Air pollution and asthma-related hospitalizations in the Malopolska region
More details
Hide details
Katedra Epidemiologii i Medycyny Zapobiegawczej, Uniwersytet Jagielloński – Collegium Medicum, Kraków Kierownik Katedry: prof. dr hab. B. Tobiasz-Adamczyk
Zakład-Centrum Monitorowania i Analiz Stanu Zdrowia Ludności, Narodowy Instytut Zdrowia Publicznego – Państwowy Zakład Higieny, Warszawa Kierownik Zakładu: dr B. Wojtyniak
Agnieszka Pac   

Katedra Epidemiologii i Medycyny Zapobiegawczej Uniwersytet Jagielloński – Collegium Medicum ul. Kopernika 7a, 31-034 Kraków tel. (12) 423 10 03
Med Srod. 2013;16(1):22–27
Asthma is one of the most frequent chronic disease worldwide. Its prevalence has grown rapidly over last years, however the differences between countries are significant.

The purpose of this study was to assess the relation between the number of urgent asthma-related hospital admissions and air pollution in the Malopolska region.

Material and Methods:
We used data collected in the frame of the project “Hospitalization” – the Polish Survey on Overall Hospital Morbidity in Poland. We analyzed hospital records for Malopolska region with primary cause of hospital admission defined as bronchial asthma or status asthmaticus (code J45.* or J46 according to ICD-10) for years 2005–2009. Air pollution data were collected from monitoring station in Malopolska. Poisson regression model was used to assess the impact of air pollution level on number of hospital admissions with adjustment for the daily mean of temperature.

During the years 2005–2009 overall 6942 urgent asthma-related hospital admissions were observed. The level of air pollution during this period was high, for example, mean daily PM10 air pollution level was higher than 50 μg/m3 for more than 30% of days in most monitoring settings. The highest PM10 level was observed to be more than 350 μg/m3. Out of the analyzed pollutant the most important predictor was found to be SO2 with RR=1,039 (95%CI: 1,014–1,064) and PM10 with RR=1,018 (95%CI: 1.008–1.029) for 10 μg/m3 increase of pollutant. We have also examined the effect of air pollution during the previous days on asthma hospitalizations. The effect of air pollution by sulfur dioxide on number of hospital admissions from asthma was also observed with RR=1,051 (95%CI: 1,028–1,075) and by PM10 with RR=1,016 (95%CI: 1,007–1,025) for a seven days delay. In our study we have also observed the relation between air pollution by NO2 in previous days and asthma-related hospital admissions.

The number of asthma hospitalizations, especially those unplanned, probably because of exacerbation of asthma episodes can be reduced by lowering air pollution level.

Bousquet J., Bousquet P.J. Godard P., Daures J.P.: The public health implication of asthma. Bull WHO 2005; 83: 548-554.
Masoli M., Fabian D. Holt S. Beasley R.: The global burden of astma: executive summary of the GINA dissemination committee report. Allergy 2004; 59: 469-478.
Liebhart J., Mololepszy J., Wojtyniak B. i wsp. Prevalence and risk factors for astma in Poland: Results from the PMSEAD Study. J Investig Allergol Clin Immunol 2007; 17(6): 367-374.
Samoliński B., Sybilski A.J., Raciborski F. i wsp.: Występowanie astmy oskrzelowej u dzieci, młodzieży i młodych dorosłych w Polsce świetle badania ECAP. Alergia Astma Immunol 2009; 14(1): 27-34.
Koening J.Q.: Air pollution and astma. J Allergy Clin Immunol 1999; 104: 717-722.
Strachan D.P.: The role of environmental factors in asthma. Br Med Bull 2000; 56: 865-882.
Anandan C., Nurmatov U. i wsp.: Is the prevalence of asthma declining? Systematic review of epidemiological studies. Allergy 2010; 65: 152-167.
Schwartz J., Slater D. i wsp.: Particulate air pollution and and hospital emergency room visits for asthma in Seattle. Am Rev Respir Dis 1993; 147: 826-831.
Ko F.W.S., Tam W. i wsp.: Effects of air pollution on asthma hospitalization rates in different age groups in Hong Kong. Clin Experim Allergy 2007; 37: 1312-1319.
Sunyer J., Spix C. i wsp.: Urban air pollution and emergency admissions for asthma in four European cities: the APHEA project. Thorax 1997; 52: 760-765.
Castellsague J., Sunyer J. i wsp.: Short-term association between air pollution and emergency room visits for asthma in Barcelona. Thorax 1995; 50: 1051-1056.
Atkinson R.W., Anderson H.R. i wsp.: Short-term association between outdoor air pollution and visit to accident and emergency departments in London for respiratory complaints. Eur Resp J 1999; 13: 257-265.