Association between long-term exposure to air pollutants and prevalence of cardiovascular disease in 108 South Korean communities in 2008-2010: A cross-sectional study

Air pollution has been linked to cardiovascular disease, which is the leading cause of death worldwide. The aim of this study was to evaluate the epidemiological association between the yearly concentration of air pollution and regional prevalence of cardiovascular disease in South Korea. In this cross-sectional study, data regarding the regional prevalence of cardiovascular disease (i.e., hypertension, stroke, myocardial infarction, and angina) and health behaviors were obtained from the Korean Community Health Survey conducted in 108 communities of South Korea in 2008-2010. Data on carbon monoxide (CO; ppb), nitrogen dioxide (NO2; ppb), and particulate matter up to 10μm in size (PM10; μg/m(3)) were collected from the National Institute of Environmental Research. We used a distributed lag model with generalized estimating equations to represent the corrected lag-response and correlation among repeated observations. Cumulative odds ratios of hypertension, hypertension in those aged >30years, stroke, and angina with an increase of 10μg/m(3) in PM10 were 1.042 (95% confidence interval [CI]: 1.009, 1.077), 1.044 (CI: 1.009, 1.079), 1.044 (CI: 0.979, 1.114), and 0.977 (CI: 0.901, 1.059), respectively; a 10ppb increase in NO2 was associated with an odds ratio of 1.077 (CI: 1.044, 1.112), 1.08 (CI: 1.043, 1.118), 1.073 (CI: 0.994, 1.157), and 1.047 (CI: 0.968, 1.134), respectively. A 10ppb increase in CO was associated with an odds ratio of 1.123 (CI: 0.963, 1.31), 1.129 (CI: 0.963, 1.387), and 1.336 (CI: 0.9887, 2.011) for hypertension, hypertension in patients >30years, and stroke >50, respectively. We found suggestive evidence of an association between the long-term exposure (i.e., delayed for 5years) to air pollutants (i.e., PM10, NO2, and CO) and the regional prevalence of chronic cardiovascular disease (i.e., hypertension, stroke, myocardial infarction, and angina) in 108 communities in South Korea.