Background

Migraine is a chronic and agonizing neurological disorder prevalent worldwide. Although its pathogenesis remains unclear, limited evidence exists on the role of air pollution.

Objective

We aimed to assess the association of short-term air pollution exposure with migraine in conjunction with the synergistic effect of temperature.

Methods

We identified 18,921 patients who visited emergency departments (EDs) for migraine as a primary disease in Seoul from the national emergency database between 2008 and 2014. We conducted a time-stratified, case-crossover analysis to compare levels of particles <2.5 μm (PM_2.5), particles <10 μm (PM₁₀), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), ozone (O₃), and carbon monoxide (CO) on ED visit days and those on the control days matched to day of the week, month, and year. We evaluated the synergistic effects of air pollution and temperature using an interaction term.

Results

Higher air pollution levels were significantly associated with risk of migraine over various lag structures. In the best fitting lags, the odds ratio (OR) associated with an interquartile range increase of PM_2.5, PM₁₀, NO₂, O₃, and CO was 1.031 (95% CI: 1.010–1.053), 1.032 (95% CI: 1.007–1.057), 1.053 (95% CI: 1.022–1.085), 1.034 (95% CI: 1.001–1.067), and 1.029 (95% CI: 1.005–1.053), respectively. The SO₂ effect was positive but not significant (OR 1.019 [95% CI: 0.991–1.047]). The PM effect was significantly stronger on high-temperature days (above the 75th percentile) than on low-temperature days (PM_2.5, high: OR 1.068, low: OR 1.021, P_interact = 0.03; PM₁₀, high: OR 1.066, low: OR 1.014, P_interact = 0.02).

Conclusion

Our study provides new evidence that air pollution exposure may trigger migraine especially on high-temperature days, and this finding may contribute in establishing preventive measures against migraine.

中文翻译：

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暴露于环境空气污染和偏头痛的风险：与高温的协同效应

背景

偏头痛是一种在世界范围内普遍存在的慢性激动性神经疾病。尽管其发病机理仍不清楚，但关于空气污染作用的证据有限。

客观的

我们旨在评估短期空气污染暴露与偏头痛以及温度的协同效应之间的关系。

方法

我们从2008年至2014年的国家急诊数据库中，确定了18,921名在首尔市因急诊就诊为偏头痛的急诊室（ED）的患者。我们进行了时间分层的病例交叉分析，比较了<2.5μm（PM）的颗粒水平。_2.5），在ED访问日和控制日的<10μm（PM ₁₀ ），二氧化氮（NO ₂ ），二氧化硫（SO ₂ ），臭氧（O ₃ ）和一氧化碳（CO）的颗粒与星期，月份和年份的日期。我们使用一个相互作用项评估了空气污染和温度的协同效应。

结果

较高的空气污染水平与各种滞后结构的偏头痛风险显着相关。在最佳拟合滞后中，与PM _2.5，PM ₁₀，NO ₂，O ₃和CO的四分位数间距增加相关的优势比（OR）为1.031（95％CI：1.010–1.053），1.032（95％CI ：1.007–1.057），1.053（95％CI：1.022–1.085），1.034（95％CI：1.001–1.067）和1.029（95％CI：1.005–1.053）。SO _2的作用是积极的，但不显着（OR 1.019 [95％CI：0.991–1.047]）。在高温天（高于第75个百分位数）时，PM效应明显强于低温天（PM _2.5，高：OR 1.068，低：OR 1.021，P_{相互作用）} = 0.03; PM ₁₀，高：OR 1.066，低：OR 1.014，P _interact  = 0.02）。

结论

我们的研究提供了新的证据，表明空气污染暴露可能会引发偏头痛，尤其是在高温天，这一发现可能有助于建立预防偏头痛的措施。