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Slovenia belongs in the group of EU countries, which are more polluted due to particulate matter (PM10). The average annual concentration of PM10 is exceeding the limit value recommended by the World Health Organization (20 µg PM10/m3). Very young children, including unborn babies and elderlies, are particularly sensitive to air pollutants like PM. Analyses show that in Slovenia every two of five children is exposed to negative consequences of PM10 pollution. Most children living in European cities are exposed to PM10 levels that do not exceed 30 micro g/m3 but in Slovenia 15 % of children are exposed to concentrations of PM10 between 30–40 µg /m3. As a consequence, 15 % of hospitalization of children is due to respiratory diseases.


This indicator shows the exposure of children (aged 1–14 years, inclusive) to polluted air due to particulate matter PM10 in Slovenia and selected European countries and the percentage of children in Slovenia who were admitted to hospitals due to diagnosed respiratory diseases.

The diameter of particles is usually described with the phrase ‘aerodynamic diameter’. Particles of the same shape and size but that have differing densities have different aerodynamic diameters. Based on the diameter size, we distinguish between PM10 particles, (with an aerodynamic diameter below 10 µm), PM2.5 particles, (with an aerodynamic diameter below 2.5 µm) and PM1.0 particles, (with an aerodynamic diameter below 1.0 µm). The size of particles formed during interactions between gases and particles, in gaseous as well as in liquid form, is mostly below 1 µm. They are called fine particles. Coarse particles (with a diameter over 1 µm) are created by surface dispersion.

Exposure to PM10 is shown in the indicator for various groups of PM10 concentration levels: 0–30 µg/m3, 30–40 µg/m3, 40–50 µg/m3 and <50 µg/m3. The percentage of children exposed to individual groups of PM10 concentration levels was calculated for Ljubljana, Maribor, Celje, Murska Sobota, Nova Gorica, Trbovlje and Zagorje ob Savi, where regular monitoring of particulate matter air pollution is provided. In calculating the percentage of children in individual groups of PM10 concentration levels, the total number of children living in a city/town is taken into account. The classification of a measurement site by PM10 total concentration level was carried out on the basis of measurement results reflecting the annual PM10 concentration level in outdoor air per individual measurement site.


Charts

Figure ZD03-1: Exposure of children (0-15 years old) in Slovenia to exceeded PM10 concentrations, from 2002 to 2013 (WHO recommended air quality level is 20 µg g/m3, the EU limit value is 40 µg/m3 of PM10)
Sources: 

National Institute of Public Health, 2015, Slovenian Environment Agency, 2015

Show data
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
0-30 µg/m3 % 0 0 0 0 0 4 67 64 61.2 48
30-40 µg/m3 % 7 7 24 63 76 92 29 36 38.8 52
40-50 µg/m3 % 93 56 76 30 24 4 4 0 0 0
> 50 µg/m3 % 0 37 0 7 0 0 0 0 0 0
2012 2013
0-30 µg/m3 % 87 84.5
30-40 µg/m3 % 13 15
40-50 µg/m3 % 0 0
> 50 µg/m3 % 0 0
Figure ZD03-2: Exposure of children (0-15 years old) in Slovenia to elevated PM10 concentrations in the outdoor environment, from 2002 to 2013 (WHO recommended air quality level is 20 µg g/m3, the EU limit value is 40 µg/m3 of PM10)
Sources: 

National Institute of Public Health, 2015, Statistical Office of the RS, 2015

Show data
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Ljubljana - children admitted to hospital No. 786 706 805 961 1020 973 1017 1333 1516 1378
Maribor - children admitted to hospital No. 544 546 526 496 433 426 441 669 722 572
Celje - children admitted to hospital No. 255 196 223 249 237 229 293 512 490 409
Murska Sobota - children admitted to hospital No. 78 73 96 81 77 104 89 419 376 377
Nova Gorica - children admitted to hospital No. 95 154 137 119 149 131 144 308 338 381
Trbovlje - children admitted to hospital No. 97 91 79 88 77 90 88 88 70 73
Zagorje ob Savi - children admitted to hospital No. 142 59 67 45 62 80 76 80 97 74
Ljubljana - children in the municipality (1.7.) No. 46046 45044 44506 44416 44330 44498 37610 46482 47814 48909
Maribor - children in the municipality (1.7.) No. 18487 18017 17660 17530 17338 17722 13571 17476 17641 17821
Celje - children in the municipality (1.7.) No. 8961 8681 8624 8538 8497 8534 6803 8527 8628 8692
Murska Sobota - children in the municipality (1.7.) No. 8443 8204 8039 7908 7787 7685 2607 7514 7444 7357
Nova Gorica - children in the municipality (1.7.) No. 7925 7709 7600 7582 7500 7515 4472 7630 7757 7831
Trbovlje - children in the municipality (1.7.) No. 2356 2245 2167 2107 2068 2057 2188 2022 2035 1997
Zagorje ob Savi - children in the municipality (1.7.) No. 2664 2605 2501 2476 2447 2443 2628 2448 2451 2461
Ljubljana % 1.70698866351 1.56735636267 1.80874488833 2.16363472622 2.30092488157 2.18661512877 2.7 2.8677767738 3.17061948383 2.81747735591
Maribor % 2.94260831936 3.03047122162 2.97848244621 2.82943525385 2.49740454493 2.40379189708 3.2 3.82810711833 4.09273850689 3.20969642557
Celje % 2.84566454637 2.25780440041 2.58580705009 2.91637385805 2.78921972461 2.68338411062 4.3 6.00445643251 5.67918405192 4.70547630005
Murska Sobota % 0.923842236172 0.889809848854 1.1941783804 1.02427921093 0.988827533068 1.35328562134 3.4 5.57625765238 5.05104782375 5.12437134702
Nova Gorica % 1.19873817035 1.99766506681 1.80263157895 1.56950672646 1.98666666667 1.74318030605 3.2 4.03669724771 4.35735464742 4.86527901928
Trbovlje % 4.11714770798 4.05345211581 3.64559298569 4.17655434267 3.72340425532 4.37530384054 4 4.35212660732 3.4398034398 3.65548322484
Zagorje ob Savi % 5.33033033033 2.26487523992 2.67892842863 1.81744749596 2.53371475276 3.27466230045 2.9 3.26797385621 3.95756833945 3.00690776107
2012 2013
Ljubljana - children admitted to hospital No. 1545 1585
Maribor - children admitted to hospital No. 521 631
Celje - children admitted to hospital No. 389 445
Murska Sobota - children admitted to hospital No. 294 332
Nova Gorica - children admitted to hospital No. 333 403
Trbovlje - children admitted to hospital No. 66 69
Zagorje ob Savi - children admitted to hospital No. 63 86
Ljubljana - children in the municipality (1.7.) No. 49976 51197
Maribor - children in the municipality (1.7.) No. 17966 18129
Celje - children in the municipality (1.7.) No. 8818 8941
Murska Sobota - children in the municipality (1.7.) No. 7344 7325
Nova Gorica - children in the municipality (1.7.) No. 7964 8070
Trbovlje - children in the municipality (1.7.) No. 1991 1998
Zagorje ob Savi - children in the municipality (1.7.) No. 2488 2466
Ljubljana % 3.1 3.1
Maribor % 2.9 3.4
Celje % 4.4 4.9
Murska Sobota % 4 4.5
Nova Gorica % 4.2 4.9
Trbovlje % 3.3 3.4
Zagorje ob Savi % 2.5 3.5
Figure ZD03-3: Exposure to the PM10 in European city populations for 2010 (WHO air quality guideline level is 20 µg /m3, the European Union limit value is 40 µg /m3 of PM10)
Sources: 

EUROSTAT, 2013

Show data
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
EU-27 µg/m3 33 28 29 28 26 27 30 27 28 30
Belgium µg/m3 41 35 34 33 34 33 36 31 30 31
Bulgaria µg/m3 0 0 0 20 29 0 59 52 49 53
Czech Republic µg/m3 35 26 25 30 32 39 41 34 34 35
Denmark µg/m3 0 0 0 0 0 24 25 20 24 27
Germany µg/m3 24 21 27 27 25 27 29 24 24 26
Estonia µg/m3 0 0 0 0 18 21 19 18 21 23
Ireland µg/m3 0 0 16 0 20 20 19 15 15 17
Greece µg/m3 0 0 0 0 35 35 34 33 29 26
Spain µg/m3 33 47 39 39 32 32 34 33 34 34
France µg/m3 0 0 0 0 21 21 23 21 20 21
Italy µg/m3 0 0 0 47 31 31 34 36 39 40
Latvia µg/m3 0 0 0 0 0 0 0 0 0 0
Lithuania µg/m3 0 0 29 0 0 0 0 23 23 20
Hungary µg/m3 0 0 0 0 0 0 34 24 39 37
Netherlands µg/m3 37 37 36 31 30 32 34 30 30 32
Austria µg/m3 0 0 0 26 33 26 31 24 29 30
Poland µg/m3 47 53 36 37 36 40 41 32 36 42
Portugal µg/m3 0 0 37 31 33 29 29 33 32 31
Romania µg/m3 0 0 0 0 0 0 50 54 49 53
Slovenia µg/m3 0 0 0 0 0 31 44 41 37 33
Slovakia µg/m3 0 0 36 29 27 29 30 31 34 31
Finland µg/m3 0 0 16 15 16 16 16 14 15 16
Sweden µg/m3 0 14 14 17 18 20 20 18 19 20
United Kingdom µg/m3 30 26 25 24 24 24 26 23 23 25
Norway µg/m3 0 0 0 0 0 0 20 17 22 22
2007 2008 2009 2010
EU-27 µg/m3 28 26 26 26
Belgium µg/m3 26 26 29 27
Bulgaria µg/m3 54 61 56 48
Czech Republic µg/m3 27 25 26 29
Denmark µg/m3 23 21 17 12
Germany µg/m3 23 21 22 23
Estonia µg/m3 19 11 11 13
Ireland µg/m3 15 14 14 16
Greece µg/m3 30 0 0 0
Spain µg/m3 31 27 26 24
France µg/m3 27 24 26 25
Italy µg/m3 36 34 32 29
Latvia µg/m3 0 24 20 24
Lithuania µg/m3 21 19 23 27
Hungary µg/m3 32 29 30 31
Netherlands µg/m3 31 27 26 25
Austria µg/m3 23 22 24 26
Poland µg/m3 32 31 35 39
Portugal µg/m3 30 24 25 24
Romania µg/m3 46 39 30 35
Slovenia µg/m3 32 29 28 28
Slovakia µg/m3 29 27 25 29
Finland µg/m3 16 14 13 13
Sweden µg/m3 17 18 15 14
United Kingdom µg/m3 24 21 19 18
Norway µg/m3 20 19 19 20
Figure ZD03-4: Percentage of children exposed to PM10 living in big cities in selected European countries, for 2009 (WHO air quality guideline level is 20 µg /m3, the European Union limit value is 40 µg /m3 of PM10)
Sources: 

ENHIS, 2011.

Show data
Iceland Finland Ireland Estonia Sweden Denmark Norway United Kingdom Switzerland Germany
PM10 No. of exposed children 113730 690541 586145 392306 1028892 203500
PM10 No. of exposed children 100482 478055 501664 759316 10402200 364528 4354978
PM10 No. of exposed children 2368978 312277 15822665
PM10 No. of exposed children
PM10 No. of exposed children
PM10 No. of exposed children
PM10 > 60 µg/m3 No. of exposed children
population covered No. of exposed children 113730 690541 586145 492788 1506947 501664 759316 12974678 676805 20177643
PM10 % of exposed children 100 100 100 79.6 68.3 0 0 1.6 0 0
PM10 % of exposed children 0 0 0 20.4 31.7 100 100 80.2 53.9 21.6
PM10 % of exposed children 0 0 0 0 0 0 0 18.3 46.1 78.4
PM10 % of exposed children 0 0 0 0 0 0 0 0 0 0
PM10 % of exposed children 0 0 0 0 0 0 0 0 0 0
PM10 % of exposed children 0 0 0 0 0 0 0 0 0 0
PM10 > 60 µg/m3 % of exposed children 0 0 0 0 0 0 0 0 0 0
annual mean PM10 µg/m3 9.7 13.3 13.5 12.6 14.8 16.7 19 19.2 20 22.4
Belarus Portugal Latvia Slovenia Lithuania Luxembourg Austria Netherlands Hungary Belgium
PM10 No. of exposed children
PM10 No. of exposed children 372000 100847
PM10 No. of exposed children 2246600 1384079 735241 267563 1039306 83226 2165313 2326067 1900107 2016016
PM10 No. of exposed children 127587 229344
PM10 No. of exposed children
PM10 No. of exposed children
PM10 > 60 µg/m3 No. of exposed children
population covered No. of exposed children 2618600 1484926 735241 267563 1039306 83226 2165313 2326067 2027694 2245360
PM10 % of exposed children 0 0 0 0 0 0 0 0 0 0
PM10 % of exposed children 14.2 6.8 0 0 0 0 0 0 0 0
PM10 % of exposed children 85.8 93.2 100 100 100 100 100 100 93.7 89.8
PM10 % of exposed children 0 0 0 0 0 0 0 0 6.3 10.2
PM10 % of exposed children 0 0 0 0 0 0 0 0 0 0
PM10 % of exposed children 0 0 0 0 0 0 0 0 0 0
PM10 > 60 µg/m3 % of exposed children 0 0 0 0 0 0 0 0 0 0
annual mean PM10 µg/m3 20.6 24.8 20.2 29.4 23 23.3 23.6 25.5 29.8 29
Slovakia Czech Republic France Spain Romania Russia Italy Albania Poland Serbia
PM10 No. of exposed children
PM10 No. of exposed children 1008276 818439 761070 107773
PM10 No. of exposed children 567747 2125088 14677679 6456773 66293 2186685 2153515
PM10 No. of exposed children 85268 459356 4933105 2479108 150267 10579300 4428274 365376.2 5233822
PM10 No. of exposed children 351385.9 2798475 2153232 1123594.3
PM10 No. of exposed children 983648
PM10 > 60 µg/m3 No. of exposed children
population covered No. of exposed children 653015 2584444 20619060 10105705.9 216560 10579300 10174504 365376.2 10631990 1123594.3
PM10 % of exposed children 0 0 0 0 0 0 0 0 0 0
PM10 % of exposed children 0 0 4.9 8.1 0 0 7.5 0 1 0
PM10 % of exposed children 86.9 82.2 71.2 63.9 30.6 0 21.5 0 20.3 0
PM10 % of exposed children 13.1 17.8 23.9 24.5 69.4 100 43.5 100 49.2 0
PM10 % of exposed children 0 0 0 3.5 0 0 27.5 0 20.3 100
PM10 % of exposed children 0 0 0 0 0 0 0 0 9.3 0
PM10 > 60 µg/m3 % of exposed children 0 0 0 0 0 0 0 0 0 0
annual mean PM10 µg/m3 24.8 25.8 26.2 26.3 30.3 33.3 32.5 38.5 35 40.1
Bulgaria Turkey Bosnia and Herzegovina - Europe
PM10 No. of exposed children 3015114
PM10 No. of exposed children 20129628
PM10 No. of exposed children 60901218
PM10 No. of exposed children 347730 29418538
PM10 No. of exposed children 1650106 8076793.2
PM10 No. of exposed children 1408304 13546193 15938145
PM10 > 60 µg/m3 No. of exposed children 341464 6596424 374558.7 7312446.6
population covered No. of exposed children 2097498 21792723 374558.7 144791882.8
PM10 % of exposed children 0 0 0 2.1
PM10 % of exposed children 0 0 0 13.9
PM10 % of exposed children 0 0 0 42.1
PM10 % of exposed children 16.6 0 0 20.3
PM10 % of exposed children 0 7.6 0 5.6
PM10 % of exposed children 67.1 62.2 0 11
PM10 > 60 µg/m3 % of exposed children 16.3 30.3 100 5.1
annual mean PM10 µg/m3 52.9 58.1 60.9

Goals

  • To reduce risks to human health and to ensure annual mean concentrations of particulate matter in ambient air that are still considered acceptable from the perspective of human health, i.e. 20 µg/m3 for PM10 and 10 µg/m3 for PM2.5,
  • to provide conditions for healthy life and promote general well-being in all periods of life,
  • to provide reliable, sustainable and modern energy sources at acceptable prices for everyone,
  • to provide conditions for open, safe, resilient and sustainable cities and other settlements,
  • to adopt measures to combat climate change and its consequences.

     


Concentration of PM10 is a good indicator of exposure to dust particles in the outdoor air. A number of epidemiological studies carried out in Europe and elsewhere in the world show a relationship between exposure to PM10 and the health of children as a particularly vulnerable social group (Cohen et al., 2004). Dust particles are present in all areas occupied by people. Humans generate dust particles with activities such as transport, energy generation, heating and industry. Dust particles smaller than 10 µm are particularly hazardous, as they can penetrate deep into the lungs (Brunekreeft, 2002).

PM10 and high ozone concentration in the air are the most common air pollutants causing harmful effects. The mechanism that causes these effects can be attributed to oxidative stress. Oxidative stress means generation of reactive substances (radicals) that may damage genetic material. Reactive oxidative species produced in response to air pollutants may disturb processes within cells, which can lead to the destruction of cells or can affect genetic material within cells. Also, pollutants harmfully affect genetic material by changing the expression of genes without damaging DNA. These mechanisms are usually targeted in the treatment of allergies. Further studies are required in order to recognise at risk children and understand how the mechanisms regulate the connectedness between genetics and the environment (Kim BJ, Hong SJ, 2012). In addition to oxidative stress, particulate matter also causes chronic inflammation of the respiratory tract, which causes a pronounced immune response. In the respiratory tract, inflammatory cytokines are released locally (CRP, IL-6, TNF-α) (Patel M, 2013). It has also been proved that neutrophils, (immune response cells) activate reactive oxidative species that additionally exacerbate an inflammatory reaction, cause hyperreactivity of the respiratory tract and damage lungs (Auerbach A, 2012). Several types of pulmonary receptors are stimulated by PM particles. The afferent autonomic system thus becomes activated and causes the prevalence of the sympathetic over parasympathetic nervous system. The consequences are numerous (fluctuating blood pressure, faster heartbeat frequency, etc.) (Peters A, 2012).

Figure ZD03-5: Movement of particles through the respiratory tracthttp://kazalci.arso.gov.si/get_file?file_name_id=10341

nose, oesophagus 5–10 µm

trachea             3–5 µm

 

bronchi 2–3 µm

bronchial tubes 1–2 µm

 

lung alveoli 0.1–1 µm

 

Source: CEHAP, 2004

According to the data provided by the National Institute of Public Health of the Republic of Slovenia, children in Slovenia aged 0–15 years are exposed to PM10 concentrations of 30–40 µg/m3, on average, which is above the WHO recommendation (20 µg PM10/m3). In 2012, 87% of children in Slovenia were exposed to the recommended maximum annual PM10 concentration (0–30 µg/m3). The lowest concentrations (below 20 µg/m3, which is the maximum acceptable limit recommended by the WHO) were measured at the stations in Iskrba, Kovk, Dobovec and Zelena Trava. Thirteen per cent of children in Slovenia were exposed to an annual recommended concentration higher than 30 µg/m3 PM10 – this value was exceeded in Celje, Trbovlje and Zagorje. The highest annual value (45 µg/m3) was measured in Ljubljana, which was expected considering the dense traffic. In other parts of Slovenia, the annual value of PM10 in 2012 was between 20 and 30 µg/m3.

The data on hospital admissions reveals that the number of children (aged 0–15 years) admitted to hospitals for respiratory diseases in the period 2002–2013 was the highest in Nova Gorica, Murska Sobota and Celje. The Slovenian Environment Agency, which carries out regular national monitoring of air pollution, estimates that the cause is a high percentage of wood burning stoves, which prevail where district heating is not provided. In 2013, the percentage of children admitted to hospitals for respiratory diseases slightly increased in Murska Sobota, as well as in Celje and Nova Gorica. These three cities are still leading in Slovenia in the number of hospital admissions for respiratory diseases. In the two-year period 2012–2013, the percentage of children admitted to hospitals for respiratory diseases increased in all cities where measurements are carried out.

The number of hospital admissions for respiratory diseases of children aged between 0 and 15 years accounts for 15% of all hospital admissions of children in Slovenia. This number would be much higher if these children were not so well looked after by paediatricians. According to WHO calculations, the number of hospital admissions for respiratory diseases of children aged between 0 and 15 years would decrease by around 200 patients if the average annual PM10 concentration in Slovenia were 20 µg/m3 (or less). A reduction of the concentration of particulate matter (PM10) by 10 µg/m3 would reduce the time children aged between 5 and 14 years suffer from diseases of the lower respiratory tract (wheezing, chest pain, shortness of breath, cough) by 1.9 days/year/child. It has also been foreseen that the use of bronchodilators would decrease by 18% per year in children with asthma aged between 5 and 14 years. The introduction of new and effective therapies has contributed considerably to a reduction of hospital admissions of patients with severe asthma.

Based on methodology developed under the auspices of the WHO (APHECOM, 2010), it was established that 20 adults died in Ljubljana in 2006 due to air pollution with PM10 particles. These were premature deaths resulting from exacerbation of existing diseases. In the same year, 40 people were admitted to hospitals for exacerbation of cardiovascular diseases and 20 were admitted for exacerbation of respiratory diseases. In all admissions, the cause was exacerbation of existing diseases due to exposure to current levels of pollution containing PM10 particles. If the average annual PM10 concentration in Slovenia were below 20 µg/m3, the above-mentioned hospital admissions or deaths would not have occurred (APHECOM, 2010).

Exposure to PM10 causes exacerbation of bronchitis in children. In Slovenia, approximately 23% of children (aged 0–17 years) are admitted to hospitals annually for chronic bronchitis (Asher MI et al., 2006). Some studies also indicate that occurrence of atherosclerosis and deterioration of lung function in adolescents are a consequence of exposure to particulate matter (Brook RD et al., 2004).

According to European Environment Agency (EEA) data, 18–41% of the EU population in the period 2001–2010 were exposed to PM10 concentrations above the EU target value for human health protection. The WHO warns that in Europe, the majority (82.8%) of the population is exposed to levels of particulate matter above the WHO recommended values (20 µg/m3), while 23.3% of the population is exposed to concentrations above the EU recommended values for environmental protection (40 µg/m3) (ENHIS, 2011). Based on the collected data, the WHO concluded that in 2009, populations of some countries in eastern and southeastern Europe were exposed to elevated concentrations of PM10. The number of exposed children depends on geographic location and measures taken by individual countries or cities to reduce air pollution. This is evident from the comparison of mean annual values of PM10 concentration between the EU-27 countries. In Slovenia, the mean annual value of PM10 concentration is above the EU-27 average (2009 data) as well as being above the limit value recommended by the WHO (ENHIS, 2011).

Long-term exposure to PM10 increases the risk of pulmonary and cardiovascular diseases and the risk of death resulting therefrom. The effects of exposure are a result of PM10 concentration and the duration of exposure. Elevated concentrations may lead to insufficient development of lungs, asthma exacerbation and respiratory disorders. The risk of mortality begins at a young age; long-term exposure to dust particles increases by 0.5% for each increase in the mean annual concentration of particles by 10 µg/m3. In setting a safe and acceptable risk limit in respect of particles smaller than 2.5 µm, the authors believe that the mean annual concentration should not exceed 13 µg/m3. The risk increases above this value. In order to decrease health risks, we therefore propose that a mean annual value of 10 µg/m3 for PM2.5 and 20 µg/m3 for PM10 be ensured (Hong et al., 2002).

 


PictureZD03-5: Path of the particle through the respiratory tract

Source: CEHAP, 2004


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