Poniedziałek Barbara, Rzymski Piotr, Zarębska-Michaluk Dorota, Flisiak Robert
Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland.
Department of Infectious Diseases, Jan Kochanowski University, Kielce, Poland.
Chemosphere. 2024 Jul;359:142256. doi: 10.1016/j.chemosphere.2024.142256. Epub 2024 May 7.
The COVID-19 pandemic has reinforced an interest in the relationship between air pollution and respiratory viral infections, indicating that their burden can be increased under poor air quality. This paper reviews the pathways through which air pollutants can enhance susceptibility to such infections and aggravate their clinical course and outcome. It also summarizes the research exploring the links between various viral infections and exposure to solid and gaseous pollution in Poland, a region characterized by poor air quality, especially during a heating season. The majority of studies focused on concentrations of particulate matter (PM; 86.7%); the other pollutants, i.e., BaP, benzene, CO, NO, O, and SO were studied less often and sometimes only in the context of a particular infection type. Most research concerned COVID-19, showing that elevated levels of PM and NO correlated with higher morbidity and mortality, while increased PM and benzo[a]pyrene levels were related to worse clinical course and outcome in hospitalized, regardless of age and dominant SARS-CoV-2 variant. PM and PM levels were also associated with the incidence of influenza-like illness and, along with NO concentrations, with a higher rate of children's hospitalizations due to lower respiratory tract RSV infections. Higher levels of air pollutants also increased hospitalization due to bronchitis (PM, NO, and O) and emergency department admission due to viral croup (PM, PM, NO, CO, and benzene). Although the conducted studies imply only correlations and have other limitations, as discussed in the present paper, it appears that improving air quality through reducing combustion processes in energy production in Poland should be perceived as a part of multilayered protection measures against respiratory viral infections, decreasing the healthcare costs of COVID-19, lower tract RSV infections, influenza, and other respiratory viral diseases prevalent between autumn and early spring, in addition to other health and climate benefits.
新冠疫情强化了人们对空气污染与呼吸道病毒感染之间关系的关注，表明在空气质量差的情况下，它们造成的负担可能会加重。本文回顾了空气污染物增强此类感染易感性并加重其临床病程和结局的途径。本文还总结了在波兰这个空气质量差的地区，特别是在供暖季节，探索各种病毒感染与接触固体和气体污染物之间联系的研究。大多数研究聚焦于颗粒物（PM；86.7%）的浓度；对其他污染物，即苯并[a]芘、苯、一氧化碳、一氧化氮、臭氧和二氧化硫的研究较少，有时仅在特定感染类型的背景下进行研究。大多数研究关注新冠病毒，结果显示颗粒物和一氧化氮水平升高与更高的发病率和死亡率相关，而住院患者中，无论年龄和主要的新冠病毒变异株如何，颗粒物和苯并[a]芘水平升高与更差的临床病程和结局有关。细颗粒物和粗颗粒物水平还与流感样疾病的发病率相关，并且与因呼吸道合胞病毒下呼吸道感染导致的儿童住院率较高有关。更高水平的空气污染物还增加了因支气管炎（细颗粒物、一氧化氮和臭氧）导致的住院率以及因病毒性喉炎（细颗粒物、粗颗粒物、一氧化氮、一氧化碳和苯）导致的急诊科就诊率。尽管所开展的研究仅表明存在相关性且有其他局限性，如本文所讨论的，但似乎通过减少波兰能源生产中的燃烧过程来改善空气质量，应被视为针对呼吸道病毒感染的多层保护措施的一部分，这除了能带来其他健康和气候效益外，还能降低新冠疫情、呼吸道合胞病毒下呼吸道感染、流感以及秋季至早春期间流行的其他呼吸道病毒疾病的医疗成本。
