Disability-Adjusted Life Years in the Assessment of Health Effects of Traffic-Related Air Pollution. In: Pokorski M, editor. Environment Exposure to Pollutants. Cham: Springer International Publishing; 2015. pp. 15-20. [DOI: 10.1007/5584_2014_11]

Influence of Selected Air Pollutants on Mortality and Pneumonia Burden in Three Polish Cities over the Years 2011-2018

Poland has one of the worst air qualities in the European Union, particularly regarding concentrations of particulate matter (PM). This study aimed to evaluate the short-term effects of air pollution and weather conditions on all-cause mortality and pneumonia-related hospitalizations in three Polish agglomerations. We investigated data from 2011 to 2018 on a number of health outcomes, concentrations of PM2.5, PM10, nitrogen dioxide (NO2), ozone (O3), and selected meteorological parameters. To examine the impact of air pollutants and weather conditions on mortality and pneumonia burden, we identified optimal general regression models for each agglomeration. The final models explained <24% of the variability in all-cause mortality. In the models with interactions, O3 concentration in Warsaw, NO2, O3, and PM2.5 concentrations in Cracow and PM10 and O3 concentrations in the Tricity explained >10% of the variability in the number of deaths. Up to 46% of daily variability in the number of pneumonia-related hospitalizations was explained by the combination of both factors, i.e., air quality and meteorological parameters. The impact of NO2 levels on pneumonia burden was pronounced in all agglomerations. We showed that the air pollution profile and its interactions with weather conditions exert a short-term effect on all-cause mortality and pneumonia-related hospitalizations. Our findings may be relevant for prioritizing strategies to improve air quality.

SH-29 and SK-119 Attenuates Air-Pollution Induced Damage by Activating Nrf2 in HaCaT Cells

Air pollution has been repeatedly linked to numerous health-related disorders, including skin sensitization, oxidative imbalance, premature extrinsic aging, skin inflammation, and increased cancer prevalence. Nrf2 is a key player in the endogenous protective mechanism of the skin. We hypothesized that pharmacological activation of Nrf2 might reduce the deleterious action of diesel particulate matter (DPM), evaluated in HaCaT cells. SK-119, a recently synthesized pharmacological agent as well as 2,2′-((1E,1′E)-(1,4-phenylenebis(azaneylylidene))bis(methaneylylidene))bis(benzene-1,3,5-triol) (SH-29) were first evaluated in silico, suggesting a potent Nrf2 activation capacity that was validated in vitro. In addition, both compounds were able to attenuate key pathways underlying DPM damage, including cytosolic and mitochondrial reactive oxygen species (ROS) generation, tested by DC-FDA and MitoSOX fluorescent dye, respectively. This effect was independent of the low direct scavenging ability of the compounds. In addition, both SK-119 and SH-29 were able to reduce DPM-induced IL-8 hypersecretion in pharmacologically relevant concentrations. Lastly, the safety of both compounds was evaluated and demonstrated in the ex vivo human skin organ culture model. Collectively, these results suggest that Nrf2 activation by SK-119 and SH-29 can revert the deleterious action of air pollution.

Estimating Health Impacts Due to the Reduction of Particulate Air Pollution from the Household Sector Expected under Various Scenarios

Emissions from the household sector are the most significant source of air pollution in Poland, one of the most polluted countries in the EU. Estimated health impacts of the reduction of these emissions under three scenarios are presented. The EMEP4PL model and base year emission inventory were used to estimate average annual PM10 and PM2.5 concentrations with spatial resolution of 4 km × 4 km. The change in emissions under each of the scenarios was based on data from a survey on household boilers and insulation. Scenario 1 included replacement of all poor-quality coal-fired boilers with gas boilers; Scenario 2 included replacement of all poor-quality coal-fired boilers with low-emission boilers but still using solid fuels; and Scenario 3 included the thermal refurbishment of houses with the worst insulation. Impacts on the following health parameters were estimated: premature deaths (PD), Chronic Bronchitis (CB), Bronchitis in Children (BiC) and Work Days Lost (WDL). The concentration–response functions recommended by the WHO HRAPIE project were used. The analysis was conducted for two regions: Lower Silesia and Lodzkie province. The largest reduction of health impact was observed for Scenario 1. For Lower Silesia, the annual PD decreased by 1122 (34.3%), CB by 1516 (26.6%), BiC by 9602 (27.7%) and WDL by 481k (34.7%). For Lodzkie province, the largest impacts were estimated as decreases in PD by 1438 (29.9%), CB by 1502 (25.3%), BiC by 9880 (26.8%) and WDL by 669k (30.4%).

Are BBQs Significantly Polluting Air in Poland? A Simple Comparison of Barbecues vs. Domestic Stoves and Boilers Emissions

The study attempts to compare the total annual emissions of selected air pollutants emitted during occasional grilling and the emission of the same pollutants from small domestic heating installations. For this purpose, in the absence of any data on the emission of pollutants during grilling processes, tests were carried out consisting of measuring the concentration of air pollutants in exhaust streams from two types of grills (solid fuel grill powered by charcoal briquette and gas grill powered by liquid propane), using popularly prepared dishes (previously marinated meat and raw, seasoned mixed vegetables). The concentrations of PM2.5, CH4, CO, CO2, H2O, NH3, N2O, NO, NO2, SO2 were measured in the exhaust stream from both grills using a particulate matter (PM) measuring device and a portable spectrometer, separately while grilling the same portions of meat and vegetables. Then, considering the available data on Poles’ barbecue habits, the emissions that are released into the air during occasional grilling were estimated. The calculated emissions were compared with the data on emissions from domestic heating installations used in Poland. It has been shown that during grilling, as much as 2.30, 92.07, 4.11, 3.83, 2.96, and 9.81 Gg of PM2.5, CO, NOx, SO2, NH3, and CH4 may be released into the atmosphere in Poland, respectively. In the case of PM, the amount of the pollutant emitted to the air is over 100 times lower than the emissions caused by the operation of small heating installations. In the case of other pollutants, the differences are smaller. Nevertheless, emissions from grills should not be underestimated as, in certain periods of the year, these sources may be responsible for not meeting the air quality standards in selected areas of the country, and thus the excessive exposure of people to pollutants resulting in negative health consequences. Therefore, attention was paid to the legitimacy of abandoning the use of charcoal and charcoal briquette grills and replacing them with gas-powered grills or electric ones, not only due to the health benefits of food and lower human exposure, but also by the reason of ecological values.

Oxidative potential of size-fractionated atmospheric aerosol in urban and rural sites across Europe

In this study we applied several assays, an in vitro rat alveolar macrophage model, a chemical ROS probe (DTT, dithiothreitol), and cytokine induction (TNFα) to examine relationships between PM-induced generation of reactive oxygen species (ROS) and PM composition, using a unique set of size-resolved PM samples obtained from urban and rural environments across Europe. From April-July 2012, we collected PM from roadside canyon, roadside motorway, and background urban sites in each of six European cities and from three rural sites spanning the continent. A Hi-Vol sampler was used to collect PM in three size classes (PM>7, PM7-3, PM3) and PM was characterized for total elements, and oxidative activity quantified in unfiltered and filtered PM extracts. We measured a remarkable uniformity in air concentrations of ROS and especially DTT activity across the continent. Only a 4-fold difference was documented for DTT across the urban sites and a similar variance was documented for ROS, implying that chemical drivers of oxidative activity are relatively similar between sites. The ROS and DTT specific activity was greater at urban background sites (and also rural sites) than at urban canyon locations. PM3 dominated the size distribution of both ROS activity (86% of total) and DTT activity (76% of total), reflecting both the large contribution of PM3 to total PM mass levels and importantly the higher specific oxidative activity of the PM3 in comparison with the larger particles. The soluble fraction of total activity was very high for DTT (94%) as well as for ROS (64%) in the PM3. However in the larger PM size fractions the contributions of the insoluble components became increasingly significant. The dominance of the insoluble PM drivers of activity was particularly evident in the TNFα data, where the insoluble contribution to cytokine production could be 100-fold greater than that from soluble components. ROS and DTT activity were strongly correlated in the PM3 (r = 0.93), however oxidative activity was not correlated with any measured inorganic element in this size cut. In contrast, significant correlations of both ROS and DTT oxidative activity with specific groups of chemical elements were documented in the larger PM size fractions.

Burden of Mortality and Disease Attributable to Multiple Air Pollutants in Warsaw, Poland

Air pollution is a significant public health issue all over the world, especially in urban areas where a large number of inhabitants are affected. In this study, we quantify the health burden due to local air pollution for Warsaw, Poland. The health impact of the main air pollutants, PM, NO_X, SO₂, CO, C₆H₆, BaP and heavy metals is considered. The annual mean concentrations are predicted with the CALPUFF air quality modeling system using the year 2012 emission and meteorological data. The emission field comprises point, mobile and area sources. The exposure to these pollutants was estimated using population data with a spatial resolution of 0.5 × 0.5 km². Changes in mortality and in disability-adjusted life-years (DALYs) were estimated with relative risk functions obtained from literature. It has been predicted that local emissions cause approximately 1600 attributable deaths and 29,000 DALYs per year. About 80% of the health burden was due to exposure to fine particulate matter (PM_2.5). Mobile and area sources contributed 46% and 52% of total DALYs, respectively. When the inflow from outside was included, the burden nearly doubled to 51,000 DALYs. These results indicate that local decisions can potentially reduce associated negative health effects, but a national-level policy is required for reducing the strong environmental impact of PM emissions.

Characteristics of PM2.5 Concentrations across Beijing during 2013-2015

High concentrations of particulate matter (PM_2.5) and frequent air pollution episodes in Beijing have attracted widespread attention. This paper utilizes data from the new air pollution network in China to examine the current spatial and temporal variability of PM_2.5 at 12 monitoring sites in Beijing over a recent 2-year period (April 2013) to March 2015). The long term (2-year) average concentration was 83 µg·m^-3, well above Chinese and international standards. Across the region, annual average concentrations varied by 20 µg·m^-3 (25% of the average level), with lower levels in suburban areas compared to periurban and urban areas, which had similar concentrations. The spatial variation in PM_2.5 concentrations was associated with several land use and economic variables, including the fraction of vegetated land and building construction activity, which together explained 71% of the spatial variation. Daily air quality was characterized as "polluted" (above 75 µg·m^-3) on 36 to 47% of days, depending on site. There were 77 pollution episodes during the study period (defined as two or more consecutive days with Beijing-wide 24-hour average concentrations over 75 µg·m^-3), and 2 to 5 episodes occurred each month, including summer months. The longest episode lasted 9 days and daily concentrations exceeded 450 µg·m^-3. Daily PM_2.5 levels were autocorrelated (r_lag1 = 0.516) and associated with many meteorological variables, including barometric pressure, relative humidity, hours of sunshine, surface and ambient temperature, precipitation and scavenging coefficient, and wind direction. Parsimonious models with meteorological and autoregressive terms explained over 60% of the variation in daily PM_2.5 levels. The first autoregressive term and hours of sunshine were the most important variables in these models, however, the latter variable is PM_2.5-dependent and thus not an explanatory variable. The present study can serve as a baseline to compare the improved air quality in Beijing expected in future years.

Socioeconomic Effects of Chronic Obstructive Pulmonary Disease from the Public Payer's Perspective in Poland

Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of death worldwide and the total number of people affected reaches over 200 million. It is estimated that approximately 50 % of persons having COPD are not aware of it. In the EU, it is estimated that the total annual costs of COPD exceed €140 billion, and the expected increase in the number of cases and deaths due to COPD would further enhance economic and social costs of the disease. In this article we present the results of cost analysis of health care benefits associated with the treatment of COPD and with the disease-related incapacity for work. The analysis is based on the data of the National Health Fund and the Social Insurance Institutions, public payers of health benefits in Poland. The annual 2012 expenditures incurred for COPD treatment was €40 million, and the benefits associated with incapacity for work reached more than €55 million. The extent of these expenditures indicates that it is necessary to optimize the functioning system, including the allocation of resources for prevention, social awareness, and detection of COPD at early stages when treatment costs are relatively low.

Repeated exposures to roadside particulate matter extracts suppresses pulmonary defense mechanisms, resulting in lipid and protein oxidative damage

Exposure to particulate matter (PM) pollution in cities and urban canyons can be harmful to the exposed population. However, the underlying mechanisms that lead to health effects are not yet elucidated. It is postulated that exposure to repeated, small, environmentally relevant concentrations can affect lung homeostasis. This study examines the impact of repeated exposures to urban PM on mouse lungs with focus on inflammatory and oxidative stress parameters. Aqueous extracts from collected urban PM were administered to mice by 5 repeated intra-tracheal instillations (IT). Multiple exposures, led to an increase in cytokine levels in both bronchoalveolar lavage fluid and in the blood serum, indicating a systemic reaction. Lung mRNA levels of antioxidant/phase II detoxifying enzymes decreased by exposure to the PM extract, but not when metals were removed by chelation. Finally, disruption of lung tissue oxidant-inflammatory/defense balance was evidenced by increased levels of lipid and protein oxidation. Unlike response to a single IT exposure to the same dose and source of extract, multiple exposures result in lung oxidative damage and a systemic inflammatory reaction. These could be attributed to compromised capacity to activate the protective Nrf2 tissue defense system. It is suggested that water-soluble metals present in urban PM, potentially from break and tire wear, may constitute major drivers of the pulmonary and systemic responses to multiple exposure to urban PM.

Single Exposure to near Roadway Particulate Matter Leads to Confined Inflammatory and Defense Responses: Possible Role of Metals

Inhalation of traffic-associated atmospheric particulate matter (PM2.5) is recognized as a significant health risk. In this study, we focused on a single ("subclinical response") exposure to water-soluble extracts from PM collected at a roadside site in a major European city to elucidate potential components that drive pulmonary inflammatory, oxidative, and defense mechanisms and their systemic impacts. Intratracheal instillation (IT) of the aqueous extracts induced a 24 h inflammatory response characterized by increased broncho-alveolar lavage fluid (BALF) cells and cytokines (IL-6 and TNF-α), increased reactive oxygen species production, but insignificant lipids and proteins oxidation adducts in mouse lungs. This local response was largely self-resolved by 48 h, suggesting that it could represent a subclinical response to everyday-level exposure. Removal of soluble metals by chelation markedly diminished the pulmonary PM-mediated response. An artificial metal solution (MS) recapitulated the PM extract response. The self-resolving nature of the response is associated with activating defense mechanisms (increased levels of catalase and glutathione peroxidase expression), observed with both PM extract and MS. In conclusion, metals present in PM collected near roadways are largely responsible for the observed transient local pulmonary inflammation and oxidative stress. Simultaneous activation of the antioxidant defense response may protect against oxidative damage.