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Int J Environ Res Public Health. 2020 Jan 24;17(3). pii: E754. doi: 10.3390/ijerph17030754.

Effect of NOx and NO2 Concentration Increase in Ambient Air to Daily Bronchitis and Asthma Exacerbation, Silesian Voivodeship in Poland.

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Department of Epidemiology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.
Department of Biostatistics, School of Health Sciences in Bytom, Medical University of Silesia, 40-055 Katowice, Poland.
Environmental Exposure Assessment Group, Institute of Epidemiology, Helmholtz Zentrum M√ľnchen, 85764 Neuherberg, Germany.


There is a discussion in Europe about the dominant role of air pollution for health effects, most researchers claim that the particulate matter is responsible for inflammatory processes in the respiratory system, while others underline the role of nitrogen dioxide. The aim of the study was to assess the risk related to NOx, NO2 and PM2.5 concentration increase and daily outpatient visits or hospitalization due to bronchitis and asthma exacerbation in the entire population of Silesian Voivodeship, Poland. To assess the relationship between daily pollutants concentrations and the number of outpatient visits or hospitalizations due to bronchitis and asthma (available in the regional registry), the multivariable log-linear Poisson regression model was used. Results were presented by relative risk (RR) of health outcomes related to the increase in pollutant concentration by unit (interquartile range). Obtained results confirmed a statistically significant association between outpatient visits and hospitalizations due to bronchitis and asthma exacerbation and daily nitrogen oxides concentrations in Silesian voivodeship, Poland. The strongest relationship was observed in the case of NO2 and outpatient visits due to bronchitis, e.g., RR = 1.434 (1.308-1.571) for exposure expressed by the 50-day moving average concentration. In the case of hospitalizations, the health effect was lagged a few days in relation to the increase in exposure.


acute respiratory effect; nitrogen oxides; particulate matter; time series study

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