Association between air pollution and paediatric intestinal intussusception in Seoul, Korea: a time-series regression approach

OBJECTIVES: The impact of air pollution on gastrointestinal diseases remains unclear. This study examines the association between air pollutants and paediatric intussusception incidence. METHODS: Using data from the Health Insurance Review and Assessment Service (HIRA), we analysed daily intussusception cases in Seoul (2009-2019). Air pollutants, including particulate matter (PM10), ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO), and sulphur dioxide (SO2), were assessed alongside temperature. A generalized linear model with a negative binomial link function evaluated the relationship between each pollutant and intussusception incidence, adjusting for long-term trends and seasonality. A distributed lag non-linear model (DLNM) examined non-linear cumulative lag effects. RESULTS: In the model without lag and non-linear effects, NO2 was significantly associated with intussusception incidence, while other pollutants and temperature showed no significant associations. DLNM analysis with a 3-day cumulative lag demonstrated a gradual increase in intussusception incidence with rising NO2 levels, with significant rate ratio changes at lag 0 and lag 1 but not at lag 2 or lag 3. Extending the cumulative lag to 2, 4 and 5 days showed progressively decreasing significant intervals. CONCLUSION: These findings suggest a potential link between NO2 exposure and paediatric intussusception. Further studies are needed to clarify underlying mechanisms.