Published online Oct 21, 2020. doi: 10.3748/wjg.v26.i39.6074
Peer-review started: July 19, 2020
First decision: August 8, 2020
Revised: August 19, 2020
Accepted: September 16, 2020
Article in press: September 16, 2020
Published online: October 21, 2020
Gastroesophageal reflux disease (GERD) is a highly prevalent disease of the upper gastrointestinal tract, and it is associated with environmental and lifestyle habits. Due to an increasing interest in the environment, several groups are studying the effects of meteorological factors and air pollutants (MFAPs) on disease development.
To identify MFAPs effect on GERD-related medical utilization.
Data on GERD-related medical utilization from 2002 to 2017 were obtained from the National Health Insurance Service of Korea, while those on MFAPs were obtained from eight metropolitan areas and merged. In total, 20071900 instances of GERD-related medical utilizations were identified, and 200000 MFAPs were randomly selected from the eight metropolitan areas. Data were analyzed using a multivariable generalized additive Poisson regression model to control for time trends, seasonality, and day of the week.
Five MFAPs were selected for the prediction model. GERD-related medical utilization increased with the levels of particulate matter with a diameter ≤ 2.5 μm (PM2.5) and carbon monoxide (CO). S-shaped and inverted U-shaped changes were observed in average temperature and air pollutants, respectively. The time lag of each variable was significant around nine days after exposure.
Using five MFAPs, the final model significantly predicted GERD-related medical utilization. In particular, PM2.5 and CO were identified as risk or aggravating factors for GERD.
Core Tip: The model showed correlation between five meteorological factors and air pollutants and gastroesophageal reflux disease (GERD)-related medical utilization. S- and inverted U-shaped changes were noted in average temperature and air pollutants. Average temperature, sunshine duration, wind speed, PM2.5, and carbon monoxide are risk factors of GERD. GERD occurrence is reduced using environmental management and national alarm systems.