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Effect of indoor air quality in the postnatal period on lung function in pre-adolescent children: a retrospective cohort study in Poland.

The purpose of this study was to determine the association between level of lung function in pre-adolescence and indoor air quality in the postnatal period. The retrospective cohort study was carried out in a sample of 1036 pre-adolescent children (9 years of age) attending schools in two residential areas of Krakow, Poland. Measurement of health outcomes considered lung function together with height and weight. Indoor air quality was based on environmental tobacco smoke and type of household heating. In addition, the number of winter months that occurred during the first 6 months of life was included as a key independent variable. Multivariate linear regression of lung function measured by forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC), and postnatal exposure to indoor pollution in the heating season (PEIP score) was adjusted for potential confounders such as maternal smoking during pregnancy and parental education as a proxy of social class. In the total study sample, the adjusted beta coefficient for FEV1 per unit of the PEIP score was -0.06 (P=0.02), while that for FVC was -0.05 (P=0.04). The analysis carried out in the more polluted area found that children living in households heated with gas or coal had a PEIP score that was strongly inversely related to lung function (adjusted beta coefficient for FEV1=-0.13; P=0.03; for FVC=-0.15, P=0.01), whereas regression coefficients were not significant in the group of children living in households with central heating. This study suggests that a lower level of lung function in pre-adolescent children can be related to postnatal exposure to indoor emissions in the winter.

Air Pollution, Indoor↗

Survival after out-of-hospital cardiac arrests in Katowice (Poland): outcome report according to the "Utstein style".

The purpose of this study was to evaluate the outcome of out-of-hospital cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) in the city of Katowice, Poland, during a period of 1 year prior to the planned reorganization of the national emergency system. Data were collected prospectively according to a modified Utstein style. To ensure accurate data collection, a special method of reporting resuscitation events with the use of a tape-recorder was introduced. Patients were followed for a 1-year period. Between 1 July 2001 and 30 June 2002, out-of-hospital cardiac arrest was confirmed in 1153 patients. Cardiopulmonary resuscitation was attempted in 188 patients. Cardiac arrest of presumed cardiac aetiology (147) was bystander witnessed in 105 (71%) cases and lay-bystander basic life support was performed in 35 (24%). In the group of bystander witnessed arrest ventricular fibrillation (VF) or tachycardia was documented in 59, asystole in 40 and other non-perfusing rhythms in six patients. Of 147 patients with cardiac aetiology, return of spontaneous circulation (ROSC) was achieved in 64 (44%) patients, 15 (10%) were discharged alive and 9 (6%) were alive 1 year later. Most of these patients had a good neurological outcome. Time to first defibrillatory shock was significantly shorter for survivors (median 7 min) compared to non-survivors (median 10 min). The most important resuscitation and patient characteristics associated with survival were VF as initial rhythm, arrest witnessed, and lay-bystander CPR.

Adolescent↗

Platinum, palladium and rhodium content in road dust, tunnel dust and common grass in Białystok area (Poland): a pilot study.

Automobile traffic is the main source of Pt, Pd and Rh, i.e. platinum-group elements (PGEs), contamination in urban areas and there is growing concern about the effects of these emerging contaminants for people living in these areas. PGE contents were determined in samples of road dust, tunnel dust and common grass as well as pine needles collected from the residential areas of Białystok, northeast Poland. High resolution (HR) and quadrupole inductively coupled plasma mass spectrometry (ICP-MS) were compared for their adequacy in the environmental analysis of Pt and Rh. Palladium was determined by total X-ray fluorescence (TXRF) and HR-ICP-MS after matrix separation by reductive co-precipitation with Hg. The highest PGEs concentration was found in road dust samples. Platinum content in road dust varied from 34.2 to 110.9 ng g(-1), while that of Rh from 6.0 to 19.7 ng g(-1). The mean concentration of Pd in this matrix was 32.8 ng g(-1) as determined by TXRF analysis and 42.2 ng g(-1) by HR-ICP-MS. The highest Pt concentration in tunnel dust was found in the size fraction below 75 microm (22.3-23.3 ng g(-1)). The mean concentrations of PGEs in grass were 8.63 ng g(-1) for Pt, 0.65 ng g(-1) for Rh and 3.2 ng g(-1) for Pd. The concentration of PGEs in pine needles was below the limits of detection of the methods used.

Dust↗

Using the Mallard to biomonitor heavy metal contamination of wetlands in north-western Poland.

Contents of iron, zinc, copper, manganese, nickel, lead and cadmium were determined in the brain, pectoral muscle, kidney, liver and bones of the Mallard (Anas platyrhynchos), a cosmopolitan, herbivorous duck species. Both immature (im; in the first year of life) and older (adult, ad) ducks were studied. The birds originated from wetlands in two areas in north-western Poland, one located in the Słońsk waterfowl reserve (n = 32 im + 24 ad) and the other near the city of Szczecin (n = 21 im + 21 ad). There were numerous significant age-dependent differences in the metal contents of the organs of the Mallards obtained from near Szczecin (Sz) and/or Słońsk (S). Copper contents in the brain (Sz and S), muscles (Sz) and kidneys (Sz) as well as cadmium contents in the liver (Sz, S), kidneys (Sz, S) and muscles (S) were observed to increase with age. Between-area differences in metal contents of individual organs were recorded as well. The S Mallard showed higher contents of iron and copper (in muscles, liver and kidneys), zinc (in liver and kidneys) and cadmium (in muscles, liver and kidneys), while the Sz ducks revealed higher contents of manganese and lead (in brain and bones). The differences observed may be related to the habitat specificity: the Sl?ońsk reserve is periodically flooded by the River Odra (Oder) waters that carry pollutants from a copper mining area 250 km away. On the other hand, the mid-field ponds near Szczecin are affected by pollutants, including those that are manganese-rich, generated by agriculture and traffic.

Age Factors↗

Trace elements in fruiting bodies of ectomycorrhizal fungi growing in Scots pine (Pinus sylvestris L.) stands in Poland.

The trace metal contents in fruiting bodies of ectomycorrhizal (ECM) fungi, symbiotic partners of Scots pine, were studied on three sites situated in west-central Poland. Elements were determined by atomic absorption spectrometry in 123 samples of 16 species. The study explored the differences in metal accumulation in relation to site, fungal species, age and part of the fruiting body and results were related to metal content in soil and plant material (roots and needles). Soil analysis revealed that results were obtained under environmental conditions not subject to strong anthropogenic pressure. Median metal concentrations did not differ disparately between sites, although the concentrations of each of the tested metals in the individual species varied to a large extent. Extremely high levels of Al with a large bioconcentration factor (BCF) were found in sporocarps of Thelephora terrestris. The spread between the highest and the lowest concentration (max/min) was very wide in Al, Cd and Pb and these elements may be considered to be absorbed preferentially by fruiting bodies of some species whereas Fe, Mn and Zn, with relatively low values of max/min, are normally absorbed by the majority of fungi. There was no clear relationship between caps and stipes in metal content. However, a tendency to higher metal concentration in the caps was observed. The metal content in young and older fruiting bodies of five different fungi was species dependent. In order to estimate the degree of accumulation of each element by plant and mushrooms, bioconcentration factors (BCFs) were calculated. In plant material (roots and needles), highest values of BCFs were noted for essential metals, like Zn and Mn. Lead showed a definite exclusion pattern (BCF below 1). In fruiting bodies of tested fungi, especially in Amanita muscaria, cadmium was the most intensively accumulated metal. Lead was excluded by plants but was accumulated or excluded by fungi depending on the species. The significance of mycological observation and quantification of the metal content in monitoring of the forest ecosystem is discussed.

Age Factors↗

Urinary mercury in adults in Poland living near a chloralkali plant.

We conducted a study within the framework of the interdisciplinary European Mercury Emission from Chloralkali Plants (EMECAP) project to assess exposure to mercury (Hg) and the contribution of Hg emissions from a mercury cell chloralkali plant to urinary mercury (U-Hg) in adults living near the plant. We collected data from questionnaires and first morning urine samples from 75 subjects living near the Tarnow plant in Poland and 100 subjects living in a reference area. Median U-Hg was 0.32 mug/g creatinine (microg/gC) and 0.20 microg/gC, respectively. The median U-Hg was also higher in the amalgam-free subjects living near the plant (0.26 microg/gC) than in the reference group (0.18 microg/gC), but no such association was found in a multivariate analysis. There was a statistically significant positive association between U-Hg and number of teeth with amalgams, a negative association with age and a tendency towards higher U-Hg in female subjects. In the amalgam-free subjects there were statistically significant effects of female sex and fish consumption, and a negative association with age. The additional long-term average air Hg concentration from the plant, based on EMECAP environmental measurements and modelling, was estimated to be 1-3.5 ng/m(3) for the residential study area and should have a very small effect on U-Hg. The other Hg emission sources such as coal combustion facilities located nearby should be taken into account in assessing the overall impact of air Hg on U-Hg in this area.

Adult↗

Free-ranging European bisons accumulate more cadmium in the liver and kidneys than domestic cattle in north-eastern Poland.

It has been shown that free-ranging big game animals accumulate several-fold more cadmium (Cd) in the liver and kidneys than domestic animals. To examine possible reasons for this difference, in the present work we determined the concentrations of Cd in the liver and kidney cortex of European bisons (n=23) from Białowieza Forest (north-eastern Poland) and domestic cattle (n=15) from the same region; in addition, analyses of Cd in the grasses and soil as well as of soil pH were carried out. The accumulation of Cd in liver and kidney cortex of the female bisons correlated significantly with the age up to 7 years, but stabilized thereafter. The 7-12-year-old bisons had 2.14- and 2.25-fold higher concentrations of Cd in the liver and kidney cortex, respectively, than the age-matched domestic cattle. Notably, the Cd levels in the liver and kidneys of the 8-12-year-old cattle were comparable to those found in the 2-year-old and 4-6-year-old bisons, respectively. The content of Cd in the grasses from Białowieza Forest appeared to be 2.1-fold higher than that in the plants from the pastures. Similarly, the concentration of water-extractable Cd in the soil was 2.7-fold greater in Białowieza Forest than in the pastures, despite the fact that nitric acid-extractable Cd (total Cd) was similar in the soils from the two sites. The concentration of water-extractable Cd in the soil as well as the content of Cd in the grasses inversely correlated with soil pH, which appeared to be significantly lower in Białowieza Forest. These data indicate that soil pH is probably responsible for the higher concentrations of Cd in the feed and tissues of bisons as compared with those of domestic cattle.

Animals↗

Environmental burden of disease due to lead in urban children from Silesia, Poland.

We performed environmental burden of disease (EBD) assessment of the neurotoxic effects of lead in the Polish urban children, in accordance with the WHO guidelines. The EBD assessment was based on the data on blood lead levels (BLL) of more than 8500 children from the lead biomonitoring programme conducted in the urban centre of the Upper Silesia Province, Poland between 1993 and 2000. In order to make the EBD assessment region specific, in the projections to years 2001 and 2005 we used 4% annual decrease in BLL, derived from the earlier analysis of the Silesian BLL data instead of the WHO proposed 7.8%. Mean BLL in the Silesian children projected for the year 2001 was higher (4.9 microg/dL) than the corresponding value for the WHO EurB region (3.9 microg/dL). The incidence rate of mild mental retardation (MMR) in the Silesian children was twice as high as in the EurB region for the year 2001, meaning more than two additional cases of MMR due to lead exposure per 1000 children aged 0-1 year, compared with 1 in 1000 children in the EurB region.

Child, Preschool↗

Distribution of polychlorinated biphenyls, organochlorine pesticides and polybrominated diphenyl ethers in human umbilical cord serum, maternal serum and milk from Wielkopolska region, Poland.

The levels of organochlorinated pesticides (OCPs): p,p'-DDT and its metabolites, hexachlorobenzene (HCB), hexachlorocyclohexane isomers (HCHs), chlordanes and their metabolites, and 18 polychlorinated biphenyl (PCB) congeners were measured in maternal serum, umbilical cord serum and human milk collected from 22 mothers living in the Wielkopolska region, Poland. Additionally, 11 polybrominated diphenyl ether (PBDE) congeners were measured in the human milk samples. p,p'-DDT and its major metabolite, p,p'-DDE, together with HCB, were found in all milk and serum samples. Median concentrations of p,p'-DDE in maternal serum, umbilical cord serum and milk were 343, 329 and 634ng/g lipid weight (lw). PCB congeners 138, 153 and 180 were the major congeners measured in all serum samples, while CB 170 was detected in 74% and 100% of umbilical cord and maternal serum, respectively. Except for CBs 74, 101 and 105, which had a detection frequency of 77%, 23% and 82%, respectively, all investigated PCB congeners were measured in all human milk samples. The median concentrations of sum PCBs in maternal serum, umbilical cord serum and milk were 79, 60 and 133 ng/g lw, respectively. A good correlation (Spearman R(S)>0.75, p<0.001) was found for major PCBs, p,p'-DDT and p,p'-DDE, between maternal and umbilical cord serum, while the correlation was weaker between milk and serum. The median of sum PBDEs in human milk was 2.0 ng/g lw (range 0.8 to 8.4), with BDE 47 being always the most abundant PBDE congener and, together with BDE 153, being present in all samples. In general, results found in the investigated group are at the low end of the concentration range measured in Europe.

Adult↗

Arsenic extractability in soils in the areas of former arsenic mining and smelting, SW Poland.

Arsenic (As) concentrations in soils and waste material in two areas of former As mining and processing: Złoty Stok (Złote Mts.) and Zeleźniak (Kaczawskie Mts.), SW Poland, were measured to assess levels and environmental risk associated with possible increases in arsenic mobility under changing pH and redox conditions. Twenty six soil samples were collected from 12 sites, and represented a broad spectrum of soil properties and parent material origin, including natural soils, mine spoils, slags and tailings. Arsenic species were examined using a sequential extraction technique. The changes in As solubility were determined from extraction test solutions adjusted to solution pH values varying from 2 to 8. The effects of reducing conditions on As mobility were examined in incubation tests. Most of soils demonstrated extremely high concentrations of As, both of natural and anthropogenic origin. Total As concentrations in all samples were in the range 100-43,500 mg/kg. Sequential extraction techniques suggested that the main species of As in all soils were those bound to iron (Fe) oxides, in particular amorphous ones, whereas the contributions of mobile and specifically sorbed As forms were relatively low. In tailings and tailings-affected alluvial soils, As occurred mainly in residual forms, however these soils also had considerable amounts of mobile As. In all other soils, mobile As forms were very low. Arsenic mobilization could be possible at extremely low or high pH conditions (pH<2 or pH>8), and this may be of particular practical importance in the case of tailings, which are highly alkaline. High pH promotes solubilization of As forms in reducing conditions, whereas in neutral and acidic soils the risk of As release under reducing conditions is limited.

Arsenic↗

Immunosuppression in kidney transplantation in Poland.

This paper presents experience with cyclosporine A in kidney allograft recipients at the Transplantation Institute, the Medical University of Warsaw. Comparative studies on pharmacokinetics and bioavailability of CsA and Neoral as well as monitoring of the drug immunosuppressive activity are presented. The implementation of CsA to immunosuppressive therapy in renal allograft recipients have greatly improved the grafts and patients survival. CsA has been used in a great percentage of patients after renal allograft in Poland (72%) and seems to be in some patients the gold standard of immunosuppression.

Animals↗

Extreme attitudes toward organ transplantation: how do supporters and opponents of this method of treatment differ in Poland?

BACKGROUND: Many medical professionals share the opinion that the negative social attitudes toward transplantation are the basic cause of the deficit of organ from deceased donors. Although public opinion polls in Poland invariably reveal overall acceptance of transplantation, it is extremely difficult to procure organs. The purpose of this study was to compare the attitudes of supporters and opponents of organ transplantation. MATERIALS AND METHODS: In social psychology, attitude is defined as a relatively stable inclination toward a positive or negative relation to a person or an object. It was assumed that positive attitudes are favorable as regards transplantation, whereas negative attitudes constitute a social obstacle to this method of treatment. The survey conducted between May and August 2002 included a representative sample of 1000 Poles over 15 years of age. The first part of the survey measured the general attitude toward transplantation on a rating scale ranging from "definitely agree" to "definitely disagree." RESULTS: We distinguished two extreme attitudes, ie, supporters and opponents. CONCLUSIONS: The attitudes of supporters were mainly cognitive, whereas the attitudes of opponents were dominated by negative emotions associated with fear of death, psychological trauma, and physical injury which led to avoidance behavior, passive resistance, and selective and biased information processing. Opponents often concealed or belittled their standpoints and were reluctant to discuss transplantation issues. Their behavior was more passive, and their familiarity with the medical and legal aspects of transplantation was relatively poor compared with supporters.

Adolescent↗

Sequence variation in pertussis S1 subunit toxin and pertussis genes in Bordetella pertussis strains used for the whole-cell pertussis vaccine produced in Poland since 1960: efficiency of the DTwP vaccine-induced immunity against currently circulating B. pertussis isolates.

The present study indicates that the appearance of the B. pertussis harbouring prn2 gene allele variant (not found among clinical isolates before 1990s) may have been induced by long-term vaccination in Poland with DTP-composed vaccine strains presenting exclusively prn1. However, ptxS1A allele of pertussis toxin subunit S1 encoding gene, predominant in the currently isolated B. pertussis strains, has been found in vaccine strains used for whole-cell pertussis component (wP) production of DTP vaccine in 1960-1978. This outrules the possibility that the appearance of ptxSIA allele might be related to vaccine pressure driven by non-ptxS1A vaccine strains used for long-term immunization with wP. Intranasal challenge animal model testing the efficiency of the clearance of B. pertussis strains harbouring different ptxS1/prn allele gene combinations revealed that currently produced DTwP vaccine may not contain adequate B. pertussis vaccine strains, since isolates with gene variants different from those observed in vaccine strains were eliminated from the lungs of the immunized animals with lower efficiency.

Animals↗

Interactions between essential and toxic elements in lead exposed children in Katowice, Poland.

OBJECTIVES: To determine the influence of the essential element status on blood concentrations of lead and other toxic metals. DESIGN AND METHODS: A group of 157 children from Katowice, an industrial area in Poland, was investigated for concentrations of lead and cadmium in whole blood, and mercury, selenium, zinc, copper, and magnesium in whole blood and serum. Relations between these elements, serum ferritin, hematological parameters, as well as serum selenoprotein P and glutathione peroxidase (GSH-px) were examined. Conversion factors for element concentrations (mumol to microgram): lead 207.19, cadmium 112.41, mercury 200.59, selenium 78.96, magnesium 24.31, copper 63.55, and zinc 65. RESULTS: Blood lead was negatively associated with concentrations of selenium in whole blood and serum as well as selenoprotein P and glutathione peroxidase in serum. The association was mainly apparent at low blood lead concentrations, which may indicate an influence of selenium on the kinetics of lead, rather than an effect of lead on the selenium status. Children with low serum ferritin levels had statistically higher blood cadmium levels and a tendency for higher blood lead levels, indicating increased gastrointestinal absorption of these metals at reduced iron stores. Blood lead was negatively correlated with mean corpuscular hemoglobin concentration, which may reflect the effect of lead on hemoglobin synthesis. There was an association between blood mercury and selenium, indicating a common source of intake through fish consumption. CONCLUSIONS: The results indicate that selenium and iron status may influence the kinetics of lead.

Adolescent↗

Assessment of lead exposure and associated risk factors in urban children in Silesia, Poland.

A program of childhood lead poisoning prevention was conducted in six cities of Silesia, the most industrialized region of Poland. We analyzed records of 11,877 children aged 24-84 months, tested between 1993 and 1998, to assess children's exposure to lead and associations of blood lead levels (BLL) with season of sampling, questionnaire data, and environmental levels of lead. Air lead concentrations and lead fallout, as measured in the ambient air monitoring system, were below current Polish air quality standards and gradually decreased. The geometric mean (GM) BLL was 6.3 microg/dL (range from 0.6 to 48 microg/dL), and >13% of children had BLL > or =10 microg/dL. Mean BLL declined from 6.8 microg/dL in 1993-1994 to almost 5.5 microg/dL in 1998. GM BLL in spring and summer ('nonheating' season) months were 10% higher than BLL in children tested in fall and winter ('heating' season), although air lead concentrations were lower in nonheating and higher in the heating season. For both the heating and nonheating seasons, there was a significant increase in the mean BLL with increasing air lead concentrations. Poor housing (odds ratio (OR): 1.82; 95% CI: 1.4, 2.3), two or more siblings in the family (OR: 3.12; 95% CI: 2.6, 3.7), lack of recreational trips outside the region (OR: 1.66; 95% CI: 1.47, 1.89), and the time child spent outdoors were associated with elevated BLL. Variables found to affect BLL in the Silesian children should be used to propose criteria to improve identification of children at risk and to focus prevention activities more effectively.

Air Pollutants↗

Pesticides in precipitation in the Gdańsk region (Poland).

Selected organonitrogen, organophosphorus and organochlorine pesticides have been determined in precipitation samples collected at 10 sites in the Gdańsk region (northern Poland) over a period of one year (1998). Compounds which were detected most often included simazine (0.11-5.80 ng/l), fenitrothion (0.1-2.10 ng/l), chlorfenvinfos (0.1-1.30 ng/l), gamma-HCH (0.012-5.06 ng/l), heptachlor epoxide (0.05-3.28 ng/l) and aldrin (0.02-3.28 ng/l). The pesticide concentrations in precipitation samples revealed seasonal fluctuations, with higher concentrations observed during the application periods (June and July). The concentrations observed were also affected by the inflow of polluted air masses from the southwest. The total pesticide concentration in the precipitation samples was strongly related to the abundance of green areas in the vicinity of the sampling sites. A weak correlation was also found between the total concentration of organonitrogen and organophosphorus pesticides, and the total concentration of organochlorine pesticides in the samples collected.

Air Pollutants↗

Human health risk assessment case study: an abandoned metal smelter site in Poland.

United States Environmental Protection Agency methodologies for human health risk assessment (HRA) were applied in a Brownfields Demonstration Project on the Warynski smelter site (WSS), an abandoned industrial site at Piekary Slaskie town, Upper Silesia, Poland. The HRA included the baseline risk assessment (BRA) and the development of risk-based preliminary remedial goals (RBPRGs). The HRA focused on surface area covered with waste materials, which were evaluated with regard to the potential risks they may pose to humans. Cadmium, copper, iron, manganese, lead, and zinc were proposed as the contaminants of potential concern (COPCs) at WSS based on archive data on chemical composition of waste located on WSS. For the defined future land use patterns, the industrial (I) and recreational (II) exposure scenarios were assumed and evaluated. The combined hazard index for all COPCs was 3.1E+00 for Scenario I and 3.2E+00 for Scenario II. Regarding potential carcinogenic risks associated with the inhalation route, only cadmium was a contributor, with risks of 1.6E-06 and 2.6E-07 for Scenario I and Scenario II, respectively. The results of the BRA indicated that the potential health risks at WSS were mainly associated with waste material exposure to cadmium (industrial and recreational scenarios) and lead (industrial scenario). RBPRGs calculated under the industrial scenario were 1.17E+03 and 1.62E+03 mg/kg for cadmium and lead, respectively. The RBPRG for cadmium was 1.18E+03 mg/kg under the recreational scenario. The BRA results, as well as RBCs, are comparable for both scenarios, so it is impossible to prioritize land use patterns for WSS based on these results. For choosing a future land use pattern or an appropriate redevelopment option, different factors would be decisive in the decision-making process, e.g., social, market needs, technical feasibility and costs of redevelopment actions or acceptance of local community.

Cadmium↗

Quality of roof runoff waters from an urban region (Gdańsk, Poland).

The paper presents the results of testing of roof runoff waters from buildings in the city of Gdańsk (Poland), carried out as a part of a broader research project aimed at the determination of pollutant levels in precipitation. The analytes determined included volatile organohalogen compounds, petroleum hydrocarbons, Na+, K+, NH4+, Mg2+, Ca2+, F-, Cl-, NO2-, NO3-, PO4(3-), SO4(2-) ions, as well as organonitrogen, organophosphorus and organochlorine pesticides. In addition, the toxicity and pH of the samples were examined. The samples were collected over a period of six months, during or immediately following precipitation events. More than half of the samples (25) were found to be toxic, with inhibition exceeding 20%. The toxicity was weakly correlated to the levels of organonitrogen and organophosphorus pesticides in runoff waters. It was established that at least in some cases the roofing material affected the levels of the pollutants found in the samples.

Cities↗