The Relationship between Daily Concentration of Fine Particulate Matter in Ambient Air and Exacerbation of Respiratory Diseases in Silesian Agglomeration, Poland

Abstract

The relationship between the worsening of air quality during the colder season of the year and respiratory health problems among the exposed population in many countries located in cold climates has been well documented in numerous studies. Silesian Voivodeship, a region located in southern Poland, is one of the most polluted regions in Europe. The aim of this study was to assess the relationship between daily concentration of particulate matter (PM: PM2.5 and PM10) in ambient air and exacerbations of respiratory diseases during the period from 1 January 2016 to 31 August 2017 in the central agglomeration area of Silesian Voivodeship. The study results confirmed a significant increase of daily fine particulate matter concentration in ambient air during the cold season in Silesian Voivodeship with a simultaneous increase of the number of outpatient visits and hospitalizations due to respiratory diseases. The moving average concentration was better suited for the modelling of biological response as a result of PM2.5 or PM10 exposure than the temporal lag of health effects. Each increase of dose expressed in the form of moving average concentration over a longer time leads to an increase in the daily number of respiratory effects. The highest risk of hospitalization due to respiratory diseases was related to longer exposure of PM expressed by two to four weeks of exposure; outpatient visits was related to a shorter exposure duration of 3 days.

Effect of NOx and NO2 Concentration Increase in Ambient Air to Daily Bronchitis and Asthma Exacerbation, Silesian Voivodeship in Poland

“…Results of previous studies suggest clear evidence of PM 10 effects on the occurrence of asthma symptom episodes, however in the case of NO 2 exposure it is difficult to interpret obtained results due to health effects depending on the examined time lags [7,9]. Moreover, in our study, the estimated Spearman correlation coefficients between NO x , NO 2 and particulate matter concentration in ambient air were very high, which makes the separation of the health effects for different pollutants difficult [2].We believe that the results of our study will help to assess the separate risk of daily outpatient visits and hospitalization due to bronchitis and asthma exacerbation in relation to nitrogen oxides exposure. We understand that obtained results can help to improve the inhabitants' knowledge on the real hazard, and will reinforce the social activity needed to improve the quality of ambient air, including acceptance for the need of modernization the heating system and the restriction of individual road transport in crowded cities.…”

“…Results of previous studies suggest clear evidence of PM 10 effects on the occurrence of asthma symptom episodes, however in the case of NO 2 exposure it is difficult to interpret obtained results due to health effects depending on the examined time lags [7,9]. Moreover, in our study, the estimated Spearman correlation coefficients between NO x , NO 2 and particulate matter concentration in ambient air were very high, which makes the separation of the health effects for different pollutants difficult [2].…”

“…In the case of hospitalizations, the health effect was lagged a few days in relation to the increase in exposure.The main task of the current study was to assess the risk related to NO x and NO 2 concentration increase and daily outpatient visits or hospitalization due to bronchitis and asthma exacerbation in the entire population of Silesian Voivodeship. Results of the previous study confirmed, that daily outpatient visits and hospitalizations due to respiratory diseases significantly increase with the worsening of ambient air quality due to an increase of PM 10 and PM 2.5 concentration during the cold season in the study area [2]. Among all NO x and NO 2 sources motor vehicle emission and also energy production are the most important [1].…”

“…Data on daily registered outpatient visits or hospitalizations due to bronchitis (J20-J21 by ICD-10) and asthma exacerbation (J45-J46 by ICD-10) in the study period (1 January 2016 to 31 August 2017) were obtained from the National Health Fund database in Katowice. The final database included health outcomes registered for about 2.5 million inhabitants of the central agglomeration area located in the Silesian voivodeship [2]. The total number of outpatient visits due to bronchitis and asthma exacerbation in the study period was the highest in the winter period and the lowest in the summertime.…”

“…While in the case of fine dust exposure (PM 2.5 ) the number of premature deaths in Poland is one of the highest in Europe, in the case of exposure to NO 2 the health effects in Poland are definitely lower [1]. The unfavourable situation was recognized in southern part of the country, such as Lesser Poland (Małopolska) and Silesian Voivodships for many reasons [2]; first because of the unfavourable geographical location (lowland surrounded by hills), secondly because of the high density of population living in both regions [3] and also high traffic intensity [4,5], finally because of pronounced coal combustion in individual heating stoves in this area [1,6].…”