PRACA POGLĄDOWA
Wpływ zanieczyszczenia powietrza na choroby z zakresu otolaryngologii
Więcej
Ukryj
1
Jędrzej Śniadecki Provincial Integrated Hospital, Białystok, Poland
2
Military Institute of Medicine – National Research Institute, Radom, Poland
3
Mix-Med Non-Public Healthcare Facility Arima, Radom, Poland
4
University Clinical Hospital No. 1, Lublin, Poland
Autor do korespondencji
Zuzanna Parfienowicz
Wojewódzki Szpital Zespolony im. Jędrzeja Śniadeckiego w Białymstoku, Wojewódzki Szpital Zespolony im. Jędrzeja Śniadeckiego w Białymstoku, M. Curie-Skłodowskiej 26, 15-950, Białystok, Polska
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
Wprowadzenie i cel:
Zanieczyszczenie powietrza stanowi istotny problem zdrowotny prowadzący do zwiększonej zachorowalności i śmiertelności z powodu chorób układu oddechowego. Zanieczyszczenia, takie jak pyły zawieszone (PM2,5, PM10), dwutlenek azotu, dwutlenek siarki, ozon oraz tlenek węgla, mogą uszkadzać drogi oddechowe poprzez stres oksydacyjny, dysfunkcję bariery nabłonkowej oraz zaburzenia odpowiedzi immunologicznej. Górne drogi oddechowe jako pierwsze mają kontakt z wdychanymi zanieczyszczeniami i są szczególnie narażone na ich szkodliwe działanie. Celem pracy było podsumowanie aktualnej wiedzy dotyczącej wpływu zanieczyszczenia powietrza na choroby laryngologiczne oraz omówienie leżących u ich podstaw mechanizmów.
Opis stanu wiedzy:
Aktualne badania wykazują istotny związek pomiędzy ekspozycją na zanieczyszczenia powietrza a występowaniem chorób takich jak nieżyt nosa, przewlekłe zapalenie zatok przynosowych, zapalenie ucha środkowego oraz choroby krtani. Zarówno krótko-, jak i długoterminowa ekspozycja na zanieczyszczenia zwiększa częstość występowania chorób, nasilenie objawów oraz liczbę kontaktów z ochroną zdrowia. Kluczową rolę w patogenezie odgrywają stres oksydacyjny, przewlekły stan zapalny, uszkodzenie bariery nabłonkowej oraz zaburzenia klirensu śluzowo-rzęskowego. Szczególnie narażone na negatywny wpływ zanieczyszczeń są dzieci oraz osoby starsze.
Podsumowanie:
Zanieczyszczenie powietrza stanowi istotny środowiskowy czynnik ryzyka chorób laryngologicznych. Jego działanie obejmuje różne mechanizmy wspólnie przyczyniające się do rozwoju zarówno ostrych, jak i przewlekłych chorób górnych dróg oddechowych. Uwzględnianie ekspozycji środowiskowej, wdrażanie działań profilaktycznych oraz dalsze badania nad mechanizmami chorób mogą przyczynić się do poprawy profilaktyki i leczenia schorzeń laryngologicznych.
Introduction and objective:
Air pollution is a major environmental health problem associated with increased respiratory morbidity and mortality. Pollutants such as particulate matter (PM2,5, PM10), nitrogen dioxide, sulpher dioxide, ozone, and carbon monoxide may damage the respiratory tract through oxidative stress, epithelial dysfunction, and immune dysregulation. Because the upper airways are the first site of contact with inhaled pollutants, otolaryngological diseases are particularly susceptible to environmental exposure. The aim of this review is to summarize current evidence regarding the impact of air pollution on ENT diseases and their underlying mechanisms.
Brief description of the state of knowledge:
Current studies demonstrate significant associations between air pollution and disorders such as rhinitis, chronic rhinosinusitis, otitis media, and laryngeal diseases. Both short- and long-term exposure to pollutants increase disease incidence, symptom severity, and healthcare utilisation. Oxidative stress, chronic inflammation, epithelial barrier dysfunction, and impaired mucociliary clearance appear to play central roles in disease pathogenesis. Children and the elderly are especially vulnerable to pollution-related upper airway diseases.
Summary:
Air pollution is an important environmental determinant of otolaryngological diseases. Its effects involve inflammatory, oxidative, and structural mechanisms contributing to both acute and chronic upper airway pathology. Recognition of environmental exposure, implementation of preventive strategies, and further research on disease mechanisms may improve prevention and clinical management of ENT disorders.
REFERENCJE (41)
1.
Vilcins D, Christofferson RC, Yoon JH, et al. Updates in Air Pollution: Current Research and Future Challenges. Ann Glob Health. 2024;90(1):9. Epub 20240201. doi:10.5334/aogh.4363. PubMed PMID: 38312715; PubMed Central PMCID: PMC10836163.
2.
Dondi A, Carbone C, Manieri E, et al. Outdoor Air Pollution and Childhood Respiratory Disease: The Role of Oxidative Stress. Int J Mol Sci. 2023;24(5). Epub 20230222. doi:10.3390/ijms24054345. PubMed PMID: 36901776; PubMed Central PMCID: PMC10001616.
3.
Holgate S. Air pollution is a public health emergency. BMJ. 2022;378:o1664. Epub 20220711. doi:10.1136/bmj.o1664. PubMed PMID: 35817464.
4.
Zhang ZQ, Li JY, Guo Q, et al. Association between air pollution and allergic upper respiratory diseases: a meta-analysis. Eur Respir Rev. 2025;34(176). Epub 20250625. doi:10.1183/16000617.0266-2024. PubMed PMID: 40562438; PubMed Central PMCID: PMC12220745.
5.
Liu Y, Wang Y, Dong J, et al. Association between air pollution and emergency department visits for upper respiratory tract infection in Lanzhou, China. Environ Sci Pollut Res Int. 2022;29(19):28816–28. Epub 20220106. doi:10.1007/s11356-021-17932-2. PubMed PMID: 34989991.
6.
Chen F, Zhang J, Xie J, Fu X. Causal relationships between air pollutants and upper respiratory tract infections: A two-sample, Mendelian randomization study. J Chin Med Assoc. 2025;88(6):481–5. Epub 20250430. doi:10.1097/JCMA.0000000000001242. PubMed PMID: 40307969; PubMed Central PMCID: PMC12718758.
7.
Wawryk-Gawda E, Miga-Orczykowska N, Matusiak J, et al. Air pollution exposure and the burden of pediatric upper respiratory tract infections in emergency departments: a retrospective time-series study. Eur J Pediatr. 2025;184(12):753. Epub 20251113. doi:10.1007/s00431-025-06572-0. PubMed PMID: 41225162; PubMed Central PMCID: PMC12612014.
8.
Ratajczak A, Badyda A, Czechowski PO, et al. Air Pollution Increases the Incidence of Upper Respiratory Tract Symptoms among Polish Children. J Clin Med. 2021;10(10). Epub 20210516. doi:10.3390/jcm10102150. PubMed PMID: 34065636; PubMed Central PMCID: PMC8156299.
9.
Glencross DA, Ho TR, Camiña N, et al. Air pollution and its effects on the immune system. Free Radic Biol Med. 2020;151:56–68. Epub 20200130. doi:10.1016/j.freeradbiomed.2020.01.179. PubMed PMID: 32007522.
10.
Huang JY, Feng W, Sang GX, et al. Association between short-term exposure to ambient air pollutants and the risk of hospital visits for acute upper respiratory tract infections among adults: a time-series study in Ningbo, China. BMC Public Health. 2024;24(1):1555. Epub 20240610. doi:10.1186/s12889-024-19030-7. PubMed PMID: 38858655; PubMed Central PMCID: PMC11163729.
11.
Meng L, Liu S, Luo J, et al. Oxidative stress and reactive oxygen species in otorhinolaryngological diseases: insights from pathophysiology to targeted antioxidant therapies. Redox Rep. 2025;30(1):2458942. Epub 20250202. doi:10.1080/13510002.2025.2458942. PubMed PMID: 39894944; PubMed Central PMCID: PMC11792148.
12.
Mihalj H, Butković J, Tokić S, et al. Expression of Oxidative Stress and Inflammation-Related Genes in Nasal Mucosa and Nasal Polyps from Patients with Chronic Rhinosinusitis. Int J Mol Sci. 2022;23(10). Epub 20220515. doi:10.3390/ijms23105521. PubMed PMID: 35628331; PubMed Central PMCID: PMC9145877.
13.
Jeanson L, Kelly M, Coste A, et al. Oxidative stress induces unfolding protein response and inflammation in nasal polyposis. Allergy. 2012;67(3):403–12. Epub 20111222. doi:10.1111/j.1398-9995.2011.02769.x. PubMed PMID: 22188019.
14.
Paciello F, Pisani A, Rolesi R, et al. Noise-Induced Cochlear Damage Involves PPAR Down-Regulation through the Interplay between Oxidative Stress and Inflammation. Antioxidants (Basel). 2021;10(8). Epub 20210726. doi:10.3390/antiox10081188. PubMed PMID: 34439436; PubMed Central PMCID: PMC8388985.
15.
Hirano S, Inufusa H, You F. The Effect of Oxidative Stress on the Human Voice. Int J Mol Sci. 2024;25(5). Epub 20240223. doi:10.3390/ijms25052604. PubMed PMID: 38473848; PubMed Central PMCID: PMC10932051.
16.
McGarry T, Biniecka M, Veale DJ, Fearon U. Hypoxia, oxidative stress and inflammation. Free Radic Biol Med. 2018;125:15–24. Epub 20180327. doi:10.1016/j.freeradbiomed.2018.03.042. PubMed PMID: 29601945.
17.
Burte E, Leynaert B, Marcon A, et al. Long-term air pollution exposure is associated with increased severity of rhinitis in 2 European cohorts. J Allergy Clin Immunol. 2020;145(3):834–42.e6. Epub 20200123. doi:10.1016/j.jaci.2019.11.040. PubMed PMID: 31983528.
18.
Salcan S, Salcan I. The correlation between air pollution and the allergic rhinitis incidence: Erzincan model. Eur Rev Med Pharmacol Sci. 2023;27(2 Suppl):51–6. doi:10.26355/eurrev_202303_31702. PubMed PMID: 36971221.
19.
Chen SW, Tsai SC, Chang KH, et al. Air Pollution-Associated Rhinitis: Exploring the Preventive Role of Nutritional Supplements Against Particulate Matter-Induced Inflammation. Nutrients. 2025;17(5). Epub 20250227. doi: 10.3390/nu17050829. PubMed PMID: 40077699; PubMed Central PMCID: PMC11902121.
20.
Liu L, Ma J, Peng S, Xie L. Prenatal and early-life exposure to traffic-related air pollution and allergic rhinitis in children: A systematic literature review. PLoS One. 2023;18(4):e0284625. Epub 20230420. doi: 10.1371/journal.pone.0284625. PubMed PMID: 37079576; PubMed Central PMCID: PMC10118164.
21.
Leland EM, Vohra V, Seal SM, et al. Environmental air pollution and chronic rhinosinusitis: A systematic review. Laryngoscope Investig Otolaryngol. 2022;7(2):349–60. Epub 20220311. doi:10.1002/lio2.774. PubMed PMID: 35434330; PubMed Central PMCID: PMC9008184.
22.
Peeters S, Wang C, Bijnens EM, et al. Association between outdoor air pollution and chronic rhinosinusitis patient reported outcomes. Environ Health. 2022;21(1):134. Epub 20221221. doi:10.1186/s12940-022-00948-7. PubMed PMID: 36544141; PubMed Central PMCID: PMC9769041.
23.
Leland EM, Zhang Z, Kelly KM, Ramanathan M. Role of Environmental Air Pollution in Chronic Rhinosinusitis. Curr Allergy Asthma Rep. 2021;21(8):42. Epub 20210909. doi:10.1007/s11882-021-01019-6. PubMed PMID: 34499234; PubMed Central PMCID: PMC8590820.
24.
Czerwaty K, Piszczatowska K, Brzost J, et al. Immunological Aspects of Chronic Rhinosinusitis. Diagnostics (Basel). 2022;12(10). Epub20220929. doi:10.3390/diagnostics12102361. PubMed PMID: 36292050; PubMed Central PMCID: PMC9600442.
25.
Zhang Z, Kamil RJ, London NR, et al. Long-Term Exposure to Particulate Matter Air Pollution and Chronic Rhinosinusitis in Nonallergic Patients. Am J Respir Crit Care Med. 2021;204(7):859–62. doi:10.1164/rccm.202102-0368LE. PubMed PMID: 34181862; PubMed Central PMCID: PMC8528530.
26.
Li C, Jiang X, Wei Y, et al. Air pollutants, seasonal influenza, and acute otitis media in children: a population-based analysis using 22-year hospitalization data. BMC Public Health. 2024;24(1):1581. Epub 20240613. doi:10.1186/s12889-024-18962-4. PubMed PMID: 38867184; PubMed Central PMCID: PMC11170825.
27.
Zemek R, Szyszkowicz M, Rowe BH. Air pollution and emergency department visits for otitis media: a case-crossover study in Edmonton, Canada. Environ Health Perspect. 2010;118(11):1631–6. doi:10.1289/ehp.0901675. PubMed PMID: 20663739; PubMed Central PMCID: PMC2974705.
28.
Park M, Han J, Park J, et al. Particular matter influences the incidence of acute otitis media in children. Sci Rep. 2021;11(1):19730. Epub 20211005. doi:10.1038/s41598-021-99247–3. PubMed PMID: 34611241; PubMed Central PMCID: PMC8492675.
29.
Brauer M, Gehring U, Brunekreef B, et al. Traffic-related air pollution and otitis media. Environ Health Perspect. 2006;114(9):1414–8. doi:10.1289/ehp.9089. PubMed PMID: 16966098; PubMed Central PMCID: PMC1570088.
30.
Girguis MS, Strickland MJ, Hu X, et al. Exposure to acute air pollution and risk of bronchiolitis and otitis media for preterm and term infants. J Expo Sci Environ Epidemiol. 2018;28(4):348–57. Epub 20171221. doi:10.1038/s41370-017-0006-9. PubMed PMID: 29269754; PubMed Central PMCID: PMC6013343.
31.
He KJ, Xu Z, Xu J, Gong G. Global and national burden of tracheal, bronchus, and lung cancer attributabled to household air pollution from solid fuels in populations aged 55 and above: an integrated study of frontier and joinpoint regression analysis. BMC Public Health. 2025;25(1):1249. Epub 20250403. doi:10.1186/s12889-025-22466-0. PubMed PMID: 40181324; PubMed Central PMCID: PMC11966841.
32.
Lao S, Li J, Li W, et al. Global trends in the burden of tracheal, bronchus, and lung cancer attributable to household air pollution. J Thorac Dis. 2025;17(11):9943–57. Epub 20251126. doi:10.21037/jtd-2025-1309. PubMed PMID: 41376946; PubMed Central PMCID: PMC12688501.
33.
Steuer CE, El-Deiry M, Parks JR, et al. An update on larynx cancer. CA Cancer J Clin. 2017;67(1):31–50. Epub 20161129. doi:10.3322/caac.21386. PubMed PMID: 27898173.
34.
Liu X, Yang Q, Pan L, et al. Burden of respiratory tract cancers in China and its provinces, 1990–2021: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Reg Health West Pac. 2025;55:101485. Epub 20250130. doi:10.1016/j.lanwpc.2025.101485. PubMed PMID: 39968450; PubMed Central PMCID: PMC11833622.
35.
Levendoski EE, Leydon C, Thibeault SL. Vocal fold epithelial barrier in health and injury: a research review. J Speech Lang Hear Res. 2014;57(5):1679–91. doi:10.1044/2014_JSLHR-S-13-0283. PubMed PMID: 24686981; PubMed Central PMCID: PMC4557797.
36.
Li J, Feng C, Ma X, Wu D. Impact of the urban atmospheric environment on otolaryngologic disease outpatient visits in Lanzhou, China. Sci Rep. 2025;15(1):21556. Epub 20250701. doi:10.1038/s41598-025-07352-4. PubMed PMID: 40595082; PubMed Central PMCID: PMC12216470.
37.
Eguiluz-Gracia I, Mathioudakis AG, Bartel S, et al. The need for clean air: The way air pollution and climate change affect allergic rhinitis and asthma. Allergy. 2020;75(9):2170–84. Epub 20200130. doi:10.1111/all.14177. PubMed PMID: 31916265.
38.
Ding N, Zhou N, Zhou M, Ren GM. Respiratory cancers and pollution. Eur Rev Med Pharmacol Sci. 2015;19(1):31–7. PubMed PMID: 25635972.
39.
Massey CJ, Tullis B, Johnson C, et al. Characterizing air pollution exposure methodologies in rhinology: a scoping review. Int J Environ Health Res. 2025;35(11):3588–603. Epub 20250313. doi:10.1080/09603123.2025.2477585. PubMed PMID: 40079501; PubMed Central PMCID: PMC13019986.
40.
Xue Y, Chu J, Li Y, Kong X. The influence of air pollution on respiratory microbiome: A link to respiratory disease. Toxicol Lett. 2020;334:14–20. Epub 20200916. doi:10.1016/j.toxlet.2020.09.007. PubMed PMID: 32949622.
41.
Bowatte G, Tham R, Perret JL, et al. Air Pollution and Otitis Media in Children: A Systematic Review of Literature. Int J Environ Res Public Health. 2018;15(2). Epub 20180203. doi:10.3390/ijerph15020257. PubMed PMID: 29401661; PubMed Central PMCID: PMC5858326.