{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T20:06:05Z","timestamp":1767211565327,"version":"build-2065373602"},"reference-count":23,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea (NRF)","doi-asserted-by":"publisher","award":["2021R1C1C1013218","20220007"],"award-info":[{"award-number":["2021R1C1C1013218","20220007"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research year of Inje University","award":["2021R1C1C1013218","20220007"],"award-info":[{"award-number":["2021R1C1C1013218","20220007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study aims to examine the association between the occurrence of diabetic foot and air quality (SO2, CO, NO2, O3). Open data were collected to conduct a big data study. Patient information was gathered from the National Health Insurance Service, and the National Institute of Environmental Science\u2019s air quality data were used. A total study population of 347,543 cases were reviewed (case = 13,353, control = 334,190). The lag period from air quality changes to the actual amputation operation was calculated for each factor. The frequency of diabetic foot amputation in each region was identified and analyzed using a distributed lag non-linear model. Gangwon-do showed the highest relative risks (RRs) for SO2 and CO, while Chungcheongnam-do exhibited the highest RR for NO2. Jeju had the highest RR for O3. Regions like Incheon, Busan, and the capital region also showed significant risk increases. These findings emphasize the importance of tailored air quality management to address diabetic foot complications effectively.<\/jats:p>","DOI":"10.3390\/ijerph21060775","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T08:52:10Z","timestamp":1718355130000},"page":"775","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Risk of the Aggravation of Diabetic Foot According to Air Quality Factors in the Republic of Korea: A Nationwide Population-Based Study"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3031-7071","authenticated-orcid":false,"given":"Saintpee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Gangbuk Etteum Hospital, Seoul 01170, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5751-5089","authenticated-orcid":false,"given":"Sungho","family":"Won","sequence":"additional","affiliation":[{"name":"RexSoft Corps, Seoul 08826, Republic of Korea"},{"name":"Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5022-4251","authenticated-orcid":false,"given":"Young","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Foot and Ankle Service, Inje University Paik Central Hospital, Seoul 04551, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"415","DOI":"10.4093\/dmj.2018.0017","article-title":"Diabetes Fact Sheet in Korea, 2016: An Appraisal of Current Status","volume":"42","author":"Won","year":"2018","journal-title":"Diabetes Metab. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1136\/bmj.321.7258.405","article-title":"Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study","volume":"321","author":"Stratton","year":"2000","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.diabres.2013.11.002","article-title":"Global estimates of diabetes prevalence for 2013 and projections for 2035","volume":"103","author":"Guariguata","year":"2014","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(03)13169-8","article-title":"Diabetic foot ulcers","volume":"361","author":"Jeffcoate","year":"2003","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Chun, D.I., Kim, S., Kim, J., Yang, H.J., Kim, J.H., Cho, J.H., Yi, Y., Kim, W.J., and Won, S.H. (2019). Epidemiology and Burden of Diabetic Foot Ulcer and Peripheral Arterial Disease in Korea. J. Clin. Med., 8.","DOI":"10.3390\/jcm8050748"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1080\/19490976.2020.1749754","article-title":"Exposure to air pollutants and the gut microbiota: A potential link between exposure, obesity, and type 2 diabetes","volume":"11","author":"Bailey","year":"2020","journal-title":"Gut Microbes"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1016\/j.ijheh.2017.06.004","article-title":"Associations between long-term exposure to air pollution, glycosylated hemoglobin and diabetes","volume":"220","author":"Honda","year":"2017","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"027008","DOI":"10.1289\/EHP11347","article-title":"Effects of Sociodemographic Characteristics, Comorbidity, and Coexposures on the Association between Air Pollution and Type 2 Diabetes: A Nationwide Cohort Study","volume":"131","author":"Poulsen","year":"2023","journal-title":"Environ. Health Perspec."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.envint.2012.05.002","article-title":"Air pollution and hospitalization for acute complications of diabetes in Chile","volume":"46","author":"Dales","year":"2012","journal-title":"Environ. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"66","DOI":"10.14193\/jkfas.2017.21.2.66","article-title":"A report on diabetic foot and amputation from the Korean health insurance review & assessment service data","volume":"21","author":"Kim","year":"2017","journal-title":"J. Korean Foot Ankle Soc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"315","DOI":"10.4093\/kdj.2009.33.4.315","article-title":"Incidence of diabetic foot and associated risk factors in Type 2 diabetic patients: A five-year observational study","volume":"33","author":"Park","year":"2009","journal-title":"Korean Diabetes J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"372","DOI":"10.4093\/jkda.2006.30.5.372","article-title":"Current status of diabetic foot in Korean patients using national health insurance database","volume":"30","author":"Chung","year":"2006","journal-title":"J. Korean Diabetes Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Won, S.H., Chung, H.-J., Lee, J., Jeon, Y.J., Chun, D.-I., Min, T.-H., Cho, J., Won, S., and Yi, Y. (2021). Diurnal Temperature Ranges in Relation to Lower Limb Amputation Rate of Diabetic Foot in South Korea: A Population Based Nationwide Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18179191"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.3346\/jkms.2019.34.e178","article-title":"Trends in lower limb amputation in patients with diabetic foot based on vascular intervention of peripheral arterial disease in Korea: A population-based nationwide study","volume":"34","author":"Kim","year":"2019","journal-title":"J. Korean Med. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/JOM.0b013e31815dba70","article-title":"The relationship between diabetes mellitus and traffic-related air pollution","volume":"50","author":"Brook","year":"2008","journal-title":"J. Occup. Environ. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3037","DOI":"10.2337\/db12-0190","article-title":"Air pollution and type 2 diabetes: Mechanistic insights","volume":"61","author":"Rajagopalan","year":"2012","journal-title":"Diabetes"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.tem.2015.05.002","article-title":"Epidemiology of air pollution and diabetes","volume":"26","author":"Thiering","year":"2015","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/EDE.0b013e31824523f0","article-title":"Air pollution and markers of coagulation, inflammation and endothelial function: Associations and epigene-environment interactions in an elderly cohort","volume":"23","author":"Bind","year":"2012","journal-title":"Epidemiology"},{"key":"ref_19","unstructured":"Carmona, J.J., Barfield, R.T., Just, A.C., Colicino, E., Testa, P., Pafundi, P., Mehta, A.J., Peng, C., Chen, J., and Schwartz, J. (2013, January 14\u201315). DNA methylation signatures in the Normative Aging Study: Epigenome-wide association analyses of air pollution exposure, biological aging, metabolism, and lung function decline. Proceedings of the PQG Conference 2013, Harvard School of Public Health, Boston, MA, USA."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.diabres.2014.08.010","article-title":"Air pollution and risk of type 2 diabetes mellitus: A systematic review and meta-analysis","volume":"106","author":"Balti","year":"2014","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1289\/ehp.1307823","article-title":"Association between ambient air pollution and diabetes mellitus in Europe and North America: Systematic review and meta-analysis","volume":"123","author":"Eze","year":"2015","journal-title":"Environ. Health Perspect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"92","DOI":"10.2337\/dc11-1155","article-title":"Diabetes incidence and long-term exposure to air pollution: A cohort study","volume":"35","author":"Andersen","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s10654-014-9907-2","article-title":"Systematic review and metaanalysis of air pollution exposure and risk of diabetes","volume":"29","author":"Janghorbani","year":"2014","journal-title":"Eur. J. Epidemiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/6\/775\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:58:47Z","timestamp":1760108327000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/6\/775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,14]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["ijerph21060775"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21060775","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2024,6,14]]}}}