Objectives: Interest in the association between particulate air pollution and appendicitis risk has been increasing in recent years, and previous studies have suggested a link between particulate matter ≤10 μm in diameter (PM₁₀) and appendicitis. However, robust evidence is currently lacking. This study explored the association between short-term PM₁₀ exposure and appendicitis using data from Ewha Womans University Mokdong Hospital, Seoul, Korea, between January 1, 2001 and December 31, 2018.

Methods: We employed a time-stratified case-crossover design using data from 6,526 appendicitis patients taken from the hospital’s electronic medical records system. We analyzed the data using a conditional logistic regression model adjusted for daily mean temperature and relative humidity. The effect size of PM₁₀ was estimated in terms of each 10 μm/m³ increase in PM₁₀ concentration. Sex, season, and age group were analyzed as subgroups.

Results: Appendicitis patients had been exposed to higher levels of PM₁₀ concentrations 3 days (OR 1.045, 95% CI : 1.007–1.084) and 7 days (OR, 1.053; 95% CI, 1.005–1.103) before hospital admission. The case-crossover analysis stratified by sex, age, and season showed that the male sex, being aged under 10, and the cold season were associated with a significantly stronger association between appendicitis and PM₁₀ concentrations.

Conclusion: Our study found that PM₁₀ concentrations were associated with appendicitis in boys aged under 10. The cold season was also a risk factor. Further research with a larger sample size and with other pollutants is required to clarify the association between PM₁₀ and appendicitis.

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• Unresolved policy on the new placement of 2,000 entrants at Korean medical schools and this issue of Ewha Medical Journal
  Sun Huh
  The Ewha Medical Journal.2024;[Epub]     CrossRef

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