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Air and water pollution linked to multimorbidity in Serbia

New research undertaken in Serbia has identified dirty air and dirty water as leading causes of multimorbidity, defined for the purposes of this research as someone having two or more self-reported diagnoses of chronic non-communicable diseases.

The study was led by the Healthy Lifespan Institute at the University of Sheffield, collaborating with the University of Belgrade, Aston University, the Institute of Public Health of Serbia, the Serbian Environmental Protection Agency and the Department of Internal Medicine.

A tall building with a sky in the background

On the air quality side, the study looked at the levels of PM10 particles, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) in the air for 2019. The levels were obtained from the state network of air quality monitoring stations. 

Six classes of multimorbidity were determined:

  1. Healthy: those with a substantially lower prevalence of all chronic diseases
  2. Multicondition: those with high probabilities of almost all chronic conditions.
  3. Cardiovascular: coronary artery disease, hypertension, myocardial infarction etc.
  4. Metabolic syndrome: hypertension, diabetes mellitus and hyperlipidemia
  5. Respiratory: asthma, chronic bronchitis, COPD, emphysema etc
  6. Musculoskeletal: chronic back pain, cervical deformity, hypertension etc.

It was found that the overall prevalence of multimorbidity in Serbia was 33.4%, with exposure to higher levels of PM10 and SO2 increasing the chance its likelihood. A similar link was also found in people exposed to polluted water.

The research found that :

  • Higher levels of SO2, PM10 and O3 increased the chances of having Multicondition and Musculoskeletal cluster
  • Higher levels of SO2 increased the chances of having Respiratory cluster
  • Higher levels of PM10 and O3 increased the chances of having Metabolic syndrome cluster

The research also looked at the geographic and socio-demographic distribution of disease, finding a significant decline in odds of having multimorbidity as the level of education increased.

It was also seen that some diseases are noticeably evident in some areas rather than others, as evidenced in the illustration below.

Professor Liddy Goyder, member of the Healthy Lifespan Institute at the University of Sheffield said: ‘This research represents a unique collaboration between the Healthy Lifespan Institute, the University of Belgrade and public health and environmental agencies in Serbia. It shows, for the first time, the association between environmental pollution and specific multimorbidity clusters, highlighting the need for policies for tackling health inequalities and multimorbidity to address both socioeconomic and environmental factors.’

The full research can be read here.

 

 

 

 

 

 

 

Paul Day
Paul is the editor of Public Sector News.

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