Effects of PM10 on mortality in pure COPD and asthma-COPD overlap: difference in exposure duration, gender, and smoking status.

We investigated the effects of particulate matter (PM) on mortality in patients diagnosed with asthma-COPD overlap (ACO) or 'pure COPD'. Subjects from the National Health Insurance Service-National Sample Cohort of Korea, who were aged 40 years or above and had newly diagnosed COPD since 2009 were selected. Finally, 6,313 patients were enrolled and divided into 'pure COPD' and ACO groups. Average PM10 exposure data were obtained using Kriging interpolation from 2001 to 2013. Hazard ratios(HR) were estimated using a time-varying Cox regression model. Exposure to PM10 for 1, 3, and 6 months was associated with an increase in non-accidental mortality in the entire COPD group, especially the ACO group. When a stratified analysis of 3-month exposure was performed by sex, the highest HR was found in women with ACO (HR = 1.153; 95% confidence intervals [CI]: 1.121, 1.185). A stratified analysis according to smoking status showed that ACO patients had the highest HR among never smokers (HR = 1.151; 95% CI; 1.124, 1.178). Average exposure to PM10 was associated with non-accidental mortality in patients with COPD, especially those diagnosed with ACO. In addition, the adverse effects of PM10 exposure are more severe in women and never-smokers.

Evaluation of mercury exposure level, clinical diagnosis and treatment for mercury intoxication.

Mercury occurs in various chemical forms, and it is different to health effects according to chemical forms. In consideration of the point, the evaluation of the mercury exposure to human distinguished from occupational and environmental exposure. With strict to manage occupational exposure in factory, it is declined mercury intoxication cases by metallic and inorganic mercury inhalation to occupational exposure. It is increasing to importance in environmental exposure and public health. The focus on the health impact of exposure to mercury is more on chronic, low or moderate grade exposure-albeit a topic of great controversy-, not high concentration exposure by methylmercury, which caused Minamata disease. Recently, the issue of mercury toxicity according to the mercury exposure level, health effects as well as the determination of what mercury levels affect health are in the spotlight and under active discussion. Evaluating the health effects and Biomarker of mercury exposure and establishing diagnosis and treatment standards are very difficult. It can implement that evaluating mercury exposure level for diagnosis by a provocation test uses chelating agent and conducting to appropriate therapy according to the result. but, indications for the therapy of chelating agents with mercury exposure have not yet been fully established. The therapy to symptomatic patients with mercury poisoning is chelating agents, combination therapy with chelating agents, plasma exchange, hemodialysis, plasmapheresis. But the further evaluations are necessary for the effects and side effects with each therapy.