Impact of Air Pollution on Lung Function among Preadolescent Children in Two Cities in Poland

Traffic-Related Air Pollution (TRAP) in relation to respiratory symptoms and lung function of school-aged children in Kuala Lumpur

Traffic-Related Air Pollution (TRAP) exposure has been connected to significant health impacts among children. A cross-sectional comparative study was conducted among school children in Malaysia to determine the relationship between their exposure to TRAP and respiratory health effects. Air monitoring was conducted in schools and residences, while the children's routines were investigated using a diary of daily activities. Respondents' background and respiratory symptoms were obtained from a validated questionnaire, while a spirometry test was performed to determine their lung function status. The distances between schools and residences from the had contributed to the higher concentration of air pollutants in this study, which had associations with the children's respiratory symptoms and lung function status. PM2.5 was the main predictor influencing the respondents' respiratory symptoms and lung function abnormalities. In conclusion, exposure of school children to a high TRAP level might increase their risk of getting respiratory symptoms and lung function reduction.

The Prevalence of Atopic Dermatitis and Food Allergy in Children Living in an Urban Agglomeration-Is There a Current Relationship?

Atopic dermatitis (AD) prevalence in Poland is more frequent in individuals who live in a city. There are more studies demonstrating that long-term exposure to air pollutants is an independent risk factor for developing AD. The aim of the study was to assess the epidemiology of AD and food allergy (FA) in school children and adolescents living in Krakow, and to find a potential relationship between the incidence of atopic dermatitis with exposure to polluted air. In this paper, we presented the incidence of AD and FA between 2014 and 2018. We analyzed data collected from nearly 30,000 children aged 7-8 and adolescents aged 16-17 from the population of children and youth in Krakow. We correlated it with annual mean concentrations of PM10 and PM2.5, which indicated a gradual improvement in the air quality in Krakow. As our research results show that the prevalence of atopic dermatitis decreased with food allergy prevalence depending on the age group. We can suspect that this is the result of children growing out of a food allergy. It may be also influenced by more consequential eating habits in a group of adolescents and the elimination of allergenic foods from the diet. The decreasing incidence of atopic dermatitis appears to be also related to improvement in air quality.

Deep learning algorithm for visual quality assessment of the spirograms

Objective. The quality of spirometry manoeuvres is crucial for correctly interpreting the values of spirometry parameters. A fundamental guideline for proper quality assessment is the American Thoracic Society and European Respiratory Society (ATS/ERS) Standards for spirometry, updated in 2019, which describe several start-of-test and end-of-test criteria which can be assessed automatically. However, the spirometry standards also require a visual evaluation of the spirometry curve to determine the spirograms' acceptability or usability. In this study, we present an automatic algorithm based on a convolutional neural network (CNN) for quality assessment of the spirometry curves as an alternative to manual verification performed by specialists.Approach. The algorithm for automatic assessment of spirometry measurements was created using a set of randomly selected 1998 spirograms which met all quantitative criteria defined by ATS/ERS Standards. Each spirogram was annotated as 'confirm' (remaining acceptable or usable status) or 'reject' (change the status to unacceptable) by four pulmonologists, separately for FEV1 and FVC parameters. The database was split into a training (80%) and test set (20%) for developing the CNN classification algorithm. The algorithm was optimised using a cross-validation method.Main results. The accuracy, sensitivity and specificity obtained for the algorithm were 92.6%, 93.1% and 90.0% for FEV1 and 94.1%, 95.6% and 88.3% for FVC, respectively.Significance.The algorithm provides an opportunity to significantly improve the quality of spirometry tests, especially during unsupervised spirometry. It can also serve as an additional tool in clinical trials to quickly assess the quality of a large group of tests.

Exposure to ambient air pollutants and short-term risk for exacerbations of allergic rhinitis: a time-stratified, case-crossover study in the three largest urban agglomerations in Poland

Allergic rhinitis (AR) affects 10% of the world population, with an increased prevalence in regions with substantial air pollution, but the association between exposure to air pollutants and the short-term risk of AR exacerbations is unclear. We used a time-series approach to analyze the risk of hospital admissions due to AR over 8 days from exposure to various air pollutants. Distributed lag nonlinear models were used to analyze data gathered between 2012 and 2018 in the three largest urban agglomerations in Poland. The analyses were carried out separately for the warm (April - September) and cold seasons (October - March). Overall, there were 1407 admissions due to AR. In the warm season, the rate ratio (95% confidence interval) for admission per 10µg/m3 was 1.202 (1.044, 1.384) for particulate matter less than 10 microns (PM10); 1.094 (0.896, 1.335) for particulate matter less than 2.5 microns (PM2.5); 0.946 (0.826, 1.085) for nitrogen dioxide (NO₂); 0.837 (0.418, 1.677) for sulfur dioxide (SO₂); and 1.112 (1.011, 1.224) for ozone (O₃). In the cold season, the rate ratio for admission per 10µg/m3 was 1.035 (0.985, 1.088) for PM10; 1.041 (0.977, 1.108) for PM2.5; 1.252 (1.122, 1.398) for NO₂; 0.921 (0.717, 1.181) for SO₂; and 1.030 (1.011, 1.050) for O₃. In conclusion, the risk of admission due to AR increased significantly after exposure to O₃ in the warm and cold seasons. Exposure to PM10 was associated with a significantly increased risk of AR hospitalizations in the warm season only, whereas exposure to NO₂ was associated with a significantly increased risk of AR admission in the cold season.

Evaluation of the Effectiveness of the National Clean Air Programme in Terms of Health Impacts from Exposure to PM2.5 and NO2 Concentrations in Poland

The health impact of air quality has recently become an emerging issue. Many regions, especially densely populated regions, have deteriorating air quality. The primary source of pollution in Poland is the municipal sector. Air pollutants have a negative impact on human health, contribute to premature deaths, and are the cause of various diseases. Over recent years, Europe's air quality has largely improved due to several measures to reduce pollutant emissions. The following paper presents the impact of annual average PM2.5 and NO₂ concentrations on premature deaths in Poland in 2019. Exposure to PM2.5 caused more than 19 000 premature deaths, and exposure to NO₂ contributed to around 6000 premature deaths in 2019. Taking 2019 as a baseline, the impact of the envisaged implementation of the national Clean Air Programme on the number of premature deaths is analysed. Implementing the mitigation measures focused on replacing inefficient stoves and boilers in individual households would significantly improve air quality, mainly particulate matter. Reducing PM2.5 concentrations would reduce premature deaths by around 3000 cases, while for NO_2, the number of premature deaths would not change much.

Impact of Different Air Pollutants (PM10, PM2.5, NO2, and Bacterial Aerosols) on COVID-19 Cases in Gliwice, Southern Poland

Many studies have shown that air pollution may be closely associated with increased morbidity and mortality due to COVID-19. It has been observed that exposure to air pollution leads to reduced immune response, thereby facilitating viral penetration and replication. In our study, we combined information on confirmed COVID-19 daily new cases (DNCs) in one of the most polluted regions in the European Union (EU) with air-quality monitoring data, including meteorological parameters (temperature, relative humidity, atmospheric pressure, wind speed, and direction) and concentrations of particulate matter (PM₁₀ and PM_2.5), sulfur dioxide (SO₂), nitrogen oxides (NO and NO₂), ozone (O₃), and carbon monoxide (CO). Additionally, the relationship between bacterial aerosol (BA) concentration and COVID-19 spread was analyzed. We confirmed a significant positive correlation (p < 0.05) between NO₂ concentrations and numbers of confirmed DNCs and observed positive correlations (p < 0.05) between BA concentrations and DNCs, which may point to coronavirus air transmission by surface deposits on bioaerosol particles. In addition, wind direction information was used to show that the highest numbers of DNCs were associated with the dominant wind directions in the region (southern and southwestern parts).

Ambient Air Pollution and Risk of Admission Due to Asthma in the Three Largest Urban Agglomerations in Poland: A Time-Stratified, Case-Crossover Study

Ambient air pollution in urban areas may trigger asthma exacerbations. We carried out a time-series analysis of the association between the concentrations of various air pollutants and the risk of hospital admission due to asthma over 7 days from exposure. We used distributed lag nonlinear models to analyze data gathered between 2010 and 2018 in the three largest urban agglomerations in Poland. Overall, there were 31,919 asthma hospitalizations. Over 7 days since exposure, the rate ratio (95%CI) for admission per 10 µg/m3 was 1.013 (1.002–1.024) for PM10; 1.014 (1.000–1.028) for PM2.5; 1.054 (1.031–1.078) for NO2; and 1.044 for SO2 (95%CI: 0.986–1.104). For all pollutants, the risk of admission was the greatest on the day of exposure (day 0), decreased below baseline on days 1 and 2, and then increased gradually up to day 6. The proportions (95%CI) of hospitalizations attributable to air pollution were 4.52% (0.80%–8.14%) for PM10; 3.74% (0.29%–7.11%) for PM2.5; 16.4% (10.0%–21.8%) for NO2; and 2.50% (−0.75%–5.36%) for SO2. In conclusion, PM2.5, PM10, NO2, and SO2 pollution was associated with an increased risk of hospital admission due to asthma in the three largest urban agglomerations in Poland over nine years.

Changes in Air-Pollution-Related Information-Seeking Behaviour during the COVID-19 Pandemic in Poland

Low air quality in Poland is a problem of particularly high urgency. Therefore, Poles must be aware of air quality levels, also during the COVID-19 pandemic. The study aimed to compare air-pollution-related information-seeking behaviour between the pre- and intra-pandemic periods as well as between the actual and theoretical machine-learning-forecasted intra-pandemic models. Google Trends search volumes (GTSVs) in Poland for air-pollution-related keywords were collected between January 2016 and January 2022. To investigate the changes that would have occurred without the outbreak of the pandemic, Seasonal Autoregressive Integrated Moving Average (SARIMA) machine-learning models were trained. Approximately 4,500,000 search queries were analysed. Between pre- and intra-pandemic periods, weighted mean GTSVs changed by −39.0%. When the actual intra-pandemic weighted mean GTSVs were compared to the intra-pandemic forecasts, the actual values were lower by −16.5% (SARIMA’s error = 6.2%). Compared to the pre-pandemic period, in the intra-pandemic period, the number of search queries containing keywords connected with air pollution decreased. Moreover, the COVID-19 pandemic might have facilitated the decrease. Possible causes include an attention shift towards everyday problems connected to the pandemic, worse mental health status and lower outdoor exposure that might have resulted in a lower intensity of non-pandemic-related active information-seeking behaviour.

Long-Term PM2.5 Exposure Is Associated with Symptoms of Acute Respiratory Infections among Children under Five Years of Age in Kenya, 2014

Introduction: Short-term exposures to air pollutants such as particulate matter (PM) have been associated with increased risk for symptoms of acute respiratory infections (ARIs). Less well understood is how long-term exposures to fine PM (PM2.5) might increase risk of ARIs and their symptoms. This research uses georeferenced Demographic Health Survey (DHS) data from Kenya (2014) along with a remote sensing based raster of PM2.5 concentrations to test associations between PM2.5 exposure and ARI symptoms in children for up to 12 monthly lags. Methods: Predicted PM2.5 concentrations were extracted from raster of monthly averages for latitude/longitude locations of survey clusters. These data and other environmental and demographic data were used in a logistic regression model of ARI symptoms within a distributed lag nonlinear modeling framework (DLNM) to test lag associations of PM2.5 exposure with binary presence/absence of ARI symptoms in the previous two weeks. Results: Out of 7036 children under five for whom data were available, 46.8% reported ARI symptoms in the previous two weeks. Exposure to PM2.5 within the same month and as an average for the previous 12 months was 18.31 and 22.1 µg/m3, respectively, far in excess of guidelines set by the World Health Organization. One-year average PM2.5 exposure was higher for children who experienced ARI symptoms compared with children who did not (22.4 vs. 21.8 µg/m3, p < 0.0001.) Logistic regression models using the DLNM framework indicated that while PM exposure was not significantly associated with ARI symptoms for early lags, exposure to high concentrations of PM2.5 (90th percentile) was associated with elevated odds for ARI symptoms along a gradient of lag exposure time even when controlling for age, sex, types of cooking fuels, and precipitation. Conclusions: Long-term exposure to high concentrations of PM2.5 may increase risk for acute respiratory problems in small children. However, more work should be carried out to increase capacity to accurately measure air pollutants in emerging economies such as Kenya.

Air Pollution in Poland: A 2022 Narrative Review with Focus on Respiratory Diseases

According to the World Bank Group, 36 of the 50 most polluted cities in the European Union are in Poland. Thus, ambient air pollution and its detrimental health effects are a matter of immense importance in Poland. This narrative review aims to analyse current findings on air pollution and health in Poland, with a focus on respiratory diseases, including COVID-19, as well as the Poles’ awareness of air pollution. PubMed, Scopus and Google Scholar databases were searched. In total, results from 71 research papers were summarized qualitatively. In Poland, increased air pollution levels are linked to increased general and respiratory disease mortality rates, higher prevalence of respiratory diseases, including asthma, lung cancer and COVID-19 infections, reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The proximity of high traffic areas exacerbates respiratory health problems. People living in more polluted regions (south of Poland) and in the winter season have a higher level of air pollution awareness. There is an urgent need to reduce air pollution levels and increase public awareness of this threat. A larger number of multi-city studies are needed in Poland to consistently track the burden of diseases attributable to air pollution.

Is It Possible to Have Home E-Monitoring of Pulmonary Function in Our Patients with Duchenne Muscular Dystrophy in the COVID-19 Pandemic?-A One Center Pilot Study

Background: Duchenne muscular dystrophy (DMD) is the most common, progressive, irreversible muscular dystrophy. Pulmonary function is crucial for duration of life in this disease. Currently, the European Respiratory Society is focused on digital health, seeking innovations that will be realistic for digital respiratory medicine to support professionals and patients during the COVID-19 pandemic. Aims: The aim of this study was to investigate whether it is possible to monitor pulmonary function at home using an individual electronic spirometry system in boys with Duchenne muscular dystrophy. Materials and methods: In this observational, prospective study, conducted from March 2021 to June 2021, twenty boys with DMD (aged 8–16) were enrolled. The patients were recruited from the Rare Disease Centre, University Clinical Centre, of Gdańsk, Poland. Medical history and anthropometric data were collected, and spirometry (Jaeger, Germany) was performed in all patients at the start of the study. Each patient received an electronic individual spirometer (AioCare) and was asked to perform spirometry on their own every day, morning and evening, at home for a period of 4 weeks. The number of measurements, correctness of performing measurements, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF) were evaluated. Results: Finally, 14 out of 20 boys enrolled in the study with a mean age of 12.5 years (7 non-ambulatory) applied and received a home spirometer (AioCare). A total of 283 measurements were performed by all patients at home for 4 weeks. Half of the patients were able to perform measurements correctly. There were no significant differences between mean values of FVC, FE1, PEF between home and hospital spirometry (p > 0.05) expect PEF pv% (p < 0.00046). Patients with higher FEV1 (p = 0.0387) and lower BMI (p = 0.0494) were more likely to take home spirometer measurements. The mean general satisfaction rating of home-spirometry was 4.33/5 (SD 0.78), the mean intelligibility rating was 4.83/5 (SD 0.58). Reasons for irregular measurements were: forgetting (43%), lack of motivation (29%), difficulty (14%), lack of time (14%). Conclusion: Home electronic monitoring of pulmonary function in patients with DMD is possible to implement in daily routines at home. This protocol should be introduced as early as possible in patients 7–8 years old with good, preserved lung function. Patients accept this form of medical care but require more education about the benefits of e-monitoring. There is a need to implement a system to remind patients of the use of electronic medical devices at home, e.g., via SMS (short message service).