Air pollution and meteorological drivers of the risk of urgent IBD hospital admission in Poland

Around 2.5-3 million European citizens, including over 100,000 in Poland, are affected by a complex chronic inflammatory bowel disease (IBD). The number of IBD-related illnesses and deaths is still increasing, while highlighting inequalities in developing countries. As a complex disruption in everyday life and far-reaching social consequences, with no clear address to triggers, IBD flares pose a serious challenge to the public health sector.

The aim of the study was to investigate variability in emergency hospitalisations among patients with noninfectious IBD at the population level in Poland and to identify the risk levels associated with atmospheric conditions. The analysis covered an 8-year period (1 January 2012 - 31 December 2019), where a total of 66,657 urgent IBD hospitalisations, including diagnoses of Crohn’s Disease (ICD-10: K50) – 24,778 and Ulcerative Colitis (ICD-10: K51)- 41,879, were studied. A targeted time-stratified case-crossover analysis was conducted to evaluate short-term associations between ambient PM10, PM2.5, SO₂, O₃, and NO_X and meteorological factors like air temperature, atmospheric pressure, air vapour pressure, and solar radiation, and urgent hospital admissions for inflammatory bowel disease (IBD). The clearest signal was observed for the same day or with a one-day lag after increased NOx exposure, enhanced by the effect of higher solar radiation totals (lag 4) in the working-age group 19-60 years old, and particularly evident in urban areas. The signs were evident in both groups, though more pronounced in UC patients. Changing living environment and daily habits may require greater effort, sacrifice, and costs than optimised self-care, including mitigating unfavourable conditions that contribute to exacerbation. In this context, results from biometeorological studies may provide significant support to the healthcare sector.