Air Pollution in Poland: A 2022 Narrative Review with Focus on Respiratory Diseases

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.

Influence of Selected Air Pollutants on Mortality and Pneumonia Burden in Three Polish Cities over the Years 2011–2018

“…In the case of a new WHO AQG [ 27 ], similar calculations would be expected. According to the analyzes performed by Nazar and Niedoszytko [ 28 ], increased concentrations of air pollutants in Poland are associated primarily with an increased risk of the total number of deaths and deaths due to respiratory diseases but also with a higher incidence of respiratory diseases (including bronchial asthma, lung cancer, and in recent years also COVID-19). The authors also point to effects in the form of reduced forced expiratory volume within the first second of expiration (FEV 1 ) and forced vital capacity (FVC).…”

Air pollution might affect the clinical course of COVID-19 in pediatric patients

“…Although the present findings provide important data for public health policy, study limitations must be stressed. The research was focused on two major air pollutants, PM 2.5 and B(a)P, in regions such as Poland, where coal and wood combustion plays a significant role in domestic heating ( Anioł et al, 2021 , Nazar and Niedoszytko, 2022 ). However, studies show that other air pollutants, i.e., nitrogen oxides and ozone, may also affect the COVID-19 severity and mortality ( Mele et al, 2021 , Khorsandi et al, 2021 , Achebak et al, 2021 ).…”

“…Both pollutants considered in the present study are particularly concerning in regions such as Central Europe, where the combustion of wood and coal continues to play a role in domestic heating. This results in elevated emissions of PM and PM-bound polycyclic hydrocarbons, especially between late autumn and early spring ( Anioł et al, 2021 , Nazar and Niedoszytko, 2022 ). Moreover, contrary to many world regions, the COVID-19 lockdown in Poland was not associated with a temporary decline in PM emissions, while in selected locations, they were even increased ( Rogulski and Badyda, 2021 ).…”

The Devil Is in the Data: Can Regional Variation in Amenable Mortality Help to Understand Changes in Health System Performance in Poland?

“…This is contrary to the trend observed in the majority of countries in Europe [ 38 ]. High levels of air pollution in Poland—which are the highest in the EU [ 31 ]—have been linked to increased respiratory diseases, including bronchitis, asthma, rhinitis, and lung cancer [ 39 ]. In addition to air pollution control and other preventive measures, such as smoking cessation campaigns or pneumococcal and influenza vaccination strategies, health care interventions such as more appropriate use of antibiotics and improved medical care can lead to a decrease in pneumonia mortality [ 38 ].…”