Long-term exposure to air pollution and precocious puberty in South Korea.

Background and Aim: The increasing prevalence of precocious puberty (PP) has emerged as a significant medical and social problem worldwide. However, research on the relationship between long-term air pollution exposure and PP has been relatively limited. We thus investigated the association between long-term air pollution exposure and the onset of PP in South Korea.
Methods: We investigated a retrospective cohort using the Korea National Health Insurance Database. Six-year-old children born from 2007 to 2009 were examined (2013-2015). We included boys ≤10 years and girls aged ≤9 years who visited hospitals for early pubertal development, were diagnosed with PP per the ICD-10 (E228, E301, and E309), and received gonadotropin-releasing hormone agonist treatment. We analyzed data for boys up until 10 years old (60-month follow-up) and for girls up to 9 years old (48-month follow-up). We assessed the association between long-term air pollution exposure and the onset of PP using a Cox proportional hazard model. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) per 1 μg/m ³ increase in fine particulate matter (PM _2.5 ) and particulate matter (PM ₁₀ ) and per 1 ppb increase in sulfur dioxide (SO ₂ ), nitrogen dioxide (NO ₂ ), and ozone (O ₃ ).
Results: This study included 1,205,784 children aged six years old between 2013 and 2015. A positive association was found between the 48-month moving average PM _2.5 (HR: 1.019; 95% CI: 1.012, 1.027), PM ₁₀ (HR: 1.009; 95% CI: 1.006, 1.013), SO ₂ (HR: 1.037; 95% CI: 1.018, 1.055), and O ₃ (HR: 1.006; 95% CI: 1.001, 1.010) exposure and PP in girls but not boys.
Conclusions: This study provides valuable insights into the harmful effects of air pollution during childhood and adolescence, emphasizing that air pollution is a risk factor that should be managed and reduced.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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