The role of ambient air quality in the etiology of chronic respiratory diseases, which has been studied in many epidemiologic surveys, is still controversial. However, in the longitudinal study of COPD in Cracow we observed that it had a significant effect. Our conclusion was that in the general population air pollution tends to increase the effects of other hazards, such as occupational exposures, on the respiratory system. Although the completeness of the data on industrial emission of air pollutants has been changing in Poland through the years, and comparisons should be made with caution, some trends over time are obvious Table 8). Whereas dust pollution is declining, the emission of gases is not, and levels of all the surveyed gases are much higher in the 1980s than in the 1970s.
The effects of indoor air pollution, though more debatable than outdoor, cannot be neglected. They have been the subject of many studies in children and adults in many parts of the world and are a subject of this conference. Little is known about the level and trends of indoor pollution in the general population in Poland; yet, there are certain indirect indications that at least some changes may be in a desired direction. The percentage of dwellings equipped with central heating increased in urban areas from 36.2 in 1970 to 68.6 in 1986 and in rural areas from 4.5 to 31.8. The frequency of dwellings with gas installations increased in urban area from 48.3% in 1970 to 67.4% in 1986, but is still rather low in villages. Though there is concern about the hazardous health effects of nitrogen dioxide (NO*) from gas-fueled cooking stoves, the results of the change may still be positive, because what is being replaced are primarily coal-fueled stoves, and sulfur oxide might be an even more hazardous indoor pollutant. сanadianhealthcaremallinc.com
The results we have presented show that CAD has not regressed as a health problem in the Polish population. Hospital discharge rates as well as death rates for chronic bronchitis have increased in recent years in both men and women. The working and living environment of the rural population as well as its access to health care requires still more attention to reduce the excess of mortality from CAD that is a particular problem in this subpopulation.
The prevalence of smoking and especially its increase among women is alarming. More serious policies of regulation and implementation of the government and appropriate social organizations are urgently needed to reduce the number of smokers and to lessen the toxic constituents of cigarettes. The new proposal of the Parliament act on education for abstinence from nicotine and counteraction against tobacco smoking is expected to bring about helpful changes in these matters. The problem of air pollution is still far from being solved. Some improvement can be seen in the reduction of dust pollution, and now the emission of about 94% of produced dust is prevented. In case of gases, however, emission of only 11.3% is prevented, and stricter controls of gas emission should be an important task for the future.
Table 8—Industrial Emission of Air Pollutants in Poland (in 100,000 Ibns)