Original Article

Regional Differentiation of Mortality from Cardiovascular and Respiratory Diseases in Correlation with Concentrations of PM10 Particles in Montenegro

Abstract

Background: We aimed to indicate whether the regional disparity in the general mortality rate from cardiovascular (CVDs) and chronic respiratory (CRDs) diseases correlates with the trends of the average annual values of PM10 particles in selected cities in Montenegro.
Methods: We used descriptive statistics together with correlation tests. The paper deals with the regional distribution of mortality caused by CVDs and chronic respiratory (CRDs) diseases in Montenegro from 2011 to 2019, while the correlation of mortality in selected cities with PM10 particles covers the period from 2011 to 2019.
Results: The selected cities from different regions of Montenegro, such as Pljevlja and Niksic, exhibited significant correlations between increased pollution concentrations and mortality from cardiovascular diseases. In Pljevlja, a strong correlation was found between PM10 concentrations and CVD mortality (r = 0.8), while in Niksic, the association between PM10 particles and CVD mortality in women was relatively strong (β=2.7). Similar, but weaker correlations were observed in Podgorica (r=0.5) and Bar (r=0.4). Regarding respiratory diseases, the correlations with PM10 particles were negative and weaker in all cities, with the lowest coefficients observed in Podgorica (r = -0.2) and Nikšić (r = -0.3), suggesting a lesser impact of pollution on mortality from respiratory diseases compared to cardiovascular diseases.
Conclusion: Mortality trends particularly for cardiovascular diseases, show a strong correlation with poor air quality in certain cities, especially Pljevlja and Niksic. Reducing pollutant emissions would significantly contribute to improving public health in Montenegro. Future research must include established measuring stations network for air quality analysis in Montenegro.

 

1. World Health Organisation. The top 10 causes of death, 2020: https://www.who.int/news/item/09-12-2020-who-reveals-leading-causes-of-death-and-disability-worldwide-2000-2019
2. Timmis A, Townsend N, Gale PC, et al (2020). European Society of Cardiology: Cardiovascular Disease Statistics 2019. Eur Heart J, 41 (1): 12-85.
3. OECD/European Union (2018). Health at a Glance: Europe 2018: State of Health in the EU Cycle. OECD Publishing, Par-is, the France.
4. Zhao D (2021). Epidemiological Features of Cardiovascular Disease in Asia. JACC Acia, 1 (1): 1-13.
5. Wan CT (2011). Trends in chronic obstruc-tive pulmonary disease in the Asia-Pacific regions. Curr Opin Pulm Med, 17 (2): 56-61.
6. Yuyun MF, Sliwa K, Kengne AP, Mocumbi AO, Bukhman G (2020). Cardiovascular Diseases in Sub-Saharan Africa Com-pared to High-Income Countries: An Epidemiological Perspective. Glob Heart, 15 (1): 15.
7. Alemayohu MA, Zanolin M, Cazzoletti L, Nyasulu P, Garcia-Larsen V (2019). Bur-den and risk factors of chronic obstruc-tive pulmonary disease in Sub-Saharan African countries, 1990-2019: a systemat-ic analysis for the Global Burden of disease study. EClin Med, 64: 102215.
8. Lee KK, Miller RM, Shah ASV (2018). Air Pollution and Stroke. J Stroke, 20 (1): 2-11.
9. Gholampour A, Nabizadeh R, Naseri S, et al (2014). Exposure and health impacts of outdoor particulate matter in two ur-ban and industrialized area of Tabriz. J Env Health Sci Eng, 1: 27.
10. Hamanaka RB, Mutlu GM (2018). Particu-late Matter Air Pollution: Effects on the Cardiovascular System. Front Endocrinol, 16 (9): 680.
11. Krzyzanowski M. (2016). Uticaj zagađenja vazduha na zdravlje u Crnoj Gori. World Health Organization. Avaliable from: https://s3.eu-central-1.amazonaws.com/web.repository/ijzcg-media/files/1573765641-uticaj-zagadenja-vazduha-na-zdravlje-u-crnoj-gori.pdf
12. Misiukiewicz-Stepien P, Paplinska-Goryca M (2021). Biological effect of PM10 on airway epithelium-focus on obstructive lung diseases. Clin Immunol, 227: 108754.
13. Du Y, Xu X, Chu M, Guo Y, Wang Y (2016). Air particulate matter and cardiovascu-lar disease: the epidemiological, bio-medical and clinical evidence. J Thorac Dis, 8 (1): E8-E19.
14. Horálek J, Vlasáková L, Schreiberová M, et al (2019). European air quality maps for 2019. PM10, PM2.5, Ozone, NO2 and NOx Spatial estimates and their uncer-tainties. Eionet Report - ETC/ATNI 2021/1. European Environment Agency, European Topic Centre on Air pollu-tion, Norway. Avaliable from: https://zenodo.org/records/6241308
15. Air Quality in Asia: Status and Trends Re-port 2018. Avaliable from: https://cleanairasia.org/sites/default/files/2021-05/2.%20Air%20Quality%20in%20Asia%20-%20Status%20and%20Trends%202018.pdf
16. Fuller HC, Amegah AK (2020). Limited Air Pollution Research on the African Con-tinent: Time to Fill the Gap. Int J Envi-ron Res Public Health, 19 (11): 6359.
17. European Union (2008). Directive of the European Parliament and of the council on ambient air quality and cleaner air for Europe. OJEU, 152: 44.
18. World Health Organisation (2017). Evolu-tion of WHO air quality guidelines: past, present and future. World Health Or-ganization, Regional Office for Europe, Denmark. Avaliable from: https://www.who.int/europe/publications/i/item/9789289052306
19. Radojičić B (2008). Crna Gora, geografske od-like, Narodna knjiga, Podgorica, str.: 17-22.
20. Popis stanovništva, domaćinstava i stanova (2024). Stanovništvo Crne Gore prema polu i starosti, Zavod za statistiku-Monstat, Pod-gorica, dostupno na: https://www.monstat.org/uploads/files/popis%202021/saopstenja/SAOPSTENJE_Popis%20stanovnistva%202023%20I_cg.pdf
21. Al-Hemoud A, Al-Dousari A, Al-Shatti AM (2018). Health Impact Assessment Asso-ciated with Exposure to PM10 and Dust Storms in Kuwait, Atmosphere, 9 (1): 6.
22. Liu C, Chen R, Sera F, et al (2019). Ambient Particulate Air Pollution and Daily Mor-tality in 652 Cities. N Engl J Med, 705-715.
23. Kunecki P, Franus W, Wdowin M (2020). Statistical study and physicochemical characterization of particulate matter in the context of Kraków, Poland. Atmos Pollut Res, 11 (3): 520-530.
24. Ioana Ciută I, Matković Puljić V, Mulić M, et al (2019). Kako se riješiti smoga? Kol-iko bi javno zdravlje Tuzle imalo koristi od provedbe zakonodavstva o kvalitetu zraka. CEE Bankwatch Network, Health and Environment Alliance, Zavod za javno zdravlje Tuzlanskog kantona, Cen-tar za ekologiju i energiju. Avaliable from: https://bankwatch.org/wp-content/uploads/2019/06/Lifting-the-smog-BIH-June-24-2019.pdf
25. Rodríguez-Villamizar LA, Rojas-Roa NY, Fernández-Niño JA (2019). Short-term joint effects of ambient air pollutants on emergency department visits for res-piratory and circulatory diseases in Co-lombia. Environ Pollut, 248: 380-387.
26. Dehghani S, Vali M, Jafarian A, et al (2022). Ecological study of ambient air pollu-tion exposure and mortality of cardio-vascular diseases in elderly. Sci Rep, 12: 21295.
27. Poloniecki JD, Atkinson RW, Leon AP, et al (1997). Daily time series for cardio-vascular hospital admissions and previ-ous day's air pollution in London, UK. Occup Environ Med, 54 (8): 535-40.
28. Rummasak T (2019). Relationship between Annual Average Concentration of Am-bient PM10 and Out-patients with Res-piratory Disease: Thailand Case Study. App Envi Res, 41 (1): 57-69.
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SectionOriginal Article(s)
Keywords
Cardiovascular diseases Respiratory diseases PM10 particles Montenegro

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How to Cite
1.
Raicevic D, Mikic M, Mijanovic I, Milentijevic N. Regional Differentiation of Mortality from Cardiovascular and Respiratory Diseases in Correlation with Concentrations of PM10 Particles in Montenegro. Iran J Public Health. 2025;54(4):785-794.