Associations Identified Between Respiratory Disease Hospitalizations, Air Pollutants

Anna Grzywa-Celińska, MD, PhD

Credit: Medical Centrum Lublin

There are significant correlations between hospitalizations for respiratory diseases such as chronic obstructive pulmonary disease (COPD) and air pollutants, according to recent findings, with results suggesting that pollution may be a modifiable disease exacerbation risk factor.¹

These results represented the conclusion of new research into hospital admissions data, with the investigators seeking evidence of a relationship between air pollutant concentrations and hospitalization rates among those with asthma, COPD, or abnormalities in breathing.

This research was led by Anna Grzywa-Celińska, MD, PhD, from the department of pneumonology, oncology and allergology at the Medical University, Lublin, in Poland. Grzywa-Celińska noted the ease of smog penetration into one’s bronchial tree, highlighting the known impacts such as malignancies, cardiovascular disease, endocrinopathies, fertility problems, etc.²

“An additional aim was to check whether the increase in air pollution levels results in a higher incidence of hospitalization for diseases, such as asthma and COPD, or non-specific breathing disorders,” Grzywa-Celińska and colleagues wrote. “Knowledge of the clinical significance of air pollution can be a supporting factor in the discussion of how to prevent the development or exacerbation of lung diseases in a population.”

Background and Methods

In the timeframe between January 2015 - December 2018, 2,131 individuals were admitted to the Emergency Department of Independent Public Clinical Hospital No. 4 in Lublin, Poland, and these patients were included in the investigators’ study. Diagnosis of COPD, asthma, or abnormalities of breathing had all been reported by these individuals.

The research team looked at the effects of major air pollutants recorded in Lublin, with data on such pollutants as PM₁₀, PM_2.5, NO₂,benzene, SO₂, CO, and O₃ being collected from the Chief Inspectorate for Environmental Protection's public database. The team assessed data from the years 2015 - 2018, using daily measurements with hourly precision.

The concentrations of these pollutants were averaged by the team on a monthly basis in the subsequent years, and the averages were also calculated in 2018 for individual days. The investigators would later compare the air pollutant concentration averages with hospitalization rates in the corresponding time periods.

Findings

The research team were able to find several major correlations, noting the substantial impact of the high concentrations of each examined contaminant on rates of patient hospitalization. A notable finding of the team was that there had been strong positive associations seen between asthma and benzene/NO₂, COPD-related hospitalizations and PM_2.5 as well as PM₁₀, and respiratory disorders overall with CO, benzene, and SO₂.

Aside from PM_2.5, levels of pollutants were shown by the investigators to have remained within the upper normal limits recommended by the World Health Organization’s 2021 guidelines. Although the team’s conclusions support the link between NO₂ exposure and instances of hospitalization, they expressed that further research may be needed to elucidate NO₂'s impact on rates in prevalent chronic respiratory issues.

“The study adds to the science by reporting associations between air pollutant concentrations and the exacerbations of chronic respiratory diseases leading to hospitalization,” they wrote.

References

1. ^{Grzywa-Celińska A, Krusiński A, Dos Santos Szewczyk K, Kurys-Denis E, Milanowski J. Relationship between concentration of air pollutants and frequency of hospitalisations due to respiratory diseases. Ann Agric Environ Med. 2024;31(1):13-23. doi:10.26444/aaem/169486.}
2. ^{Grzywa-Celińska A, Krusiński A, Milanowski J. ‘Smoging kills’ – Effects of air pollution on human respiratory system. Ann Agric Environ Med. 2020;27(1):1–5. https://doi.org/10.26444/aaem/110477.}