Comparison of child morbidity in regions of Ostrava, Czech Republic, with different degrees of pollution: a retrospective cohort study

Comparison of polycyclic aromatic hydrocarbon metabolite concentrations in urine of mothers and their newborns

Polycyclic aromatic hydrocarbons (PAHs) are environmental contaminants produced during incomplete combustion of organic matter. Humans can be exposed to them via several pathways (inhalation, digestion, dermal exposure). The aim of this study was to assess the concentration of 11 monohydroxylated metabolites of PAHs (OH-PAHs) in 660 urine samples collected from mothers and their newborns residing in two localities of the Czech Republic - Most and Ceske Budejovice - in 2016 and 2017. After enzymatic hydrolysis, the target analytes were extracted from the urine samples using liquid-liquid extraction, with extraction solvent ethyl acetate and a clean-up step using dispersive solid-phase extraction (d-SPE) with the Z-Sep sorbent. For identification and quantification, ultra-high performance liquid chromatography coupled with tandem mass spectrometry was applied. 2-OH-NAP was the compound present in all of the measured samples and it was also the compound at the highest concentration in both mothers' and newborns' urine samples (median concentration 5.15 μg/g creatinine and 3.58 μg/g creatinine). The total concentrations of OH-PAHs in urine samples collected from mothers were 2 times higher compared to their children. The most contaminated samples were collected in Most in the period October 2016-March 2017 from both mothers (12.59 μg/g creatinine) and their newborns (8.29 μg/g creatinine). The concentrations of OH-PAHs in urine samples, which were collected from both mothers and their newborns as presented in this study, are comparable with those found in our previous study between 2013 and 2014. In addition, they are slightly lower or comparable to other studies from Poland, USA, Germany, China, and Australia. The results might indicate that the population in the previously highly air-polluted mining districts carries some long-term changes (maybe existing changes in genetic information), which also affect the metabolism of PAHs. It could be related to the long-lasting effect, and thus corresponding to the shortened life expectancy.

Concentration Variability of Water-Soluble Ions during the Acceptable and Exceeded Pollution in an Industrial Region

This study investigates the chemical composition of water-soluble inorganic ions at eight localities situated in the Moravian-Silesian Region (the Czech Republic) at the border with Poland. Water-soluble inorganic ions were monitored in the winter period of 2018 (January, 11 days and February, 5 days). The set was divided into two periods: the acceptable period (the 24-h concentration of PM₁₀ < 50 µg/m³) and the period with exceeded pollution (PM₁₀ ˃ 50 µg/m³). Air quality in the Moravian-Silesian Region and Upper Silesia is among the most polluted in Europe, especially in the winter season when the concentration of PM₁₀ is repeatedly exceeded. The information on the occurrence and behaviour of water-soluble inorganic ions in the air during the smog episodes in Europe is insufficient. The concentrations of water-soluble ions (chlorides, sulphates, nitrates, ammonium ions, potassium) during the exceeded period are higher by two to three times compared with the acceptable period. The major anions for both acceptable period and exceeded pollution are nitrates. During the period of exceeded pollution, percentages of water-soluble ions in PM₁₀ decrease while percentages of carbonaceous matter and insoluble particles (fly ash) increase.

Ambient Air Quality in the Czech Republic: Past and Present

Based on an analysis of related core papers and reports, this review presents a historical perspective on ambient air pollution and ambient air quality development in the modern-day Czech Republic (CR) over the past seven decades, i.e., from the 1950s to the present. It offers insights into major air pollution problems, reveals the main hot spots and problematic regions and indicates the principal air pollutants in the CR. Air pollution is not presented as a stand-alone problem, but in the wider context of air pollution impacts both on human health and the environment in the CR. The review is arranged into three main parts: (1) the time period until the Velvet Revolution of 1989, (2) the transition period of the 1990s and (3) the modern period after 2000. Obviously, a major improvement in ambient air quality has been achieved since the 1970s and 1980s, when air pollution in the former Czechoslovakia culminated. Nevertheless, new challenges including fine aerosol, benzo[a]pyrene and ground-level ozone, of which the limit values are still vastly exceeded, have emerged. Furthermore, in spite of a significant reduction in overall emissions, the atmospheric deposition of nitrogen, in particular, remains high in some regions.

Relation between personal exposure and outdoor concentrations of carcinogenic polycyclic aromatic hydrocarbons during smog episode

OBJECTIVES

To our knowledge this is the first study measuring personal exposure to carcinogenic polycyclic aromatic hydrocarbons (cPAHs) bound to airborne particulate matter ≤ 2.5 µm (PM_2.5) in periods of high air pollution (smog episode) in which citizen were tracked.

METHODS

Measurements were performed in industrial regions of the Czech Republic: Ostrava, Karviná, Havířov. The city of Prague served as a control. Personal monitoring was conducted by active personal monitors for 48 hours. Non-smoking city policemen from Prague, Karviná and Havířov, office workers from Ostrava city and volunteers from Ostrava-Radvanice and Bartovice participated in the study (N = 214).

RESULTS

The average personal exposure to benzo[a]pyrene (B[a]P) was highest in Ostrava (17.2 ng/m³), followed by Karviná, Havířov, Radvanice and Bartovice, and Prague (14.2, 12.0, 9.3, and 2.8 ng/m³, respectively). We tested for association between the personal exposure to cPAHs and various health-related factors extracted from the questionnaires, including lifestyle factors and day-to-day activities.

CONCLUSIONS

Exposure to outdoor cPAHs, environmental tobacco smoke (ETS), commuting, and time spent indoors (in restaurants, workplace or home) were found to be the main determinants of the personal exposure. Daily cPAHs measurements in highly polluted areas are needed for evaluating the personal exposure and to avoid its underestimation resulting from stationary monitoring.

Benzo[a]pyrene is associated with dysregulated myelo-lymphoid hematopoiesis in asthmatic children

BACKGROUND

The extent to which ambient benzo[a]pyrene (B[a]P) contributes to mechanistically distinct de novo asthma remains unknown.

OBJECTIVES

To identify molecular signatures and regulatory networks underlying childhood exposure to ambient B[a]P and asthma, using robust and unbiased systems biology approaches.

METHODS

Clinically confirmed asthmatic (n = 191) vs. control (n = 194) children (aged, 7-15) were enrolled from a polluted urban center and semi-rural region in Czech Republic. Contemporaneous B[a]P concentration, gene expressions, DNA methylation data were analyzed against asthma diagnosis, as well as a modified prognostic index of asthma, using integrative multiscale co-expression network analysis. Sample-wise cell type compositions were inferred by a machine learning approach (i.e. CIBERSORT) with reference gene expressions of purified 38 distinct hematopoietic cell states from umbilical cord (i.e. stem cell/progenitors) or peripheral blood (i.e. lymphocytes).

RESULTS

The median outdoor B[a]P was increased near the homes of the urban children with 'moderate' or 'severe' prognostic markers of asthma, but not in the urban controls. An elevated B[a]P induced epigenetic suppression of NF-κB inflammation, decreased Natural Killer T (NKT) cells and activated anti-inflammatory IL10-secreting CD8+ T effective memory cells. B[a]P was positively correlated with an increased expression of a heme biosynthesis gene, ALAS2, which in turn, appears to promote concurrent increase of neutrophilic metamyelocyte and mature CD71^low erythroid cells. Furthermore, erythroid-specific master transcription regulator gene (GATA1), glutathione transferase genes (GSTM1 and GSTM3) and Eosinophil marker (IL5RA) were simultaneously activated in the urban asthma cases.

CONCLUSIONS

B[a]P might contribute to concurrent suppression of pro-inflammatory (e.g. NF-κB mediated NKT cells), and activation of anti-inflammatory pathways (e.g. IL10-secreting CD8+ T cells) in the urban asthmatic children. In addition, B[a]P appears to elevate heme biosynthesis, which in turn, promotes neutrophilic metamyelocyte expansion and reduction of CD71⁺ erythroids.

The influence of local emissions and regional air pollution transport on a European air pollution hot spot

The EU air quality standards have been frequently exceeded in one of the European air pollution hot spots: Ostrava. The aim of this study was to perform an air quality comparison between an urban site (Radvanice), which has a nearby metallurgical complex, and a suburban site (Plesná) to estimate air pollution sources and determine their local and/or regional origins. Twenty-four hour PM₁ and PM₁₀ (particular matter) concentrations, detailed mass size distributions (MSDs) to distinguish the sources of the fine and coarse PM, and their chemical compositions were investigated in parallel at both sites during the winter of 2014. Positive matrix factorization (PMF) was applied to the PM₁ and PM₁₀ chemical compositions to investigate their sources. During the measurement campaign, prevailing northeastern-southwestern (NE-SW) wind directions (WDs) were recorded. Higher average PM₁₀ concentration was measured in Radvanice than in Plesná, whereas PM₁ concentrations were similar at both sites. A source apportionment analysis revealed six and five sources for PM₁₀ and PM₁, respectively. In Radvanice, the amount of PM and the most chemical species were similar under SW and NE WD conditions. The dominant sources were industrial (43% for PM₁₀ and 27% for PM₁), which were caused by a large metallurgical complex located to the SW, and biomass burning (25% for PM₁₀ and 36% for PM₁). In Plesná, the concentrations of PM and all species significantly increased under NE WD conditions. Secondary inorganic aerosols were dominant, with the highest contributions deriving from the NE WD. Therefore, regional pollution transport from the industrial sector in Silesian Province (Poland) was evident. Biomass burning contributed 22% and 24% to PM₁₀ and PM₁, respectively. The air quality in Ostrava was influenced by local sources and regional pollution transport. The issue of poor air quality in this region is complex. Therefore, international cooperation from both states (the Czech Republic and Poland) is needed to achieve a reduction in air pollution levels.

Impact of fugitive sources and meteorological parameters on vertical distribution of particulate matter over the industrial agglomeration

The aim of the study was to characterize vertical distribution of particulate matter, in an area well known by highest air pollution levels in Europe. A balloon filled with helium with measuring instrumentation was used for vertical observation of air pollution over the fugitive sources in Moravian-Silesian metropolitan area during spring and summer. Synchronously, selected meteorological parameters were recorded together with particulate matter for exploration its relationship with particulate matter. Concentrations of particulate matter in the vertical profile were significantly higher in the spring than in the summer. Significant effect of fugitive sources was observed up to the altitude ∼255 m (∼45 m above ground) in both seasons. The presence of inversion layer was observed at the altitude ∼350 m (120-135 m above ground) at locations with major source traffic load. Both particulate matter concentrations and number of particles for the selected particle sizes decreased with increasing height. Strong correlation of particulate matter with meteorological parameters was not observed. The study represents the first attempt to assess the vertical profile over the fugitive emission sources - old environmental burdens in industrial region.

Environmental and Socioeconomic Health Inequalities: a Review and an Example of the Industrial Ostrava Region

BACKGROUND AND AIM

According to the World Health Organization (WHO) more than 2 million premature deaths and 7 million of total deaths each year can be attributed to the effects of air pollution. The contribution of air pollution to the health status of population is estimated to be about 20%. Health is largely determined by factors outside the reach of healthcare sector, including low income, unemployment, poor environment, poor education, and substandard housing. The aim of the paper was to review a current knowledge of relationships among air pollution, socioeconomic health inequalities, socio-spatial differentiation, and environmental inequity. The relationships were demonstrated on an example of the Ostrava region. Also basic approaches to health valuation were reviewed.

RESULTS

Social differences are reasons both for health inequalities and spatial patterns of unprivileged area housing. In urban environments with poor air quality there is also a large concentration of low income residents. Less affluent population groups are more often affected by inadequate housing conditions including second-hand smoking and higher environmental burden in their residential neighbourhoods. Environmental injustice is highly correlated with other factors that link poverty with poor health, including inadequate access to medical and preventive care, lack of availability of healthful food, lack of safe play spaces for children, absence of good jobs, crime, and violence.

CONCLUSIONS

The theoretical background and also results of the studies brought evidence that population health is affected by both socioeconomic and environmental inequalities. Air pollution is unevenly distributed in Ostrava and is related to distribution of socially disadvantaged environment and social exclusion as well.

How sustainable household environment and knowledge of healthy practices relate to childhood morbidity in South Asia: analysis of survey data from Bangladesh, Nepal and Pakistan

OBJECTIVES

Prevalence of diarrhoea and acute respiratory infection (ARI) is considerably high among South Asian children. The objective of this study is to compare the associations of sustainable household environment and knowledge of healthy practices with episodes of these diseases among the children in the region.

DESIGN

The study analysed the latest, nationally representative and cross-sectional Demographic and Health Survey data.

SETTING

Data from three countries were analysed: Bangladesh, Nepal and Pakistan.

PARTICIPANTS

Women aged between 12 and 49 years living in selected households provided information on 23 940 of their children under the age of 5 years.

PRIMARY OUTCOMES MEASURES

The morbidity status of the children was recorded with respect to episodes of diarrhoea and/or ARI in the 2 weeks preceding data collection.

RESULTS

Consuming unhygienic drinking water increased the risks of childhood diarrhoea, and use of solid fuel for indoor cooking increased the risk of ARI, across all three countries investigated. However, far more significant were the effects of mother's education, with incomplete primary education leading to an odds of diarrhoea approaching twice that of a mother with secondary education or higher (OR 1.70 in Bangladesh, 95% CI 1.16 to 2.49).

CONCLUSIONS

Results from the current research underline the importance of developing and implementing integrated strategic plans for mothers and children in the countries investigated. Promoting hygienic water and sanitation facilities can help reduce the prevalence of childhood diarrhoea. Replacing indoor solid fuel cooking arrangements with cleaner fuel or more airy conditions can help reduce the prevalence of ARI. However, these strategies need to be integrated with education for women to raise the likelihood that reduced risks are actually realised.

Linking childhood allergic asthma phenotypes with endotype through integrated systems biology: current evidence and research needs

Asthma and other complex diseases results from a complex web of interactions involving inflammation, immunity, cell cycle, apoptosis, and metabolic perturbations across multiple organ systems. The extent to which various degrees of the age at onset, symptom severity, and the natural progression of the disease reflect multiple disease subtypes, influenced by unique process of development remains unknown. One of the most critical challenges to our understanding stems from incomplete understanding of the mechanisms. Within this review, we focus on the phenotypes of childhood allergic asthma as the basis to better understand the endotype for quantitative define subtypes of asthma. We highlight some of the known mechanistic pathways associated with the key hallmark events before the asthma onset. In particular, we examine how the recent advent of multiaxial -omics technologies and systems biology could help to clarify our current understanding of the pathway. We review how a large volume of molecular, genomic data generated by multiaxial technologies could be digested to identify cogent pathophysiologic molecular networks. We highlight some recent successes in application of these technologies within the context of other disease conditions for therapeutic interventions. We conclude by summarizing the research needs for the predictive value of preclinical biomarkers.

Relationship between atmospheric pollution in the residential area and concentrations of polycyclic aromatic hydrocarbons (PAHs) in human breast milk

Human milk is an important source of beneficial nutrients and antibodies for newborns and infants and, under certain circumstances, its analysis may provide information on mothers' and infants' exposure to various contaminants. In the presented study, we have introduced the new analytical approach for analysis of 24 highly occurring polycyclic aromatic hydrocarbons (PAHs) in this indicator matrix. The sample preparation procedure is based on an ethyl acetate extraction of milk; the transfer of analytes into an organic layer is enhanced by addition of inorganic salts, i.e. sodium chloride and magnesium sulphate. Following the clean-up of a crude extract on silica SPE columns, gas chromatography coupled to triple quadrupole mass spectrometry is used for PAH identification and quantitation. The average recoveries of targeted PAHs from spiked samples were in the range of 68-110% with repeatabilities below 30% and method quantitation limits ranging from 0.03 to 0.3ng/g lipid weight. This newly validated method was successfully applied for analyses of 324 human milk samples collected from nonsmoking women during two sampling periods (summer and winter) in two residential areas in the Czech Republic differing in atmospheric pollution by PAHs. From 24 targeted analytes 17 were detected at least in one sample. Phenantherene, fluoranthrene, pyrene and fluorene were the most abundant compounds found at average concentration of 13.81, 1.80, 0.86, and 2.01ng/g lipid weight respectively. Comparing the data from two sampling periods, in both areas higher concentrations were measured in samples collected during winter. Also in the highly industrialized locality with heavily contaminated air PAH amounts in milk were higher than in the control locality. These first data on PAH concentrations in human milk collected in the Czech Republic are comparable with measurements for nonsmoking women reported earlier in the United States but significantly lower than results from China, Turkey or Italy.

Source apportionment of size resolved particulate matter at a European air pollution hot spot

Positive Matrix Factorization-PMF was applied to hourly resolved elemental composition of fine (PM0.15-1.15) and coarse (PM1.15-10) aerosol particles to apportion their sources in the airshed of residential district, Ostrava-Radvanice and Bartovice in winter 2012. Multiple-site measurement by PM2.5 monitors complements the source apportionment. As there were no statistical significant differences amongst the monitors, the source apportionment derived for the central site data is expected to apply to whole residential district. The apportioned sources of the fine aerosol particles were coal combustion (58.6%), sinter production-hot phase (22.9%), traffic (15%), raw iron production (3.5%), and desulfurization slag processing (<0.5%) whilst road dust (47.3%), sinter production-cold phase (27.7%), coal combustion (16.8%), and raw iron production (8.2%) were resolved being sources of the coarse aerosol particles. The shape and elemental composition of size-segregated aerosol airborne-sampled by an airship aloft presumed air pollution sources helped to interpret the PMF solution.