Vpliv ultrafinih delcev v zraku na zdravje prebivalcev Ljubljane

Viher Hrženjak, Vesna (author), Eržen, Ivan (mentor), Stanimirović, Dalibor (comentor)

Izhodišče: Izpostavljenost ultrafinim delcem (UFP) v zraku lahko povzroči škodljive posledice za zdravje človeka, zlasti vpliva negativno na dihalno in srčno-žilno obolevnost in umrljivost. Zaključki raziskav, ki so proučevale druge zdravstvene izide, kot je sladkorna bolezen, so glede učinkov UFP nedokončni in nezadostni. Namen raziskave je bil pridobiti kakovostne podatke za načrtovanje in oblikovanje z dokazi podprtih javnozdravstvenih politik na področju varovanja zdravja prebivalcev v povezavi z onesnaženostjo zunanjega zraka z UFP. Metode: Z ekološko študijo časovnih trendov smo na podlagi rutinsko zbranih zdravstvenih in okoljskih podatkov na populacijski ravni ocenili povezanost med dnevnim številom prvih kurativnih obiskov v Zdravstvenem domu Ljubljana (ZD Ljubljana) zaradi bolezni dihal, bolezni obtočil in sladkorne bolezni v skupinah vse starosti, otroci in starejši. Raziskava je bila izvedena za obdobje 1. 1. 2013 do 31. 12. 2017. Za časovno analizo povezanosti med opazovanimi zdravstvenimi izidi, pojasnjevalnim dejavnikom, motečimi dejavniki in dejavniki ozadja so bili uporabljeni Poissonovi regresijski modeli. Rezultati: Statistično značilne pozitivne povezanosti med koncentracijo UFP vseh velikostnih razredov v zunanjem zraku in dnevnim številom prvih kurativnih obiskov v ZD Ljubljana zaradi bolezni dihal, bolezni obtočil in sladkorne bolezni v starostnih skupinah vse starosti, otroci in starejši nismo mogli dokazati razen za povišane koncentracije UFP0,05–0,07 (50 do 70 nm; p < 0,001) z zamikom treh dni, ki so bile pozitivno in statistično značilno povezane z višjim dnevnim številom prvih kurativnih obiskov zaradi sladkorne bolezni v ZD Ljubljana v skupini otroci. Zaradi omejitev raziskave bodo za potrditev teh rezultatov sicer potrebne še nadaljnje raziskave. Dodatno je raziskava potrdila, da ima izpostavljenost različnim onesnaževalom v zunanjem zraku (predvsem PM2,5, NO2, SO2 in O3) z različnimi časovnimi zamiki škodljive učinke na zdravje, ki se odrazijo z večjim dnevnim številom obiskov na primarni ravni zdravstvenega varstva v vseh preiskovanih starostnih skupinah. Zaključek: Raziskava obravnava nekatere pomembne izzive na področju javnega zdravja – tako na področju raziskovanja kakor tudi na področju okoljske in zdravstvene politike Slovenije in drugih držav. Zaključki raziskave bodo služili kot osnova za oblikovanje priporočil snovalcem okoljske in zdravstvene politike v Sloveniji o potrebnosti sprejema ustrezne zakonske podlage za redno rutinsko merjenje UFP v državni merilni mreži za spremljanje kakovosti zunanjega zraka v Sloveniji (DMKŽ), o potrebnosti objavljanja rezultatov meritev in obveščanja o možnih ukrepih blaženja in prilagajanja tako na ravni družbe kot posameznika.

• Language: Slovenian
• Keywords: onesnaženost zunanjega zraka, ultrafini delci (UFP), bolezni dihal, bolezni obtočil, sladkorna bolezen, ekološka študija časovnih trendov
• Work type: Doctoral dissertation
• Organization: FGG - Faculty of Civil and Geodetic Engineering
• Year: 2023
• PID: 20.500.12556/RUL-152255
• Publication date in RUL: 15.11.2023

Secondary language

• Language: English
• Title: The impact of ultrafine particles in the air on the health of Ljubljana inhabitants

Abstract

Background: Exposure to ultrafine particles (UFP) in the air can cause adverse effects on human health, particularly affecting respiratory and cardiovascular morbidity and mortality. Conclusions from studies that have examined other health outcomes, such as diabetes, are inconclusive and insufficient regarding the effects of UFP. The aim of this study was to obtain quality data for the planning and formulation of evidence-based public health policies in the area of population health protection in connection with outdoor air pollution with UFP. Methods: Via an ecological time-trend study based on routinely collected health and environmental data, we assessed the association between the daily number of first curative visits to the Ljubljana Health Center (ZD Ljubljana) for respiratory diseases, circulatory diseases, and diabetes mellitus at the population level in groups of all ages, including children and the elderly. The research was carried out during the period from 01.01.2013 to 31.12.2017. Poisson regression models were used to analyse temporal associations between observed health outcomes, explanatory factors, confounding factors, and background factors. Results: We could not find a statistically significant positive correlation between the concentration of UFP of all size classes in outdoor air and the daily number of first curative visits to ZD Ljubljana for respiratory diseases, circulatory diseases, and diabetes mellitus in any age groups, except for elevated concentrations of UFP0.05-0.07 (50 to 70 nm; p 䁤 0.001) with a delay of 3 days, which were positively and statistically significantly associated with a higher daily number of first curative visits to ZD Ljubljana due to diabetes mellitus in the group of children. Due to the limitations of the study, further research will be needed to confirm these results. In addition, the research confirmed that exposure to various pollutants in the ambient air (mainly PM2.5, NO2, SO2 and O3) with various time lags has harmful effects on health, which are reflected in a higher daily number of visits at the primary health care level in all investigated age groups. Conclusion: This study addresses some important challenges in the field of public health, both in the field of research and in the field of environmental and health policy in Slovenia and other countries. The results of this study will serve as a basis for formulating recommendations to environmental and health policy makers in Slovenia regarding the need to adopt an appropriate legal basis for regular routine UFP measurement within the national measurement network for monitoring outdoor air quality in Slovenia (DMKŽ) and regarding the need to publish measurement results, and to inform regarding possible mitigating and adaptive measures, both at the societal and at the individual level.

• Keywords: air pollution, ultrafine particles, respiratory diseases, cardiovascular diseases, diabetes mellitus, ecological time-trend study