Spatiotemporally resolved particulate matter (PM) estimates are essential for reconstructing long and short-term exposures in epidemiological research. Improved estimates of PM
and PM
concentrations ...were produced over Italy for 2013-2015 using satellite remote-sensing data and an ensemble modeling approach. The following modeling stages were used: (1) missing values of the satellite-based aerosol optical depth (AOD) product were imputed using a spatiotemporal land-use random-forest (RF) model incorporating AOD data from atmospheric ensemble models; (2) daily PM estimations were produced using four modeling approaches: linear mixed effects, RF, extreme gradient boosting, and a chemical transport model, the flexible air quality regional model. The filled-in MAIAC AOD together with additional spatial and temporal predictors were used as inputs in the three first models; (3) a geographically weighted generalized additive model (GAM) ensemble model was used to fuse the estimations from the four models by allowing the weights of each model to vary over space and time. The GAM ensemble model outperformed the four separate models, decreasing the cross-validated root mean squared error by 1-42%, depending on the model. The spatiotemporally resolved PM estimations produced by the suggested model can be applied in future epidemiological studies across Italy.
Daily air pollution has been linked with mortality from urban studies. Associations in rural areas are still unclear and there is growing interest in testing the role that air pollution has on other ...causes of death. This study aims to evaluate the association between daily air pollution and cause-specific mortality in all 8092 Italian municipalities.
Natural, cardiovascular, cardiac, ischemic, cerebrovascular, respiratory, metabolic, diabetes, nervous and psychiatric causes of death occurred in Italy were extracted during 2013–2015. Daily ambient PM10, PM2.5 and NO2 concentrations were estimated through machine learning algorithms. The associations between air pollutants and cause-specific mortality were estimated with a time-series approach using a two-stage analytic protocol where area-specific over-dispersed Poisson regression models where fit in the first stage, followed by a meta-analysis in the second. We tested for effect modification by sex, age class and the degree of urbanisation of the municipality.
We estimated a positive association between PM10 and PM2.5 and the mortality from natural, cardiovascular, cardiac, respiratory and nervous system causes, but not with metabolic or psychiatric causes of death. In particular, mortality from nervous diseases increased by 4.55% (95% CI: 2.51–6.63) and 9.64% (95% CI: 5.76–13.65) for increments of 10 μg/m3 in PM10 and PM2.5 (lag 0–5 days), respectively. NO2 was positively associated with respiratory (6.68% (95% CI: 1.04–12.62)) and metabolic (7.30% (95% CI: 1.03–13.95)) mortality for increments of 10 μg/m3 (lag 0–5). Higher associations with natural mortality were found among the elderly, while there were no differential effects between sex or between rural and urban areas.
Short-term exposure to particulate matter was associated with mortality from nervous diseases. Mortality from metabolic diseases was associated with NO2 exposure. Other associations are confirmed and updated, including the contribution of lowly urbanised areas. Health effects were also found in suburban and rural areas.
•Time-series analysis of cause-specific mortality occurred in Italy.•Machine learning estimated daily PM10, PM2.5 and NO2 concentrations.•PM10 and PM2.5 positive associated with the mortality from nervous system causes.•NO2 positively associated only with respiratory and metabolic mortality.•Associations found in highly urbanised areas but also in suburban and rural ones.
The standard deviations of wind components (σu, σv, σw) are used by Particle Dispersion (PD) models to calculate the random motion causing the dispersion of pollutants. The goodness of concentration ...results is known to be dependent on the accuracy of the evaluations of wind component fluctuations. A study has been conducted to investigate the ability of the boundary layer formulations used in the PD model SPRAY in estimating the actual variance of wind components. A comparison of the σw and u* data calculated by SPRAY, with those measured by means of a sonic anemometer and a SODAR system, both located in a coastal area, has been carried out. Modelled and observed σwdata have been studied under different atmospheric turbulence and wind conditions. The effect of the land use of the model cell and its representativeness with respect to the land/sea wind direction, were also investigated. A seasonal statistical comparison was conducted by means of least-square and frequency of occurrence methods, both applied at different heights. Results exhibit a general underestimation of σwdata predicted by SPRAY with respect to the measured one. The level of agreement is found to be dependent on the atmospheric stability and on land/sea wind regimes. A strong dependence on friction velocity estimations is found as well. A way to improve the model estimations is also presented.
to assess the association between the occupational sector and respiratory mortality in the metropolitan longitudinal studies of Rome and Turin.
retrospective cohort study.
the 2011 census cohorts of ...residents of Rome and Turin aged 30 years and older who had worked for at least one year in the private sector between 1970s and 2011 was analysed. The individuals included in the study were followed from 9 October 2011 to 31 December 2018. Occupational history was obtained from archives of private sector contributions at the National Social Insurance Agency (INPS) and then was linked to data from the longitudinal studies.
the study outcome was non-malignant respiratory mortality. The exposure of interest was whether or not individuals had worked in one of the 25 occupational sectors considered (agriculture and fishing, steel industry, paper and printing, pharmaceuticals, manufacturing, textile, energy and water, food and tobacco industry, non-metal mining, glass & cement industry, metal processing, electrical construction, footwear and wood industry, construction, trade, hotel and restaurants, transportation, insurance, healthcare, services, laundries, waste management, hairdressing, cleaning services, and gas stations). The association between the occupational sector and respiratory mortality, adjusted for potential confounders (age, marital status, place of birth, educational level), was estimated using Cox models. All analyses were stratified by sex and city.
a total of 910,559 people were analysed in Rome and 391,541 in Turin. During the eight years of follow-up, 4,133 people in Rome and 2,772 people in Turin died from respiratory causes. The sectors associated with high respiratory mortality in both cities among men were footwear and wood industry (adjusted HR for age: 1.37 (95%CI 1.07-1.76) and 1.48 (95%CI 1.08-2.03) in Rome and Turin, respectively), construction (HR: 1.31 (95%CI 1.20-1.44) in Rome and 1.51 (95%CI 1.31-1.74) in Turin), hotel and restaurant sector (HR: 1.25 (95%CI 1.07-1.46) in Rome and 1.68 (95%CI 1.20-2.33) in Turin), and cleaning services (HR: 1.57 (95%CI 1.19-2.06) in Rome and 1.97 (95%CI 1.51-2.58) in Turin). Some sectors had high respiratory mortality only in one of the two cities: in Rome, the food& tobacco industry, and gas stations, while in Turin, the metal processing industry. Among female workers, the cleaning services sector was associated with higher respiratory mortality in both Rome and Turin (HR: 1.52, 95%CI 1.27-1.82, e 1.58, 95%CI 1.17-2.12, respectively).
the data confirm the previously known associations between occupational sectors and respiratory mortality for exposures characteristic of specific sectors, such as construction, hotel and restaurant sector, and cleaning services. The differences reported between the two cities reflect the different composition of the workforce and the size of the two study populations. Administrative social insurance data can provide helpful information for epidemiological studies of occupational exposure.
to estimate the impact of daily exposure to extreme air temperatures (heat and cold) on cause-specific mortality in Italy and to evaluate the differences in the association between urban, suburban ...and rural municipalities.
time series analyses with two-stage approach were applied: in the first stage, multiple Poisson regression models and distributed lag non-linear models (DLNM) were used to define the association between temperature and mortality; in the second one, meta-analytic results were obtained by adopting BLUP (Best Linear Unbiased Prediction) coefficients at provincial level, which were then used to estimate the Attributable Fractions of cause-specific deaths.
cause-specific deaths from 2006to 2015 in Italy have been analysed by region and overall.
5,648,299 total deaths included. Fractions (and relative 95% empirical confidence interval) of deaths attributable to increases from 75th to 99th percentiles of temperature, for heat, and decreases from 25th to 1st percentile, for cold.
the overall impact of air temperature on causespecificmortality is higher for heat than for cold. When considering heat, the attributable fraction is higher for diseases of the central nervous system (3.6% 95% CI 1.9-4.9) and mental health disease (3.1% 95% CI 1.7-4.4), while considering cold, ischemic disease (1.3% 95% CI 1.1-1.6) and diabetes (1.3% 95% CI 0.7-1.8) showed the greater impact. By urbanization level, similar impacts were found for cold temperature, while for heat there was an indication of higher vulnerability in rural areas emerged.
results are relevant for the implementation and promotion of preventive measures according to climate change related increase in temperature. The available evidence can provide the basis to identify vulnerable areas and population subgroups to which address current and future heat and cold adaptation plans in Italy.
the health status of people living near industrial plants is often exposed to several environmental risk factors, including air pollution. The aim of this study is to assess the relationship between ...daily PM10 levels and cause-specific mortality in a selection of municipalities near two industrial plants from 2006 to 2015.
a time-series design with Poisson regression adjusted for a predefined set of confounders was used to quantify the association between exposure, calculated as daily PM10 levels extrapolated from machine-learning models using satellite data, and cause-specific mortality.
twenty municipalities near the thermal power plants in Civitavecchia and Brindisi were selected. The municipalities were then divided into three scenarios of chronic exposure derived from SPRAY simulation models of pollutant deposition.
daily cause-specific non-accidental, cardiovascular, and respiratory deaths defined according to the International Classification of Diseases code at the municipality level.
a total of 41,942 deaths were observed in the entire area (10,503 in the Civitavecchia area and 31,439 in the Brindisi area), of which approximately 41% were due to cardiovascular causes and 8% due to respiratory causes. The association showed an increase in shortterm effects in municipalities with higher chronic levels of pollution exposure. For example, risk estimates reported as percentage increases per 10-unit increase in PM10 were 6.7% (95% CI 0.9, 12.7%) in scenario 3 (highest exposure) compared to 4.2% (-1.2, 9.9%) and 2.7% (-4.2, 10.2%) in scenarios 2 and 1, respectively, in the area near the Civitavecchia plant. Similar effects were observed for the Brindisi area.
despite the well-documented relationship between short-term pollution and mortality, it appears that greater chronic exposure to industrial pollutants leads to increased short-term effects of PM10. The limited number of events suggests that this study could serve as a starting point for a larger investigation.
The effects of heat on health have been well documented, while less is known about the effects among agricultural workers. Our aim is to estimate the effects and impacts of heat on occupational ...injuries in the agricultural sector in Italy. Occupational injuries in the agricultural sector from the Italian national workers' compensation authority (INAIL) and daily mean air temperatures from Copernicus ERA5-land for a five-year period (2014-2018) were considered. Distributed lag non-linear models (DLNM) were used to estimate the relative risk and attributable injuries for increases in daily mean air temperatures between the 75th and 99th percentile and during heatwaves. Analyses were stratified by age, professional qualification, and severity of injury. A total of 150,422 agricultural injuries were considered and the overall relative risk of injury for exposure to high temperatures was 1.13 (95% CI: 1.08; 1.18). A higher risk was observed among younger workers (15-34 years) (1.23 95% CI: 1.14; 1.34) and occasional workers (1.25 95% CI: 1.03; 1.52). A total of 2050 heat-attributable injuries were estimated in the study period. Workers engaged in outdoor and labour-intensive activities in the agricultural sector are at greater risk of injury and these results can help target prevention actions for climate change adaptation.
Air pollution effects on cardiovascular hospitalizations in small urban/suburban areas have been scantly investigated. Such effects were assessed among the participants in the analytical ...epidemiological survey carried out in Pisa and Cascina, Tuscany, Italy (2009-2011). Cardiovascular hospitalizations from 1585 subjects were followed up (2011-2015). Daily mean pollutant concentrations were estimated through random forests at 1 km (particulate matter: PM
, 2011-2015; PM
, 2013-2015) and 200 m (PM
, PM
, NO
, O
, 2013-2015) resolutions. Exposure effects were estimated using the case-crossover design and conditional logistic regression (odds ratio-OR-and 95% confidence interval-CI-for 10 μg/m
increase; lag 0-6). During the period 2011-2015 (137 hospitalizations), a significant effect at lag 0 was observed for PM
(OR = 1.137, CI: 1.023-1.264) at 1 km resolution. During the period 2013-2015 (69 hospitalizations), significant effects at lag 0 were observed for PM
(OR = 1.268, CI: 1.085-1.483) and PM
(OR = 1.273, CI: 1.053-1.540) at 1 km resolution, as well as for PM
(OR = 1.365, CI: 1.103-1.690), PM
(OR = 1.264, CI: 1.006-1.589) and NO
(OR = 1.477, CI: 1.058-2.061) at 200 m resolution; significant effects were observed up to lag 2. Larger ORs were observed in males and in subjects reporting pre-existent cardiovascular/respiratory diseases. Combining analytical and routine epidemiological data with high-resolution pollutant estimates provides new insights on acute cardiovascular effects in the general population and in potentially susceptible subgroups living in small urban/suburban areas.
It has been amply demonstrated that exposure to fine particulate matter, containing polycyclic aromatic hydrocarbons (PAHs), may have adverse effects on human health, affecting especially the ...respiratory and cardiovascular systems. Among population, school-age children and elders present particular susceptibilities and unique exposures to environmental factors. The study presented in this paper belongs to the Project EXPAH, founded by the European (EU) LIFE+ instrument, and consists of the personal monitoring of five elementary school children and four elders during the spring and the summer/autumn of the year 2012 in the city of Rome, Italy. The average exposure, expressed as the sum of eight high-molecular-weight PAHs, resulted equal to 0.70 ng/m
3
(
SD
= 0.37) for children and 0.59 ng/m
3
(
SD
= 0.23) for the elderly people. The mean levels of gravimetric PM
2.5
were equal to 23 μg/m
3
(
SD
= 10) and 15 μg/m
3
(
SD
= 4) for children and elders, respectively. During spring and summer seasons, personal BaP
eq
resulted well below the EU Air Quality reference value of 1 ng/m
3
. The personal monitoring average values were in the same order of magnitude with available indoor and outdoor environmental data in Rome during the same periods, for both PAHs and PM
2.5
. The results suggest that, during non-heating seasons, the personal exposure to PAHs in the city of Rome can be mainly ascribed to the urban background, especially traffic emissions and road dust resuspension; secondhand cigarette smoke can be also considered another possible source of PAHs personal exposure.
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