Hyewon Lee1, Woojae Myung2, Hae-Kwan Cheong3, Seung-Muk Yi4, Yun-Chul Hong5, Sung-Il Cho6, Ho Kim7. 1. Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea; Department of Neuropsychiatry, Pain Center, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. 2. Department of Neuropsychiatry, Pain Center, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea. Electronic address: wjmyung@snubh.org. 3. Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea. 4. Department of Air Pollution and Climate Change, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea. 5. Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea. 6. Department of Chronic Disease Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea. 7. Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea; Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea. Electronic address: hokim@snu.ac.kr.
Abstract
BACKGROUND: Migraine is a chronic and agonizing neurological disorder prevalent worldwide. Although its pathogenesis remains unclear, limited evidence exists on the role of air pollution. OBJECTIVE: We aimed to assess the association of short-term air pollution exposure with migraine in conjunction with the synergistic effect of temperature. METHODS: We identified 18,921 patients who visited emergency departments (EDs) for migraine as a primary disease in Seoul from the national emergency database between 2008 and 2014. We conducted a time-stratified, case-crossover analysis to compare levels of particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) on ED visit days and those on the control days matched to day of the week, month, and year. We evaluated the synergistic effects of air pollution and temperature using an interaction term. RESULTS: Higher air pollution levels were significantly associated with risk of migraine over various lag structures. In the best fitting lags, the odds ratio (OR) associated with an interquartile range increase of PM2.5, PM10, NO2, O3, and CO was 1.031 (95% CI: 1.010-1.053), 1.032 (95% CI: 1.007-1.057), 1.053 (95% CI: 1.022-1.085), 1.034 (95% CI: 1.001-1.067), and 1.029 (95% CI: 1.005-1.053), respectively. The SO2 effect was positive but not significant (OR 1.019 [95% CI: 0.991-1.047]). The PM effect was significantly stronger on high-temperature days (above the 75th percentile) than on low-temperature days (PM2.5, high: OR 1.068, low: OR 1.021, Pinteract = 0.03; PM10, high: OR 1.066, low: OR 1.014, Pinteract = 0.02). CONCLUSION: Our study provides new evidence that air pollution exposure may trigger migraine especially on high-temperature days, and this finding may contribute in establishing preventive measures against migraine.
BACKGROUND:Migraine is a chronic and agonizing neurological disorder prevalent worldwide. Although its pathogenesis remains unclear, limited evidence exists on the role of air pollution. OBJECTIVE: We aimed to assess the association of short-term air pollution exposure with migraine in conjunction with the synergistic effect of temperature. METHODS: We identified 18,921 patients who visited emergency departments (EDs) for migraine as a primary disease in Seoul from the national emergency database between 2008 and 2014. We conducted a time-stratified, case-crossover analysis to compare levels of particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) on ED visit days and those on the control days matched to day of the week, month, and year. We evaluated the synergistic effects of air pollution and temperature using an interaction term. RESULTS: Higher air pollution levels were significantly associated with risk of migraine over various lag structures. In the best fitting lags, the odds ratio (OR) associated with an interquartile range increase of PM2.5, PM10, NO2, O3, and CO was 1.031 (95% CI: 1.010-1.053), 1.032 (95% CI: 1.007-1.057), 1.053 (95% CI: 1.022-1.085), 1.034 (95% CI: 1.001-1.067), and 1.029 (95% CI: 1.005-1.053), respectively. The SO2 effect was positive but not significant (OR 1.019 [95% CI: 0.991-1.047]). The PM effect was significantly stronger on high-temperature days (above the 75th percentile) than on low-temperature days (PM2.5, high: OR 1.068, low: OR 1.021, Pinteract = 0.03; PM10, high: OR 1.066, low: OR 1.014, Pinteract = 0.02). CONCLUSION: Our study provides new evidence that air pollution exposure may trigger migraine especially on high-temperature days, and this finding may contribute in establishing preventive measures against migraine.
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