Remotely supervised spirometry versus laboratory-based spirometry during the COVID-19 pandemic: a retrospective analysis.

BACKGROUND: The COVID-19 pandemic has constrained access to spirometry, and the inherent risk of infectious transmission during aerosol-generating procedures has necessitated the rapid development of Remotely Supervised Spirometry (RSS). This innovative approach enables patients to perform spirometry tests at home, using a mobile connected spirometer, all under the real-time supervision of a technician through an online audio or video call. METHODS: In this retrospective study, we examined the quality of RSS in comparison to conventional Laboratory-based Spirometry (LS), using the same device and technician. Our sample included 242 patients, with 129 undergoing RSS and 113 participating in LS. The RSS group comprised 51 females (39.5%) with a median age of 37 years (range: 13-76 years). The LS group included 63 females (55.8%) with a median age of 36 years (range: 12-80 years). RESULTS: When comparing the RSS group to the LS group, the percentage of accurate Forced Expiratory Volume in one second (FEV1) measurements was 78% (n = 101) vs. 86% (n = 97), p = 0.177; for Forced Vital Capacity (FVC) it was 77% (n = 99) vs. 82% (n = 93), p = 0.365; and for both FEV1 and FVC, it was 75% (n = 97) vs. 81% (n = 92), p = 0.312, respectively. CONCLUSIONS: Our findings demonstrate no significant difference in the quality of spirometry testing between RSS and LS, a result that held true across all age groups, including patients aged over 65 years. The principal advantages of remote spirometry include improved access to pulmonary function tests, reduced infectious risk to curtail disease spread, and enhanced convenience for patients.

Inhaler use technique course: an effective postgraduate training solution for pharmacists to enhance therapeutic outcomes as part of patient education.

BACKGROUND: Patients with asthma and chronic obstructive pulmonary disease could benefit from education on using inhalers provided by pharmacists. However, pharmacists may have limited competencies, indicating the necessity to implement appropriate postgraduate courses. The study aimed to evaluate an inhaler use course for pharmacists, including its impact on participants' knowledge and satisfaction. METHODS: The study involved 261 pharmacists from community pharmacies and was conducted between September 2019 and March 2021. A pre-post analysis of their knowledge of the topic was applied. Additionally, at the beginning of the course, participants were asked about their educational needs, and at the end, they completed a satisfaction survey. The preferred learning formats indicated by participants were interactive workshops and lectures. RESULTS: As a result of the course, both their actual and self-assessed level of knowledge significantly increased. The percentage of correct answers in the test before the training was 24.4%, while after, it was 84.3% (p < 0.0001). Before the course, their average self-assessed level of knowledge was 52.0%, and after the training, it increased to 90.0% (p < 0.0001). Almost all respondents stated that the course met their expectations. They estimated their satisfaction at 94.0% and the usefulness of the provided information at 98.0%. CONCLUSIONS: Improved preparation of pharmacists resulting from their participation in the course can contribute to providing more professional advice to patients, thereby positively influencing the pharmaceutical care process in community pharmacies.

Home self-monitoring in patients with asthma using a mobile spirometry system.

BACKGROUND: Self-management is an appealing strategy for prevention of asthma exacerbations. This study aimed to evaluate the feasibility and safety of a portable spirometer for unsupervised home spirometry measurements among patients with asthma. METHODS: A multi-center, prospective, single-arm, open study recruited 86 patients with controlled or partly controlled asthma (41 women, 38.6 ± 10.4 y/o and 45 men, 36.2 ± 12.1 y/o). After a training session, patients performed daily spirometry at home with the AioCare® mobile spirometry system. Each spirometry examination was recorded and evaluated according to the ATS/ERS acceptability and repeatability criteria. The primary endpoint was defined as three or more acceptable examinations in any given seven-day period (+/- 1 day) during any of the three weeks of the study. The system allowed for online review of measurements by physicians/nurses to provide feedback to patients. RESULTS: Of 78 patients with complete data, 67 (86%) achieved the primary endpoint. Seventy-five (96%) participants used the device correctly once or more, and 10 (13%) patients succeeded every single day over the three-week follow-up. The rate of acceptable spirometry examinations differed between the sites (p = 0.013). Retraining was required in 20 of 62 (32%) eligible patients, and successful in 8 individuals (40%). Satisfaction with the AioCare® system was high, 90% of respondents perceived it as useful and user-friendly. CONCLUSIONS: Self-monitoring of asthma with a connected mobile spirometer is feasible, safe and satisfactory for patients with asthma. It remains to be established whether unsupervised home spirometry measurements may improve early diagnosis and outcomes of self-management in cases of exacerbation or loss of asthma control.

Highlights BoxThis study aimed to evaluate the ability of patients with asthma to perform high-quality daily spirometry examinations at home with using the AioCare^® mobile spirometry system. The study showed that unsupervised home spirometry is safe and feasible in patients with asthma. Most patients used the device on most days of the study, and nearly 90% of all patients achieved the primary endpoint. There were no device-related adverse events.

Ambient PM2.5 Exposure and Mortality Due to Lung Cancer and Cardiopulmonary Diseases in Polish Cities.

Air pollution, one of ten most important causes of premature mortality worldwide, remains a major issue also in the EU, with more than 400,000 premature deaths due to exposure to PM2.5 reported yearly. The issue is particularly significant in Poland, where there is the highest concentration of PM2.5 among the UE countries. This study focused on the proportion of mortality due to lung cancer and cardiopulmonary diseases attributable to PM2.5 in eleven biggest Polish cities in the years 2006-2011. The findings demonstrate that the mean annual concentration of PM2.5 varied from 14.3 to 52.5 µg/m3. The average population attributable fractions varied from 0.195 to 0.413 in case of lung cancer and from 0.130 to 0.291 for cardiopulmonary diseases. Such substantial values of this ratio translate into a considerable number of deaths, which ranged between 9.6 and 22.8 cases for lung cancer and 48.6 to 136.6 cases for cardiopulmonary diseases per 100,000 inhabitants. We conclude that the impact of PM2.5 concentration on the incidence of premature deaths is unduly high in Polish cities.

Socioeconomic Effects of Chronic Obstructive Pulmonary Disease from the Public Payer's Perspective in Poland.

Chronic obstructive pulmonary disease (COPD) is currently the third most common cause of death worldwide and the total number of people affected reaches over 200 million. It is estimated that approximately 50 % of persons having COPD are not aware of it. In the EU, it is estimated that the total annual costs of COPD exceed €140 billion, and the expected increase in the number of cases and deaths due to COPD would further enhance economic and social costs of the disease. In this article we present the results of cost analysis of health care benefits associated with the treatment of COPD and with the disease-related incapacity for work. The analysis is based on the data of the National Health Fund and the Social Insurance Institutions, public payers of health benefits in Poland. The annual 2012 expenditures incurred for COPD treatment was €40 million, and the benefits associated with incapacity for work reached more than €55 million. The extent of these expenditures indicates that it is necessary to optimize the functioning system, including the allocation of resources for prevention, social awareness, and detection of COPD at early stages when treatment costs are relatively low.

Pulmonary Function and Incidence of Selected Respiratory Diseases Depending on the Exposure to Ambient PM10.

It is essential in pulmonary disease research to take into account traffic-related air pollutant exposure among urban inhabitants. In our study, 4985 people were examined for spirometric parameters in the presented research which was conducted in the years 2008-2012. The research group was divided into urban and rural residents. Traffic density, traffic structure and velocity, as well as concentrations of selected air pollutants (CO, NO2 and PM10) were measured at selected areas. Among people who live in the city, lower percentages of predicted values of spirometric parameters were noticed in comparison to residents of rural areas. Taking into account that the difference in the five-year mean concentration of PM10 in the considered city and rural areas was over 17 µg/m³, each increase of PM10 by 10 µg/m³ is associated with the decline in FEV1 (forced expiratory volume during the first second of expiration) by 1.68%. These findings demonstrate that traffic-related air pollutants may have a significant influence on the decline of pulmonary function and the growing rate of respiratory diseases.

Assessment of Air Pollution Effects on the Respiratory System Based on Pulmonary Function Tests Performed During Spirometry Days.

The Polish Spirometry Day is an initiative aimed at increasing awareness of the causes, symptoms, course, and effects that accompany respiratory diseases, especially asthma and chronic obstructive pulmonary disease (COPD). In 2013, the second edition of the Spirometry Day was held. It gathered 180 medical centers and other institution. The final analysis encompassed a total of 1187 persons from 26 different locations, including rural areas, and smaller and larger city agglomerations. Of this total, 755 persons (63.6 %) completed their spirometry tests for the first time in life. Each person fulfilled a questionnaire regarding the personal information, respiratory diseases, symptoms, lifestyle, and a place of residence. In the total group, 234 (19.7 %) cases of bronchial obstruction were diagnosed. A hundred and thirty four persons with obstruction, among those tested for the first time in life (17.8 %), were unaware of their disease. The lowest values of FEV1 and FEF(1)/FVC, corresponding to the highest percentage of persons with obstruction (27.9 %) were observed in small and medium cities (100,000-500,000 inhabitants). There were differences in the prevalence of obstruction depending on the distance of the place of residence from a busy traffic road. A significant decrease of both spirometric variables was observed among people living in cities above 100,000 inhabitants within a distance lower than 50 m from roads. In general, better spirometry results were observed among inhabitants living more than 150 m from main roads.

Relative risk of lung obstruction in relation to PM10 concentration as assessed by pulmonary function tests.

Epidemiological studies show that long-term exposure to air pollution may increase the relative risk of obstructive lung diseases such as COPD or asthma. The risk of increased obstruction is higher among residents living in close proximity to high traffic routes where there are high concentrations of PM(10). The present study consists of two parts: the measurement of the concentration of air pollutants and of pulmonary function in selected groups of people. The study was conducted in Warsaw, Poland, in seven localizations with typical urban canyon characteristics and roads with high traffic. The control group consisted of people living in other regions of Poland with a significantly lower (p < 0.05) concentration of air pollutants. The study was performed in the years 2008-2012. The incidence of obstructive lung disease was determined according to the GOLD guidelines. The study subjects were all non-smokers. The relative risk of disease took into account different exposure times to air pollutants. The findings indicate that an increase in PM(10) concentration by each 10 µg/m(3) caused an increase in the relative risk of lung obstruction by a factor of 1.27, 1.24, and 1.19 for the residence period in the vicinity to heavy traffic city roads for 20, 30, and 40 years, respectively as compared with the residence of rural unpolluted areas. A decrease in the number of people with lung obstruction with the length of residence actually indicates that people exposed to high concentrations of PM(10) become affected by lung obstruction at a lower age. The study shows a positive relative risk of lung obstruction due to an exposure to high PM(10) emission.

[Influence of inhaler and fine particle on efficacy of inhalation therapy in COPD]. / Wplyw doboru inhalatora i czastki na skutecznosc terapii wziewnej w POChP.

Orally inhaled products delivered via inhalation exert their effect directly to the target organ. This allows to administer a very low dose of a drug compared with an oral route with similar clinical effect and significantly reduced toxicity. However inhalation therapy is also limited by several factors. Delivery of the desired dose of the drug to the airways depends on a type of the inhaler - pressurised metered-dose inhaler (pMDI) or dry powder inhaler (DPI), inhaler characteristics (low or high internal resistance, diameter of particles and distribution of the generated aerosol fine particles), thermal conditions of air, and ability of patient to generate sufficient inspiratory flow (for DPI) or to coordinate actuation with inhalation (for pMDI). Unlike pMDIs, DPIs are breath- -actuated, hence avoiding the need for the patient to coordinate actuation with inspiration. Furthermore, DPIs are propellant-free and do not produce the cold sensation on inhalation. Currently available DPIs vary widely in design, operating characteristics and performance. And poor inhalation technique may compromise treatment efficacy. Hence, there is a clear need for a careful selection of DPIs for different patient groups, including children, elderly patients and those with severe airway obstruction.

Exposure to traffic-related air pollutants as a risk of airway obstruction.

Dynamic increases in the number of vehicles, particularly in large urban areas, cause a visible decline in the average speed of cars. Street networks are not able to efficiently handle generated traffic, which could result in increasing levels of air pollutant emissions and consequently in a greater incidence of people suffering from respiratory diseases. This study presents the effects of investigations on the influence of traffic-related air pollutants on inhabitants of two Polish cities living in the proximity of busy roads. As a control group rural area residents were taken. In 2005-2006 and 2008-2009 respiratory function tests were conducted on a group of 3,506 people (including residents of non-urban areas). The investigation has shown that people living near busy urban roads had a significant increase in the risk of bronchi obstruction.

Spirometry day: a means to enhance social knowledge on respiratory diseases.

The chapter presents the results of pulmonary function tests conducted as part of the Polish Spirometry Day of 2011, an initiative aimed at increasing the awareness of causes, symptoms, and delayed effects of common respiratory diseases, in particular of bronchial asthma and chronic obstructive pulmonary disease, and at demonstrating the role of regular examinations, especially in higher risk groups. The results show that there was a relatively substantial group of persons, 11.2 % of the population sample studied, not being aware of a respiratory disease they had. Furthermore, the results show that quite often, 12.4-16.0 % of the population studied, obstruction was diagnosed in persons who did not have any spirometry tests done before, despite some respiratory symptoms that should raise the attention of general practitioners to perform such tests.

Influence of traffic-related air pollutants on lung function.

We investigated the influence of traffic-related air pollutants on respiratory function, with a focus on the non-smoking residents of the capital city of Warsaw in Poland, who lived close to busy streets. The results demonstrate that people living in some parts of the city show symptoms of bronchial obstruction over four times more often than those from the control group consisting of the inhabitants of a remote region in eastern Poland, with considerably less air pollution. Using multiple regression models it was shown that, apart from the place of living, the floor the apartment is situated on, the length of residence, allergy, and physical activity are the factors that significantly influence the forced expiratory volume in 1 s (FEV1) and the pseudo-Tiffenau index (FEV1/FVC).

Air pollution and long-term risk of hospital admission due to chronic obstructive pulmonary disease exacerbations in Poland: a time-stratified, case-crossover study.

INTRODUCTION: Airborne pollutants may worsen the course of chronic obstructive pulmonary disease (COPD). Previous studies have shown that both particulate and gaseous pollutants increase airway inflammation, which may lead to an exacerbation of COPD. OBJECTIVES: The aim of the study was to investigate the association between exposure to airborne pollutants and the risk of COPD exacerbations in 3 the largest urban agglomerations in Poland: Warsaw, Kraków, and Tricity. PATIENTS AND METHODS: We used a case­crossover approach to analyze data from the years 2011-2018. This time­series study used distributed lag linear-nonlinear models to analyze the risk of hospital admission due to COPD exacerbations during 21 days following the exposure to particulate matter (PM), NO2, and SO2. RESULTS: Overall, there were 26 948 admissions due to COPD exacerbations. During 21 days after exposure, the rate ratio (95% CI) for admissions per 10 µg/m3 was 1.028 (1.008-1.049) for PM10, 1.030 (1.006-1.055) for PM2.5, 1.032 (0.988-1.078) for NO2, and 1.145 (1.038-1.262) for SO2. The risk for admission peaked at 10 days after the exposure to PM10 and PM2.5, whereas for NO2 and SO2 the risk was the greatest on the day of exposure. The proportion (95% CI) of hospitalizations attributable to air pollution was 9.08% (3.10%-15.08%) for PM10, 7.61% (1.27%-13.49%) for PM2.5, 9.77% (-3.63% to 21.48%) for NO2, and 7.70% (2.30%-12.84%) for SO2. CONCLUSIONS: PM2.5, PM10, NO2, and SO2 pollution was associated with an increased risk of COPD exacerbations that needed hospitalization. There were different risk patterns for particulate and gaseous pollutants. Improving air quality in Polish cities could reduce the burden of COPD.

Exposure to ambient air pollutants and short-term risk for exacerbations of allergic rhinitis: A time-stratified, case-crossover study in the three largest urban agglomerations in Poland.

Allergic rhinitis (AR) affects 10 % of the world population, with an increased prevalence in regions with substantial air pollution, but the association between exposure to air pollutants and the short-term risk of AR exacerbations is unclear. We used a time-series approach to analyze the risk of hospital admissions due to AR over 8 days from exposure to various air pollutants. Distributed lag nonlinear models were used to analyze data gathered between 2012 and 2018 in the three largest urban agglomerations in Poland. The analyses were carried out separately for the warm (April - September) and cold seasons (October - March). Overall, there were 1407 admissions due to AR. In the warm season, the rate ratio (95 % confidence interval) for admission per 10 µg/m3 was 1.202 (1.044, 1.384) for particulate matter less than 10 µm (PM10); 1.094 (0.896, 1.335) for particulate matter less than 2.5 µm (PM2.5); 0.946 (0.826, 1.085) for nitrogen dioxide (NO2); 0.837 (0.418, 1.677) for sulfur dioxide (SO2); and 1.112 (1.011, 1.224) for ozone (O3). In the cold season, the rate ratio for admission per 10 µg/m3 was 1.035 (0.985, 1.088) for PM10; 1.041 (0.977, 1.108) for PM2.5; 1.252 (1.122, 1.398) for NO2; 0.921 (0.717, 1.181) for SO2; and 1.030 (1.011, 1.050) for O3. In conclusion, the risk of admission due to AR increased significantly after exposure to O3 in the warm and cold seasons. Exposure to PM10 was associated with a significantly increased risk of AR hospitalizations in the warm season only, whereas exposure to NO2 was associated with a significantly increased risk of AR admission in the cold season.

Ambient Air Pollution and Risk of Admission Due to Asthma in the Three Largest Urban Agglomerations in Poland: A Time-Stratified, Case-Crossover Study.

Ambient air pollution in urban areas may trigger asthma exacerbations. We carried out a time-series analysis of the association between the concentrations of various air pollutants and the risk of hospital admission due to asthma over 7 days from exposure. We used distributed lag nonlinear models to analyze data gathered between 2010 and 2018 in the three largest urban agglomerations in Poland. Overall, there were 31,919 asthma hospitalizations. Over 7 days since exposure, the rate ratio (95%CI) for admission per 10 µg/m3 was 1.013 (1.002-1.024) for PM10; 1.014 (1.000-1.028) for PM2.5; 1.054 (1.031-1.078) for NO2; and 1.044 for SO2 (95%CI: 0.986-1.104). For all pollutants, the risk of admission was the greatest on the day of exposure (day 0), decreased below baseline on days 1 and 2, and then increased gradually up to day 6. The proportions (95%CI) of hospitalizations attributable to air pollution were 4.52% (0.80%-8.14%) for PM10; 3.74% (0.29%-7.11%) for PM2.5; 16.4% (10.0%-21.8%) for NO2; and 2.50% (-0.75%-5.36%) for SO2. In conclusion, PM2.5, PM10, NO2, and SO2 pollution was associated with an increased risk of hospital admission due to asthma in the three largest urban agglomerations in Poland over nine years.

Influence of Selected Air Pollutants on Mortality and Pneumonia Burden in Three Polish Cities over the Years 2011-2018.

Poland has one of the worst air qualities in the European Union, particularly regarding concentrations of particulate matter (PM). This study aimed to evaluate the short-term effects of air pollution and weather conditions on all-cause mortality and pneumonia-related hospitalizations in three Polish agglomerations. We investigated data from 2011 to 2018 on a number of health outcomes, concentrations of PM2.5, PM10, nitrogen dioxide (NO2), ozone (O3), and selected meteorological parameters. To examine the impact of air pollutants and weather conditions on mortality and pneumonia burden, we identified optimal general regression models for each agglomeration. The final models explained <24% of the variability in all-cause mortality. In the models with interactions, O3 concentration in Warsaw, NO2, O3, and PM2.5 concentrations in Cracow and PM10 and O3 concentrations in the Tricity explained >10% of the variability in the number of deaths. Up to 46% of daily variability in the number of pneumonia-related hospitalizations was explained by the combination of both factors, i.e., air quality and meteorological parameters. The impact of NO2 levels on pneumonia burden was pronounced in all agglomerations. We showed that the air pollution profile and its interactions with weather conditions exert a short-term effect on all-cause mortality and pneumonia-related hospitalizations. Our findings may be relevant for prioritizing strategies to improve air quality.

The Influence of the Pharmacists' Training on the Quality and Comprehensiveness of Professional Advice Given in the Field of Inhalation Techniques in Community Pharmacies in Poland.

BACKGROUND: Following the example of other countries, it is very important to educate patients on the correct use of inhalers by properly trained healthcare professionals, including pharmacists. OBJECTIVES: The aim of the study was to assess the quality and comprehensiveness of professional advice given by pharmacists on the use of inhalers, which was determined by the pharmacists' level of training. METHODS: The study was conducted from June 2019 to March 2020. 150 pharmacists from Poznan and Warsaw (Poland) were involved. Before the study began, the professional education of 240 pharmacists was conducted in Warsaw to implement standard operating procedures. The study used the model of a mystery shopper. RESULTS: The conversation with a trained pharmacist lasted on average 5.5 min, with an untrained one-3.0 min (p < 0.0001). Placebo inhalers were used more often by trained pharmacists during patients' education (p < 0.0001). Moreover, 10.3% of untrained pharmacists did not provide any education. Additionally, untrained employees' quality of advice was assessed on an average of 3.5 points, while trained ones-7.6 points (p < 0.0001). CONCLUSIONS: This study has shown that there is a need for professional training among pharmacists in Poland, which translates into better patient education in the field of inhalation techniques.

Impact of Air Pollution on Lung Function among Preadolescent Children in Two Cities in Poland.

Ambient air pollution impairs lung development in children, particularly in industrialized areas. The air quality in Zabrze, a city located in the Upper Silesian Industrial Region of Poland, is among the worst in Europe. We compared lung function and the frequency of respiratory or allergic symptoms between children living in Zabrze and those living in Gdynia, a city on the Baltic coast, which has the best long-term air quality in Poland. We enrolled children aged 9-15 years from both cities who were able to perform a spirometry. The following spirometry variables were measured for all participants: forced vital capacity (FVC), forced expiratory volume during the first second of expiration (FEV1), FEV1/FVC index, and peak expiratory flow (PEF). The frequencies of respiratory or allergic symptoms were taken from a survey completed by the participants' parents. In total, 258 children from Gdynia and 512 children from Zabrze were examined. The mean values of FVC, FEV1, and PEF were significantly greater among children in Gdynia than those reported in Zabrze (p ≤ 0.032), and the frequencies of seasonal rhinorrhea (p = 0.015) or coughing episodes (p = 0.022) were significantly higher in Zabrze than in Gdynia. In conclusion, lung function was significantly impaired in children living in Zabrze, an area which is associated with poor air quality. Strategies to improve air quality in the Silesia region are urgently needed.

Air Pollutants' Concentrations Are Associated with Increased Number of RSV Hospitalizations in Polish Children.

Respiratory syncytial virus (RSV) contributes significantly to pediatric hospitalizations. An association between air pollution and an increased number of RSV cases has been suggested. We sought to evaluate the short-term impact of air pollutants on RSV hospitalizations in Polish children in the period 2010-2019. Daily concentrations of PM10 and PM2.5 (particulate matter with an aerodynamic diameter less than or equal to 10 µm and 2.5 µm, respectively) and nitrogen dioxide (NO2) were analyzed in general regression models (GRM) to establish their influence and full interaction scheme. Significant seasonal and annual periodicity among 53,221 hospitalizations was observed; finally, data from the 2012-2019 RSV high-risk seasons created models for seven agglomerations. The addition of PM2.5, PM10, and NO2 to the basic model for RSV seasonality explained 23% (4.9-31%, univariate model) to 31.4% (8.4-31%, multivariate model) of the variance in RSV hospitalizations. A 10 µg/m3 increase in PM2.5, PM10, and NO2 concentrations was associated with 0.134 (0.087-0.16), 0.097 (0.031-0.087), and 0.212 (0.04-0.29) average increases in hospitalizations, respectively. In the multivariate models, PM2.5, PM10, and NO2 alone, as well as PM2.5-NO2, PM2.5-PM10, and PM10-NO2 interactions, were associated with hospitalizations in some of the locations, while the metaregression showed statistically significant interactions between each of the pollutants, and between the pollutants and the year of the study. The inclusion of PM2.5, PM10, and NO2 in GRM explains a significant number of RSV hospitalizations. The pollutants act alone and interact together in a varied manner. Reducing air contamination might decrease the costs of hospital healthcare.

Risk of bronchi obstruction among non-smokers--review of environmental factors affecting bronchoconstriction.

In order to find relationship between exposure to traffic and traffic-related air pollutants, pulmonary function tests and a detailed questionnaire were conducted among 3997 selected inhabitants of Warsaw (Poland) and 988 residents of rural areas. Advanced statistical analyses (including GRM models, correspondence analysis and parametrical tests) have been completed. Statistically significant differences between average percentages of predicted values of pulmonary function parameters were found. Among urban area inhabitants the values of FEV1, MEF50 and FEV1/FVC were statistically significant (p<0.05) lower compared with the residents of rural areas (in the non-smoking group this differences were strong (p<0.001)). General linear regression models indicated that residence in the vicinity of urban busy roads fosters a decrease of spirometric parameters. Physical activity however has a positive effect on pulmonary function (exemplified by FEV1) and allows to reduce part of the negative health effects of traffic-related emissions. The results of the presented study demonstrate that long-term residence under the influence of heavy traffic and high concentrations of traffic-related air pollutants reduces respiratory function parameters, which may result in increased bronchial hyperresponsiveness.