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Background Although time-series studies of the impact of air pollution on mortality are numerous in the literature there is noticeable lack of the results from multi-city studies in Poland. The aim of our analysis is to fill this gap and give estimates based on the most actual data. Methods A multi-city ecological time series analysis was carried out. A database contained a daily number of deaths from all causes (excluding external), by sex and age groups (below 65, 65 and more), PM10 and PM2.5 levels as well as meteorological conditions in 3 agglomerations and 19 big cities in Poland. The analysis was performed using generalized additive models. The distributed lag model method was used to investigate the mortality displacement phenomenon. Results Two versions of time-series analysis considering the level of air pollution from the current and previous day (acute effect) as well as from the past 30 days (allowing for mortality displacement) in the total population as well as in sub-populations determined by sex and age-group were done in each localization. The pooled effect estimate was calculated based on estimates obtained in each city. The value of the relative risk of death from all causes associated with an increase of air pollution with PM10 and PM2.5 was equal to (respectively) 1.005 (1.003-1.006) and 1.004 (1.002-1.005) for acute effect and 1.016 (1.011-1.021) and 1.021 (1.015-1.026) for delayed pollution effect. Higher relative risks were obtained for females and in the older age group. Conclusions A statistically significant short-term effect of air pollution with both PM10 and PM2.5 on mortality was found. The relative risks for PM2.5 were higher than for PM10. Population of females and people aged 65 years and above were more at risk. Key messages The existence of the short-term effect of dust air pollution on mortality in Poland has been confirmed. The air pollution effect modification by sex and age was found.

Background The 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for the management of arterial hypertension and the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline for the prevention, detection, evaluation, and management of high blood pressure in adults differ in approach to defining stages of hypertension and recommendations for treatment of high blood pressure. Purpose To contrast the implications of the ESC/ESH versus ACC/AHA hypertension guidelines among the general population in Poland – a country representing a high CVD risk region in Europe. Methods We used data from a representative random sample of 1439 Polish adults aged 40 to 79 from the research program NATPOL 2011. The analysis was weighted in order to reflect the structure of the population in Poland and was stratified by age and gender. We applied the ESC/ESH 10-year SCORE (Systematic COronary Risk Evaluation) and the ACC/AHA ASCVD (atherosclerotic CV disease) risk assessment tools and followed guideline-specific algorithms to detect hypertension and follow recommendations for treatment. Results The overall prevalence of hypertension among Polish adults according to the ACC/AHA guideline was 76.9% (95% CI, 74.7–79.0%) versus 51.8% (95% CI, 49.2–54.4%) according to the ESC/ESH guidelines. Application of the ACC/AHA guideline recommendations would result in antihypertensive drug treatment for 63.0% (95% CI, 60.5–65.5%) of Polish adults compared with 46.2% (95% CI, 43.6–48.7%) based on application of the ESC/ESH guidelines (difference 16.8% (95% CI, 14.9–18.8%), table 1). Table 1 2017 ACC/AHA guideline 2018 ESC/ESH guideline Δ (difference) Hypertension Recommended treatment Hypertension Recommended treatment Hypertension Recommended treatment % (95% CI) % (95% CI) % (95% CI) % (95% CI) % (95% CI) % (95% CI) Age 40–49 (n=391) 63.2 (58.4–68.0) 37.3 (32.6–42.1) 32.0 (27.4–36.6) 21.2 (17.2–25.3) 31.2 (26.6–35.8) 16.1 (12.5–19.8) 50–59 (n=452) 77.7 (73.8–81.5) 61.7 (57.2–66.2) 49.1 (44.5–53.7) 40.0 (35.5–44.6) 28.5 (24.4–32.7) 21.7 (17.9–25.5) 60–69 (n=356) 82.3 (78.3–86.3) 75.3 (70.8–79.8) 62.4 (57.3–67.4) 61.5 (56.5–66.6) 19.9 (15.8–24.1) 13.8 (10.2–17.3) 70–79 (n=231) 90.0 (86.2–93.9) 90.0 (86.2–93.9) 74.5 (68.8–80.1) 76.6 (71.2–82.1) 15.6 (10.9–20.3) 13.4 (9.0–17.8) Gender Male (n=689) 80.4 (77.4–83.4) 67.5 (64.0–71.0) 52.5 (48.8–56.3) 47.2 (43.4–50.9) 27.9 (24.5–31.2) 20.3 (17.3–23.3) Female (n=741) 73.6 (70.4–76.7) 58.8 (55.3–62.4) 51.2 (47.6–54.8) 45.2 (41.6–48.8) 22.4 (19.4–25.4) 13.6 (11.2–16.1) Conclusions Application of the ACC/AHA guideline would result in a considerable increase in the prevalence and antihypertensive drug treatment of hypertension in Polish adults compared with application of the ESC/ESH guidelines.

This study aims to investigate the association between educational level and breast cancer mortality in Europe in the 2000s. Unlike most other causes of death, breast cancer mortality tends to be positively related to education, with higher educated women showing higher mortality rates. Research has however shown that the association is changing from being positive over non-existent to negative in some countries. To investigate these patterns, data from national mortality registers and censuses were collected and harmonized for 18 European populations. The study population included all women aged 30-74. Age-standardized mortality rates, mortality rate ratios, and slope and relative indexes of inequality were computed by education. The population was stratified according to age (women aged 30-49 and women aged 50-74). The relation between educational level and breast cancer mortality was predominantly negative in women aged 30-49, mortality rates being lower among highly educated women and higher among low educated women, although few outcomes were statistically significant. Among women aged 50-74, the association was mostly positive and statistically significant in some populations. A comparison with earlier research in the 1990s revealed a changing pattern of breast cancer mortality. Positive educational differences that used to be significant in the 1990s were no longer significant in the 2000s, indicating that inequalities have decreased or disappeared. This evolution is in line with the "fundamental causes" theory which stipulates that whenever medical insights and treatment become available to combat a disease, a negative association with socio-economic position will arise, independently of the underlying risk factors.

The dynamic measurement of beat flux gives a lagged and out of shape electrical response due to the heat transfer through the materials. So, it is necessary to use dynamic correctors to get the real response.

The prevalence of asthma depends on both hereditary and environmental factors. Knowledge of the effects of environmental and congenital factors on the frequency of occurrence of asthma may provide important clues to its pathogenesis and prevention.The Polish Multicentre Study of Epidemiology of Allergic Diseases was designed to obtain estimates representative of the entire Polish population to assess asthma prevalence and risk factors.Thirty-three areas were selected in 11 regions of Poland. Epidemiologic diagnoses of asthma were verified by a single recognized expert in each region on the basis of collected data as well as available medical documentation, in accordance with the 1997 guidelines of the Global Initiative for Asthma. Ambient air concentrations of sulfur dioxide and suspended particulates (black smoke) were measured directly or estimated by statistical modelling.Results were obtained for asthma in 16 238 subjects, including 3268 children (aged 3 to 16 years) and 12 970 adults (17 to 80 years). The overall prevalence of asthma was 8.6% (95% confidence interval [CI], 7.7%-9.6%) among children and 5.4% (95% CI, 5.0%-5.8%) among adults. Several risk factors for asthma were identified: family history of asthma, black smoke, residential exposure to traffic-related air pollution in both children and adults, and damp or overcrowded housing in adults. No statistically significant association was observed for passive smoking in the home, use of gas stoves, pet ownership, or exposure to ambient air pollution with sulfur dioxide.Our results show that the prevalence of asthma is associated with several host and environmental factors in the Polish population.

Air pollution has been linked to respiratory outcomes but controversy persists about its long-term effects. We used a novel technique to estimate the outdoor concentrations of sulphur dioxide (SO2) at small-area level to study the long-term effects on respiratory symptoms and disease in children.As part of the international SAVIAH study, parents of 8,013 children aged 7-10 studied in Prague (Czech Republic) and Poznan (Poland) completed a questionnaire covering respiratory health, demographic and socio-economic factors and health behaviours (response rate 91%). This report is based on 6,959 children with complete data. Outdoor SO2 was measured by passive samplers at 80 sites in Poznan and 50 sites in Prague during 2-week campaigns. Concentrations of SO2 at each point (location) in the study areas were estimated from these data by modelling in a geographical information system. The mean of the estimated SO2 concentrations at children's homes and schools was used as an indicator of exposure to outdoor SO2.The prevalence of respiratory outcomes was similar in both cities. In the pooled data, 12% of children had experienced wheezing/whistling in the past 12 months; 28% had a lifetime prevalence of wheezing/whistling; 14% had a dry cough at night; and 3% had had asthma diagnosed by a doctor. The estimated mean exposure to outdoor SO2 was 80 (range 44-140) microg/m3 in Poznan and 84 (66-97) microg/m3 in Prague. After socio-economic characteristics and other covariates were controlled for, SO2 was associated with wheezing/whistling in the past 12 months (adjusted OR per 50 microg/m3 1.32, 95% CI 1.10-1.57), lifetime prevalence of wheezing/whistling (OR 1.13, 95% CI 0.99-1.30), and lifetime prevalence of asthma diagnosed by a doctor (OR 1.39, 95% CI 1.01-1.92). The association with dry cough at night did not reach statistical significance.In these two Central European cities with relatively high levels of air pollution, small-area based indicators of long-term outdoor winter concentrations of SO2 were associated with wheezing/whistling and with asthma diagnosed by a doctor.

The paper presents psychiatric problems included in national, health interview survey, recommended by the WHO, carried out by the Central Statistical Office in Poland in 1996. Authors are going to estimate the prevalence of a bad frame of mind and neurosis among Polish adult people and try to appoint the relationships between psychiatric disorders and gender and place of residence. We estimated results in 49 provinces. There were significant differences between east and west Poland. People who live in eastern provinces have a worse psychological condition than western. Women have higher rate of these this psychiatric problems. We also found a major correlation between dissemination of a bad frame of mind and neurosis among men and women.

Major chronic diseases continue to be the main health scourge of the most developed countries, have only recently been retreating in frequency in the fledgling market economies, and are becoming dominant in many populous areas of the developing world. The descriptive evidence from the developments of the near past strongly suggests that much of the control outcomes have already been achieved with the existent imperfect causative knowledge. The continuation of desirable trends in major chronic diseases in some places like CentralEastern Europe, is uncertain within the intermediate time range without gaining more etiological clues, among which the role of medical care is worthy of reconsideration. Other factors can grow in importance, like obesity, which may be freed from the suppressive influence of cigarette smoking to trigger major mass pathologies, like type 2 diabetes mellitus, arterial hypertension, some cancers etc. The role of social underpriviledge seems recalcitrant, although the part played by social share of biological risk agents may diminish in response to educational persuasion. The remotest destinies of some chronic diseases may depend on the mixture of external and genetic influences ending as predispositions towards some ailments, antecedents of which might have protected their carriers from dangers of the past unfriendly environment, like obesity (or diabetes) against famine, or hypertension against inefficient defense reaction. The resulting medium-range prediction of well-being for inhabitants of more developed world may not be forbidding, since increasing life expectancy needs not be synonymous with disability, and attaining old age does not require excessive sacrifice, beyond reducing number smoked, or preserving decent respiratory volumes.

The authors are going to estimate the prevalence poor frame of mind and neurosis among Polish adult people, and try to appoint the relationships between psychiatric disorders and gender, age, civil status, education and maintenance. The questionnaire contains questions about quality of sleep, possibility to fix one's attention on acting, inner tension, self-confidence. Almost 1/4 of women and 18% of men have poor frame of mind. We find very strong and important relationships between neurosis and the poor frame of mind. There were no differences in mental state between people living in towns and villages. The unemployed and the cripples have worse psychological condition than working men. People who are divorced and widowed have statistically more often poor frame of mind and neurosis than the married. We also found a major correlation between poor frame of mind and neurosis and education. Low education is connected with poor psychological condition.

Accumulating evidence from European cities indicates that current levels of ambient air pollution are likely to be associated with detectable effects on daily mortality and hospital admissions. Public health authorities everywhere are concerned about the possible effects of air pollution on the health of their populations but there are no guidelines for how these effects can efficiently be monitored. Furthermore, decisions about air pollution monitoring tend to be made without reference to the epidemiological requirements of health monitoring. The APHEA project (Air Pollution and Health a European Approach) investigated the short-term health effects of air pollution in 15 European cities. Experience gained in this project provides a basis for recommendations to public health and environmental authorities concerning the requirements for a basic health monitoring system. This paper considers the theoretical and practical aspects of a monitoring system and makes recommendations concerning 1) the minimum data set required, 2) the methods of statistical analysis and presentation and 3) Europe-wide coordination of monitoring.

Air pollution concentration measurement in Poland are routinely carried on using aspiration methods. This technique required suitable measurement point preparation and its monitoring. During last years passive monitors are used more and more frequently for some air pollutants concentrations measurement. The above mentioned method is recommended when spatial differentiation of air pollution are analized. Results of such measurements carried of in the area of Poznań are presented in this contribution.

Ten large European cities provided data on daily air pollution as well as mortality from respiratory and cardiovascular mortality. We used Poisson autoregressive models that controlled for trend, season, influenza epidemics, and meteorologic influences to assess the short-term effects of air pollution at each city. We then compared and pooled the city-specific results in a meta-analysis. The pooled relative risks of daily deaths from cardiovascular conditions were 1.02 [95% confidence interval (CI) = 1.01-1.04] for a 50 microg/m3 increment in the concentration of black smoke and 1.04 (95% CI = 1.01-1.06) for an increase in sulfur dioxide levels in western European cities. For respiratory diseases, these figures were 1.04 (95% CI = 1.02-1.07) and 1.05 (95% CI = 1.03-1.07), respectively. These associations were not found in the five central European cities. Eight-hour averages of ozone were also moderately associated with daily mortality in western European cities (relative risk = 1.02; 95% CI = 1.00-1.03 for cardiovascular conditions and relative risk = 1.06; 95% CI = 1.02-1.10 for respiratory conditions). Nitrogen dioxide did not show consistent relations with daily mortality. These results are similar to previously published data and add credence to the causal interpretation of these associations at levels of air pollution close to or lower than current European standards.

In 1995, the Government of the Russian Federation initiated an Environmental Management Project with a general aim to improve environmental conditions and associated human health [1]. An Environmental Epidemiology Component of the Russian Environmental Management Project was initiated to perform policy-oriented environmental epidemiology and risk assessment, and to establish systems for information transfer to decision-makers in environmental policy. Harvard School of Public Health, representing a broad group of international investigators, was chosen as a consultant to the Environmental Epidemiology Component.

The air pollution concentrations of SO2 and suspended particulate matter in 1993 in one Polish city Poznan and over entire Poland have been modeled and mapped. The data for Poznan were obtained during special epidemiological study by means of a dense network of passive samples and the data for Poland were obtained from the routine network operated by Sanitary Epidemiological Stations. The modeling employed the kriging method of ARC/INFO computer package. It was found that about 1/3 of Polish population was exposed to the SO2 and/or SPM level that exceeded annual recommended values. In Poznan 25% of children aged 8-9 years were exposed to SO2 level above 100 during heating season 1992/1993.

Recent studies investigating the adverse health effects of air pollution indicate that effects exist around and below the current national and international air quality guidelines and standards. However, the difficult methodological issues involved, and the diversity of analytical techniques so far applied, hinder direct between-study comparability and the drawing of clear conclusions. The APHEA (Air Pollution on Health: European Approach) project is an attempt to provide quantitative estimates of the short-term health effects of air pollution, using an extensive data base from 10 different European countries, which represent various social, environmental and air pollution situations. Within the framework of the project, the methodology of analysing epidemiological time series data, as well as that of performing meta-analysis, are further developed and standardized. Data have been collected from 15 European cities with a total population exceeding 25 million. The exposure data consist of daily measurements of black smoke, sulphur dioxide, suspended particles, nitrogen dioxide and ozone (each available in several, though not all, cities) from already existing monitoring networks. There is substantial variability in air pollution mixtures and air pollutant levels in participating cities. The mean (24 h) levels of SO2 range 27-327 micrograms.m-3 in the winter season, and those of black smoke range 15-292 micrograms.m-3. The mean (1 h) levels of ozone in the summer season range 32-166 micrograms.m-3. The outcome data are daily counts of total and cause-specific deaths and hospital emergency admissions. Data on potential confounders (mainly meteorological and chronological variables) are also used. There is large diversity in the climatic conditions in the different cities.(ABSTRACT TRUNCATED AT 250 WORDS)

The purpose of the analysis was to evaluate an association between selected factors of home environment and respiratory symptoms (wheezing/whistling) and asthma diagnosed by physician in 4333 children of age 7-8 years in Poznań. The data were collected within the scope of the EU funded multinational SAVIAH study. It was found that presence of the symptoms as well as asthma were significantly associated with presence of damp spots and/or mould at home and disturbance by traffic fumes and/or noise at home. The association of respiratory symptoms with ETS and presence of pets was less clear.

Within the framework of international collaboration an epidemiological study has been carried out in Poznań with the objective to develop and assess new methodologies in environmental epidemiology in Poland. The network of passive samplers has been set up for estimation of SO2 and NO2 air pollution exposure, small area analysis methods and Geographic Information System will be used for assessment of the relationship of respiratory symptoms and air pollution while controlling for socioeconomic factors and household characteristic.

The present study was aimed at assessment of a degree of regional differences in hospitalized morbidity in Poland for some of diseases considered to be related to environmental contamination and its relationship with general environmental characteristic of the regions. The performed analysis has shown that however in recent years there have been substantial differences in the discharge rates between provinces of Poland, these differences are not well explained by differences in general environmental factors. The possible reasons of these results have been discussed.

In the present study of hospitalization rates during the period 1979-1990 for some of the diseases considered to be related to environmental contamination were analyzed. Selected diagnosis included malignant melanoma and other malignant neoplasm of skin, malignant neoplasm of bladder, myeloid and monocytic leukaemia, aplastic anaemia, chronic obstructive pulmonary disease and asthma, diseases of skin and subcutaneous tissue, spontaneous abortion and congenital anomalies. The performed analysis has shown that in 1979-1990 discharge rates had significant growing trends in the both urban and rural population in the case of malignant neoplasm of bladder, leukaemia, spontaneous abortion and congenital anomalies in infants. There were no significant trends in hospitalization of malignant melanoma and other malignant neoplasm of skin, aplastic anaemia and asthma.

Following two prevalence studies of arterial hypertension carried out at 5-year interval on 6487 adult inhabitants of Ochota District, Warsaw, screening for new cases was performed at the end of the five- or ten-year observation period. Interviews were collected from 472 incident and unknown prevalence cases and 499 randomly chosen non-cases regarding social and work conditions, selected behavioral traits and personal habits. The risk of hypertension was more closely associated with blue collar social status, poor economic self-assessment and repetitive type of work in women than men. In males, but not females, higher risk was connected with expressed anger followed by feeling of guilt, but no otherwise suppressed anger was predictive of hypertension. In both sexes the incidence of the disease was higher among people reporting less life events, and with less involvement in the household and/or professional activities.

Several studies indicated that short-term increases in concentration of pollution in the atmosphere of a town may result in increased mortality in the days following the episode. To evaluate this relationship we analyzed data on daily mortality in Cracow, Poland, in the period 1977-1989 and data on daily concentrations of suspended particulates (PM 20) and sulfur dioxide (SO2) in the town area. This analysis was restricted to winter months. In 1167 winter days, an average of 18.4 deaths of Cracow residents occurred daily. PM 20 concentration exceeded 300 micrograms/m3 in 21%, and SO2 exceeded 200 micrograms/m3 in 19% of those days. The correlation coefficient of the daily number of deaths with the air pollution in the 24 hours preceding the day of death was 0.093 (p0.01) for PM 20, and was 0.141 (p0.001) for SO2. Similar correlations were found for air pollution levels in the four days preceding death, and the correlation decreased for earlier days. The effects were more pronounced in people over 65 years of age than in those younger, especially in males. After adjustment for SO2 levels, PM 20 had no additional effect on mortality. It was estimated that with an increase of SO2 concentration of 100 micrograms/m3, the daily number of deaths due to respiratory system diseases increased by 19% and deaths due to circulatory system diseases by 10%.

The prevalence of nonspecific respiratory diseases was confirmed by two physical examinations taken five years apart. Data were analysed in relation to the area of residence within the city. Particular emphasis was placed on higher or lower levels of atmospheric air pollution. Using multivariate methods of analysis it was shown that air pollution increased the risk of: persistent cough or phlegm, chronic bronchitis and reduced ventilatory capacity in the group of man exposed to occupational hazards. Additionally, it was noted that amongst men reporting persistent cough or phlegm, the prevalence of exacerbation of these symptoms was much greater in residents of more highly polluted parts of the city. In women, the prevalence of exacerbation of symptoms was associated with particular indoor environments.

The role of atmospheric air pollution in the aetiology of chronic respiratory diseases has been studied in many epidemiological surveys, but until now their results have been rather controversial. It seems that further investigations in this field should take into consideration factors that possibly confound the effect of air pollution. The definition of “chronic” respiratory symptoms employed may have some impact on the results obtained. In several studies, spontaneous remission of symptoms believed to be “chronic” was observed. As the diagnosis of chronic chest diseases may be biased by the temporary occurrence of cough or phlegm and by a short-term variability in lung function, it was decided to define as chronic the persistence of chest symptoms over a 5-year period.

The main purpose of the paper was to compare the effects of outdoor and indoor air quality on the development of chronic respiratory diseases measured in the prospective study of chronic chest diseases among the inhabitants of Cracow, Poland. The 5-year follow-up study covered a probability sample of 4355 adult inhabitants. Data on respiratory symptoms and lung function in addition to variables related to environmental and socioeconomic factors were included. To assess the separate and joint effects of the chosen environmental factors on chronic chest problems, the multiple logistic regression analysis has been carried out. As expected, smoking habit was the strongest single of the factors related to the persistence of the respiratory symptoms. The effect of smoking was more marked in men than in women and this can be attributed to longer duration of smoking and more cigarettes smoked daily by men. Out of all considered adverse occupational factors only chemicals increased the risk of chronic bronchitis in men while dust increased the risk of exacerbations in women. The data showed a significant decrease in risk of exacerbations among the women who used a gas stove for cooking. The study also confirmed the harmful effect of smoking on lung function. Against this particular background the importance of variable temperature combined with ambient air pollution appeared to have rather strong detrimental biologic impact.

This report presents national statistics on hospital use from the U.S. National Hospital Discharge Survey and the Polish General Hospital Morbidity Study. Comparisons are made of discharge rates, average lengths of stay, rates of patient care days, and fatality rates by sex, age, and diagnostic category. The similarities and differences between the two countries in population characteristics, health status, health services systems, and health care resources are also described.

To ascertain whether measles vaccination was associated with reduced mortality rates in rural Bangladeshi children, the authors conducted a case-control study in four contiguous areas, two of which had participated in an intensive measles vaccination program which began in the spring of 1982. Cases were 536 children who had died in the four-area region at the age of 10-60 months between April 1982 and December 1984. Two age- and sex-matched controls were selected from the four-area region for each case; each control had survived at least through the date of death of the matched case. Measles vaccination was associated with a 36% (95% confidence interval 21%-48%) proportionate reduction in the overall rate of death and a 57% (95% confidence interval 43%-67%) reduction in the rate of deaths directly attributed to measles or ascribed to diarrhea, respiratory illness, or malnutrition. The association of measles vaccination and reduced mortality remained unchanged after the authors restricted controls to children who had survived at least one year after the deaths of their matched cases. Moreover, children vaccinated in 1982 exhibited a sustained reduction in the rate of death in 1983 and 1984. The authors concluded that measles vaccination was associated with a pronounced and sustained reduction in the rate of death among children in this study.