HomeBlogWhen smog hovers, the number of admissions to hospitals grows. A medical warning

When smog hovers, the number of admissions to hospitals grows. A medical warning

Soon, the Chief Statistical Office (GUS) is going to publish an official report on pollutions in Poland in 2020. The available relevant data pertain mainly to 2018. Despite its very liberal norms, for a long time Poland has been a red beacon on the map of air quality in the European Union. We have asked experts about the nature of smog, if it really is lethal and how to tackle the problem.

What is smog?

The major gas pollutants emitted to the atmosphere that Poland needs to monitor include sulphur dioxide (SO2 ), nitrogen oxides (NOx ), carbon monoxide (CO), ammonia (NH3 ) and volatile organic compounds (VOC), greenhouse gases – carbon monoxide (CO2 ), methane (CH4 ), nitrous oxide (N2O) and industrial gases: hydrofluorocarbon, fluorocarbons, sulphur hexafluoride and nitrogen trifluoride and dust.

According to official data, emissions of most of these substances are falling. Emissions of dust, volatile organic compounds and ammonia are also on the decrease. On the other hand, for several years the total emission of carbon dioxide has stayed on more or less the same level or has even increased (by 6% against 2000).

“By definition, all air pollutants are hazardous. The WHO defines air pollution as causing respiratory and other diseases and is an important source of morbidity and mortality“, says Prof. Edward Franek, head of the Clinic of Internal Diseases, Endocrinology i Diabetology of the Central Clinical Hospital in Warsaw. “Particulate matter and its impact on the respiratory system are given the widest coverage but in long-terms, greenhouse gases like carbon dioxide and methane are the most dangerous. In different ways, they can pose a threat not only to single and numerous people but to the whole of humanity”.

The air is polluted mainly by fuel combustion products used in the industry, in households and in transport. For example, the lion’s share of sulphur dioxide comes from combusting carbon (97%); Poland ranks very high in the EU with respect to the amount of emitted sulphur monoxides. Fuel combustion is also the biggest source of emissions of nitrogen monoxides. The main culprits include road transport (39%); despite a higher quality of the fuels, due to a significant growth in the number of cars, the content of the monoxides in the air is not decreasing. With respect to emissions thereof, Poland ranks fourth following Germany, the UK and France.

The carbon monoxide in the air comes mainly from fuel combustion in households, institutions, trade, services etc. They represent more than 65% of the country’s total emissions. Transport is another significant source of CO emissions (23%).

Heavy metals are another group of hazardous substances. They include cadmium, mercury, lead, arsenic, chromium, copper, nickel and zinc. In the case of copper and cadmium alone, the emissions in 2018 exceeded the level from 2000, by 37% and 8%, respectively. The general emissions of lead, chromium and arsenic were accelerated by fuel combustion including coal used in households. Emissions from road transport have increased; in 2017 they represented almost 10% of total emissions in Poland. Transport is also the main source of copper emissions with road transport (approx. 34%) now being the main factor behind the growth. The biggest amounts of nickel are emitted by power and heat plants, coupled by households (approx. 23%). Zinc is a by-product of fuel combustion in the industry (27%), the power industry (approx. 23%) and households (approx. 22%).

Finally, what we colloquially call smog is high concentration of dust hovering in the air. Winter smog (called also aerosol smog) is an effect of emissions of dust and gas pollutants as well as the chemical reactions taking place in the atmosphere. The conducive factors include light wind, strong thermal inversion, fog and the average daily air temperature below 5°C.

The composition of the dust in the air strongly translates into air quality and is strictly related to the origin, place of occurrence and the season. In Poland, coarse particulate matter (PM10) and fine particulate matter (PM2.5) consist mainly of carbon in the form of organic compounds, elementary carbon, sulphates, nitrates, chlorides, ammonia compounds, quartz, aluminium and iron compounds as well as trace amounts of heavy metals. Carbon emissions in 2018 matched those from 2017 (378 thou. tons). The biggest growth was noted in the industry (by approx. 5%). However, households where unsustainable boilers are used remain the major polluters (approx. 38% of total emissions).

Since 2015, the indicator of average exposure to PM2.5 particulate matter has exceeded the level agreed for Poland by 5%. Unfortunately, in 2019 Poland failed again to accomplish the domestic goal of reducing the risk of exposure to PM2.5 particulate matter.

The biggest threat is posed to the residents of cities and agglomerations of more than 100 thou. These include the Upper Silesia and Krakow Agglomerations, the Rybnik-Jastrzębie and the Bielsko-Biała Agglomerations. In 14 Polish cities and agglomerations, located mainly in southern Poland, in 2019 the allowed concentration of the particulate matter was exceeded.

“Poland stands out in a bad way in Europe with its high level of air pollution, specifically during the heating season”, says Prof. Edward Franek. “Polish cities represent a majority of the 50 most affected European cities. These are big cities like Krakow and towns that we tend to associate with clean air like Otwock and Żywiec. It would probably be easier to pinpoint locations with clean air: these are the less populated, afforested regions of Lubusz, West Pomerania, Podlasie and the Bieszczady Mountains. You can see it clearly in the Internet and in applications which show air pollution.”

Pollutants generated by means of road transport come chiefly from fuel combustion in car engines, tyres rubbing, break shoes wear and tear and secondary blow-away of dust from the road and street surfaces. The amount of emission is mostly affected by the number and age of the vehicles, the condition of the road surface and traffic organisation.

In 2018, there were nearly 32 million cars registered in Poland (the number grows regularly; since 2000 the growth had more than doubled). 76% was represented by passenger cars. More than 58% of passenger cars are over 15 years old and almost 16% are 31+. Despite introducing increasingly restrictive norms for fuels and the development of road infrastructure, emissions from road transport remain one of the most important problems, specifically in big cities.

“The respiratory system is the most affected because particulate matter permeates the body through the lungs. The worst consequences include lung cancer, asthma and chronic obstructive pulmonary disease as well as infection of the respiratory tract”, explains Prof. Franek. “As for the blood circulation system, air pollution can cause atherosclerosis and a tendency towards blood clotting with all the consequences like heart attack, stroke, hypertension and arrhythmia. Air pollution negatively affects the central nervous system and the reproductive system.”

It is a well-known fact that air pollution is related to allergies. Human skin is directly affected which may result in atopic dermatitis and allergic contact dermatitis. Top it with all the allergic diseases of the respiratory tract – allergic rhinitis and asthma.

The ability of heavy metals to accumulate in the human body leads to damage to the nervous system, anaemia, sleep disturbance, diminished intellectual prowess, aggressive behaviour and various types of cancer.

Fine and very fine particulate matter is a different story as their harmfulness depends on the chemical content. Therefore, PM2.5 particulate matter permeates the deepest layers of the lungs where it is accumulated or dissolved in body fluids and then transported by blood to the other parts of the body. It can aggravate asthma, trigger off acute reactions of the respiratory tract and weaken lung activity.

“We also breathe in man-made plastic”, noted Prof. Michał Pirożyński from the Clinic of Anaesthesiology and Intensive Care in the Centre of Medical Post-Graduate Education in Warsaw. “For example, synthetic rubber. Let’s not forget that cars create the worst possible aerosol – rubber. Breathed in, it negatively affects the respiratory tract. And when it contains latex, it is a strong allergen.”

When asked if life in a smog translates into diseases and excess deaths of the residents of very polluted areas, Prof. Edward Franek replies: “Definitely, the number of diseases, their gravity and the number of deaths are growing. The problem is that sometimes it is hard to diagnose. Together with doctor Slama and a team from the Prime Minister’s Chancellery we were looking for the impact of the concentration of particulate matter on acute hospitalisation. In other words, we tried to find out if the peaks of air pollution lead to acute courses of diseases or emergence of new symptoms so severe that the patients need to be referred to hospitals. Initially we could not find anything. But when we traced the number of hospitalisations resulting from respiratory tract diseases not on the pollution peak day but a week later, it turned out that our hypothesis was right. There is simply an interval between a pollution peak and a growing number of hospitalisations. These correlations are easy to overlook.”

The expert added: “Of course the bigger the pollution, the easier it is to identify the relation between it and diseases and deaths. It is estimated that in 1952, the London smog caused as many as 12 thou. deaths while the bigger frequency of the pulmonary tract and blood circulation diseases, coupled with an increased number of deaths, prevailed for several weeks after the smog. These things, on the other hand, are hard to overlook! On a global scale, air pollution is estimated to contribute to 7 million deaths a year.

What protection against smog?

A lot has been said about the importance of exchanging old coal boilers to the natural environment. The programme is subsidised by local governments and the central government but the concern is that it will not rise to the expectations.

“Has it occurred to the authorities that not everyone can afford clean but more expensive boilers?”, Prof. Pirożyński asks. “There should be a programme compensating for the growing costs, for the sake of public health.”

Another issue to be kept in mind by city authorities is maintaining undeveloped natural air currents in cities.

“In Warsaw, the so-called air admittance wedges were taken care of before WWII”, reminds Prof. Pirożyński. “Whereas now, all the air admittance wedges in the capital city are occupied by blocks of flats”.

The residents of the more polluted cities should also realise that watering streets and cleaning pavements not only removes dust but also reduces dust concentration. When smog is on the offensive, it is better to exercise indoors.

“When you exercise in the open, exposure to air pollution increases with the length of your stay outside”, Prof. Franek emphasises. “Physical exercise forces us to take faster and deeper breaths. Moreover, sports apparel typically reveals more bare skin that usual clothes which adds to the exposure.”

“Wear masks”, Prof. Pirożyński encourages. “A filtering mask eliminates 30 – 90% of harmful aerosols. It may be uncomfortable but protects the human respiratory tract.”

There are many actions we can take.

“Firstly, we can contribute to decreasing air pollution e.g. by abstaining from using tyres as stove fuel”, says Prof. Franek tongue-in-cheek; what he means is not to turn the household boiler into a waste incinerator.

“You can invest in public health and buy an electric car, use public transport or a bicycle instead of an old diesel. Secondly, you can avoid going out on days when the air pollution exceeds the norms which can be easily checked on a regular basis. And consider giving up smoking because when you smoke at home, the air is even worse than outside. You can also purchase an indoor air filter.

Recent Posts

If you want to get to know us better during the fair, the next opportunity will come in Budapest. Planet Budapest 2021 Sustainability Expo and […]

In the times of the climate crisis and growing concerns about the future of our planet, the topics related to the fight for cleaner air […]

Polluted air has a negative impact on our health and functioning. Unfortunately, smog and harmful substances are particularly dangerous for pregnant women and children. How […]