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

The worldwide incidence of precocious puberty, which is associated with negative health outcomes, is increasing. Several studies have suggested that environmental factors contribute to the development of precocious puberty alongside genetic factors. Some epidemiological studies have provided limited evidence suggesting an association between exposure to air pollution and changes in pubertal development. This systematic review aimed to summarize existing evidence on the association between air pollution exposure and precocious puberty. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched two databases (PubMed and Web of Science) until August 2023. The included studies assessed the association between air pollutant exposure and the risk of precocious puberty, early menarche, or pubertal development. Two authors independently performed study selection and data extraction. A meta-analysis and analysis of the risk of bias were infeasible due to the limited number of studies and the heterogeneity among them. The literature search resulted in 184 studies, from which we included six studies with sample sizes ranging from 437 to 4,074 participants. The studies reported heterogeneous outcomes. Four studies found that increased exposure to air pollution was related to earlier pubertal onset. One study was inconclusive, and another suggested that air pollutant exposure may delay the onset of thelarche. Most studies suggest that exposure to air pollutants accelerates pubertal development; however, the results from the available studies are inconsistent. More extensive and well-designed longitudinal studies are required for a comprehensive understanding of the association between air pollution and precocious puberty.

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  Sofia Malave-Ortiz, Cameron Grant, Natalie D. Shaw
  Current Opinion in Pediatrics.2025;[Epub]     CrossRef
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  Sun Huh
  The Ewha Medical Journal.2024;[Epub]     CrossRef