Yıl: 2021 Cilt: 41 Sayı: 3 Sayfa Aralığı: 225 - 233 Metin Dili: İngilizce İndeks Tarihi: 16-02-2022

Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study

Öz:
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.
Anahtar Kelime:

Marmara Bölgesi’nde Parçacık Madde ve Azot Dioksit Değerlerinin Kronik Bronşit İnsidansı ve Mortalite Üzerine Etkisi: Geriye Dönük Kohort Çalışması

Öz:
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/m3olarak 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 Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Tmmob Çevre Mühendisleri Odası [Internet]. [Cited: 07.01.2019]. Hava kirliliği raporu-2018. Available from: [Link]
  • 2. world Health Organization [Internet]. © 2019 wHO [Cited: 07.01.2019]. Air pollution. Available from: [Link]
  • 3. Temiz Hava Hakkı Platformu [Internet]. [Cited: 07.01.2018]. Hava kirliliği ve sağlık etkileri. Kara rapor. 2019. Available from: [Link]
  • 4. Jimoda LA. Effects of particulate matter on human health, the ecosystem, climate and materials: a review. working and Living Environmental Protection. 2012;9(1):27-44. [Link]
  • 5. Maji KJ, Arora M, Dikshit AK. Burden of disease attributed to ambient PM2.5 and PM10 exposure in 190 cities in China. Environ Sci Pollut Res Int. 2017;24(12):11559-72. [Crossref] [Pubmed]
  • 6. van Donkelaar A, Martin RV, Brauer M, Boys BL. Use of satellite observations for long-term exposure assessment of global concentrations of fine particulate matter. Environ Health Perspect. 2015;123(2):135-43. [Crossref] [Pubmed] [PMC]
  • 7. Orellano P, Reynoso J, Quaranta N, Bardach A, Ciapponi A. Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: systematic review and meta-analysis. Environ Int. 2020;142: 105876. [Crossref] [Pubmed]
  • 8. fasola S, Maio S, Baldacci S, La Grutta S, ferrante G, forastiere f, et al; On Behalf Of The Beep Collaborative Group. Effects of par ticulate matter on the incidence of respiratory diseases in the Pisan longitudinal study. Int J Environ Res Public Health. 2020;17(7):2540. [Crossref] [Pubmed] [PMC]
  • 9. world Health Organization [Internet]. © 2020 wHO [Cited: 10.12.2020]. Health effects of particular Matter (2013). Available from: [Link] 10. world Health Organization [Internet]. [Cited: 23.11.2019]. Ambient (outdoor) air quality and health. Available from: [Link]
  • 11. Burnett RT, Stieb D, Brook JR, Cakmak S, Dales R, Raizenne M, et al. Associations between short-term changes in nitrogen dioxide and mortality in Canadian cities. Arch Environ Health. 2004;59(5):228-36. [Crossref] [Pubmed]
  • 12. Chen R, Yin P, Meng X, wang L, Liu C, Niu Y, et al. Associations between ambient nitrogen dioxide and daily cause-specific mortality: evidence from 272 Chinese cities. Epidemiology. 2018;29(4):482-9. [Crossref] [Pubmed]
  • 13. Tao Y, Huang w, Huang X, Zhong L, Lu SE, Li Y, et al. Estimated acute effects of ambient ozone and nitrogen dioxide on mortality in the Pearl River Delta of southern China. Environ Health Perspect. 2012;120(3):393-8. [Crossref] [Pubmed] [PMC]
  • 14. wikipedia [Internet]. [Cited: 18.01.2020]. 2009 Turkish flash floods. Available from: [Link]
  • 15. world Health Organization [Internet]. [Cited: 23.01.2019]. AirQ+: software tool for health risk assessment of air pollution. Available from: [Link]
  • 16. T.C. Çevre ve Şehircilik Bakanlığı [Internet] Cited: 23.01.2019]. Hava kalitesi bülteni. Yıllık, 2018. Available from: [Link]
  • 17. TURKSTAT [Internet]. [Cited: 23.01.2019]. Provincial populations by years 2018. Available from: [Link]
  • 18. TURKSTAT [Internet]. [Cited: 25.01.2019]. Death cause statistics 2018. Available from: [Link]
  • 19. T.C. Sağlık Bakanlığı [Internet]. [Cited: 03.06.2019]. Türkiye hastalık yükü çalışması 2004. Available from: [Link]
  • 20. Turkish Thoracic Society [Internet]. [Cited: 14.11.2019]. what is COPD? Available from: [Link]
  • 21. General Directorate of Mapping [Internet]. [Cited: 23.06.2019]. Available from: [Link]
  • 22. Liu S, Zhou Y, Liu S, Chen X, Zou w, Zhao D, et al. Association between exposure to ambient particulate matter and chronic obstructive pulmonary disease: results from a cross-sectional study in China. Thorax. 2017;72(9):788- 95. [Crossref] [Pubmed] [PMC]
  • 23. Khaefi M, Geravandi S, Hassani G, Yari AR, Soltani f, Dobaradaran S, et al. Association of particulate matter impact on prevalence of chronic obstructive pulmonary disease in Ahvaz, Southwest Iran during 2009-2013. Aerosol and Air Quality Research. 2017; 17:230-7. [Crossref]
  • 24. Ling SH, van Eeden Sf. Particulate matter air pollution exposure: role in the development and exacerbation of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2009;4:233-43. [Crossref] [Pubmed] [PMC]
  • 25. Resmî Gazete (06.06.2008, Issue: 26898) Hava Kalitesi Değerlendirme ve Yönetimi Yönetmeliği; 2008. [Link]
  • 26. Schikowski T, Sugiri D, Ranft U, Gehring U, Heinrich J, wichmann HE, et al. Long-term air pollution exposure and living close to busy roads are associated with COPD in women. Respiratory Resarch BMC. 2005;6:152. [Crossref] [Pubmed] [PMC]
  • 27. Miri M, Ebrahimi Aval H, Ehrampoush MH, Mohammadi A, Toolabi A, Nikonahad A, et al. Human health impact assessment of exposure to particulate matter: an AirQ software modeling. Environ Sci Pollut Res Int. 2017; 24(19):16513-9. [Crossref] [Pubmed]
  • 28. Miri M, Derakhshan Z, Allahabadi A, Ahmadi E, Oliveri Conti G, ferrante M, et al. Mortality and morbidity due to exposure to outdoor air pollution in Mashhad metropolis, Iran. The AirQ model approach. Environ Res. 2016;151:451-7. [Crossref] [Pubmed]
  • 29. Goudarzia G, Mohammadi MJ, Angali KA, Neisi KA, Babaei AA, Mohammadi B, et al. Estimation of health effects attributed to NO2 exposure using AirQ model. Arch Hyg Sci. 2012;1(2):59-66. [Link]
  • 30. Atkinson Rw, Butland BK, Anderson HR, Maynard RL. Long-term concentrations of nitrogen dioxide and mortality: a meta-analysis of cohort studies. Epidemiology. 2018;29(4):460- 72. [Crossref] [Pubmed] [PMC]
  • 31. Sunyer J, Basaga-a X, Belmonte J, Antó JM. Effect of nitrogen dioxide and ozone on the risk of dying in patients with severe asthma. Thorax. 2002;57(8):687-93. [Crossref] [Pubmed] [PMC]
  • 32. Bahrami Asl f, Leili M, Vaziri Y, Salahshour Arian S, Cristaldi A, Oliveri Conti G, et al. Health impacts quantification of ambient air pollutants using AirQ model approach in Hamadan, Iran. Environ Res. 2018;161:114- 21. [Crossref] [Pubmed]
APA Palanbek Yavaş S, Önal A, Pacci S, ÇAGLAYAN Ç (2021). Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. , 225 - 233.
Chicago Palanbek Yavaş Seher,Önal Ayşe Emel,Pacci Selvi Nur,ÇAGLAYAN ÇIGDEM Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. (2021): 225 - 233.
MLA Palanbek Yavaş Seher,Önal Ayşe Emel,Pacci Selvi Nur,ÇAGLAYAN ÇIGDEM Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. , 2021, ss.225 - 233.
AMA Palanbek Yavaş S,Önal A,Pacci S,ÇAGLAYAN Ç Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. . 2021; 225 - 233.
Vancouver Palanbek Yavaş S,Önal A,Pacci S,ÇAGLAYAN Ç Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. . 2021; 225 - 233.
IEEE Palanbek Yavaş S,Önal A,Pacci S,ÇAGLAYAN Ç "Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study." , ss.225 - 233, 2021.
ISNAD Palanbek Yavaş, Seher vd. "Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study". (2021), 225-233.
APA Palanbek Yavaş S, Önal A, Pacci S, ÇAGLAYAN Ç (2021). Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. Türkiye Klinikleri Tıp Bilimleri Dergisi, 41(3), 225 - 233.
Chicago Palanbek Yavaş Seher,Önal Ayşe Emel,Pacci Selvi Nur,ÇAGLAYAN ÇIGDEM Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. Türkiye Klinikleri Tıp Bilimleri Dergisi 41, no.3 (2021): 225 - 233.
MLA Palanbek Yavaş Seher,Önal Ayşe Emel,Pacci Selvi Nur,ÇAGLAYAN ÇIGDEM Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. Türkiye Klinikleri Tıp Bilimleri Dergisi, vol.41, no.3, 2021, ss.225 - 233.
AMA Palanbek Yavaş S,Önal A,Pacci S,ÇAGLAYAN Ç Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2021; 41(3): 225 - 233.
Vancouver Palanbek Yavaş S,Önal A,Pacci S,ÇAGLAYAN Ç Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2021; 41(3): 225 - 233.
IEEE Palanbek Yavaş S,Önal A,Pacci S,ÇAGLAYAN Ç "Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study." Türkiye Klinikleri Tıp Bilimleri Dergisi, 41, ss.225 - 233, 2021.
ISNAD Palanbek Yavaş, Seher vd. "Effect of Particulate Matter and Nitrogen Dioxide Levels on Chronic Bronchitis Incidence and Mortality in Marmara Region: Retrospective Cohort Study". Türkiye Klinikleri Tıp Bilimleri Dergisi 41/3 (2021), 225-233.