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Seasonal mortality patterns and regional contrasts in Portugal

100%
Almendra R., Santana P., Freire E., Vasconcelos J.
Bulletin of Geography. Socio-economic Series
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2016
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vol. 32
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issue 32
7-18
EN
The main aim of this study is to identify the geographical seasonal mortality patterns in Portugal and, for the first time, to assess the relationship between seasonal and overall mortality. Monthly data from the Portuguese mortality database (2000-2009) by major cause of death were analysed and standardized to 30 days with adjustments for leap years. The chi-square goodness-of-fit test was used to compare the observed monthly deaths with deaths that could be expected if mortality were randomly distributed throughout the year. The seasonal burden was measured using the excess winter deaths (EWD) rate and the seasonal impact of winter on mortality was assessed through the EWD Index. The regions were clustered according to the overall mortality rate and the seasonal impact: 1-low seasonality and high values of overall mortality; 2-high seasonality and high values of overall mortality; 3-low values of seasonality and low overall mortality; 4-high seasonality and low overall mortality. Significant seasonal mortality increases were found in all causes of death. There were 86,000 EWDs, mostly through circulatory and respiratory diseases. 73% of the population lives in regions with high winter vulnerability to respiratory mortality and 60% in regions with high winter vulnerability to circulatory mortality. This study reinforces the idea that vulnerability to cold weather may play an important role in the public health in Portugal. This knowledge may be used to construct a set of regulations or policies designed to implement better health planning procedures and more effective warning systems.
2
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Overall human mortality and morbidity due to exposure to air pollution

86%
Samek L.
International Journal of Occupational Medicine and Environmental Health
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2016
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vol. 29
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issue 3
417-426
EN
Objectives Concentrations of particulate matter that contains particles with diameter ≤ 10 mm ($\text{PM}_\text{10}$) and diameter ≤ 2.5 mm ($\text{PM}_\text{2.5}$) as well as nitrogen dioxide ($\text{NO}_{2}$) have considerable impact on human mortality, especially in the cases when cardiovascular or respiratory causes are attributed. Additionally, they affect morbidity. An estimation of human mortality and morbidity due to the increased concentrations of $\text{PM}_\text{10}$, $\text{PM}_\text{2.5}$ and $\text{NO}_{2}$ between the years 2005–2013 was performed for the city of Kraków, Poland. For this purpose the Air Quality Health Impact Assessment Tool (AirQ) software was successfully applied. Material and Methods The Air Quality Health Impact Assessment Tool was used for the calculation of the total, cardiovascular and respiratory mortality as well as hospital admissions related to cardiovascular and respiratory diseases. Data on concentrations of $\text{PM}_\text{10}$, $\text{PM}_\text{2.5}$ and $\text{NO}_{2}$, which was obtained from the website of the Voivodeship Inspectorate for Environmental Protection (WIOS) in Kraków, was used in this study. Results Total mortality due to exposure to $\text{PM}_\text{10}$ in 2005 was found to be 41 deaths per 100 000 and dropped to 30 deaths per 100 000 in 2013. Cardiovascular mortality was 2 times lower than the total mortality. However, hospital admissions due to respiratory diseases were more than an order of magnitude higher than the respiratory mortality. Conclusions The calculated total mortality due to $\text{PM}_\text{2.5}$ was higher than that due to $\text{PM}_\text{10}$. Air pollution was determined to have a significant effect on human health. The values obtained by the use of the AirQ software for the city of Kraków imply that exposure to polluted air can result in serious health problems.
3
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Respiratory health problems in adolescents living near main roads in the Upper Silesian industrial zone, Poland

86%
Skrzypek M., Kowalska M., Kasznia-Kocot J., Czech E. M., Niewiadomska E.
International Journal of Occupational Medicine and Environmental Health
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2019
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vol. 32
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issue 4
553-567
EN
Objectives This study explores the association between self-reported exposure to traffic-related air pollution and respiratory health symptoms, as well as lung functions and skin prick tests in adolescents living in the vicinity of main roads. Material and Methods The data in the study were acquired using a cross-sectional study conducted between 2004–2005 in Chorzów (Silesia, Poland) among adolescents (N = 936) aged 13–15 years, attending junior high schools. Adverse respiratory health symptoms and exposure to traffic-related air pollution were determined on the basis of a questionnaire. Moreover, all children underwent spirometry and skin prick tests. Multivariable logistic regression with multiple imputation for missing data was used to assess the prevalence of adverse respiratory symptoms in relation to self-reported exposure to traffic-related air pollution, adjusted for socioeconomic and environmental factors. Results Among respiratory tract diseases, asthma and allergic rhinitis associations were statistically significant (OR = 2.16, 95% CI: 1.12–4.15 and OR = 1.69, 95% CI: 1.08–2.64, respectively). Likewise, among respiratory disorders, statistically significant associations were found in the case of wheezes and dyspnea attack (OR = 1.58, 95% CI: 1.10–2.26 and OR = 2.39, 95% CI: 1.56–3.66, respectively), with respect to the vicinity of the main road. Living in the area with high traffic intensity was statistically significantly associated with a higher prevalence of asthma and wheezes (OR = 2.31, 95% CI: 1.22–4.39 and 1.48, 95% CI: 1.09–2.01, respectively). The results obtained did not confirm the relationship between the adopted way of exposure to traffic-related air pollution and lung function indices or skin prick tests. Conclusions Results of the study suggest that children living in the area with intense traffic are more likely to develop respiratory disorders. Moreover, the vicinity of a main road as well as traffic intensity could be suitable in assessing the relationship between road transport and potential health problems among exposed inhabitants. Int J Occup Med Environ Health. 2019;32(4):553–67
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Dobra praktyka w opiece profilaktycznej: opieka profilaktyczna i aktywizacja zawodowa osób niepełnosprawnych z chorobami układu oddechowego

72%
Wiszniewska M., Tymoszuk D., Lipińska-Ojrzanowska A., Wągrowska-Koski E., Walusiak-Skorupa J.
Medycyna Pracy
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2013
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vol. 64
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issue 3
427-438
EN
Respiratory diseases are a cause of long-term sickness absence, and even of partial or complete inability to work. This paper presents the first in Poland description of principles of good practice in occupational health service provided for people with respiratory diseases. The issues concerning the certification of the ability to work in this group of patients are discussed. The key-principles of preventive care of workers with obstructive and interstitial lung diseases with particular attention paid to the control of major risk factors are also presented. The importance of possible contraindications for job performance by workers affected by these diseases, as well as the responsibilities of occupational health physicians were highlighted. Med Pr 2013;64(3):427–438
PL
Choroby układu oddechowego są istotną przyczyną długotrwałej absencji chorobowej, a nawet częściowej lub całkowitej niezdolności do pracy zawodowej. Artykuł jest pierwszym w Polsce opracowaniem zasad dobrych praktyk w opiece profilaktycznej nad osobami z chorobami układu oddechowego. Omówiono w nim zagadnienia związane z orzekaniem o zdolności do pracy u tych osób oraz przedstawiono kluczowe elementy opieki profilaktycznej nad pracownikiem z obturacyjnymi i śródmiąższowymi chorobami układu oddechowego, ze szczególnym uwzględnieniem kontroli czynników ryzyka. Zwrócono również uwagę na możliwe przeciwwskazania do wykonywania pracy w przypadku tych schorzeń oraz zadań lekarza sprawującego opiekę profilaktyczną. Med. Pr. 2013;64(3):427–438
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Związek stężenia drobnego pyłu $\text{PM}_\text{2,5}$ zawartego w powietrzu atmosferycznym podczas epizodu smogowego z dobowymi zaostrzeniami chorób układu oddechowego w populacji województwa śląskiego

58%
Kowalska M., Zejda J. E.
Medycyna Pracy
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2018
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vol. 69
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issue 5
523-530
EN
Background Recurring winter smog episodes, recently observed in Poland, have inspired the researches to assess the epidemiological situation concerning the registered exacerbations of respiratory diseases related to worsening of the ambient air quality. Material and Methods The model comprising the ecological study results and secondary epidemiological data on registered outpatient visits and hospitalizations in the Silesian voivodeship was used. We assessed the effect of smog observed in January 2017 on the number of acute respiratory disorders registered in that month. Aerosanitary situation was obtained from the Provincial Inspectorate for Environmental Protection in Katowice database. Results It was documented that the increase in $\text{PM}_\text{2.5}$ concentration (with simultaneously observed unfavorable meteorological parameters) was related to a higher number of acute respiratory disorders registered daily. Moreover, the increase in the number of outpatient visits due to asthma exacerbation or bronchitis was observed on the first day of episode, and hospitalizations took place with delay of 1–2 days. Conclusions The preliminary results indicate the relationship between worsening of ambient air quality during the winter smog and the increase in daily number of registered outpatient visits and hospitalizations due to acute respiratory diseases. Med Pr 2018;69(5):523–530
PL
Wstęp Obserwowane w ostatnich latach w Polsce cyklicznie powtarzające się – w każdym sezonie zimowym – epizody smogowe stały się inspiracją do badań nad sytuacją epidemiologiczną zaostrzeń chorób układu oddechowego zarejestrowanych w odpowiedzi na pogorszenie jakości powietrza atmosferycznego. Materiał i metody Na podstawie modelu badania ekologicznego i wtórnych danych epidemiologicznych dotyczących rejestrowanych porad ambulatoryjnych oraz hospitalizacji w województwie śląskim oceniono wpływ smogu ze stycznia 2017 r. na liczbę udzielonych w tym miesiącu świadczeń medycznych z powodu ostrych incydentów oddechowych. Informacje o sytuacji aerosanitarnej w badanym okresie pochodzą z bazy danych Wojewódzkiego Inspektoratu Ochrony Środowiska w Katowicach. Wyniki Zaobserwowano wpływ wzrostu stężeń pyłu $\text{PM}_\text{2,5}$ (przy jednocześnie notowanych niekorzystnych parametrach meteorologicznych) na zwiększenie dziennej liczby udzielanych świadczeń medycznych z powodu ostrych incydentów oddechowych. Wzrost liczby porad z powodu zaostrzenia astmy oraz zapalenia oskrzeli zanotowano już pierwszego dnia epizodu. Liczba osób hospitalizowanych zwiększyła się natomiast dopiero po 2 dniach. Wnioski Uzyskane wyniki wstępnych badań wskazują na związek między pogorszeniem jakości powietrza w trakcie zimowego epizodu smogowego a wzrostem liczby rejestrowanych porad ambulatoryjnych i hospitalizacji z powodu ostrych chorób układu oddechowego. Med. Pr. 2018;69(5):523–530
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