RESEARCH PAPER
Air pollution: how many cigarettes does each Pole ‘smoke’ every year and how does it influence health, with special respect to lung cancer?
 
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1
Chair and Department of Thoracic Surgery, Medical University, Lublin, Poland
 
2
Department of Thoracic Surgery, Holy Cross Cancer Centre, Kielce, Poland
 
3
Independent Public Clinical Hospital No. 4, Lublin, Poland
 
4
Department of Emergency Medicine, Medical University, Lublin, Poland
 
5
Department of Anaesthesiology and Intensive Care, Children’s University Hospital, Lublin, Poland
 
6
Institute of Rural Health, Lublin, Poland
 
 
Corresponding author
Robert Chudzik   

Chair and Department of Thoracic Surgery, Medical University of Lublin, Poland
 
 
Ann Agric Environ Med. 2019;26(4):566-571
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Air pollution is one of the most important issues of our times. Air quality assessment is based on the measurement of the concentration of substances formed during the combustion process and micro-particles suspended in the air in the form of an aerosol. Microscopic atmospheric particulate matters (PM) 2.5 and 10 are mixtures of organic and inorganic pollutants smaller than 2.5 and 10 µm, respectively. They are the main cause of negative phenomena in the earth’s atmosphere of Earth and human health, especially on the respiratory and cardiovascular systems. Particulates have the ability to cause permanent mutations of tissue, leading to neoplasms and even premature deaths. Nitrogen dioxide (NO2) is one of the main pollutants which arises mainly during the burning of fossil fuels. Based on numerous scientific researches, it has been proved that long-term exposure to NO2 could increase morbidity of cancer due to inflammatory processes increasing abnormal mutations.

Material and methods:
Data available in the Polish National Cancer Registry, Chief Inspectorate for Environmental Protection and Map of Health Needs in the Field of Oncology for Poland, WHO Air Quality Guidelines 2005 were analyzed. Air pollution was also evaluated: PM2.5, PM10, NO2, and compared with lung cancer morbidity.

Results and conclusions:
Based on the available data and literature, it can be concluded that in 2009–2017, on average, each Pole smoked ten cigarettes a day +/- 2. Therefore, it can be estimated that after 60 years everyone had 30 package-years of smoking, leading to a high risk of lung cancer and other smoking related diseases. Additionally air quality in Poland is not satisfactory, exceeding the standards presented in the WHO Guidelines 2005. It can be assumed that this may translate into an additional, independent continuous increase in morbidity and mortality dependent on smoking.

 
REFERENCES (39)
1.
Polish Energy Market Agency, 2017.
 
2.
Jeričević A, Gašparac G, Mikulec MM, Kumar P, Prtenjak MT. Identification of diverse air pollution sources in a complex urban area of Croatia. J Environ Manage. 2019 Aug 1; 243: 67-77. doi: 10.1016/j.jenvman.2019.04.024. Epub 2019 May 9. PubMed PMID: 31078930.
 
3.
World Bank and Institute for Health Metrics and Evaluation. 2016. The Cost of Air Pollution: Strengthening the Economic Case for Action. Washington, DC: World Bank. License: Creative Commons Attribution CC BY 3.0 IGO.
 
4.
Orru H, Maasikmets M, Lai T, et al. Health impacts of particulate matter in five major Estonian towns: main sources of exposure and local differences. Air Quality, Atmosphere & Health 2011; 4: 247-58.
 
5.
Franklin M, Koutrakis P, Schwartz P. The role of particle composition on the association between PM2.5 and mortality. Epidemiology. 2008 Sep; 19(5): 680-9.
 
6.
World cancer report / edited by Bernard W. Stewart and Christopher P. Wild, 2014 ISBN 978-92-832-0443-5.
 
7.
Wojciechowska Urszula, Didkowska Joanna. Morbidity and mortality from malignant tumors in Poland. National Cancer Registry,– The Maria Skłodowska-Curie. Institute — Oncology Center. Available at http://onkologia.org.pl/raport... access from 01/03/2019.
 
8.
Guo Y, Zeng H, Zheng R, Li S, Barnett AG, Zhang S, Zou X, Huxley R, Chen W, Williams G. The association between lung cancer incidence and ambient air pollution in China: A spatiotemporal analysis. Environ Res. 2016 Jan; 144(Pt A): 60-65. doi: 10.1016/j.envres.2015.11.004. Epub 2015 Nov 9. PubMed PMID:26562043.
 
9.
Cui P, Huang Y, Han J, Song F, Chen K. Ambient particulate matter and lung cancer incidence and mortality: a meta-analysis of prospective studies. Eur J Public Health. 2015 Apr; 25(2): 324-9. doi: 10.1093/eurpub/cku145. Epub 2014 Sep 8.PubMed PMID: 25201901.
 
10.
Korniluk A, Koper O, Kemona H, Dymicka-Piekarska V. From inflammation to cancer. Ir J Med Sci. 2017 Feb;186(1):57-62. doi: 10.1007/s11845-016-1464-0. Epub 2016 May 7. Review. PubMed PMID: 27156054; PubMed Central PMCID: PMC5323483.
 
11.
Jin Y, Wu W, Zhang W, Zhao Y, Wu Y, Ge G, Ba Y, Guo Q, Gao T, Chi X, Hao H, Wang J, Feng F. Involvement of EGF receptor signaling and NLRP12 inflammasome in fine particulate matter-induced lung inflammation in mice. Environ Toxicol. 2017 Apr; 32(4): 1121-1134. doi: 10.1002/tox.22308. Epub 2016 Jul 5. PubMed PMID: 27377055.
 
12.
Zhao H, Li W, Gao Y, Li J, Wang H. Exposure to particular matter increases susceptibility to respiratory Staphylococcus aureus infection in rats via reducing pulmonary natural killer cells. Toxicology. 2014 Nov 5;325:180-8. doi: 10.1016/j.tox.2014.09.006. Epub 2014 Sep 16. PubMed PMID: 25220797.
 
13.
Cachon BF, Firmin S, Verdin A, Ayi-Fanou L, Billet S, Cazier F, Martin PJ, Aissi F, Courcot D, Sanni A, Shirali P. Proinflammatory effects and oxidative stress within human bronchial epithelial cells exposed to atmospheric particulate matter (PM(2.5) and PM(>2.5)) collected from Cotonou, Benin. Environ Pollut. 2014 Feb;185:340-51. doi: 10.1016/j.envpol.2013.10.026. Epub 2013 Dec 10. PubMed PMID: 24333687.
 
14.
Tecer LH, Alagha O, Karaca F, Tuncel G, Eldes N. Particulate matter (PM(2.5), PM(10-2.5), and PM(10)) and children's hospital admissions for asthma and respiratory diseases: a bidirectional case-crossover study. J Toxicol Environ Health A. 2008;71(8):512-20. doi: 10.1080/15287390801907459. PubMed PMID: 18338286.
 
15.
Ji X, Han M, Yun Y, Li G, Sang N. Acute nitrogen dioxide (NO2) exposure enhances airway inflammation via modulating Th1/Th2 differentiation and activating JAK-STAT pathway. Chemosphere. 2015 Feb;120:722-8. doi: 10.1016/j.chemosphere.2014.10.039. Epub 2014 Nov 11. PubMed PMID: 25462318.
 
16.
Al-Ahmadi K, Al-Zahrani A. NO(2) and cancer incidence in Saudi Arabia. Int J Environ Res Public Health. 2013 Nov 4;10(11):5844-62. doi: 10.3390/ijerph10115844. PubMed PMID: 24192792; PubMed Central PMCID: PMC3863874.
 
17.
Marino E, Caruso M, Campagna D, Polosa R. Impact of air quality on lung health: myth or reality? Ther Adv Chronic Dis. 2015 Sep;6(5):286-98. doi: 10.1177/2040622315587256. Review. PubMed PMID: 26336597; PubMed Central PMCID:PMC4549691.
 
18.
Hamra GB, Laden F, Cohen AJ, Raaschou-Nielsen O, Brauer M, Loomis D. Lung Cancer and Exposure to Nitrogen Dioxide and Traffic: A Systematic Review and Meta-Analysis. Environ Health Perspect. 2015 Nov;123(11):1107-12. doi: 10.1289/ehp.1408882. Epub 2015 Apr 14. Review. PubMed PMID: 25870974; PubMed Central PMCID: PMC4629738.
 
19.
Raaschou-Nielsen O, Andersen ZJ, Beelen R, Samoli E, Stafoggia M, Weinmayr G, Hoffmann B, Fischer P, Nieuwenhuijsen MJ, Brunekreef B, Xun WW, Katsouyanni K,Dimakopoulou K, Sommar J, Forsberg B, Modig L, Oudin A, Oftedal B, Schwarze PE, Nafstad P, De Faire U, Pedersen NL, Ostenson CG, Fratiglioni L, Penell J, Korek M, Pershagen G, Eriksen KT, Sørensen M, Tjønneland A, Ellermann T, Eeftens M, Peeters PH, Meliefste K, Wang M, Bueno-de-Mesquita B, Key TJ, de Hoogh K, Concin H, Nagel G, Vilier A, Grioni S, Krogh V, Tsai MY, Ricceri F, Sacerdote C, Galassi C, Migliore E, Ranzi A, Cesaroni G, Badaloni C, Forastiere F, Tamayo I, Amiano P,Dorronsoro M, Trichopoulou A, Bamia C, Vineis P, Hoek G. Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol. 2013 Aug;14(9):813-22. doi: 10.1016/S1470-2045(13)70279-1. Epub 2013 Jul 10. PubMed PMID: 23849838.
 
20.
Couraud S, Zalcman G, Milleron B, Morin F, Souquet PJ. Lung cancer in never smokers--a review. Eur J Cancer. 2012 Jun;48(9):1299-311. doi: 10.1016/j.ejca.2012.03.007. Epub 2012 Mar 28. Review. PubMed PMID: 22464348.
 
21.
van der Zee SC, Fischer PH, Hoek G. Air pollution in perspective: Health risks of air pollution expressed in equivalent numbers of passively smoked cigarettes. Environ Res. 2016 Jul;148:475-483. doi: 10.1016/j.envres.2016.04.001. Epub 2016 Apr 30. PubMed PMID: 27136673.
 
22.
WHO Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide. World Health Organization 2006.
 
23.
Directive 2008/50/EC of the European Parliament and of the Council of 21 May 2008 on ambient air quality and cleaner air for Europe.
 
24.
REGULATION OF THE MINISTER OF THE ENVIRONMENT of August 24, 2012 on the levels of certain substances in the air.
 
25.
Database Main Inspectorate of Environmental Protection http://powietrze.gios.gov.pl/p....
 
26.
Maps of health needs - Database of System and Implementation Analyzes in the field of oncology prepared by the Ministry of Health of Poland.
 
27.
Piotr Wojtyś, Andrzej Antczak, Dariusz Godlewski, Predictions of cancer mortality, in Poland in 2020. Cent Eur J Med. 2014; 9(5): 667-675; DOI: 10.2478/s11536-013-0307-x.
 
28.
Czaderny k. Determinants of Propensity for Cigarette Smoking. Results of Structural Equation Modelling. Studia Demograficzne 2017; 1(171): 49-69, 67-68.
 
29.
Wang T, Xia Z, Wu M, Zhang Q, Sun S, Yin J, Zhou Y, Yang H. Pollution characteristics, sources and lung cancer risk of atmospheric polycyclic aromatic hydrocarbons in a new urban district of Nanjing, China. J Environ Sci (China). 2017 May; 55:118-128. doi: 10.1016/j.jes.2016.06.025. Epub 2016 Aug 15. PubMed PMID: 28477805.
 
30.
Pinsky PF, Zhu CS, Kramer BS. Lung cancer risk by years since quitting in 30+ pack year smokers. J Med Screen. 2015 Sep;22(3):151-7. doi: 10.1177/0969141315579119. Epub 2015 Apr 29. PubMed PMID: 25926339.
 
31.
Pinsky PF, Kramer BS. Lung Cancer Risk and Demographic Characteristics of Current 20-29 Pack-year Smokers: Implications for Screening. J Natl Cancer Inst. 2015 Oct 19;107(11). pii: djv226. doi: 10.1093/jnci/djv226. Print 2015 Nov. PubMed PMID: 26483244; PubMed Central PMCID: PMC4849359.
 
32.
Wilson, JM, Junger, G. Principles and Practice of Screening for Disease. Genewa; WHO, 1968.
 
33.
Goffin JR, Flanagan WM, Miller AB, Fitzgerald NR, Memon S, Wolfson MC, Evans WK. Cost-effectiveness of Lung Cancer Screening in Canada. JAMA Oncol. 2015 Sep; 1(6): 807-13. doi: 10.1001/jamaoncol.2015.2472. PubMed PMID: 26226181.
 
34.
Pope CA 3rd, Cropper M, Coggins J, Cohen A. Health benefits of air pollution abatement policy: Role of the shape of the concentration-response function. J Air Waste Manag Assoc. 2015 May; 65(5):516-22. doi: 10.1080/10962247.2014.993004.PubMed PMID: 25947311.
 
35.
Li Q, Jiang J, Wang S, Rumchev K, Mead-Hunter R, Morawska L, Hao J. Impacts of household coal and biomass combustion on indoor and ambient air quality in China: Current status and implication. Sci Total Environ. 2017 Jan 15;576:347-361. doi: 10.1016/j.scitotenv.2016.10.080. Epub 2016 Oct 25. PubMed PMID: 27792953.
 
36.
Cohen AJ, Brauer M, Burnett R, Anderson HR, Frostad J, Estep K, Balakrishnan K, Brunekreef B, Dandona L, Dandona R, Feigin V, Freedman G, Hubbell B, Jobling A, Kan H, Knibbs L, Liu Y, Martin R, Morawska L, Pope CA 3rd, Shin H, Straif K, Shaddick G, Thomas M, van Dingenen R, van Donkelaar A, Vos T, Murray CJL, Forouzanfar MH. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2017 May 13;389(10082):1907-1918. doi: 10.1016/S0140-6736(17)30505-6. Epub 2017 Apr 10. Erratum in: Lancet. 2018 Apr 21;391(10130):1576. Lancet. 2017 Jun 17;389(10087):e15. PubMed PMID: 28408086;PubMed Central PMCID: PMC5439030.
 
37.
Eckel SP, Cockburn M, Shu YH, Deng H, Lurmann FW, Liu L, Gilliland FD. Air pollution affects lung cancer survival. Thorax. 2016 Oct;71(10):891-8. doi: 10.1136/thoraxjnl-2015-207927. Epub 2016 Aug 4. PubMed PMID: 27491839; PubMed Central PMCID: PMC5400105.
 
38.
Frumkin H, Haines A. Global Environmental Change and Noncommunicable Disease Risks. Annu Rev Public Health. 2019 Jan 11. doi:10.1146/annurev-publhealth-040218-043706. [Epub ahead of print] PubMed PMID: 30633714.
 
39.
European Environment Agency - https://www.eea.europa.eu access from 28.01.2019.
 
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ISSN:1232-1966
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