초미세먼지 주의보발령상태의 건강피해 예측

이종태

고려대학교 환경보건학과3/12/2014

차례

1. 미세먼지와 인간– 입자크기와 노출

– 화학적 조성

2. 미세먼지로 인한 건강영향 (국내사례)

3. 초미세먼지 주의보발령 건강부담

4. 정책적 관점– 미세먼지 관리방향

– 민감 및 취약인구 우선 관리

1. 미세먼지와 인간

입자크기와 노출

입자크기와 노출

입자크기와 노출

• 용어

– PM10 : respirable particles – 미세먼지?

– PM2.5 : fine particles – 초미세먼지?

– PM1.0 : ultra fine particles – 초초미세먼지?

화학적 조성

Fine particle (PM2.5)

SulfateNitrateAmmoniumHydrogen ion (H+)Elemental carbonOrganic compounds(PAHs, PNAs)Metals (Pb, Cd, V, Ni, Cu, Zn, Mn, Fe)

Coarse particle (PM2.5-10)

Re-suspended dustCoal and oil fly ashMetal oxides Sea saltPollen, mold spores;Tyrewear debris

화학적 조성

• 입자 크기가 작을수록

– 위해물질이 상대적으로 많이 함유됨

• Nitrates, Sulfates, H+, PAHs, Pb, Cd, Ni, V

– 폐포까지 노출될 확률이 커짐

• 기도 또는 기관지와 다르게 노출된 먼지를 제거할수 있는 해부학적 기능이 없음

2. 미세먼지와 건강영향

EHP 2011;119:725-730

Survival analysis of long-term exposure to different sizes of airborne particulate matter and risk of infant mortality

using a birth cohort in Seoul, Korea

Ji-Young Son, Michelle L. Bell, Jong-Tae Lee

Table 1. Hazard ratios for an IQR increase from Cox proportional hazards modela on all-cause infant mortality in a birth cohort, Seoul, Korea, 2004-2007

Gestational exposure

Hazard ratio (95% CI)

Normal birth weight(n=352,405)

Low birth weight(n=7,054)

TSP (IQR, 8.91 µg/m3) 1.44 (1.06-1.97) 1.69 (0.38-7.49)

PM10 (IQR, 6.93 µg/m3) 1.65 (1.18-2.31) 1.48 (0.38-5.80)

PM2.5 (IQR, 3.15 µg/m3) 1.53 (1.22-1.90) 1.00 (0.34-2.94)

PM10-2.5 (IQR, 3.71 µg/m3) 1.19 (0.83-1.70) 1.92 (0.49-7.63)

aThe model included the following variables: sex, gestation period, education level of mother, maternal age, season of birth, and heat index

Survival analysis of long-term exposure to different sizes of airborne particulate matter and risk of infant

mortality using a birth cohort in Seoul, Korea

• 임신기간 중 입자상 오염물질의 노출이 영아사망을 증가시킴

• 특히 초미세먼지(PM2.5)의 영향이 주요한 역할을 하는 것으로 추정됨– 조대먼지(PM10-2.5)의 경우 유의한 상관성 부재

Survival analysis of long-term exposure to different sizes of airborne particulate matter and risk of infant

mortality using a birth cohort in Seoul, Korea

The adverse effects of fine particle air pollution on respiratory function in the elderly

Jong-Tae Lee, Ji-Young Son, Yong-Sung Cho

Sci Tot Environ 2007;385:28-36

Table 2 Number of participants and age in each survey

Survey Period# of

participants (Male)

Age (year)

Complete ≥ 4 weeks, 100-800 l/min, and participating

at least two surveys (%)Remarks

1st survey(11/02/00~12/15/00)

61 (36) 78.2 32 (52.5)Correlation between Spirometer and Peak flow meter = 0.67

2nd survey(04/23/01~06/03/01)

47 (30) 78.1 31 (66.0) No spirometer

3rd survey(10/29/01~12/02/01)

41 (23) 77.7 30 (71.4) No spirometer

Table 3 Mean concentrations of air particles and PEFR in each survey

Survey PeriodMean concentration (µg/m3) and standard errors

PEFR (l/min)PM10 PM2.5

1st survey(11/02/00~12/15/00)

75.2 (31.2) 51.9 (19.2) 240.9

2nd survey(04/23/01~06/03/01)

79.9 (28.1) 55.4 (19.4) 245.6

3rd survey(10/29/01~12/02/01)

83.6 (38.3) 61.8 (29.7) 249.3

The adverse effects of fine particle air pollution on respiratory function in the elderly

Table 4. Estimated change in peak expiratory flow rates and 95% confidence intervals (CIs) for two separate particle sizes using mixed modelsa

PollutantsEstimated change (l/min) 95% CI

PM2.5 (10 µg/m3) -0.54 -0.89, -0.19

PM10 (10 µg/m3) -0.39 -0.63, -0.14

aThe model included the following variables: an intercept, categorical variables of survey and sex, date, age, air temperature, relative humidity

The adverse effects of fine particle air pollution on respiratory function in the elderly

• 입자상 오염물질이 노인들의 폐기능(PEFR) 저하와 연관성이 있음

• 이러한 관련성은 PM2.5에서 더 크게 관찰됨

• 따라서 보다 작은 입자상 오염물질에 대한 관리가 필요함

The adverse effects of fine particle air pollution on respiratory function in the elderly

초미세먼지(PM2.5)의 건강 영향 평가 및 관리 정책연구 I

한국환경정책·평가연구원(2012.03)

Table1. Percent increase in daily deaths1 and 95% CIs associated with a 10㎍/㎥ increase in PM2.5

Cause of Death

Age Lag effectPercent increase

95% CI

All cause2All age Lag 0 0.95 0.57-1.34

Over 65 Lag 0 1.37 0.90-1.84

CardiovascularAll age Lag 0 1.63 0.89-2.37

Over 65 Lag 0 1.75 0.91-2.59

1Seoul, 2006-20102Excluding all deaths due to accidents and other external causes

Association of fine particulate matter from different sources with daily mortality in Six U.S. cities

Laden et al. (2000) EHP 108:941-947

3. 주의보발령 상황으로 인한 건강부담 추정

국내 PM2.5 주의보 발령과 사망 부담 추정

• 초미세먼지 주의보발령

– 주의보(경보)발령: 농도 85㎍/㎥(120㎍/㎥)이 2시간 이상 지속되는

경우

– 2014년 2월24일 정오~27일 오후 3시까지 총 75시간 동안 서울지역

초미세먼지 주의보발령

• 국내 PM2.5 대기환경기준

– 연평균 25㎍/㎥(WHO 10㎍/㎥);

– 24시간 평균50㎍/㎥ (WHO 25㎍/㎥)

• 주의보발령 기간 전후의 초과사망자수의 추정

– 서울지역 2012년 외인사 제외 총사망자수 : 40,040명 (일평균

109.4명)

– 일평균 기준과 연평균 기준을 각각 적용하여 초과사망자수 추정

Table1. Estimated excessive deaths due to PM2.5 episode

DayDaily mean

concentration

Domestic study result a

(0.95%/10㎍/㎥)Laden et al. b

(3.4%/10㎍/㎥)

Daily standard(50㎍/㎥)

Yearly standard(25㎍/㎥)

Daily standard(50㎍/㎥)

Yearly standard(25㎍/㎥)

2014-02-23 58 0.83 3.43 2.98 12.27

2014-02-24 84 3.53 6.13 12.65 21.95

2014-02-25 86 3.74 6.34 13.39 22.69

2014-02-26 73 2.39 4.99 8.55 17.85

2014-02-27 62 1.25 3.85 4.46 13.76

2014-02-28 58 0.83 3.43 2.98 12.27

Total 70.2 12.6 28.2 44.9 100.8

aPM2.5 10㎍/㎥ 증가로 인한 일사망증가율. 한국환경정책평가연구원 (2012)b국외 PM2.5 10㎍/㎥ 증가 중 motor source로 인한 일사망증가율

PM2.5 10㎍/㎥ 증가로 인한 연간 조기사망자수의 추정

• WHO의 대기오염으로 인한 사망부담의 계산 방법을 이용하여 추정

• 추정에 필요한 변수

– Attributable fraction(AF) : 인체건강영향의 농도-반응관계를 연구한 역

학연구를 통해 산출 (AF =𝑅𝑅−1

𝑅𝑅)

– 서울지역 사망률(B) : 2012년 서울지역 사망률

– 노출 인구(P) : 2013년 서울 인구 수

• Premature deaths per year = AF x B x P

Table2. Premature deaths per year due to 10㎍/㎥ increase of PM2.5

Domestic study result(0.95 percent increase)

Laden et al.(3.4 percent increase)

Estimate 95% CI Estimate 95% CI

388.7 234.1 - 546.1 1358.2 690.4 - 2041.6

4. 정책적 관점

미세먼지 관리

• 미세먼지의 발생특성에 따라 차별화 정책

• 도시의 경우 자동차 운용제한

• 민감 및 취약인구

Characterization of fine particulate matter and associations between particulate chemical constituents

and mortality in Seoul, Korea

Ji-Young Son, Jong-Tae Lee, Ki-Hyun Kim, Kweon Jung, Michelle Bell

EHP 2012;120:872-878

Characterization of fine particulate matter and associations between particulate chemical constituents and mortality in

Seoul, Korea

Characterization of fine particulate matter and associations between particulate chemical constituents and mortality in

Seoul, Korea

• 국내 초미세먼지 구성 성분 중 NO3, SO4, NH4

등이 주요하게 포함됨

• 미세먼지 성분 중 Mg (p-value<0.05)을 포함하여 NO3 (p-value<0.10), SO4 (p-value<0.10), NH4 (p-value<0.05)가 사망률과 통계적으로 유의한 관련성을 보임

A comparison of mortality related to urban air particles between periods with Asian dust days and without Asian

dust days in Seoul, Korea, 2000-2004

Jong-Tae Lee, Ji-Young Son, Yong-Sung Cho

Environ Res 2007;105:409-13

Table 1 Summary statistics of daily concentrations of air pollutants and total death counts on model with/without Asian dust days included in Seoul, Korea, 2000-2004

Variable Mean (SD)

Model without Asian dust days included

(N=1764 days)

Asian dust days only (N=63 days)

PM10 (µg/m3)CO (ppm)NO2 (ppb)SO2 (ppb)O3 (ppb)Temperature (℃)Humidity (%)Pressure (hPa)Total death counts (per day)

65.77 (33.60)0.92 (0.41)

37.38 (12.22)5.20 (2.17)

26.70 (14.78)13.03 (10.19)62.79 (14.28)

1016.19 (8.15)93.18 (12.08)

188.49 (142.85)1.00 (0.47)

36.41 (12.58)5.62 (2.35)

30.07 (12.56)9.15(5.62)

54.27 (14.90)1013.59 (5.55)95.38 (10.07)

A comparison of mortality related to urban air particles between periods with Asian dust days and without Asian dust days in Seoul,

Korea, 2000-2004

A comparison of mortality related to urban air particles between periods with Asian dust days and without Asian dust days in Seoul,

Korea, 2000-2004

Table 2 Estimated percentage increases in the risk of total death and 95% confidence intervals for total death by an interquartile range (IQR)1 using a single-pollutant model2

Air Pollutants [lag time]

Percentage increases

Model with Asian dust days included

(N=1827 days)

Model without Asian dust days included

(N=1764 days)

PM10 (µg/㎥) [lag1+2+3] 0.7 (0.2, 1.3) 1.0 (0.2, 1.8)

CO (ppm) [lag1] 3.3 (2.5, 4.1) 3.3 (2.5, 4.2)

NO2 (ppb) [lag1] 2.4 (1.6, 3.1) 2.5 (1.7, 3.3)

SO2 (ppb) [lag1] 2.5 (1.7, 3.3) 2.7 (1.8, 3.5)

O3 (ppb) [lag1+2] 0.4 (-0.6, 1.4) 0.5 (-0.5, 1.5)

1 The IQR was 41.49µg/㎥ for PM10, 0.54ppm for CO, 17.93ppb for NO2, 3.06ppb for SO2, 21.03ppb for O3

2 The model included the following variables: an intercept, indicator variables for days of the week, and smooth spline functions for date, temperature, humidity, and air pressure

• 황사 시기를 제외한 경우 미세먼지의 위해도가 상대적으로 더 컸음

• 황사시기를 제외하지 않고 수도권 미세먼지 위해도가 평가될 경우 실제 미세먼지 건강위해 크기가 과소평가될가능성이 있음– 현재 평가결과들 보다 실제 위해크기는 더 클 수 있음

• 미세먼지 관리가 발생원 특성 등을 고려한 차별화된 정책적 접근 필요

A comparison of mortality related to urban air particles between periods with Asian dust days and without Asian dust days in Seoul,

Korea, 2000-2004

JA&WMA 2007;57:968-73

Benefits of mitigated ambient air quality due to transportation control on childhood asthma hospitalization during the 2002 Summer Asian

Games in Busan, Korea

Jong-Tae Lee, Ji-Young Son, Yong-Sung Cho

September 8 September 29 October 15 November 4

Asian Game

Period/Block II

Pre-Asian Game

Period/Block I

Post-Asian Game

Period/Block III

Baseline Period Effective Period

Percent Change of Air Pollutants

-40

-30

-20

-10

0

10

20

30

40

50

60

1999 2000 2001 2002 2003

Year

%

C

h

a

n

g

e

CO

NO2

SO2

PM10

O3

Figure 1 Study period sections analyzed in the study.

Figure 2 Percent changes of air pollution levels in Busan during the effective period (post-Asian Games period, from October 15 to November 4) compared with the baseline periods (pre-Asian and Asian Games periods, from September 8 to October 14) in several calendar years.

Pollutant CO NO2 SO2 PM10 O3

RR(95% confidence

interval)

1.01(0.74-1.38)

1.35(1.01-1.80)

1.34(1.06-1.68)

1.34(1.13-1.60)

1.24(1.04-1.48)

1An IQR is 0.44 ppm for CO, 15.09 ppb for NO2, 3.64 ppb for SO2, 28.82 μg/m3 for PM10, and 12.39 ppb for O32The model included the following variables: an intercept, indicator variables for day of week, a variable for each

pollutant; and smooth functions for date, temperature, humidity, and air pressure.

Table 1 Estimated relative risks and their 95% confidence intervals of hospital admissions for asthma by an interquartile range (IQR)1 in the daily concentrations of ambient air pollutants using a single-pollutant model2 (data from September 8 to November 4 of 2002)

Year

2002 2003

RR (95% Confidence Interval) 0.73 (0.49, 1.11) 1.78 (1.27, 2.48)

Daily mean (SD) asthma hospital admissions

Baseline period2 5.5 (3.9) 4.1 (2.8)

Effective period3 3.3 (2.3) 6.2 (3.4)

% change -40 +51.2

1The model included the following variables: an intercept, indicator variables for day of week, calendar year and period, an interaction term of year and period; and smooth functions for temperature, humidity, air pressure

2From September 8 to October 14;3From October 15 to November 4

Table 2 Estimated relative risks and daily mean (SD) of hospital admissions for asthma among the children less than 15 years of age during the post-Asian Game period compared with the baseline period (pre-Asian and Asian Game periods) using a baseline model with an interaction term by year1

Benefits of mitigated ambient air quality due to transportation control on childhood asthma hospitalization during the 2002 Summer Asian Games in

Busan, Korea

• 아시안게임 동안 대기오염 수준이 저감되었음– 자동차 통행량 규제가 도시대기오염을 저감하는 효과적인

대안

• 미세먼지를 포함한 대기오염 저감이 아동천식 입원율 저감과 같은 건강편익을 발생시킨다는 실증적 사례

• 도시대기오염의 경우 자동차 통행량 또는 배출가스규제 등의 관리가 오염도 저감의 효과적인 대안

Arch Environ Health 2003, 58

Air Pollution and Hospital Admissions for Ischemic Heart Diseasesamong Individuals 64+ Years of Age Residing in Seoul, Korea

Air Pollution and Hospital Admissions for Ischemic Heart Diseasesamong Individuals 64+ Years of Age Residing in Seoul, Korea

• 노인들의 경우 보다 취약한 인구집단임

– 미세먼지로 인한 노인들의 허혈성심장질환으로 인한입원 증가

Effect of Air Pollution on Asthma-Related Hospital Admissions for Children by Socioeconomic Status Associated With Area of Residence

Effect of Air Pollution on Asthma-Related Hospital Admissions for Children by Socioeconomic Status Associated With Area of Residence

• 사회경제수준이 낮은 지역에서의 미세먼지 영향이 크게 나타나고 있음

– 사회경제수준이 낮은 지역에 대한 환경관리 우선 필요성

정책적 대안(정리)

• 발생원 특성을 고려한 차별화된 정책

• 도시의 경우 자동차 관련 관리 필요성

• 노인, 임산부와 영유아, 아동에 대한 관리

• 사회경제수준이 낮은 지역에 대한 우선관리

• 건강부담(서울지역)

– 주의보발령: 12~100명의 초과사망자

– 초미세먼지 10 ㎍/㎥: 연간 388~1358명 사망