Abstract

۱٫ Introduction

۲٫ Methods and Materials

۳٫ International Perspective on Air Pollution

۴٫ General and Respiratory Disease Hospitalization and Mortality Rates

۵٫ Children

۶٫ Adults

۷٫ COVID-19 Pandemic

۸٫ Social Awareness of Air Pollution in Poland

۹٫ Limitations and Future Perspectives

۱۰٫ Conclusions

Abbreviations

References

Abstract

     According to the World Bank Group, 36 of the 50 most polluted cities in the European Union are in Poland. Thus, ambient air pollution and its detrimental health effects are a matter of immense importance in Poland. This narrative review aims to analyse current findings on air pollution and health in Poland, with a focus on respiratory diseases, including COVID-19, as well as the Poles’ awareness of air pollution. PubMed, Scopus and Google Scholar databases were searched. In total, results from 71 research papers were summarized qualitatively. In Poland, increased air pollution levels are linked to increased general and respiratory disease mortality rates, higher prevalence of respiratory diseases, including asthma, lung cancer and COVID-19 infections, reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The proximity of high traffic areas exacerbates respiratory health problems. People living in more polluted regions (south of Poland) and in the winter season have a higher level of air pollution awareness. There is an urgent need to reduce air pollution levels and increase public awareness of this threat. A larger number of multi-city studies are needed in Poland to consistently track the burden of diseases attributable to air pollution.

Introduction

     Ambient air pollution is one of the most significant environmental issues affecting health and wellbeing. It is linked to increased mortality from cardiovascular and respiratory diseases, including lung cancer and chronic obstructive pulmonary disease (COPD), shortening life expectancy [1]. It is estimated that in Europe in 2019, about 307,000 premature deaths were caused by chronic exposure to fine particulate matter with a diameter of 10 micrometres or smaller (PM10) and to coarse particulate matter with a diameter of 2.5 micrometres or smaller (PM2.5) [2]. In addition, about 40,000 premature deaths were attributed to chronic nitrogen dioxide (NO2) exposure [2].

     According to the World Bank Group, 36 of the 50 most polluted cities in the European Union are in Poland [3]. Moreover, Polish cities are among the urban areas with the highest estimated PM mortality burden [4]. Despite a consistent decrease in annual outdoor PM concentrations in the most polluted Polish cities in the recent decade, current values still do not meet the World Health Organisation (WHO) guidelines [5,6].

Conclusions

     In Poland, increased air pollution levels are linked to increased general and respiratory disease mortality and hospitalization rates as well as a higher prevalence of respiratory symptoms (wheezing, dyspnoea attacks, chronic cough) and respiratory diseases, including bronchitis, asthma, rhinitis, lung cancer and COVID-19 infections. Reduced FEV1 and FVC in spirometry tests are also observed. Infants, children, adolescents as well as adults are affected by worse air quality. Living in the proximity of high traffic areas exacerbates respiratory health problems.

     There is ample evidence that the course of asthma and bronchitis is exacerbated in areas with high ambient air pollution, while the indicators of subjective quality of life in asthmatic patients are lower. In atopic subjects, air pollution seems to sensitise the body and trigger an excessive response when combined with the usual allergen. There is also some evidence that higher concentrations of PM2.5, PM10, SO2, NO2 and ozone may facilitate the spread and infectiousness of SARS-CoV-2.