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Emissions from the household sector are the most significant source of air pollution in Poland, one of the most polluted countries in the EU. Estimated health impacts of the reduction of these emissions under three scenarios are presented. The EMEP4PL model and base year emission inventory were used to estimate average annual PM10 and PM2.5 concentrations with spatial resolution of 4 km &times, 4 km. The change in emissions under each of the scenarios was based on data from a survey on household boilers and insulation. Scenario 1 included replacement of all poor-quality coal-fired boilers with gas boilers, Scenario 2 included replacement of all poor-quality coal-fired boilers with low-emission boilers but still using solid fuels, and Scenario 3 included the thermal refurbishment of houses with the worst insulation. Impacts on the following health parameters were estimated: premature deaths (PD), Chronic Bronchitis (CB), Bronchitis in Children (BiC) and Work Days Lost (WDL). The concentration&ndash, response functions recommended by the WHO HRAPIE project were used. The analysis was conducted for two regions: Lower Silesia and Lodzkie province. The largest reduction of health impact was observed for Scenario 1. For Lower Silesia, the annual PD decreased by 1122 (34.3%), CB by 1516 (26.6%), BiC by 9602 (27.7%) and WDL by 481k (34.7%). For Lodzkie province, the largest impacts were estimated as decreases in PD by 1438 (29.9%), CB by 1502 (25.3%), BiC by 9880 (26.8%) and WDL by 669k (30.4%).

Ambient air pollution impairs lung development in children, particularly in industrialized areas. The air quality in Zabrze, a city located in the Upper Silesian Industrial Region of Poland, is among the worst in Europe. We compared lung function and the frequency of respiratory or allergic symptoms between children living in Zabrze and those living in Gdynia, a city on the Baltic coast, which has the best long-term air quality in Poland. We enrolled children aged 9–15 years from both cities who were able to perform a spirometry. The following spirometry variables were measured for all participants: forced vital capacity (FVC), forced expiratory volume during the first second of expiration (FEV1), FEV1/FVC index, and peak expiratory flow (PEF). The frequencies of respiratory or allergic symptoms were taken from a survey completed by the participants’ parents. In total, 258 children from Gdynia and 512 children from Zabrze were examined. The mean values of FVC, FEV1, and PEF were significantly greater among children in Gdynia than those reported in Zabrze (p ≤ 0.032), and the frequencies of seasonal rhinorrhea (p = 0.015) or coughing episodes (p = 0.022) were significantly higher in Zabrze than in Gdynia. In conclusion, lung function was significantly impaired in children living in Zabrze, an area which is associated with poor air quality. Strategies to improve air quality in the Silesia region are urgently needed.

This study aimed to evaluate the mass concentration of size-resolved (PM1, PM2.5, PM4, PM10, PM100) particulate matter (PM) in the Wieliczka Salt Mine located in southern Poland, compare them with the concentrations of the same PM fractions in the atmospheric air, and estimate the dose of dry salt aerosol inhaled by the mine visitors. Measurements were conducted for 2 h a day, simultaneously inside (tourist route, passage to the health resort, health resort) and outside the mine (duty-room), for three days in the summer of 2017 using DustTrak DRX devices (optical method). The highest average PM concentrations were recorded on the tourist route (54–81 µg/m3), while the lowest was in the passage to the health resort (49–62 µg/m3). At the same time, the mean outdoor PM concentrations were 14–20 µg/m3. Fine particles constituting the majority of PM mass (68–80%) in the mine originated from internal sources, while the presence of coarse particles was associated with tourist traffic. High PM deposition factors in the respiratory tract of children and adults estimated for particular mine chambers (0.58–0.70), the predominance of respirable particles in PM mass, and the high content of NaCl in PM composition indicate high health benefits for mine visitors.

Group-B streptococci (GBS) are commensal bacteria of the human body. They may, however, pose a serious life hazard to pregnant women. During labour, newborns of GBS-positive mothers run the risk of infections that may eventually lead to severe complications, sepsis or even death. For this reason, it is very important to find new diagnostic markers that will enable fast and effective diagnostics and control of the disease process. The level of procalcitonin emerges as a promising diagnostic parameter. AIM. Analysis of the impact of the procalcitonin (PCT) level in GBS-positive pregnant women on the possibility of complications and infections in mothers and newborns MATERIAL AND METHODS. The study group consisted of 115 GBS-positive pregnant women. For each mother-to-be, the CRP and the PCT concentration levels were determined. The clinical state of 117 newborns (2 twin pregnancies) was also assessed. After delivery, the CRP concentration level was determined in the newborns. The examinations had a retrospective character. RESULTS. 30 women showed a raised concentration of CRP and 13 – of PCT. No correlation was found between the two diagnostic markers. Similarly, no relation was found between a raised concentration of PCT and the occurrence of a bacterial infection or other complications in the parturient. A raised concentration of procalcitonin in the mother did not translate into the development of an infection in the newborn, either. CONCLUSIONS. The results of the study indicate that there is no correlation between a raised concentration of PCT in GBS-positive pregnant women and a raised CRP level. Abnormal PCT levels in the women covered by the study did not involve a higher frequency of the occurrence of complications or bacterial infections either in the mothers or in the newborns.

Many studies have shown associations between exposure to air pollutants and negative health effects such as increased number of Hospital Admissions for respiratory and cardiovascular diseases or even increased daily mortality due to those causes. To assess air quality in ambient air continuous monitoring is run in many cities worldwide. Data which is collected at these points should represent exposure of the population and is used to monitor medium and long-term trends. To provide an information for citizens about the impact of air quality on their health several governmental and municipal agencies developed air quality health indices These tools are based on environmental epidemiology models and on-line air quality data. The health risk is assessed differently for each index. In this paper review of Canadian, American, Hong Kong’s Air Quality Health Index.

Background: 69.3% of individual households in Poland produces thermal energy from coal burning (in 13.7% there are also fireplaces for wood and biomass). They are responsible for 55.8% of fine particulate matter (PM2.5) emission. As mentioned by Badyda et al. Adv Exp Med Biol 2016;944:1-9 in Polish cities PM2.5 is responsible for 10-33% of cardiopulmonary mortality. Material and Methods: 500 people from a small city in the agglomeration of Warsaw were surveyed in an ongoing study on the exposure to PM2.5 from individual households. A questionnaire was conducted and selected 100 people are undergoing medical examination (spirometry test, induced sputum composition, FeNO, CO in the exhaled air, skin prick tests, total and specific IgE, hemodynamics, vascular endothelial function). Statistical analysis was completed (e.g. ANOVA, GRM, PCA). Results: PM2.5 standards in the city are not met (in 2015 were >32 μg/m3). Though only 21% of the investigated inhabitants suppose that air quality is low or very low. Significant fraction of never-smokers (56.4% of the whole examined group) demonstrate symptoms typical for people exposed to air pollutants (PM), like conjunctivitis (21.5% of the non-smokers), rhinitis (34.2%), larynx inflammation (18.1%), frequent respiratory infections (16.1%) but also breathlessness/tightness and pain behind the breastbone (14.8%). Pulmonary symptoms significantly more often occur in people with FEV1 Conclusion: Exposure to PM2.5 in never smokers may increase the prevalence of respiratory and cardiovascular diseases.

Background : Exposure to polycyclic aromatic hydrocarbons (PAHs) consumed with grilled meat might be hazardous for human health. There is still lack of data on inhalation exposure to PAHs in barbecue smoke. Total PM emission from grill is very high (Rogula-Kozlowska et al. Environ Monit Assess 2013;185:581-601) and such PM concentrations might influence increased cancer risk (Badyda et al. Adv Exp Med Biol 2016;944:1-9). Material and methods : 3 types of fuel were used: liquid propane (LP), lump charcoal (LC) and charcoal briquettes (CB). 16 PAHs congeners were extracted from PM 2.5 samples and measured using GC chromatograph. Size dependent deposition in different parts of human respiratory tract was modelled. Probabilistic risk model was developed to assess the incremental lifetime cancer risk (ILCR). Results : Significant increase in PAH concentrations from grill powered by CB was noticed. Total concentration of PAHs ranged from 3 (charcoal briquettes. Daily exposure doses of PM 2.5 bound-BaP eq for typical grill master while grilling meat was 326.9; 401.6 and 0.04 ng/day, for LC, CB and LP powering respectively. Inhalation-ILCR (geometric mean) ranged from of 5.57×10 −5 (exposure to PM 2.5 -bound PAHs from unloaded gas grill) to 5.77×10 −1 (food grilled using charcoal briquettes). The risk for people inhaling grill emission gases for 5 hours/day, 20 days/year exceeded 10 −3 , suggesting high probability of cancer occurrences due to PAHs exposure. Conclusion : Charcoal briquettes are most dangerous concerning inhalation exposure to PAHs from BBQ emissions. To protect against such risk exposure duration should be less than 1 hour.

Background: Due to the widespread use of coal and wood in households for heating purposes, Poland has one of the weakest air quality in the EU. Moreover in East-Central Europe there is still relatively little evidence on the relationship between air pollution, respiratory efficiency and the occurrence of obstructive diseases. Material: 500 people living in a small city in the Warsaw area were surveyed in the ongoing investigation focused on exposure to fine PM originating from the low-stack emission sources. A questionnaire was conducted followed by selected pulmonary, allergy and cardiology examinations (e.g. spirometry, induced sputum, FeNO, SPT, IgE, hemodynamics, vascular endothelial function). Stochastic-exploratory analysis (e.g. ANOVA, GRM or PCA) was conducted. Results: PM 2.5 concentration in the city does not meet the EU standards (in 2014 exceeded 31 ug/m 3 -the highest in the region). Though only 21% of the investigated inhabitants suppose that air quality is low or very low. Significant fraction of never-smokers (56.4% of the whole examined group) demonstrate symptoms typical for people exposed to polluted air, like conjunctivitis (21.5% of the non-smokers), rhinitis (34.2%), larynx inflammation (18.1%) but also breathlessness/tightness and pain behind the breastbone (14.8%). 16.1% of the never-smokers suffer from frequent respiratory infections. Asthma was diagnosed in 8.1%, CHD in 4.7% and COPD in 2% of the group. Conclusion: The initial results may indicate a relationship between continuous exposure to PM 2.5 and the prevalence of respiratory and circulatory systems diseases in never smokers. Ongoing research will help to verify this thesis.

Background: People living in the vicinity of roads are likely to be more exposed to adverse effects of ambient air pollution. In East-Central Europe there is relatively little evidence on the relationship between air pollution, respiratory efficiency and the occurrence of obstructive diseases. Material: 3,997 inhabitants living in proximity of 7 selected urban busy roads in Warsaw (Poland) and 988 people living in rural areas with low PM 10 concentration were investigated in 2008-2012. Pulmonary function tests (EasyOne spirometers) were completed and occurrence of respiratory system diseases, allergies, smoking, sport activities, etc. was examined. Generalized and logistic regression were used to check the association between exposure to PM 10 and respiratory efficiency. Differences in obstructive diseases incidence were assessed with ANOVA-FS test. Results: Statistically significant differences (p 1 , PEF and MEF 50 were observed between inhabitants of Warsaw and the control group. Significant association between living close to a busy road and risk of obstruction was found and was particularly high among non-smokers (4.1-times higher RR of obstruction). A 3% decrease of FEV 1 among non-smokers was associated with a 17.6 μg/m 3 increase of 5-years mean PM 10 concentration. Statistically significant differences (p Conclusion: The results prove a significant role of PM air pollution in development of diseases causing bronchial stricture. The risk of flow limitation highly depends on place of living, particularly among non-smokers.

The Polish Spirometry Day is an initiative aimed at increasing awareness of the causes, symptoms, course, and effects that accompany respiratory diseases, especially asthma and chronic obstructive pulmonary disease (COPD). In 2013, the second edition of the Spirometry Day was held. It gathered 180 medical centers and other institution. The final analysis encompassed a total of 1187 persons from 26 different locations, including rural areas, and smaller and larger city agglomerations. Of this total, 755 persons (63.6 %) completed their spirometry tests for the first time in life. Each person fulfilled a questionnaire regarding the personal information, respiratory diseases, symptoms, lifestyle, and a place of residence. In the total group, 234 (19.7 %) cases of bronchial obstruction were diagnosed. A hundred and thirty four persons with obstruction, among those tested for the first time in life (17.8 %), were unaware of their disease. The lowest values of FEV1 and FEF(1)/FVC, corresponding to the highest percentage of persons with obstruction (27.9 %) were observed in small and medium cities (100,000-500,000 inhabitants). There were differences in the prevalence of obstruction depending on the distance of the place of residence from a busy traffic road. A significant decrease of both spirometric variables was observed among people living in cities above 100,000 inhabitants within a distance lower than 50 m from roads. In general, better spirometry results were observed among inhabitants living more than 150 m from main roads.

Children exposure to PM2.5 is associated with several negative health effects. Particulate air pollution in the ambient and indoor air could lead to exacerbation of respiratory diseases and even influence cognitive function in children. One of the methods to improve indoor air quality is to use electronic air purifiers. Such an equipment is still not commonly used in Polish kindergartens and homes. The aim of the study was to assess changes in children exposure to particulate air pollution in kindergarten classrooms due to the occurrence of air purifier. Automatic PM2.5 concentration monitors were used to assess the air quality changes in the indoor and ambient air. As it was a pilot study, four kindergartens in Warsaw has been chosen as research fields. Concentration measurements were conducted in cold season. In each kindergarten measurements of the PM2.5 concentration were made in two classrooms - one with air purifier switched on and the other one without air purification. Changes in air quality were observed due to opening windows and the presence of the children. Air quality in classrooms with air purification was on average almost 40%-50% better than in those without any procedures to decrease air pollutants concentration.

The Polish Spirometry Day is an initiative aimed at increasing awareness of the causes, symptoms, course, and effects that accompany respiratory diseases, especially asthma and chronic obstructive pulmonary disease (COPD). In 2013, the second edition of the Spirometry Day was held. It gathered 180 medical centers and other institution. The final analysis encompassed a total of 1187 persons from 26 different locations, including rural areas, and smaller and larger city agglomerations. Of this total, 755 persons (63.6 %) completed their spirometry tests for the first time in life. Each person fulfilled a questionnaire regarding the personal information, respiratory diseases, symptoms, lifestyle, and a place of residence. In the total group, 234 (19.7 %) cases of bronchial obstruction were diagnosed. A hundred and thirty four persons with obstruction, among those tested for the first time in life (17.8 %), were unaware of their disease. The lowest values of FEV1 and FEF(1)/FVC, corresponding to the highest percentage of persons with obstruction (27.9 %) were observed in small and medium cities (100,000-500,000 inhabitants). There were differences in the prevalence of obstruction depending on the distance of the place of residence from a busy traffic road. A significant decrease of both spirometric variables was observed among people living in cities above 100,000 inhabitants within a distance lower than 50 m from roads. In general, better spirometry results were observed among inhabitants living more than 150 m from main roads.

Epidemiological studies show that long-term exposure to air pollution may increase the relative risk of obstructive lung diseases such as COPD or asthma. The risk of increased obstruction is higher among residents living in close proximity to high traffic routes where there are high concentrations of PM(10). The present study consists of two parts: the measurement of the concentration of air pollutants and of pulmonary function in selected groups of people. The study was conducted in Warsaw, Poland, in seven localizations with typical urban canyon characteristics and roads with high traffic. The control group consisted of people living in other regions of Poland with a significantly lower (p 0.05) concentration of air pollutants. The study was performed in the years 2008-2012. The incidence of obstructive lung disease was determined according to the GOLD guidelines. The study subjects were all non-smokers. The relative risk of disease took into account different exposure times to air pollutants. The findings indicate that an increase in PM(10) concentration by each 10 μg/m(3) caused an increase in the relative risk of lung obstruction by a factor of 1.27, 1.24, and 1.19 for the residence period in the vicinity to heavy traffic city roads for 20, 30, and 40 years, respectively as compared with the residence of rural unpolluted areas. A decrease in the number of people with lung obstruction with the length of residence actually indicates that people exposed to high concentrations of PM(10) become affected by lung obstruction at a lower age. The study shows a positive relative risk of lung obstruction due to an exposure to high PM(10) emission.

Epidemiological studies show that long-term exposure to air pollution may increase the relative risk of obstructive lung diseases such as COPD or asthma. The risk of increased obstruction is higher among residents living in close proximity to high traffic routes where there are high concentrations of PM10. The present study consists of two parts: the measurement of the concentration of air pollutants and of pulmonary function in selected groups of people. The study was conducted in Warsaw, Poland, in seven localizations with typical urban canyon characteristics and roads with high traffic. The control group consisted of people living in other regions of Poland with a significantly lower (p < 0.05) concentration of air pollutants. The study was performed in the years 2008–2012. The incidence of obstructive lung disease was determined according to the GOLD guidelines. The study subjects were all non-smokers. The relative risk of disease took into account different exposure times to air pollutants. The findings indicate that an increase in PM10 concentration by each 10 μg/m3 caused an increase in the relative risk of lung obstruction by a factor of 1.27, 1.24, and 1.19 for the residence period in the vicinity to heavy traffic city roads for 20, 30, and 40 years, respectively as compared with the residence of rural unpolluted areas. A decrease in the number of people with lung obstruction with the length of residence actually indicates that people exposed to high concentrations of PM10 become affected by lung obstruction at a lower age. The study shows a positive relative risk of lung obstruction due to an exposure to high PM10 emission.

Traffic-related air pollutants have an impact on human health and have been recognized as one of the main stressors that cause mortality and morbidity in urban areas. Research confirms that citizens living in the vicinity of main roads are strongly exposed to high concentrations of numerous air pollutants. In the present study the measurements of traffic-related parameters such as density, velocity, and structure were performed for cross-sections of selected street canyons in Warsaw, the capital city of Poland. In addition, the results of the general traffic measurements were used to describe the number of cars crossing the border of the city. Vehicle emissions of PM10 were calculated for the whole city area and changes of the PM10 concentration were modeled to present the exposure to this pollutant that could be attributable to traffic. The principles of the environmental burden of disease (EBD) were used. The assessment of the impact of traffic-related air pollutants on human health was made. The results, presented in disability-adjusted life years (DALY), were based on the outcomes of the study conducted in 2008–2012 in Warsaw, one the most congested agglomerations in Europe, and included the health damage effect of the exposure to high concentrations of air pollutants. DALY calculations were performed in accordance to the methodologies used in renowned international scientific research on EBD.

The chapter presents the results of pulmonary function tests conducted as part of the Polish Spirometry Day of 2011, an initiative aimed at increasing the awareness of causes, symptoms, and delayed effects of common respiratory diseases, in particular of bronchial asthma and chronic obstructive pulmonary disease, and at demonstrating the role of regular examinations, especially in higher risk groups. The results show that there was a relatively substantial group of persons, 11.2 % of the population sample studied, not being aware of a respiratory disease they had. Furthermore, the results show that quite often, 12.4-16.0 % of the population studied, obstruction was diagnosed in persons who did not have any spirometry tests done before, despite some respiratory symptoms that should raise the attention of general practitioners to perform such tests.

The chapter presents the results of pulmonary function tests conducted as part of the Polish Spirometry Day of 2011, an initiative aimed at increasing the awareness of causes, symptoms, and delayed effects of common respiratory diseases, in particular of bronchial asthma and chronic obstructive pulmonary disease, and at demonstrating the role of regular examinations, especially in higher risk groups. The results show that there was a relatively substantial group of persons, 11.2 % of the population sample studied, not being aware of a respiratory disease they had. Furthermore, the results show that quite often, 12.4–16.0 % of the population studied, obstruction was diagnosed in persons who did not have any spirometry tests done before, despite some respiratory symptoms that should raise the attention of general practitioners to perform such tests.