Archives of Environmental & Occupational Health
ISSN: 1933-8244 (Print) 2154-4700 (Online) Journal homepage: http://www.tandfonline.com/loi/vaeh20
Association between Air Pollution and Benign Prostatic Hyperplasia: An Ecological Study Sung Ryul Shim, Jae Heon Kim, Yun Seob Song & Won Jin Lee To cite this article: Sung Ryul Shim, Jae Heon Kim, Yun Seob Song & Won Jin Lee (2015): Association between Air Pollution and Benign Prostatic Hyperplasia: An Ecological Study, Archives of Environmental & Occupational Health, DOI: 10.1080/19338244.2015.1093458 To link to this article: http://dx.doi.org/10.1080/19338244.2015.1093458
Accepted online: 17 Sep 2015.
Submit your article to this journal
Article views: 19
View related articles
View Crossmark data
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=vaeh20 Download by: [Korea University]
Date: 29 September 2015, At: 01:02
ACCEPTED MANUSCRIPT Running title: Air pollution and benign prostate hyperplasia Association between Air Pollution and Benign Prostatic Hyperplasia: An Ecological Study Sung Ryul Shim1, Jae Heon Kim2, Yun Seob Song2, Won Jin Lee3
1
Institute for clinical molecular biology research, Soonchunhyang University Hospital, Seoul,
Downloaded by [Korea University] at 01:02 29 September 2015
Korea; 2
3
Department of Urology, Soonchunhyang University School of Medicine, Seoul, Korea;
Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
Correspondence to: Won Jin Lee, MD, MPH, PhD. Department of Preventive Medicine, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 136-705, South Korea. Email:
[email protected] Phone: +82-2-2286-1413; Fax: +82-2-927-7220 Abstract Benign prostate hyperplasia (BPH) is a prevalent medical condition; however, little is known about the effect of environmental factors. Therefore, we conducted surveys to examine the association between air pollution and the risk of BPH in South Korea between May 2010 and April 2013, yielding data for 1,734 men. Air pollution information was obtained from the National Air Pollutants Emission 2010 report. Logistic regression analyses were conducted after
1
ACCEPTED MANUSCRIPT
ACCEPTED MANUSCRIPT adjusting for potential confounders. The International Prostate Symptom Score significantly increased with increasing per capita air pollutant emissions. The risk of BPH increased as the overall concentration of air pollutants increased (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.55–3.21). In particular, nitrogen oxides (OR, 1.73; 95% CI, 1.25–2.39) and sulfur oxides (OR, 2.02; 95% CI, 1.42–2.88) showed a dose-dependent association. Our findings support a
Downloaded by [Korea University] at 01:02 29 September 2015
positive association between the risk of BPH and air pollution. Keywords air pollution, epidemiology, reproductive health.
2
ACCEPTED MANUSCRIPT
ACCEPTED MANUSCRIPT Introduction Benign prostatic hyperplasia (BPH) is a highly prevalent medical condition in middle-aged men worldwide that varies geographically [1]. Large geographic differences in BPH prevalence may be related to genetic, lifestyle, and environmental factors [2, 3]. However, the etiology of such differences is still largely unknown.
Downloaded by [Korea University] at 01:02 29 September 2015
Although previous epidemiological studies have shown associations between ambient air pollution and risk for prostate cancer [4-9], little is known about the role of environmental factors in benign tumors associated with BPH. Therefore, we focused on air pollution as an environmental factor and attempted to explain the regional differences in BPH prevalence in relation to air pollution. The aim of this study was to evaluate the hypothesis that air pollution is associated with an increased risk of BPH. Material and methods Study population The study population and methods for this cross-sectional study have been described in detail [11]. In brief, the present study used data from two large population studies: a communitybased interview survey and a university hospital outpatient-based interview survey. Both investigations were conducted in men aged 50 years and older who provided consent for the survey questionnaire and voluntarily expressed the intention to participate. To enhance the validity of the International Prostate Symptom Score (IPSS), both studies excluded patients who had undergone urological surgery that could affect the IPSS, who had received any treatment for BPH or prostate cancer, and who were taking or had taken any drug for these conditions. A total of 1,734 subjects were included after excluding those with missing values. The present study
3
ACCEPTED MANUSCRIPT
ACCEPTED MANUSCRIPT covered 36 community senior welfare centers and 20 university hospitals in 9 major areas in South Korea (Seoul, Gyeonggido, Incheon, Daejeon, Daegu, Busan, Gangwondo, Gwangju, and Ulsan) between May 2010 and April 2013. Air pollution data Data on the emissions of air pollutants per capita were obtained from the National Air
Downloaded by [Korea University] at 01:02 29 September 2015
Pollutants Emission (NAPE) 2010 report published by the National Institute of Environmental Research within the Korean Ministry of Environment [12]. National emissions of air pollutants have been reported by the Clean Air Policy Support System (CAPSS) for 7 different pollutants: carbon monoxide [CO], nitrogen oxides [NOx], sulfur oxides [SOx], total suspended particles [TSP], particulate matter
