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 10 µg/m3 was 1.202 (1.044, 1.384) for particulate matter less than 10 µm (PM10); 1.094 (0.896, 1.335) for particulate matter less than 2.5 µm (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 10 µg/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.

Air pollution and long-term risk of hospital admission due to chronic obstructive pulmonary disease exacerbations in Poland: a time-stratified, case-crossover study.

INTRODUCTION: Airborne pollutants may worsen the course of chronic obstructive pulmonary disease (COPD). Previous studies have shown that both particulate and gaseous pollutants increase airway inflammation, which may lead to an exacerbation of COPD. OBJECTIVES: The aim of the study was to investigate the association between exposure to airborne pollutants and the risk of COPD exacerbations in 3 the largest urban agglomerations in Poland: Warsaw, Kraków, and Tricity. PATIENTS AND METHODS: We used a case­crossover approach to analyze data from the years 2011-2018. This time­series study used distributed lag linear-nonlinear models to analyze the risk of hospital admission due to COPD exacerbations during 21 days following the exposure to particulate matter (PM), NO2, and SO2. RESULTS: Overall, there were 26 948 admissions due to COPD exacerbations. During 21 days after exposure, the rate ratio (95% CI) for admissions per 10 µg/m3 was 1.028 (1.008-1.049) for PM10, 1.030 (1.006-1.055) for PM2.5, 1.032 (0.988-1.078) for NO2, and 1.145 (1.038-1.262) for SO2. The risk for admission peaked at 10 days after the exposure to PM10 and PM2.5, whereas for NO2 and SO2 the risk was the greatest on the day of exposure. The proportion (95% CI) of hospitalizations attributable to air pollution was 9.08% (3.10%-15.08%) for PM10, 7.61% (1.27%-13.49%) for PM2.5, 9.77% (-3.63% to 21.48%) for NO2, and 7.70% (2.30%-12.84%) for SO2. CONCLUSIONS: PM2.5, PM10, NO2, and SO2 pollution was associated with an increased risk of COPD exacerbations that needed hospitalization. There were different risk patterns for particulate and gaseous pollutants. Improving air quality in Polish cities could reduce the burden of COPD.

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.