Search

According to the 5th Assessment Report of IPCC, one of the greatest health impacts of climate change will be the heat-related excess mortality. In Hungary, the National Adaptation Geo-Information System (NAGiS) helps the adaptation process of climate change. Within CRIGiS project, which was initiated to extend the NAGiS, our special subtask was the assessment of heat-related excess mortality at different area levels in the present and for two predicted future periods. This assessment is described in this paper. The Hungarian Central Statistical Office provided the daily mortality data for the period of May 1 - Sep 30, 2005-2014. The observed daily mean temperature data for the same period at small area level (NUTS 4, Nomenclature of territorial units for statistics) were provided by the Hungarian Meteorological Service (HMS). The modeled daily mean temperature data at NUTS 4 level based on the ALADIN-Climate model for three periods, May 1 - Sep 30 of 1991-2020, 2021-2050, and 2071-2100, were also provided by HMS. The heatwave days were defined by the 90th percentile of the frequency distribution of daily mean temperatures at different area levels. The excess mortality was computed by extracting the mean daily mortality of cool days from the number of deaths on heatwave days. As we found a difference between the frequency distributions of observed and modeled present periods, a correction was done assuring that the yearly sums of excess mortality were the same in the observed and modeled present periods. Based on the corrected threshold values the changes in the future could be predicted. During 2005-2014, the range of daily threshold temperature was between 22.3 °C and 25.4 °C, the mean excess mortality was 15.8% on the heatwave days at NUTS 4 level. At national level, daily mortality was higher by 51 cases on heatwave days than on cool days, which corresponded to an excess of 783 death cases per year in average. According to the climate model, the number and intensity of heatwave days will increase in relation to the present situation. Assuming the same population and level of sensitivity, for 2021-2050 a 2.6-fold, for 2071-2100 a 7.4-fold increase of excess deaths is predicted causing 2030 and 5800 cases per year, respectively. The prediction of excess mortality at different area levels in the NAGiS database will help stakeholders to prepare adaptation measures to climate change. [ABSTRACT FROM AUTHOR]

Several studies have reported significant health effects of air pollution even at low levels of air pollutants, but in most of theses studies linear nonthreshold relations were assumed. We investigated the exposure–response association between ambient particles and mortality in the 22 European cities participating in the APHEA (Air Pollution and Health—A European Approach) project, which is the largest available European database. We estimated the exposure–response curves using regression spline models with two knots and then combined the individual city estimates of the spline to get an overall exposure–response relationship. To further explore the heterogeneity in the observed city-specific exposure–response associations, we investigated several city descriptive variables as potential effect modifiers that could alter the shape of the curve. We conclude that the association between ambient particles and mortality in the cities included in the present analysis, and in the range of the pollutant common in all analyzed cities, could be adequately estimated using the linear model. Our results confirm those previously reported in Europe and the United States. The heterogeneity found in the different city-specific relations reflects real effect modification, which can be explained partly by factors characterizing the air pollution mix, climate, and the health of the population.

The increase of Lyme borreliosis (LB) can be expected due to climate change, while the distribution of the disease and annual activity of the vector and host animals depend on several factors of the environment. The presented study aimed to assess expressly the spring season temperature dependence on the incidence of LB in Hungary. The weekly LB data were obtained from the National Epidemiologic and Surveillance System for a period of 13 years--1998-2010. Daily temperature data were derived from the European Climate Assessment and Dataset. The association was studied at national level, descriptive statistics and linear regression models were applied. A significant increasing trend was observed in the mean temperature of the analysed years (0.052°C per year). The annual LB incidence doubled during the 13 year period. The incidence rates of the periods 1998-2001 and 2007-2010 were 11.1 resp. 17.0 per 100,000. The start of a steep increase in weekly LB incidence (0.1 per 100,000) shifted significantly by 3 weeks earlier, the start date of spring showed similar trend (p=0.0041). LB incidence increased more steadily in spring than in summer, with 79% of the increase being reported during weeks 15-28, with maximum rates of increase occurring in weeks 23-25. The trend was significant between the weeks 15-28. In the warmer years with 19.02°C mean temperature in May and June, the LB incidence curve reached the annual peak 2-3 weeks earlier, and the descending phase of the curve started earlier than in the colder years with 17.06°C of the same period.

Introduction: According to the data of the Hungarian pulmonological network, the prevalence of asthma in the last 15 years has increased (almost linearly) in Hungary. In 2004 it was 1.8%. There are only a few data about the prevalence of childhood asthma., Aims: The aim of the authors was to measure the prevalence of bronchial asthma in childhood in Budapest in 1995, 1999 and 2003, using questionnaires directed to district pediatricians., Methods: There were only two questions in these questionnaires: how many children are in their districts, and how many are suffering from asthma? Besides of this survey the dust, CO, NO(2) and SO(2) concentrations in the air were measured on-line at 8 points in Budapest, while ozone level measurements were also made at 2 stations. The counts of pollen and of fungal elements in the air were calculated separately for Buda and for Pest., Results: In 1995, replies were received from 118 pediatricians in 11 districts, who were responsible for the supervision of 104,060 children, out of these 1.88+/-0.87% had been diagnosed as having asthma. In 1999 replies were sent by 153 physicians in 22 of the 23 districts, who had a total of 142,679 children under their care. These included 3228 asthmatics, i.e. a prevalence of 2.26+/-0.95%. In 2003 the authors received answers from all of the 23 districts of Budapest. The 204 pediatricians were responsible for the supervision of 176 049 children. The number of patients with the diagnosis of asthma was 4712 (corresponding for a prevalence of 2.68+/-1.3%). The increase between 1995 and 1999, and between 1999 and 2003 was highly significant (p < 0.0001). This significant increase was valid even when the authors analysed only those 11 districts, which answered already in 1995. The level of air pollution in Budapest did not deteriorate in the period in question, and the concentration of pollen grains of plants causing allergy did not increase compared to previous years., Conclusions: On the basis of the results of more than 100 thousand children, the authors conclude that between 1995 and 2003 the proportion of asthmatic children increased by 50% in Budapest, while the air pollution did not deteriorate and the pollen concentration from sensitizing plants did not increase.

Introduction: The mortality of the Hungarian population is very unfavourable in relation to other European countries. Mortality from malignant diseases is the second most frequent cause of death in both sexes. The most frequent localisation of cancer is that of the bronchi and the lungs, followed by colorectal, breast and oral cavity cancers., Aim: Of the publication was to demonstrate the spatial distribution of mortality from malignant diseases of all sites, bronchi and the lungs, as well as mortality from cancer of the thyroid gland and leukaemias, and to evaluate the possible impact of the Chernobyl nuclear accident on the frequency of cancer mortality., Method: The spatial distribution of mortality in the country is evaluated by computing standardized mortality ratio on settlement level, using geographical information system. In case of frequent mortality events a region analysis was carried out, in the opposite case--a cluster analysis., Results: Regarding the spatial distribution of mortality from all malignant diseases of 0-64 year-old males there are regions with excess mortality in almost each county. In case of women of this age group, there is a significantly higher mortality in Budapest, in three counties in the Eastern part of the country, and in some settlements in Transdanubia. Mortality from the cancer of the bronchi and the lungs significantly accumulates in both sexes in four counties in Eastern Hungary. Mortality from cancer of the thyroid gland and leukaemias does not show typical spatial accumulation as well., Conclusions: The premature mortality from all malignant diseases and of cancer of the bronchi and lungs of the Hungarian male and female population shows an increasing tendency. Mortality from the latter cause shows a typical spatial accumulation, which causes should be investigated in analytical epidemiological studies. The potential causative role of the Chernobyl accident could not be proven in any case.

The authors examined the spatial accumulation of mortality and morbidity of cancer of the prostate of the total as well as age stratified male population of Hungary. Using GIS, a descriptive epidemiological study was carried out examining the spatial differences of mortality on settlement level with 2000 inhabitants by calculating standardized mortality and morbidity ratios. The significance of the difference of mortality and morbidity from the national mean was tested by chi square probe. On the basis of the results a significant excess in mortality was detected in 11 regions of the country. The unfavourable regions cover 11.6% of the territory of the country where 25.6% of the male population live. A significant excess morbidity can be observed in 8 counties. A significant correlation was found between the unfavourable regions of mortality and morbidity (r=0.443, p<0.05). The age-specific analysis of morbidity revealed the highest excess in morbidity in the age group over 70 years accumulating in 3 counties of Transdanubia and in 6 counties of the Great Plain. On the basis of the results of mortality and morbidity analysis according to age and areas the unfavourable regions can be identified where mortality and morbidity from cancer of the prostate accumulates. These studies serve as a basis for intervention strategies.