Povezanost aerozagađenja i meteoroloških uslova sa pogoršanjima astme i hronične opstruktivne bolesti pluća kod odraslih stanovnika Smedereva

  • Ivan Miodrag Stevanovic Department of Internal Medicine, General Hospital Smederevo, Smederevo, Serbia
  • Milena Jovašević-Stojanović Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
  • Jamina Jović-Stošić National Poison Control Center, Military Medical Academy, Belgrade, Serbia; §Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
DOI: https://doi.org/10.2298/4857
Ključne reči: air pollution||, ||vazduh, zagađenje, particle size||, ||čestice, veličina, weather||, ||vreme (klima), disease progression||, ||bolest, progresija, risk factors||, ||faktori rizika, pulmonary disease, chronic obstructive||, ||pluća, opstruktivne bolesti, hronične, asthma||, ||astma,

Sažetak


Uvod/Cilj. Smederevo je jedini grad u Srbiji u kome postoji železara čiji rad doprinosi aerozagađenju. Stoga se kontinuirano kontroliše kvalitet vazduha. Poslednjih godina beleže se visoke koncentracije suspendovanih čestica (paticulate matter – PM), grubih čestica PM10 i finih čestica (PM2.5). Cilj rada bio je da se ispita da li postoji povezanost pogoršanja respiratornih oboljenja, hronične opstruktivne bolesti pluća (HOBP) i astme, sa aerozagađenjem i meteorološkim faktorima. Metode. Ispitivanje je obavljeno u Opštoj bolnici u Smederevu koja pokriva oko 81 000 stanovnika, nastanjenih u krugu od približno 7 kilometara oko automatske stanice za praćenje kvaliteta vazduha, sa koje su dobijeni verifikovani podaci o nivou aerozagađivača i o meteorološkim faktorima. Podaci o bolesnicima su dobijeni iz medicinske dokumentacije. Korelacija učestalosti pogoršanja bolesti sa brojem dana u mesecu tokom kojih je zabeleženo prekoračenje graničnih vrednosti aeropolutanata i prosečnim mesečnim vrednostima meteoroloških parametara određena je pomoću Pirsonovog testa u programu SPSS. Rezultati. Ispitivanu populaciju činile su 1 624 odrasle osobe obolele od astme ili HOBP koje su tokom perioda opservacije (2011. godina) imale ukupno 570 epizoda značajnog (umerenog ili teškog) pogoršanja bolesti. Pogoršanje astme bilo je značajno češće kod žena nego kod muškaraca. Broj dana u mesecu sa visokim nivoima suspendovanih čestica PM2.5 bio je u statistički značajnoj pozitivnoj korelaciji sa ukupnim brojem umerenih i teških epizoda pogoršanja obe bolesti (astme i HOBP) kod žena. Takođe, značajna povezanost utvrđena je sa brojem umerenih epizoda pogoršanja astme u podgrupama nepušača i gojaznih bolesnika. Pozitivna korelacija mesečnog broja dana sa prekoračenjem granične vrednosti za PM10 i pogoršanja bolesti utvrđena je samo za podgrupu gojaznih nepušača sa astmom. Nije nađena značajna povezanost aerozagađenja suspendovanim česticama i egzacerbacija HOBP. Analiza povezanosti sa ambijentalnom temperaturom pokazala je postojanje negativne korelacije sa brojem pogoršanja astme u kategorijama gojaznih žena i nepušača. Povišen atmosferski pritisak bio je u korelaciji sa porastom broja umerenog pogoršanja HOBP kod žena pušača. Zaključak. Izloženost suspendovanim česticama, posebno frakciji PM2.5, i niskoj temperaturi vazduha može biti pokretač pogoršanja astme koja zahteva urgentno lečenje. Najosetljivije mogu biti žene i gojazni bolesnici.

 

 


Biografija autora

Ivan Miodrag Stevanovic, Department of Internal Medicine, General Hospital Smederevo, Smederevo, Serbia
PhD candidate, clinical and experimental pharmacology, Medical faculty, University of Kragujevac

Reference

Katsouyanni K. Ambient air pollution and health. Br Med Bull 2003; 68(1): 143−56.

Halonen J, Lanki T, Yli-Tuomi T, Kulmala M, Tiittanen P, Pekkanen J. Urban air pollution, and asthma and COPD hospital emergency room visits. Thorax 2008; 63(7): 635−41.

Karakatsani A, Analitis A, Perifanou D, Ayres JG, Harrison RM, Kotronarou A, et al. Particulate matter air pollution and respira-tory symptoms in individuals having either asthma or chronic obstructive pulmonary disease: a European multicentre panel study. Environ Health 2012;11(1): 75.

Brunekreef B, Forsberg B. Epidemiological evidence of effects of coarse airborne particles on health. Eur Respir J 2005; 26(2): 309−18.

Peters A, Wichmann H, Tuch T, Heinrich J, Heyder J. Respiratory effects are associated with the number of ultrafine particles. Am J Respir Crit Care Med 1997; 155(4): 1376−83.

Vernon MK, Wiklund I, Bell JA, Dale P, Chapman KR. What do we know about asthma triggers? a review of the literature. J Asthma 2012; 49(10): 991−8.

Ko FW, Hui DS. Air pollution and chronic obstructive pulmo-nary disease. Respirology 2012; 17(3): 395−401.

Melgert BN, Ray A, Hylkema MN, Timens W, Postma DS. Are there reasons why adult asthma is more common in females. Curr Allergy Asthma Rep 2007; 7(2): 143−50.

Meng Y, Wilhelm M, Rull RP, English P, Ritz B. Traffic and out-door air pollution levels near residences and poorly controlled asthma in adults. Ann Allergy Asthma Immunol 2007; 98(5): 455−63.

Beuther DA, Sutherland E. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med 2007; 175(7): 661−6.

Assad N, Qualls C, Smith LJ, Arynchyn A, Thyagarajan B, Schuyler M, et al. Body mass index is a stronger predictor than the metabolic syndrome for future asthma in women The longitudinal CARDIA study. Am J Respir Crit Care Med 2013; 188(3): 319−26.

Mosen DM, Schatz M, Magid DJ, Camargo CA. The relationship between obesity and asthma severity and control in adults. J Allergy Clin Immunol 2008; 122(3): 507−11.

Schaub B, von Mutius E. Obesity and asthma, what are the links. Curr Opin Allergy Clin Immunol 2005; 5(2): 185−93.

Tsaroucha A, Daniil Z, Malli F, Georgoulias P, Minas M, Kostikas K, et al. Leptin, adiponectin, and ghrelin levels in female patients with asthma during stable and exacerbation periods. J Asthma 2013; 50(2): 188−97.

Brochu P, Bouchard M, Haddad S. Physiological daily inhalation rates for health risk assessment in overweight/obese children, adults, and elderly. Risk Anal 2014; 34(3): 567−82.

Rossi O, Kinnula V, Tienari J, Huhti E. Association of severe asthma attacks with weather, pollen, and air pollutants. Thorax 1993; 48(3): 244−8.

Abe T, Tokuda Y, Ohde S, Ishimatsu S, Nakamura T, Birrer RB. The relationship of short-term air pollution and weather to ED visits for asthma in Japan. Am J Emerg Med 2009; 27(2): 153−9.

Guo Y, Jiang F, Peng L, Zhang J, Geng F, Xu J, et al. The Associa-tion between Cold Spells and Pediatric Outpatient Visits for Asthma in Shanghai, China. PLoS ONE 2012; 7(7): e42232.

Atkinson R, Anderson H, Sunyer J, Ayres J, Baccini M, Vonk J, et al. Acute effects of particulate air pollution on respiratory ad-missions: results from APHEA 2 project Air Pollution and Health: a European Approach. Am J Respir Crit Care Med 2001; 164(10): 1860−6.

Schwartz J. Short term fluctuations in air pollution and hospital admissions of the elderly for respiratory disease. Thorax 1995; 50(5): 531−8.

Tseng C, Chen Y, Ou S, Hsiao Y, Li S, Wang S, et al. The effect of cold temperature on increased exacerbation of chronic ob-structive pulmonary disease: a nationwide study. PLoS ONE 2013; 8(3): e57066.

Ferrari U, Exner T, Wanka ER, Bergemann C, Meyer-Arnek J, Hildenbrand B, et al. Influence of air pressure, humidity, solar radiation, temperature, and wind speed on ambulatory visits due to chronic obstructive pulmonary disease in Bavaria, Germany. Int J Biometeorol 2012; 56(1): 137−43.

Jenkins C, Celli B, Anderson J, Ferguson G, Jones P, Vestbo J, et al. Seasonality and determinants of moderate and severe COPD exacerbations in the TORCH study. Eur Respir J 2012; 39(1): 38−45

Objavljeno
2017/01/27
Broj časopisa
Vol. 73 Br. 2 (2016)
Rubrika
Originalni članak