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Effective contact tracing is critical to controlling the spread of coronavirus disease (COVID-19) (1). South Korea adopted a rigorous contact-tracing program comprising traditional shoe-leather epidemiology and new methods to track [...]

Background: Exposure to air pollution aggravates symptoms of atopic dermatitis (AD) in children in the population studies. Variability in individual patient's response from individual susceptibility is needed to be explored. Objective: This study aimed to investigate spectrum of individual variability in the associations between AD symptoms and air quality. Methods: We enrolled 89 children aged 0‐6 years with AD (22 890 person‐days). Daily manifestation of symptoms was recorded for an average of 257 days (range 100‐499). Both an individual analysis using logistic regression models and an overall analysis using a generalized estimating equation were performed. Results: The odds ratios of an individual ranged 0.24‐8.11 for particulate matter <10 μm in diameter (PM10), 0.09‐101.92 for nitrogen oxide (NO2), 0.03‐44.00 for ozone (O3), 0.11‐58.30 for sulfur dioxide (SO2), 0.00‐15.83 for carbon monoxide (CO), 0.00‐39 446.94 for temperature, and 0.03‐5.18 for relative humidity, demonstrating a wide individual variability. In the overall analysis, PM10, NO2, SO2, and CO had a significantly positive association, whereas temperature and relative humidity were negatively associated with AD symptoms. Air pollution was responsible for aggravation of symptoms from 24.7% (O3) to 39.3% (SO2) of AD children. Overall, 71.9% of the AD children responded to at least one or more air pollution and weather variable. Conclusion: Responses of AD children to air pollution and weather variable were considerably variable among individuals. An individualized model would be useful to forecast and manage AD symptoms in patients. [ABSTRACT FROM AUTHOR]

Introduction: Studies on the associations between phthalate exposures and respiratory outcomes are limited. We investigated the association of phthalates exposure with pulmonary function and airway inflammation in asthmatic children. Methods: Fifty-six children with asthma living in Seoul Metropolitan Area, Korea aged 6–16 years were enrolled. Their pulmonary function including forced expiratory volume in 1 sec (FEV1) and peak expiratory flow rate (PEFR) were measured, and the fractional exhaled nitric oxide (FeNO) as a marker of airway inflammation was examined repeatedly up to four times during the study period. Urinary levels of mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), metabolites for di-(2-ethylhexyl) phthalate (DEHP), and mono-n-butyl phthalate (MnBP), a metabolite of di-n-butyl phthalate (DnBP), were also measured on the same days. The effects of phthalate metabolites on the respiratory symptoms were analyzed using linear mixed effect models with adjustment for potential cofounders. Results: An increase in phthalate metabolites was associated with a decrease in pulmonary function and an increase in FeNO in asthmatic children. As one natural log-unit (ln-unit) levels of urinary MEHHP and MEOHP increased, FeNO levels on the same day increased by 19.47 ppb [95% confidence interval (CI): 9.28, 29.67] and 17.93 ppb (95% CI: 5.86, 30.01), respectively. An increases in the urinary level of MEHHP, MEOHP, and MnBP by one ln-unit was associated with a decrease in PEFR on the next day by 12.17 L/min (95% CI: 2.59, 21.74), 10.80 L/min (95% CI: 0.29, 21.32), and 13.65 L/min (95% CI: 5.07, 22.24), respectively. Conclusion: Phthalates, especially DEHP, may worsen pulmonary function and airway inflammation in asthmatic children. To control asthma symptoms, exposure to phthalates needs to be avoided. [ABSTRACT FROM AUTHOR]

Introduction: The effects of weather and air pollution on the severity and persistence of atopic dermatitis (AD) are important issues that have not been investigated in detail. The objective of our study was to determine the short-term effects of meteorological variables and air pollution on AD symptoms in children. Methods: We enrolled 177 AD patients with 5 years or younger from the Seoul Metropolitan Area, Korea, and followed for 17 months between August 2013 and December 2014. Symptoms records of 35,158 person-days, including itching, sleep disturbance, erythema, dry skin, oozing, and edema, were obtained. We estimated the effect of meteorological variables including daily mean temperature, relative humidity (RH), diurnal temperature range (DTR), rainfall and air pollutants including particulate matter with an aerodynamic diameter ≤10 μm (PM10), nitrogen dioxide (NO2), and tropospheric ozone (O3) on AD symptoms using a generalized linear mixed model with adjustment for related confounding factors. Results: A 5°C increase in outdoor temperature and a 5% increase in outdoor RH was associated with 12.8% (95% confidence intervals (CI): 10.5, 15.2) and 3.3% (95% CI: 1.7, 4.7) decrease in AD symptoms, respectively, on the same day. An increase of rainfall by 5 mm increased AD symptoms by 7.3% (95% CI: 3.6, 11.1) for the days with <40 mm rainfall. The risk of AD symptoms increased by 284.9% (95% CI: 67.6, 784.2) according to a 5°C increase in DTR when it was >14°C. An increase in PM10, NO2, and O3 by 10 units increased the risk of AD symptoms on the same day by 3.2% (95% CI: 1.5, 4.9), 5.0% (95% CI: 1.4, 8.8), and 6.1% (95% CI: 3.2, 9.0), respectively. Conclusion: Exposure to meteorological variables and air pollutants are associated with AD symptoms in young children. [ABSTRACT FROM AUTHOR]

Background: Despite increasing evidence on the relationship between exposure to phthalates and bisphenol A with allergies and asthma, reports on atopic dermatitis (AD) with these chemicals are few. We assessed the association between AD symptoms and the exposure to phthalates and bisphenol A and in children.Methods: We surveyed 18 boys with AD (age 3-7 years) in a day care center in Seoul between May 2009 and April 2010. AD symptoms were recorded by using a daily symptom diary. We collected 460 series of pooled urine twice a day, in the morning and afternoon, over 230 working days and measured the concentrations of mono-2-ethyl-5-oxohexyl phthalate (5-oxo-MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate (5-OH-MEHP), mono-isobutyl phthalate (MnBP) and bisphenol A glucuronide (BPAG) in the pooled urine. Logistic regression was used for statistical analysis.Results: Most phthalate metabolite levels were higher in the morning than in the afternoon (p < 0.0001). There was seasonal variation in the levels of phthalates and bisphenol A metabolites. Levels of 5-OH-MEHP, MnBP, and BPAG were highest in summer (p < 0.0001). Manifestation of AD symptoms was associated with an increase in urinary levels of MnBP (adjusted odds ratio, aOR = 2.85, 95% CI: 1.12-7.26 per 1 μg/L of MnBP) and BPAG (aOR = 1.79, 95% CI: 0.91-3.52 per 1 μg/L BPAG) on the same day. The levels of MnBP and BPAG in the previous day increased AD symptoms (aOR = 2.74, 95% CI: 1.21-6.20, for 1 μg/L of MnBP and aOR = 2.01, 95% CI: 1.08-3.74 for 1 μg/L BPAG).Conclusion: Our results suggest that exposure to phthalates and bisphenol A is associated with aggravation of AD symptoms in children. [ABSTRACT FROM AUTHOR]

We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation. [ABSTRACT FROM AUTHOR]

We estimated the exposure to ambient air pollutants and analyzed the associations with allergic diseases. We enrolled 177 children with atopic dermatitis (AD) and 70 asthmatic adults living in Seoul Metropolitan Area, Korea, and followed for 17 months between August 2013 and December 2014. Parents or patients recorded symptom scores on a daily basis. Exposure to particulate matter with a diameter < 10 μm (PM 10 ) and nitrogen dioxide (NO 2 ) was estimated in four different ways in each individual, using the AQ1 (measurements from the nearest air quality monitoring station to residential houses), AQ2 (measurements modified from AQ1 with the indoor level of air pollutants and time activity of each individual), AQ1-DI, and AQ2-DI (measurements modified from AQ1 and AQ2, respectively, with daily inhalation intakes of air pollutants). A generalized linear mixed model (GLMM) was used to analyze the associations between exposure metrics and clinical symptoms after adjusting for ambient temperature and humidity, age, season, gender, and time trend. The exposure metrics for PM 10 and NO 2 showed different distributions. Symptoms of AD and asthma were positively associated with exposure to PM 10 , but not NO 2 , in all exposure metrics. The effect size of PM 10 exposure on asthma symptoms was slightly greater in metrics with inhalation capacity (AQ-DIs) than in those without (AQs). This pattern was not observed in AD. Exposure to PM 10 is associated with symptom aggravation in childhood AD and adult asthma. Different exposure estimates may be used to evaluate the impact of air pollution on different allergic diseases. [ABSTRACT FROM AUTHOR]