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Prenatal, perinatal and neonatal risk factors for autism - study in Poland

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Mrozek-Budzyn D., Majewska R., Kieltyka A.
Open Medicine
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2013
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vol. 8
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issue 4
424-430
EN
The results of conducted research studies suggest that heredity and early fetal and neonatal development play a causal role in autism. The objective was to determine a relationship between pre-, peri-, and neonatal factors and autism. The relationship between genders and individual risk factors for autism was also examined. A case-control study was conducted among 288 children (96 cases with childhood or atypical autism and 192 controls individually matched to cases by the year of birth, sex, and general practitioners). Data on autism diagnosis and other medical conditions were acquired from physicians. All other information on potential autism risk factors were collected from mothers. Autism risk was significantly higher when mothers were taking medications (OR=2.72, 95%CI: 1.47-5.04) and smoked during pregnancy (OR=3.32, 95%CI: 1.12-9.82). It was also significantly associated with neonatal dyspnea (OR=3.20, 95%CI: 1.29-8.01) and congenital anomalies (OR=7.17, 95%CI: 2.23-23.1). In gender analysis only congenital anomalies were significantly associated with autism for girls but all of mentioned factors stayed independent risk factors for boys.
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Zanieczyszczenie powietrza a liczba hospitalizacji z powodu astmy oskrzelowej w województwie małopolskim

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Pac A., Majewska R., Goryński P.
Medycyna Środowiskowa - Environmental Medicine
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2013
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vol. 16
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issue 1
22-27
EN
Introduction: Asthma is one of the most frequent chronic disease worldwide. Its prevalence has grown rapidly over last years, however the differences between countries are significant. Aim: The purpose of this study was to assess the relation between the number of urgent asthma-related hospital admissions and air pollution in the Malopolska region. Material and methods: We used data collected in the frame of the project “Hospitalization” – the Polish Survey on Overall Hospital Morbidity in Poland. We analyzed hospital records for Malopolska region with primary cause of hospital admission defined as bronchial asthma or status asthmaticus (code J45.* or J46 according to ICD-10) for years 2005–2009. Air pollution data were collected from monitoring station in Malopolska. Poisson regression model was used to assess the impact of air pollution level on number of hospital admissions with adjustment for the daily mean of temperature. Results: During the years 2005–2009 overall 6942 urgent asthma-related hospital admissions were observed. The level of air pollution during this period was high, for example, mean daily PM10 air pollution level was higher than 50 μg/m3 for more than 30% of days in most monitoring settings. The highest PM10 level was observed to be more than 350 μg/m3. Out of the analyzed pollutant the most important predictor was found to be SO2 with RR41,039 (95%CI: 1,014–1,064) and PM10 with RR41,018 (95%CI: 1.008–1.029) for 10 μg/m3 increase of pollutant. We have also examined the effect of air pollution during the previous days on asthma hospitalizations. The effect of air pollution by sulfur dioxide on number of hospital admissions from asthma was also observed with RR41,051 (95%CI: 1,028–1,075) and by PM10 with RR41,016 (95%CI: 1,007–1,025) for a seven days delay. In our study we have also observed the relation between air pollution by NO2 in previous days and asthma-related hospital admissions. Conclusions: The number of asthma hospitalizations, especially those unplanned, probably because of exacerbation of asthma episodes can be reduced by lowering air pollution level.
PL
Wstęp: Astma oskrzelowa należy do najczęściej występujących chorób przewlekłych. Częstość astmy na świecie wzrasta bardzo szybko, jakkolwiek pomiędzy poszczególnymi państwami chorobowość różni się znacząco. Cel: Badania miały na celu ocenę zależności pomiędzy liczbą hospitalizacji w trybie nagłym z powodu astmy oskrzelowej a poziomem zanieczyszczenia powietrza w województwie małopolskim. Materiał i metody: W badaniu wykorzystano dane pochodzące z ogólnopolskiej bazy danych projektu „Hospitalizacja” – (Ogólnopolskie Badanie Chorobowości Szpitalnej Ogólnej). W niniejszym opracowaniu wykorzystano dane osób hospitalizowanych w latach 2005–2009 w województwie małopolskim, dla których zasadnicza przyczyna hospitalizacji określona została jako astma oskrzelowa lub stan astmatyczny (kody ICD-10: J45.* oraz J46). W analizie statystycznej wykorzystano wieloczynnikowy model regresji Poissona, aby ocenić wpływ poziomu zanieczyszczenia powietrza na liczbę hospitalizacji w trybie nagłym z powodu astmy. Wyniki: Ogółem w latach 2005–2009 w województwie małopolskim zanotowano 6942 przypadki hospitalizacji w trybie nagłym z powodu astmy oskrzelowej. Obserwowany poziom zanieczyszczenia powietrza w tym samym okresie był stosunkowo wysoki. Przykładowo dla zanieczyszczenia pyłem PM10 częstość przekroczeń dopuszczalnego dziennego poziomu zanieczyszczenia powietrza przekraczała w większości stacji 30% dni, przy czym najwyższe odnotowane wartości przekraczały wartość 350 μg/m3. Spośród analizowanych zanieczyszczeń powietrza najwyższą zależność liczby hospitalizacji zaobserwowano w stosunku do zanieczyszczenia SO2 (RW41,039; 95%CI: 1,014–1,064) oraz dla PM10 (RW41,018; 95%CI: 1,008– 1,029) dla wzrostu poziomu zanieczyszczenia o 10 μg/m3. Analizując długość okresu od wystąpienia wysokiego poziomu zanieczyszczenia najsilniejszą zależność zaobserwowano dla okresu siedmiu dni. Ryzyko hospitalizacji dla zanieczyszczenia dwutlenkiem siarki wynosiło RW41,051 (95%CI: 1,028–1,075), natomiast dla PM10 RW41,016 (95%PU: 1,007–1,025). W badaniach wykazano również istotne znaczenie poziomu zanieczyszczenia dwutlenkiem azotu w dniach poprzedzających hospitalizację. Wnioski: Liczbę hospitalizacji z powodu astmy oskrzelowej w znaczącym stopniu można wytłumaczyć zależnością od poziomu zanieczyszczenia powietrza.
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Rubella outbreak in Poland in 2013 – an analysis of surveillance data at the national and province level

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Mrozek-Budzyn D., Majewska R., Kiełtyka A., Augustyniak M.
Polish Journal of Public Health
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2015
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vol. 125
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issue 2
65-71
EN
Introduction. Poland is a member of the WHO European Region where a complete eradication of measles and rubella is planned to be finished by 2015. Poland accounted for 99% of all reported rubella cases in 27 EU/EEA countries in 2013. It is a good time to evaluate whether the established Polish vaccination strategy was sufficient to reach the goal of rubella elimination in the near future. Aim. The aim of this study was to analyze the epidemiology of rubella in Poland when the disease outbreak took place in 2013, to determine the reasons of that situation and to find the solution for future rubella elimination strategies. Material and methods. To analyze the epidemiology of rubella in Poland during the disease outbreak in 2013 the authors used rubella surveillance data collected by the Provincial and National Notifiable Disease Reporting System in 2004-2013. The information at the provincial level derived from one of the 16 provinces (Malopolska). The data on MMR vaccination coverage in 2003-2012 derived from the National Surveillance System. The percentages of rubella cases and vaccine coverage between Poland with Malopolska province were compared. Results. The outbreak started in late 2012 and continued through 2013, when 38548 rubella cases (incidence rate 100.1/ 100 000) were notified. Geographically, rubella cases were reported from the entire country, with the highest incidence rate in Malopolska province (254.9/100 000). Only 5 cases from Malopolska and 120 in whole country were laboratory confirmed, the remaining 99.7% were reported solely on the basis of clinical signs. The vaccination coverage was not sufficient to protect the population against rubella outbreak in Poland, especially among adolescents and young adult males. Conclusions. The strengthening of routine immunization program and implementation of some additional vaccination campaigns in young adults as well as laboratory confirmation of all suspected cases are the challenges that will have to be met to eliminate rubella in Poland
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