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

NCT05198492 | Active Not Recruiting

• 1 other identifier: UMB-KKI-104
• Study Type: observational
• Target: 8,300,000
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

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

Keywords

Air Pollution; Public Health; Acute Coronary Syndromes; Atrial Fibrillation; Kidney Diseases; Particulate Matter; Cardiovascular Diseases

Outcome Measures

Primary Outcomes (6)

• Number of acute coronary syndromes related to the 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 to the 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 to the 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 to the 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 to the 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 ischemic strokes related to the impact of air pollution.

  Short- and long- term influence of air pollution on the number of hospital admissions for ischemic strokes.

  Through study completion, an average of 1 year

Secondary Outcomes (3)

• Cardiovascular mortality

  Through study completion, an average of 1 year

• Neoplasm mortality

  Through study completion, an average of 1 year

• Kidney disease mortality

  Through study completion, an average of 1 year

Study Arms (7)

Patients with hospitalizations or emergency room visits due to acute coronary syndromes

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

Patients with hospitalizations or emergency room visits due to atrial fibrillation

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

Patients with hospitalizations or emergency room visits due to kidney diseases

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

Patients who died due to cardiovascular diseases

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

Patients who died due to neoplasm diseases

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

Patients who died due to kidney diseases

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

Patients with hospitalizations or emergency room visits due to ischemic strokes

Data on hospitalization for ischemic strokes 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

Interventions

Impact of air pollution OTHER

To assess the short- and long- term impact of air pollution

Patients who died due to cardiovascular diseases; Patients who died due to kidney diseases; Patients who died due to neoplasm diseases; Patients with hospitalizations or emergency room visits due to acute coronary syndromes; Patients with hospitalizations or emergency room visits due to atrial fibrillation; Patients with hospitalizations or emergency room visits due to ischemic strokes; Patients with hospitalizations or emergency room visits due to kidney diseases

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will be based on residents of Eastern Poland. This term covers 5 voivodships - Warmińsko-Mazurskie, Podlaskie, Lubelskie, Świętokrzyskie, Podkarpackie - with total area of 99,004 km2. The inhabitants of this region constitute 21.3% of the population of Poland and 1.6% of the population of the European Union. The area characterized by unique natural features, large areas covered by forests, lack of factories, and relatively low industrialization is not free of air pollution. As 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.

You may qualify if:

• Residents from the analyzed area

You may not qualify if:

• None

Sponsors & Collaborators

• Medical University of Bialystok: lead
• Charles University, Czech Republic: collaborator
• University of Liverpool: collaborator
• University of Skopje: collaborator
• University of Lodz: collaborator

Study Sites (1)

Department of Invasive Cardiology, Medical University of Bialystok

Bialystok, Podlaskie Voivodeship, 15-276, Poland

Location

Related Publications (11)

• Kuzma L, Dabrowski EJ, Kurasz A, Bachorzewska-Gajewska H, Dobrzycki S. The 10-Year Study of the Impact of Particulate Matters on Mortality in Two Transit Cities in North-Eastern Poland (PL-PARTICLES). J Clin Med. 2020 Oct 27;9(11):3445. doi: 10.3390/jcm9113445.

  PMID: 33120927 BACKGROUND

• Kuzma L, Struniawski K, Pogorzelski S, Bachorzewska-Gajewska H, Dobrzycki S. Gender Differences in Association between Air Pollution and Daily Mortality in the Capital of the Green Lungs of Poland-Population-Based Study with 2,953,000 Person-Years of Follow-Up. J Clin Med. 2020 Jul 23;9(8):2351. doi: 10.3390/jcm9082351.

  PMID: 32717977 BACKGROUND

• Kuzma L, Malyszko J, Bachorzewska-Gajewska H, Kralisz P, Dobrzycki S. Exposure to air pollution and renal function. Sci Rep. 2021 Jun 1;11(1):11419. doi: 10.1038/s41598-021-91000-0.

  PMID: 34075149 BACKGROUND

• Kuzma L, Wanha W, Kralisz P, Kazmierski M, Bachorzewska-Gajewska H, Wojakowski W, Dobrzycki S. Impact of short-term air pollution exposure on acute coronary syndrome in two cohorts of industrial and non-industrial areas: A time series regression with 6,000,000 person-years of follow-up (ACS - Air Pollution Study). Environ Res. 2021 Jun;197:111154. doi: 10.1016/j.envres.2021.111154. Epub 2021 Apr 17.

  PMID: 33872649 BACKGROUND

• Kuzma L, Pogorzelski S, Struniawski K, Bachorzewska-Gajewska H, Dobrzycki S. Exposure to air pollution-a trigger for myocardial infarction? A nine-year study in Bialystok-the capital of the Green Lungs of Poland (BIA-ACS registry). Int J Hyg Environ Health. 2020 Aug;229:113578. doi: 10.1016/j.ijheh.2020.113578. Epub 2020 Aug 3.

  PMID: 32758862 BACKGROUND

• Kuzma L, Pogorzelski S, Struniawski K, Dobrzycki S, Bachorzewska-Gajewska H. Effect of air pollution on the number of hospital admissions for acute coronary syndrome in elderly patients. Pol Arch Intern Med. 2020 Jan 31;130(1):38-46. doi: 10.20452/pamw.15064. Epub 2019 Nov 19.

  PMID: 31742576 BACKGROUND

• Kuzma L, Dabrowski EJ, Kurasz A, Swieczkowski M, Jemielita P, Kowalewski M, Wanha W, Kralisz P, Tomaszuk-Kazberuk A, Bachorzewska-Gajewska H, Dobrzycki S, Lip GYH. Effect of air pollution exposure on risk of acute coronary syndromes in Poland: a nationwide population-based study (EP-PARTICLES study). Lancet Reg Health Eur. 2024 Apr 22;41:100910. doi: 10.1016/j.lanepe.2024.100910. eCollection 2024 Jun.

  PMID: 38665621 RESULT

• Swieczkowski M, Dobrzycki S, Kuzma L. Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study). Int J Environ Res Public Health. 2023 Apr 18;20(8):5566. doi: 10.3390/ijerph20085566.

  PMID: 37107848 RESULT

• Swieczkowski M, Lip GYH, Kurasz A, Jemielita P, Duzinkiewicz M, Januszko T, Dobrzycki S, Kuzma L. Short-term exposure to air pollution and risk of ischemic stroke requiring intravenous thrombolysis: a population-level analysis in Poland from the EP-PARTICLES study. Environ Health. 2025 Sep 29;24(1):69. doi: 10.1186/s12940-025-01230-2.

  PMID: 41024000 DERIVED

• Swieczkowski M, Lip GYH, Abohashem S, Jemielita P, Kurasz A, Duzinkiewicz M, Januszko T, Tomaszuk-Kazberuk A, Dobrzycki S, Kuzma L. Interplay between mental health, greenness, and environmental factors in cardiovascular mortality: insights from AIR-MIND. Eur J Prev Cardiol. 2025 Dec 23;32(18):1915-1927. doi: 10.1093/eurjpc/zwaf534.

  PMID: 40884214 DERIVED

• Swieczkowski M, Lip GYH, Kurasz A, Dabrowski EJ, Tomaszuk-Kazberuk A, Kaminski JW, Struzewska J, Dobrzycki S, Kuzma L. Association between exposure to air pollution and increased ischaemic stroke incidence: a retrospective population-based cohort study (EP-PARTICLES study). Eur J Prev Cardiol. 2025 Mar 18;32(4):276-287. doi: 10.1093/eurjpc/zwae301.

  PMID: 39301834 DERIVED

MeSH Terms

Conditions

Acute Coronary Syndrome; Atrial Fibrillation; Kidney Diseases; Ischemic Stroke; Cardiovascular Diseases

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Vascular Diseases; Arrhythmias, Cardiac; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Stroke; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Study Officials

• Łukasz Kuźma

  Medical University of Bialystok

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: January 6, 2022
• First Posted: January 20, 2022
• Study Start: January 1, 2011
• Primary Completion: December 31, 2020
• Study Completion (Estimated): December 1, 2030
• Last Updated: June 21, 2024

Record last verified: 2024-06

Locations

PL (1)