Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study
Marmara Bölgesi'nde Parçacık Madde ve Azot Dioksit Değerlerinin Kronik Bronşit İnsidansı ve Mortalite Üzerine Etkisi: Geriye Dönük Kohort Çalışması
Seher PALANBEK YAVAŞa, Ayşe Emel ÖNALa, Selvinur PACCİb, Çiğdem ÇAĞLAYANc
aDepartment of Public Health and Environmental Health, İstanbul University İstanbul Faculty of Medicine, İstanbul, TURKEY
bDepartment of Public Health, İstanbul University İstanbul Faculty of Medicine, İstanbul, TURKEY c Department of Public Health, Kocaeli University Faculty of Medicine, Kocaeli, TURKEY
Turkiye Klinikleri J Med Sci. 2021;41(3):225-33
doi: 10.5336/medsci.2020-80509
Article Language: EN
Full Text
ABSTRACT
 Objective: The harmful effects of air pollution on human health have been proven by epidemiological studies. The aim of this study was to investigate the effect of two parameters that are determinants of air quality: particulate matter (PM10) and nitrogen dioxide (NO2) pollution levels on the incidence of chronic bronchitis and deaths due to air pollution. Material and Methods: We made the calculations by entering the 2018 population, mortality and PM10 and NO2 values of 11 provinces in the Marmara Region (İstanbul, Kocaeli, Edirne, Tekirdağ, Kırklareli, Sakarya, Bilecik, Bursa, Balıkesir, Çanakkale and Yalova) into the AirQ+ program [World Health Organization (WHO)]. All calculations made by AirQ+ are based on methodologies and dose-response functions established by epidemiological studies. In the calculations, the PM10 and NO2 limit value has been accepted as 20 μg/m3 . Results: It has been determined that the annual average PM10 level of all provinces in our study and the annual average NO2 level of eight provinces did not comply with the limit values recommended by WHO. Consistent with the particulate matter values, the highest incidence of chronic bronchitis among provinces are 43.71% [confidence interval (CI) 95%, relative risk (RR): 18.43-59.31] in Bursa and Sakarya 38.5% (CI 95%, RR: 15.71- 52.96); the highest number of people with chronic bronchitis attributed to air pollution has been found to be 2,349 (minimum 912-maximum 3,404) in İstanbul. Conclusion: Findings indicate the incidence of chronic bronchitis attributed to air pollution and the share of air pollution in deaths. Studies in different cities may contribute to the literature.

Keywords: PM10; NO2; air pollution; chronic bronchitis; mortality
ÖZET
 Amaç: Hava kirliliğinin insan sağlığı üzerindeki zararlı etkileri epidemiyolojik çalışmalarla kanıtlanmıştır. Bu çalışmada, hava kalitesinin belirleyicisi olan 2 parametrenin; parçacık madde (PM10) ve azot dioksit (NO2) kirlilik düzeylerinin kronik bronşit insidansına ve hava kirliliğine bağlı ölümler üzerine etkisinin araştırılması amaçlandı. Gereç ve Yöntemler: Marmara Bölgesi'ndeki 11 ilin (İstanbul, Kocaeli, Edirne, Tekirdağ, Kırklareli, Sakarya, Bilecik, Bursa, Balıkesir, Çanakkale ve Yalova) 2018 nüfus, ölüm ve PM10 ve NO2 değerlerini AirQ+ programına [Dünya Sağlık Örgütü (DSÖ)] girerek hesaplamaları yaptık. AirQ+ tarafından yapılan tüm hesaplamalar epidemiyolojik çalışmalar tarafından oluşturulan metodolojilere ve doz-yanıt fonksiyonlarına dayanmaktadır. Hesaplamalarda, PM10 ve NO2 sınır değeri 20 μg/m3 olarak alınmıştır. Bulgular: Çalışmamızda, tüm illerin yıllık ortalama PM10 düzeyinin ve 8 ilin yıllık ortalama NO2 düzeyinin DSÖ tarafından önerilen sınır değerlere uymadığı tespit edilmiştir. Partikül madde değerleri ile uyumlu olarak, iller arasında en yüksek kronik bronşit insidansı Bursa'da %43,71 [güven aralığı (GA) %95, rölatif risk (RR): 18,43-59,31] ve Sakarya'da %38,5 (GA %95, RR: 15,71-52,96); hava kirliliğine atfedilen en yüksek kronik bronşitli kişi sayısı 2.349 (minimum 912-maksimum 3.404) olarak İstanbul'da bulundu. Sonuç: Bulgularımız, hava kirliliğine atfedilen kronik bronşit insidansı ve ölümlerde hava kirliliğinin payını göstermektedir. Farklı şehirlerde yapılacak çalışmalar, literatüre katkıda bulunabilir.

Anahtar Kelimeler: PM10; NO2; hava kirliliği; kronik bronşit; mortalite
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