Abstract：
Persons with disabilities (PwD), the world\'s largest minority, can be more susceptible to particulate matter (PM) than persons without disabilities. Although numerous studies have addressed population susceptibility to PM, PwD have not been studied in air pollution epidemiology. This study investigated the association between short-term exposure to PM with an aerodynamic diameter smaller than 10 μm (PM10) and cardiovascular hospital admissions by the existence of a disability, while also considering intersections of disability and other socio-demographic characteristics in South Korea. We used the National Health Insurance Service-National Sample Cohort (NHIS-NSC) to investigate the association between short-term exposure to PM10 and cardiovascular hospital admissions in seven metropolitan cities from 2002 to 2015. We conducted a time-stratified case-crossover analysis using conditional logistic regression and adjusted for daily temperature, relative humidity, air pressure, and national holidays. We conducted stratified analyses according to the existence of a disability, disability type and severity, and socio-demographic characteristics. The results showed that a 10 μg/m3 increase in the 0-3 moving average level of PM10 was associated with 1.9 % (95 % confidence interval [CI]: 0.7 %, 3.2 %) and 0.0 % (95 % CI: -0.5 %, 0.5 %) increase in cardiovascular admissions in persons with and without disabilities, respectively. Among PwD, the associations were pronounced in people with brain lesion disorders (percent change [PC]: 2.7 %, 95 % CI: 0.5 %, 5.0 %), people with visual impairment (PC: 3.0 %, 95 % CI: -1.0 %, 7.1 %), and people with severe disability (PC: 3.0 %, 95 % CI: 0.9 %, 5.0 %). We found that PwD may be more adversely affected by PM10 than their non-disabled counterparts. This suggests that PwD is a social identity reflecting the socially marginalized and disadvantaged population in air pollution epidemiology.
摘要：
残疾人（PwD）世界上最大的少数民族，与非残疾人相比，更容易受到颗粒物（PM）的影响。尽管许多研究已经解决了人群对PM的易感性，PwD尚未在空气污染流行病学中进行研究。这项研究调查了短期暴露于空气动力学直径小于10μm（PM10）的PM与存在残疾的心血管住院之间的关系，同时还考虑了韩国残疾和其他社会人口特征的交叉点。我们使用国家健康保险服务-国家样本队列（NHIS-NSC）调查了2002年至2015年七个大城市的PM10短期暴露与心血管住院之间的关系。我们使用条件逻辑回归进行了时间分层的病例交叉分析，并针对每日温度进行了调整，相对湿度,空气压力,和国家假日。我们根据残疾的存在进行了分层分析，残疾类型和严重程度，和社会人口特征。结果表明，PM10的0-3移动平均水平增加10μg/m3与1.9％相关（95％置信区间[CI]：0.7％，3.2%）和0.0%（95%CI：-0.5%，0.5％）残疾人和非残疾人的心血管住院人数增加，分别。在PwD中,这种关联在患有脑部病变疾病的人中很明显（百分比变化[PC]：2.7％，95%CI:0.5%,5.0%），视力障碍患者（PC：3.0%，95%CI：-1.0%，7.1%)，和严重残疾的人(PC：3.0%，95%CI：0.9%，5.0%）。我们发现，与未禁用的PM10相比，PwD可能会受到更大的不利影响。这表明PwD是一种社会身份，反映了空气污染流行病学中的社会边缘化和弱势群体。
