Long-term exposure to air pollutants significantly increases the morbidity and mortality associated with various diseases. However, little is known about the relationship between air pollutants and end-stage renal disease (ESRD)-related mortality. A total of 5041 patients who started dialysis between 2008 and 2015 were prospectively enrolled in the Clinical Research Center for End-Stage Renal Disease (CRC-ESRD) cohort study. We assigned a daily mean concentration of air pollutants (PM₁₀, NO₂, and SO₂) to each participant. Time-varying Cox models were used to investigate the relationship between air pollutants and mortality in ESRD patients. During the follow-up period (mean 4.18 years), 1475 deaths occurred among 5041 participants. We found a significant long-term relationship between mortality risk and PM₁₀ (HR 1.33, CI 1.13–1.58), NO₂ (HR 1.46, CI 1.10–1.95), and SO₂ (HR 1.07, CI 1.03–1.11). Elderly patients and patients who lived in metropolitan areas had an increased risk associated with PM₁₀. Elderly patients also had increased risks associated NO₂ and SO₂. Long-term exposure to air pollutants had negative effects on mortality in ESRD patients. These effects were prominent in elderly patients who lived in metropolitan areas, suggesting that ambient air pollution, in addition to traditional risk factors, is important for the survival of these patients.

Certain underlying diseases such as diabetic mellitus and hypertension are a risk factor for the severity and mortality of coronavirus disease (COVID-19) patients. Furthermore, both angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) are controversial at role in the process of COVID-19 cases. The aim of the study was to investigate whether underlying diseases and taking ACEi/ARBs, affect the duration of hospitalization and mortality in patients with confirmed COVID-19. Medical usage claims data for the past three years until 15 May 2020, from the “CORONA-19 International Cooperation Research” project was used. We analyzed the medical insurance claims data for all 7590 coronavirus (COVID-19) patients confirmed by RT-PCR tests nationwide up to 15 May 2020. Among the comorbidities, a history of hypertension (hazard ratio [HR], 1.51; 95% confidence interval [CI], 1.056–2.158) and diabetes (HR, 1.867; 95% CI, 1.408–2.475) were associated significantly with mortality. Furthermore, heart failure (HR, 1.391; 95% CI, 1.027–1.884), chronic obstructive pulmonary disease (HR, 1.615; 95% CI, 1.185–2.202), chronic kidney disease (HR, 1.451; 95% CI, 1.018–2.069), mental disorder (HR, 1.61; 95% CI, 1.106–2.343), end stage renal disease (HR, 5.353; 95% CI, 2.185–13.12) were also associated significantly with mortality. The underlying disease has increased the risk of mortality in patients with COVID-19. Diabetes, hypertension, cancer, chronic kidney disease, heart failure, and mental disorders increased mortality. Controversial whether taking ACEi/ARBs would benefit COVID-19 patients, in our study, patients taking ACEi/ARBs had a higher risk of mortality.

As climate change progresses, understanding the impact on human health associated with the temperature and air pollutants has been paramount. However, the predicted effect on temperature associated with particulate matter (PM₁₀) is not well understood due to the difficulty in predicting the local and regional PM₁₀. We compared temperature-attributable mortality for the baseline (2003–2012), 2030s (2026–2035), 2050s (2046–2055), and 2080s (2076–2085) based on a distributed lag non-linear model by simultaneously considering assumed levels of PM₁₀ on historical and projected temperatures under representative concentration pathway (RCP) scenarios. The considered projected PM₁₀ concentrations of 35, 50, 65, 80, and 95 μg/m³ were based on historical concentration quantiles. Our findings confirmed greater temperature-attributable risks at PM₁₀ concentrations above 65 μg/m³ due to the modification effect of the pollutants on temperature. In addition, this association between temperature and PM₁₀ was higher under RCP8.5 than RCP4.5. We also confirmed regional heterogeneity in temperature-attributable deaths by considering PM₁₀ concentrations in South Korea with higher risks in heavily populated areas. These results demonstrated that the modification association of air pollutants on health burdens attributable to increasing temperatures should be considered by researchers and policy makers.