Short- and Long-term Health Effects of Air Pollution in Poland

Study Overview
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Brief Summary
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The effects of air pollution on the frequency of hospital admissions and mortality due to acute coronary syndromes, atrial fibrillation, and renal disfunction are noted also in areas perceived as pollution-free (due to the lack of large industry). The aim of the project is to assess the impact of air pollution in Eastern Poland on regional public health.

Detailed Description
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The project will be conducted in Eastern Poland - the area characterized by unique natural features, large areas covered by forests, lack of factories, and relatively low industrialization. On the other hand, the region is also characterized by low socioeconomic status, in the cold season the residents' suboptimal heating choices are in result posing a major anthropogenic threat to air quality in the form of low emissions. The vast majority of studies on air pollution were conducted in highly polluted areas, in which patients are exposed to moderate and extreme concentrations of pollutants. Taking into consideration the scarce number of surveys from areas with a low level of pollution the investigators intend to analyze the relationship between air pollution and cardiovascular and renal outcomes in Eastern Poland. The examination of the impact of so-called Polish smog on mortality and morbidity in the study area is not without significance. It would be the first major study of the impact of this type of pollution on human health. In the subsequent part of the study, we will evaluate the effects of Polish smog in the entire country. In light of extant body of literature, the following will be considered as the public health indicators: acute coronary syndromes, episodes of atrial fibrillation, kidney disease hospitalizations or emergency room visits, cardiovascular and renal mortality.

Official Title
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Short- and Long-term Health Effects of Air Pollution in Poland

Conditions
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Acute Coronary Syndrome, Atrial Fibrillation, Kidney Diseases, Particulate Matter Inhalation Injury, Pollution; Exposure, Oxidative Stress

Intervention / Treatment
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* Other: Impact of air pollution


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Residents from the analyzed area Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with hospitalizations or emergency room visits due to acute coronary syndromes<br>Data on hospitalization for acute coronary syndromes were obtained and extracted from the National Health Fund reports. In the present analysis, we used data from patients registered as residents in the Podlaskie, Lubelskie, Podkarpackie, Świetokrzyskie, and Warminsko-Mazurskie voivodeships from January 1, 2011 to December 31, 2020. The set of variables that were subjected to the analysis included demographic features and ICD-10 codes. The diagnosis was based on reports obtained from to the National Health Fund, and these reports have not been reviewed with patient hospital documentation. | Other: Impact of air pollution<br>* To assess the short- and long- term impact of air pollution<br>|
| Patients with hospitalizations or emergency room visits due to atrial fibrillation<br>Data on hospitalization for atrial fibrillation were obtained and extracted from the National Health Fund reports. In the present analysis, we used data from patients registered as residents in the Podlaskie, Lubelskie, Podkarpackie, Świetokrzyskie, and Warminsko-Mazurskie voivodeships from January 1, 2011 to December 31, 2020. The set of variables that were subjected to the analysis included demographic features and ICD-10 codes. The diagnosis was based on reports obtained from to the National Health Fund, and these reports have not been reviewed with patient hospital documentation. | Other: Impact of air pollution<br>* To assess the short- and long- term impact of air pollution<br>|
| Patients with hospitalizations or emergency room visits due to kidney diseases<br>Data on hospitalization for kidney diseases were obtained and extracted from the National Health Fund reports. In the present analysis, we used data from patients registered as residents in the Podlaskie, Lubelskie, Podkarpackie, Świetokrzyskie, and Warminsko-Mazurskie voivodeships from January 1, 2011 to December 31, 2020. The set of variables that were subjected to the analysis included demographic features and ICD-10 codes. The diagnosis was based on reports obtained from to the National Health Fund, and these reports have not been reviewed with patient hospital documentation. | Other: Impact of air pollution<br>* To assess the short- and long- term impact of air pollution<br>|
| Patients who died due to cardiovascular diseases<br>Data on mortality were collected from the National Statistical Office in Poland. These include information on all the deaths recorded in the Podlaskie, Lubelskie, Podkarpackie, Świetokrzyskie, and Warminsko-Mazurskie voivodeships from January 1, 2011 to December 31, 2020 The records included sex and age of people who had died, and the causes of deaths were classified according to codes in the International Classification of Diseases-10th Revision (ICD-10). | Other: Impact of air pollution<br>* To assess the short- and long- term impact of air pollution<br>|
| Patients who died due to neoplasm diseases<br>Data on mortality were collected from the National Statistical Office in Poland. These include information on all the deaths recorded in the Podlaskie, Lubelskie, Podkarpackie, Świetokrzyskie, and Warminsko-Mazurskie voivodeships from January 1, 2011 to December 31, 2020 The records included sex and age of people who had died, and the causes of deaths were classified according to codes in the International Classification of Diseases-10th Revision (ICD-10). | Other: Impact of air pollution<br>* To assess the short- and long- term impact of air pollution<br>|
| Patients who died due to kidney diseases<br>Data on mortality were collected from the National Statistical Office in Poland. These include information on all the deaths recorded in the Podlaskie, Lubelskie, Podkarpackie, Świetokrzyskie, and Warminsko-Mazurskie voivodeships from January 1, 2011 to December 31, 2020 The records included sex and age of people who had died, and the causes of deaths were classified according to codes in the International Classification of Diseases-10th Revision (ICD-10). | Other: Impact of air pollution<br>* To assess the short- and long- term impact of air pollution<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of acute coronary syndromes related with impact of air pollution. | Short- and long- term influence of air pollution on the number of hospital admissions for acute coronary syndromes. | Through study completion, an average of 1 year | 
| Number of atrial fibrillation episodes related with impact of air pollution. | Short- and long- term influence of air pollution on the number of hospital admissions for atrial fibrillation. | Through study completion, an average of 1 year | 
| Number of hospitalizations due to kidney diseases related with impact of air pollution. | Long- term influence of air pollution on the number of hospital admissions for kidney disease. | Through study completion, an average of 1 year | 
| Number of hospitalizations due to acute kidney diseases related with impact of air pollution. | Long- term influence of air pollution on the number of hospital admissions for kidney disease. | Through study completion, an average of 1 year | 
| Number of patients under hemodialysis related with impact of air pollution. | Long- term influence of air pollution on the number of hospital admissions for kidney disease. | Through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiovascular mortality | Short- and long- term influence of air pollution on the number of cardiovascular mortality. | Through study completion, an average of 1 year | 
| Neoplasm mortality | Short- and long- term influence of air pollution on neoplasm mortality. | Through study completion, an average of 1 year | 
| Kidney disease mortality | Short- and long- term influence of air pollution on mortality related to renal function. | Through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Air Pollution, Public Health, Acute Coronary Syndromes, Atrial Fibrillation, Kidney Diseases, Particulate Matter, Cardiovascular Diseases