Anna Šplíchalová

Cancer incidence in Czech black coal miners in association with coalworkers' pneumoconiosis.

ObjectiveThe aim of the study was comparison of cancer incidence risk of lungs, stomach, colon, bladder and kidneys from ex-miners of black coal mines and the general male population of the Czech Republic.Materials and methodsThe analysis was conducted in two cohorts of ex-miners according to the presence of coalworkers’ pneumoconiosis (CWP). The first cohort included the miners without CWP (N = 6705), and the second cohort included the miners who were compensated for CWP (N = 2158). Personal and occupational data was merged with the data in the National Population Register and the National Oncological Register for the period from 1992 to 2006. Cancer risk in miners in comparison to the general male population of the Czech Republic was evaluated by SIR (Standardized Incidence Ratio) and 95% confidence interval (CI).ResultsAbout twice as high risk of lung cancer was found in miners with CWP (SIR = 2.21; 95% CI: 1.75–2.76). Lung cancer risk correlated with the severity of CWP (simple CWP SIR=1.96; 95% CI: 1.48–2.56, progressive massive fibrosis SIR = 4.29; 95% CI: 2.09–7.87). No increased risk of lung cancer was found in ex-miners without CWP. The risk of malignant neoplasm at the other selected sites was comparable with the risk in the general male population of the Czech Republic.ConclusionsThis study found increased lung cancer risk in coal miners with CWP, but not in those without CWP, comparing with the general population. These results served as the basis for the inclusion of lung cancer in association with CWP into a new Czech list of occupational diseases.

Czech socio-economic deprivation index and its correlation with mortality data

Objectives:The aim of the study was to create an index of socio-economic deprivation (SESDI) and to analyse correlation between SESDI and mortality data.Methods:The SESDI components were selected from the census data (2001) at enumeration district and district level. Two methods were used for creating the SESDI: 1/ a sum of Z-scores of specific components (INDEX1); and 2/ standardized score – average values of specific components were divided by a maximum value of the specific component at the corresponding geographical level (INDEX2). Pearson’s correlation coefficient was used for assessing the relationship between indices, and between indices and mortality data (SMR).Results:The final indices were applied to districts in the Czech Republic (N = 77). The correlation of INDEX1 and INDEX2 was high (r = 0.99). Analysis of relationships between degree of deprivation and total and selected specific SMR in the Czech Republic confirmed that mortality was associated with degree of deprivation.Conclusion:The use of socio-economic deprivation indices in analysis of routinely collected mortality data in public health might help to explain health inequalities.

Mortality in Miners with Coal-Workers’ Pneumoconiosis in the Czech Republic in the Period 1992–2013

While working underground, miners are exposed to a number of risk factors that have a negative impact on their health and may be a cause of an increased mortality in miners. The aim of the study was to compare total and specific mortality in black coal miners with acknowledged coal-workers’ pneumoconiosis (CWP) and without CWP, and the mortality of the general male population in the Czech Republic in the period 1992–2013. The sample consisted of 3476 coal miners with CWP and 6687 ex-coal miners without CWP, who were removed after achieving the maximum permissible exposure (MPE). The mortality risk differences were analyzed with the use of the standardized mortality ratio (SMR) and 95% confidence interval. Significantly higher total mortality (SMR = 1.10; 95% CI: 1.02–1.17), and mortality from malignant neoplasm (SMR = 1.16; 95% CI: 1.03–1.30), lung cancers (SMR = 1.70; 95% CI: 1.41–2.04), and non-malignant respiratory diseases (SMR = 2.78; 95% CI: 2.32–3.31) were found in the sample of coal miners with CWP. In this sample, the severity of CWP was assessed, and the SMR increased with the severity of CWP. The total (SMR = 0.86; 95% CI: 0.82–0.91) and specific mortality of miners without CWP were not higher compared with the general population. In the case where the miners were removed from underground work after achieving the MPE (without CWP), their mortality was not higher than that of the general population, but the mortality of miners with CWP was higher compared to the general population. This mortality was affected by malignant and non-malignant respiratory diseases.

PM10 Air Pollution and Acute Hospital Admissions for Cardiovascular and Respiratory Causes in Ostrava

BACKGROUND AND AIM The city of Ostrava and its surroundings belong to the most long-therm polluted areas in the Czech Republic and Europe. For identification of health risk, the World Health Organization recommends a theoretical estimation of increased short-term PM10 concentrations effect on hospital admissions for cardiac complaints based on a 0.6% increase per 10 µg.m-3 PM10 and 1.14% increase for respiratory causes. The goal of the present study is to verify the percentage increase of morbidity due to cardiovascular and respiratory causes, as per WHO recommendations for health risk assessment, in the population of Ostrava. METHOD The input data include data on PM10 air pollution, meteorological data, the absolute number of hospital admissions for acute cardiovascular and respiratory diseases in the period 2010-2012. To examine the association between air pollution and health outcomes the time series Poisson regression adjusted for covariates was used. RESULTS A significant relationship was found between the cardiovascular hospital admissions (percentage increase of 1.24% per 10 µg.m-3) and values of PM10 less than 150 µg.m-3 in the basic model, although after adjustment for other factors, this relationship was no longer significant. A significant relationship was also observed for respiratory causes of hospital admissions in the basic model. Contrary to cardiovascular hospitalization, the relationship between respiratory hospital admissions and PM10 values below 150 µg.m-3 (percentage increase of 1.52%) remained statistically significant after adjustment for other factors. CONCLUSIONS The observed significant relationship between hospital admissions for respiratory causes was consistent with the results of large European and American studies.