The LIFE MED HISS project aims at setting up a surveillance system on the long term effects of air pollution on health, using data from National Health Interview Surveys and other currently available ...sources of information in most European countries. Few studies assessed the long term effect of air pollution on hospital admissions in European cohorts.
The objective of this paper is to estimate the long term effect of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) on first-ever (incident) cause-specific hospitalizations in Italy.
We used data from the Italian Longitudinal Study (ILS), a cohort study based on the 1999–2000 National Health Interview Survey (NHIS), followed up for hospitalization (2001–2008) at individual level. The survey contains information on crucial potential confounders: occupational/educational/marital status, body mass index (BMI), smoking habit and physical activity.
Annual mean exposure to PM2.5 and NO2 was assigned starting from simulated gridded data at spatial resolution of 4 × 4 km2 firstly integrated with data from monitoring stations and then up-scaled at municipality level.
Statistical analyses were conducted using Cox proportional hazard models with robust variance estimator.
For each cause of hospitalization we estimated the hazard ratios (HRs) adjusted for confounders with 95% Confidence Interval (CI) related to a 10 μg/m3 increase in pollutants. For PM2.5 and NO2, respectively, we found positive associations for circulatory system diseases 1.05(1.03–1.06); 1.05(1.03–1.07), myocardial infarction 1.15(1.12–1.18); 1.15(1.12–1.18), lung cancer 1.18(1.10–1.26); 1.20(1.12–1.28), kidney cancer 1.24(1.11–1.29); 1.20(1.07–1.33), all cancers (but lung) 1.06(1.04–1.08); 1.06(1.04–1.08) and Low Respiratory Tract Infections (LRTI) 1.07 (1.04–1.11); 1.05 (1.02–1.08).
Our results add new evidence on the effects of air pollution on first-ever (incident) hospitalizations, both in urban and rural areas. We demonstrated the feasibility of a low-cost monitoring system based on available data.
•A low-cost monitoring system to study effect of air pollution has been tested.•This surveillance system could be implemented in all European countries.•Italian Health Interview Survey has been followed-up for hospitalizations.•For PM2.5 and NO2 we found effects of air pollution on first-ever hospitalizations.•The adverse health effects can be seen both in urban and rural areas.
•The regulating ES provided by forests is analyzed in 10 Italian cities.•The removal of O3 and PM10 is affected by forest cover.•PM10 deposition on forests mainly depends on LAI.•O3 absorption is ...mainly influenced by forest functional diversity.•These findings can be useful to a nature-based urban sustainable management.
Urban and periurban forests, which are integrated within the concept of Green Infrastructure, provide important Ecosystem Services, including air purification. In this study, we quantified the Ecosystem Service of particulate matter (PM10) and Ozone (O3) removal from urban and periurban forests in ten metropolitan cities in Italy, and its total monetary value. In order to gain a better understanding of how Ecosystem Services can be regulated on a wider scale, the vegetation ecosystem types were grouped into Physiognomic-Structural Categories of Vegetation according to morphofunctional criteria. The pollution removal was mapped using a remote sensing and GIS approach, by applying a deposition model and a stomatal flux model. We estimated, for the ten metropolitan cities, an overall pollution abatement of 7150Mg of PM10 and 30,014Mg of O3 in the year 2003, which was an extremely hot year. Our findings indicate that structural characteristics (i.e. Leaf Area Index) and functional diversity, linked to stomatal conductance, exert a marked influence on the provision of the regulating Ecosystem Services, whose total monetary value was estimated to be equal to 47 and 297 million USD for PM10 and O3 removal, respectively. This study represent the first national-scale assessment of the Ecosystem Services of air pollution removal in Europe, thus providing information that may be useful to stakeholders to manage Green Infrastructure more efficiently.
Spatial representativeness of air quality monitoring stations is a critical parameter when choosing location of sites and assessing effects on population to long term exposure to air pollution. ...According to literature, the spatial representativeness of a monitoring site is related to the variability of pollutants concentrations around the site.
As the spatial distribution of primary pollutants concentration is strongly correlated to the allocation of corresponding emissions, in this work a methodology is presented to preliminarily assess spatial representativeness of a monitoring site by analysing the spatial variation of emissions around it. An analysis of horizontal variability of several pollutants emissions was carried out by means of Geographic Information System using a neighbourhood statistic function; the rationale is that if the variability of emissions around a site is low, the spatial representativeness of this site is high consequently.
The methodology was applied to detect spatial representativeness of selected Italian monitoring stations, located in Northern and Central Italy and classified as urban background or rural background. Spatialized emission data produced by the national air quality model MINNI, covering entire Italian territory at spatial resolution of 4 × 4 km2, were processed and analysed.
The methodology has shown significant capability for quick detection of areas with highest emission variability. This approach could be useful to plan new monitoring networks and to approximately estimate horizontal spatial representativeness of existing monitoring sites. Major constraints arise from the limited spatial resolution of the analysis, controlled by the resolution of the emission input data, cell size of 4 × 4 km2, and from the applicability to primary pollutants only.
•Horizontal emission variability of air pollutants in Italy: heavy metals, PAHs, PM.•Useful methodology to appropriately design new air quality monitoring networks.•Study of emission variability of primary pollutants by means of GIS.•Preliminary assessment of spatial representativeness of air quality monitoring sites.
In recent years several European air pollution policies have been based on a cost-effectiveness approach. In the European Union, the European Commission starts using the multi-pollutant, multi-effect ...GAINS (Greenhouse Gas Air Pollution Interactions and Synergies) model to identify cost-effective National Emission Ceilings and specific emission control measures for each Member State to reach these targets. In this paper, we apply the GAINS methodology to the case of Italy with 20 subnational regions. We present regional results for different approaches to environmental target setting for PM2.5 pollution in the year 2030. We have obtained these results using optimization techniques consistent with those of GAINS-Europe, but at a higher resolution. Our results show that an overall health-impact oriented approach is more cost-effective than setting a nation-wide limit value on ambient air quality, such as the one set for the year 2030 by the European Directive on ambient air quality and cleaner air for Europe. The health-impact oriented approach implies additional emission control costs of 153 million €/yr on top of the baseline costs, compared to 322 million €/yr for attaining the nation-wide air quality limit. We provide insights into the distribution of costs and benefits for regions within Italy and identify the main beneficiaries of a health-impact approach over a limit-value approach.
•The GAINS cost-optimization methodology has been applied to the Italian territory.•Different environmental target setting approaches have been compared.•A regulatory approach focusing on health impacts rather than on air quality is more cost-effective.•Distribution of costs and benefits for the 20 Italian regions are presented.
This paper presents a comprehensive evaluation of AMS-MINNI modelling system for the year 2005, over Italian peninsula and major islands Sicily and Sardinia, for gas-phase species ozone (O3) and ...nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter less than or equal to 10 μm (PM10), against surface measurements from the Italian air quality database. Statistical indicators currently used in air quality models performance assessment and recommended by European Union (EU) guidelines were calculated at rural, urban and suburban background air quality monitoring stations, on purpose of understanding the model behaviour in areas not directly affected by anthropogenic pollution sources. Results show that measured O3 concentrations are generally well reproduced by the model, with the best agreement between model and observations at rural stations. Simulated PM10 annual average concentrations are generally lower than those observed but simulated and observed variabilities are comparable at urban and suburban stations. As for NO2, the model underestimates concentrations at all stations but gives similar variability to the observed one. Overall, the values of the statistical indicators comply with the acceptance criteria requested by EU legislation and are similar with those published by previous studies for the three pollutants investigated in this study. Further work will be carried out to evaluate the impact of uncertainties in input data (meteorology, emissions and boundary conditions) and in description of gaseous and aerosol chemical and physical processes on the simulated concentrations.
•First yearly air quality study over whole Italy using modeling and measurements.•3rd study verifying compliance of an air quality system with last AQ EU directive.•A multi-pollutant study based on an up-to-date model and coherent/consistent data.
The Italian Air Quality legislation underwent sweeping changes with the implementation of the 1996 European Air Quality Framework Directive when the Italian administrative Regions were entrusted with ...air quality management tasks. The most recent Regional Air Quality Management Plans (AQMPs) highlighted the importance of Non-Technical Measures (NTMs), in addition to Technical Measures (TMs), in meeting environmental targets. The aim of the present work is to compile a list of all the TMs and NTMs taken into account in the Italian Regional AQMPs and to give in the target year, 2010, an estimation of SO
2, NO
x and PM
10 emission reductions, of PM
10 concentration and of the health impact of PM
2.5 concentrations in terms of Life Expectancy Reduction. In order to do that, RAINS-Italy, as part of the National Integrated Modeling system for International Negotiation on atmospheric pollution (MINNI), has been applied. The management of TMs and NTMs inside RAINS have often obliged both the introduction of exogenous driving force scenarios and the control strategy modification. This has inspired a revision of the many NTM definitions and a clear choice of the definition adopted. It was finally highlighted that only few TMs and NTMs implemented in the AQMPs represent effective measures in reaching the environmental targets.
A large portion of the Italian population is exposed to high air pollution levels exceeding both European and WHO standards. To face this serious environmental risk, several efforts have been ...undertaken at policy-administration level in Italy and a national-regional cooperation act (the Po Basin Agreement, PBA) was adopted in 2013 in Northern Italy. The signatory parties agreed to identify and implement concerted actions contrasting air pollution, in addition to measures already in place. In this paper, a first evaluation of the identified measures has been carried out using the MINNI model, an integrated assessment model that allows the impact evaluation of emission variations. Assuming that PBA measures are applied in the whole Italian territory and focusing on residential heating, road transport and agriculture, the consequent impact on air quality was assessed for the scenario years 2020 and 2030. The Current Legislation scenario for the year 2030 shows that neither the national emission ceilings (NEC) nor the European air quality standards would be reached with the measures already in place and that additional actions are needed. The PBA 2030 scenario shows the attainment of the NEC targets, but non-compliance for daily PM10, daily maxima of 8 h running means of O3 and annual PM2.5 concentrations still remains.
•The integrated assessment model MINNI was applied to study the Po Basin Agreement measures for reducing air pollution.•The 2030 CLE scenario does not allow to reach neither the NEC emission ceilings nor the EU air quality standards.•The 2030 PBA scenario would allow the attainment of the NEC ceilings but not the attainment of the AQ standards.
To compare the diagnostic accuracy of stress computed tomography myocardial perfusion (CTP) for the detection of significant coronary artery disease with visual approach vs. quantitative analysis ...with transmural perfusion ratio (TPR) in consecutive symptomatic patients scheduled for invasive coronary angiography (ICA) plus invasive fractional flow reserve (FFR).
Eighty-eight consecutive symptomatic patients underwent rest coronary computed tomography angiography (cCTA) followed by static stress-CTP. Diagnostic accuracy of cCTA + stress-CTP with visual evaluation and with TPR measurement was calculated and compared with ICA and invasive FFR. Addition of stress-CTP with qualitative evaluation to rest-cCTA showed sensitivity, specificity, negative and positive predictive values, and accuracy at a vessel and patient level of 92%, 92%, 97%, 82%, 92% and 98%, 80%, 97%, 82%, 89%, respectively indicating a significant improvement of specificity, positive predictive value, and accuracy values vs. rest-cCTA in both models. Similarly, addition of stress-CTP with TPR evaluation to rest-cCTA showed sensitivity, specificity, negative and positive predictive values, and accuracy at a vessel and patient level of 84%, 90%, 93%, 76%, 88% and 91%, 71%, 89%, 75%, 81%, respectively indicating a significant improvement of specificity, positive predictive value values vs. rest-cCTA only in a vessel-based model and of positive predictive value in a patient-based model. When cCTA + stress-CTP with qualitative evaluation was compared with cCTA + stress-CTP with TPR estimation, no differences were found in terms of diagnostic performance.
The addition of stress-CTP with visual evaluation to cCTA imaging has similar diagnostic performance when compared with the quantitative analysis of myocardial perfusion based on TPR measurement.
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