₀ by area
$Fig. 2. Spatial distribution of PM<sub>10</sub> attributable fraction and number of deaths for cardiovascular mortality in 2018 using the nationwide (A1, A2) or area specific (B1, B2) relative risks$ 그림 Fig. 2. Spatial distribution of PM₁₀ attributable fraction and number of deaths for cardiovascular mortality in 2018 using the nationwide (A1, A2) or area specific (B1, B2) relative risks
$Table 3. PM attributable fraction and number of deaths using the nationwide or area-specific relative risks$ 표 Table 3. PM attributable fraction and number of deaths using the nationwide or area-specific relative risks
$Fig. 3. Spatial distribution of PM<sub>10</sub> attributable fraction and number of deaths for respiratory mortality in 2018 using the nationwide (A1, A2) or area specific (B1, B2) relative risks$ 그림 Fig. 3. Spatial distribution of PM₁₀ attributable fraction and number of deaths for respiratory mortality in 2018 using the nationwide (A1, A2) or area specific (B1, B2) relative risks
표 Table 4. Socioeconomic costs of premature deaths attributable to PM (billion won)

참고문헌 (23)

Pope CA 3rd, Dockery DW. Health effects of fine particulate air pollution: lines that connect. J Air Waste Manag Assoc. 2006; 56(6): 709-742.

상세보기
Ruckerl R, Schneider A, Breitner S, Cyrys J, Peters A. Health effects of particulate air pollution: a review of epidemiological evidence. Inhal Toxicol. 2011; 23(10): 555-592.

상세보기
Bae HJ. Effects of short-term exposure to PM 10 and PM 2.5 on mortality in Seoul. J Environ Health Sci. 2014; 40(5): 346-354.

원문보기 상세보기
Lee H. Hospital visits, admissions and hospital costs among patients with respiratory and cardiovascular diseases according to particulate matter in Seoul. J Environ Health Sci. 2016; 42(5): 324-332.

원문보기 상세보기
Cohen AJ, Brauer M, Burnett R, Anderson HR, Frostad J, Estep K, et al. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2017; 389(10082): 1907-1918.

상세보기
Bae HJ. The health impacts and benefits of cardiovascular and respiratory hospitalization attributed to PM 2.5 . Korea Rev Appl Econ. 2016; 18(3): 125-139.
Han C, Kim S, Lim YH, Bae HJ, Hong YC. Spatial and temporal trends of number of deaths attributable to ambient PM 2.5 in the Korea. J Korean Med Sci. 2018; 33(30): e193.

상세보기
Kim JH, Oh IH, Park JH, Cheong HK. Premature deaths attributable to long-term exposure to ambient fine particulate matter in the Republic of Korea. J Korean Med Sci. 2018; 33(37): e251.

상세보기
Krewski D, Burnett RT, Goldberg MS, Hoover K, Siemiatycki J, Jerrett M, Abrahamowicz M, White WH. Reanalysis of the Harvard Six Cities Study and the American Cancer Society Study of Particulate Air Pollution and Mortality. Cambridge: Health Effects Institute; 2000.
Burnett RT, Pope CA 3rd, Ezzati M, Olives C, Lim SS, Mehta S, et al. An integrated risk function for estimating the global burden of disease attributable to ambient fine particulate matter exposure. Environ Health Perspect. 2014; 122(4): 397-403.

상세보기
Turner MC, Jerrett M, Pope CA 3rd, Krewski D, Gapstur SM, Diver WR, et al. Long-term ozone exposure and mortality in a large prospective study. Am J Respir Crit Care Med. 2016; 193(10): 1134-1142.

상세보기
Kim H, Kim H, Lee JT. Spatial variation in lag structure in the short-term effects of air pollution on mortality in seven major South Korean cities, 2006-2013. Environ Int. 2019; 125: 595-605.

상세보기
Kim S, Kim H, Lee JT. Interactions between ambient air particles and greenness on cause-specific mortality in seven Korean metropolitan cities, 2008-2016. Int J Environ Res Public Health. 2019; 16(10): 1866.

상세보기
Zeka A, Zanobetti A, Schwartz J. Short term effects of particulate matter on cause specific mortality: effects of lags and modification by city characteristics. Occup Environ Med. 2005; 62(10): 718-725.

상세보기
Lee J, Lee JS, Park SH, Shin SA, Kim K. Cohort profile: The National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. Int J Epidemiol. 2017; 46(2): e15.

상세보기
Samuelsen SO, Eide GE. Attributable fractions with survival data. Stat Med. 2008; 27(9): 1447-1467.

상세보기
Kelly FJ, Fussell JC. Size, source and chemical composition as determinants of toxicity attributable to ambient particulate matter. Atmos Environ. 2012; 60: 504-526.

상세보기
Shin YC. Establishment of Socio-Economic Analysis Foundation for Chemical Substances Management. Incheon: National Institute of Environmental Research; 2017.
Chen J, Hoek G. Long-term exposure to PM and all-cause and cause-specific mortality: a systematic review and meta-analysis. Environ Int. 2020; 143: 105974.

상세보기
Kim H, Byun G, Choi Y, Kim S, Kim SY, Lee JT. Effects of long-term exposure to air pollution on all-cause mortality and cause-specific mortality in seven major cities of South Korea: Korean national health and nutritional examination surveys with mortality follow-up. Environ Res. 2021; 192: 110290.

상세보기
Shin YC. Estimating the value of statistical life by analysing disease protective behavior: focusing on medical examination of cancer. Environ Resour Econ Rev. 2008; 17(4): 845-873.
United States Environmental Protection Agency. Guidelines for Preparing Economic Analyses. Washington, D.C.: EPA; 2010.
Goldman GT, Mulholland JA, Russell AG, Strickland MJ, Klein M, Waller LA, et al. Impact of exposure measurement error in air pollution epidemiology: effect of error type in time-series studies. Environ Health. 2011; 10: 61.

상세보기

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증