ORIGINAL RESEARCH
Air Pollution and Hospital Admissions
for Respiratory Diseases in Nis, Serbia
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1
University of Nis, Faculty of Medicine, Dr Zorana Djindjica 81, 18000 Nis, Serbia
2
University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, 21000 Novi Sad, Serbia
3
State University of Novi Pazar, Departmant of Biomedical sciences, Vuka Karadzica 9, 36300 Novi Pazar, Serbia
Submission date: 2020-10-26
Final revision date: 2021-01-14
Acceptance date: 2021-01-25
Online publication date: 2021-08-30
Publication date: 2021-09-22
Pol. J. Environ. Stud. 2021;30(5):4677-4686
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ABSTRACT
The study was aimed to investigate the effects of air pollutants particulate matter (PM2.5, PM10),
sulfur dioxide (SO2) and NO2 on hospital admissions for respiratory diseases in the residents of Nis,
Serbia, during the period 2012-2014. The findings of average daily concentrations of air pollutants
were obtained both by the measurements made by the Public Health Institute Nis and by the state
ambient air quality monitoring network of the Agency for Environmental Protection of the Republic of
Serbia. The respiratory diseases analyzed in the study are pneumonia, asthma, and chronic obstructive
pulmonary disease (COPD). Patients were categorized into three age groups (0-17.9, 18-64.9 and >65).
Poisson regression was used to examine the link between air pollutants and respiratory health outcome
at lag 0. Results was expressed as the increase in Relative Risk (RR) for hospital admissions for each
daily increase in air pollutants for 10 μg/m3. NO2 had the most significant effect on hospital admission,
although its concentrations did not exceed the prescribed values. With an increase in the daily NO2
concentrations of 10 μg/m3, the RR of daily asthma and COPD hospital admissions in Nis older than
65 years increased by 1.2% and 0.7%, respectively. In women older than 65 years, with an increase in
daily concentrations of NO2 of 10 μg/m3, the risk of daily hospital admissions for asthma increased by
1.5%. In multi-polluted statistical analysis (adjusted with PM2.5 and SO2) each daily increase in NO2 for
10 μg/m3 was statistically significant associated with the increased RR by 1.3%. In men 18 to 64 years
of age, with an increase in daily NO2 concentrations of 10 μg/m3, the RR of hospital admissions for
asthma increased by 2.0%, and in the PM2.5-adjusted model, increased by 1.8%. The suspended particles
had an effect on hospital admission for pneumonia in men up to 17.9 years of age. With an increase
in daily concentrations of suspended PM2,5 particles of 10 μg/m3, the risk of hospital admissions for
pneumonia in them increases by 0.6% and 0.4%, respectively. We found that the concentration of NO2
even lower of national limit value had the greatest impact on hospital admission due to COPD in elderly men and asthma in elderly women. Suspended particles had a significant effect on hospital admission
for pneumonia in younger men.