Objectives: Many studies have shown that air pollution and temperature have adverse effects on mortality and morbidity. But the interactive effect between air pollution and temperature on mortality has been rarely investigated. This study aims to explore whether temperature modifies the associations between ambient particulate matter less than 10 μm in diameter (PM10) and mortality in Seoul, Korea. Methods: The time-series analysis examined the effect of the interaction between PM10 and temperature on mortality from 1999 to 2010 in Seoul. In order to examine the interactive effect between PM10 and temperature on mortality, we fitted a response surface model controlling the time-trends and meteorological variables. The effects of PM10 were stratified by temperature stratum to quantitatively estimate the PM10-health outcome associations. Results: When temperature was low (below the threshold temperature), the percentage increases per 10 μg/m3 increase of PM10 increased 0.38% (95% Confidence Interval[CI]: 0.09~0.68%) and 0.31% (95% CI: - 0.07~0.68%) of mortality in the all age group and ≥ 65 year age group, respectively. When temperature was high (above the threshold temperature), the percentage increases per 10 μg/m3 increase of PM10 increased 1.09% (95% CI: 0.47~1.72%) and 1.35% (95% CI: 0.65~2.06%) for mortality in the all age group and ≥ 65 year age group, respectively. Conclusion: The results of this study showed strong modification by temperature in the association between PM10 and mortality. We recommend that public health strategies to minimize adverse health impact of heat and PM10 should be considered in control and prevention measures for air pollution and weather-related health impacts.
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