Abstract
A strong and consistent association has been observed between morbidity or mortality rates and PM concentration, and is well documented in many countries. In Poland, despite poor air quality, studies concerning the evaluation of acute health effects of ambient air pollution on morbidity from respiratory or cardiovascular diseases are rare. We examined the short-term impact of PMx concentration on hospital admission in 31 Polish cities based on the daily PM10, PM2.5 concentration, meteorological variables, and hospital data. The generalized additive model (GAM) and a random-effects meta-analysis were used to assess the impact of air pollution on morbidity within the exposed population. Almost 1.6 million cardiovascular admissions and 600 thousand respiratory disorders were analyzed. The RR values for PM10-related cardiovascular and respiratory hospital admissions in Poland are equal to 1.0077 (95% confidence interval, 1.0062 to 1.0092) and 1.0218 (95% confidence interval, 1.0182 to 1.0253), respectively, while for PM2.5 1.0088 (95% confidence interval, 1.0072 to 1.0103) and 1.0289 (95% confidence interval, 1.0244 to 1.0335), respectively. Moreover, a moderate heterogeneity of RR estimates was observed between the analyzed cities (I2 values from 27% to 45%). The presented analysis confirms the significant association between hospital admission and PMx concentration, especially during heating seasons.
Highlights
Associations between ambient air pollution and adverse health effects are well documented, with both long-term [1,2,3] and short-term health impacts [4,5,6]
On the other hand, when the NMMAPS protocol was applied, the results for PM2.5 and PM10 differed considerably (Tables 4 and 5). This may suggest that the generalized additive model (GAM)-fitting method used within the APHEA protocol might have been too constrained and/or caused model overfitting, which led to unsatisfactory results
Time-series analyses of particulate matter (PM)-related morbidity in Poland are still rare and, to the authors’ knowledge, until the end of 2021, no paper was published that included an analysis of the risk of hospitalizations with the use of GAM models
Summary
Associations between ambient air pollution and adverse health effects are well documented, with both long-term [1,2,3] and short-term health impacts [4,5,6]. The health effects of air pollution include cardiovascular diseases and symptoms [6,9,12,13], and respiratory problems [9,13,14], as well as premature mortality [1,2,3,5,7,9,10,11,12] Each of these health effects can be represented by a need for hospitalization, and many studies have examined the relationship between short-term changes in air pollution and the hospital admission rates in the exposed population [4,6,12,15]. Most air pollutants can be associated with their characteristic, Pollutant
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