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  • Andrea Ranzi1

  1. ARPA, Modena
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Ricerca bibliografica periodo 2 giugno 2011 – 2 agosto 2011

Per leggere le caratteristiche di questa ROUTINE di ricerca clicca qui

Database: Pubmed/MEDline
Stringa:
((pollution OR pollutant* OR climate change) AND (Italy) AND (epidemiology OR health effects)
Criteri di esclusione degli articoli: Articoli su riviste italiane, Articoli su E&P, Editoriali e Review narrative

Di ogni articolo è disponibile l'abstract. Per visualizzarlo basta cliccare sul titolo.

1. Guerriero C, Bianchi F, Cairns J, Cori L.
Policies to clean up toxic industrial contaminated sites of Gela and Priolo: a cost-benefit analysis. . Environ Health. 2011 Jul 28;10(1):68.
Abstract
BACKGROUND: Cost-benefit analysis is a transparent tool to inform policy makers about the potential effect of regulatory interventions, nevertheless its use to evaluate clean-up interventions in polluted industrial sites is limited. The two industrial areas of Gela and Priolo in Italy were declared "at high risk of environmental crisis" in 1990. Since then little has been done to clean the polluted sites and reduce the health outcomes attributable to pollution exposure. This study, aims to quantify the monetary benefits resulting from clean-up interventions in the contaminated sites of Gela and Priolo.
METHODS: A damage function approach was used to estimate the number of health outcomes attributable to industrial pollution exposure. Extensive one way analyses and probabilistic analyses were conducted to investigate the sensitivity of results to different model assumptions.

RESULTS: It has been estimated that, on average, 47 cases of premature death, 281 cases of cancer and 2,702 cases of non-cancer hospital admission could be avoided each year by removing environmental exposure in these two areas. Assuming a 20 year cessation lag and a 4% discount rate we calculate that the potential monetary benefit of removing industrial pollution is E3,592 million in Priolo and E6,639 million in Gela.

CONCLUSIONS: Given the annual number of health outcomes attributable to pollution exposure the effective clean-up of Gela and Priolo should be prioritised. This study suggests that clean-up policies costing up to E6,639 million in Gela and E3,592 million in Priolo would be cost beneficial. These two amounts are notably higher than the funds allocated thus far to clean up the two sites, E127.4 million in Gela and E774.5 million in Priolo, implying that further economic investments - even considerable ones - could still prove cost beneficial.

Breve commento a cura di Andrea Ranzi
L’articolo di Guerriero et al., così come il successivo di questa selezione (Forastiere et al.) forniscono stime di impatto di situazioni reali o di scenari legate alla presenza di fattori di pressione ambientale sul territorio. Gli strumenti metodologici e le misure utilizzate sono differenti; il primo articolo fornisce stime economiche basate su dati epidemiologici per definire piani di bonifica in due siti inquinati, il secondo propone strumenti di valutazione di impatto sanitario relativo alla presenza di impianti di smaltimento dei rifiuti. Mi sembra però abbiano in comune la volontà di fornire ai decisori (e più in generali ai diversi stakeholder) informazioni utili per la scelta delle politiche da adottare nella pianificazione territoriale. La quantificazione degli impatti è un processo sicuramente complesso e multidisciplinare, ma assolutamente necessario e attuale per le richieste che vengono fatte agli epidemiologi. Le definizioni di politiche energetiche, di gestione dei rifiuti, dei trasporti o altro non sono mai “neutre”, a impatto zero; proprio per questo uno o più strumenti di quantificazione dei differenti impatti che può avere una scelta piuttosto che un'altra, un piano di bonifica, l’insediamento o meno di nuovi impianti di smaltimento rifiuti, può essere di grande aiuto nelle scelte.

2. Forastiere F, Badaloni C, de Hoogh K, von Kraus MK, Martuzzi M, Mitis F, Palkovicova L, Porta D, Preiss P, Ranzi A, Perucci CA, Briggs D.
Health impact assessment of waste management facilities in three European countries.
Environ Health. 2011 Jun 2;10:53.
Department of Epidemiology, Regional Health Service, Lazio, Via Santa Costanza 53, 00198, Rome, Italy. forastiere@asplazio.it.

Abstract
BACKGROUND: Policies on waste disposal in Europe are heterogeneous and rapidly changing, with potential health implications that are largely unknown. We conducted a health impact assessment of landfilling and incineration in three European countries: Italy, Slovakia and England.
METHODS: A total of 49 (Italy), 2 (Slovakia), and 11 (England) incinerators were operating in 2001 while for landfills the figures were 619, 121 and 232, respectively. The study population consisted of residents living within 3 km of an incinerator and 2 km of a landfill. Excess risk estimates from epidemiological studies were used, combined with air pollution dispersion modelling for particulate matter (PM10) and nitrogen dioxide (NO2). For incinerators, we estimated attributable cancer incidence and years of life lost (YoLL), while for landfills we estimated attributable cases of congenital anomalies and low birth weight infants.
RESULTS: About 1,000,000, 16,000, and 1,200,000 subjects lived close to incinerators in Italy, Slovakia and England, respectively. The additional contribution to NO2 levels within a 3 km radius was 0.23, 0.15, and 0.14 μg/m3, respectively. Lower values were found for PM10. Assuming that the incinerators continue to operate until 2020, we are moderately confident that the annual number of cancer cases due to exposure in 2001-2020 will reach 11, 0, and 7 in 2020 and then decline to 0 in the three countries in 2050. We are moderately confident that by 2050, the attributable impact on the 2001 cohort of residents will be 3,621 (Italy), 37 (Slovakia) and 3,966 (England) YoLL. The total exposed population to landfills was 1,350,000, 329,000, and 1,425,000 subjects, respectively. We are moderately confident that the annual additional cases of congenital anomalies up to 2030 will be approximately 2, 2, and 3 whereas there will be 42, 13, and 59 additional low-birth weight newborns, respectively. CONCLUSIONS: The current health impacts of landfilling and incineration can be characterized as moderate when compared to other sources of environmental pollution, e.g. traffic or industrial emissions, that have an impact on public health. There are several uncertainties and critical assumptions in the assessment model, but it provides insight into the relative health impact attributable to waste management.

3. Nuvolone D, Balzi D, Chini M, Scala D, Giovannini F, Barchielli A. Short-term association between ambient air pollution and risk of hospitalization for acute myocardial infarction: results of the cardiovascular risk and air pollution in Tuscany (RISCAT) study.

Am J Epidemiol. 2011 Jul 1;174(1):63-71.
Abstract
Air pollutant levels have been widely associated with increased hospitalizations and mortality from cardiovascular disease. In this study, the authors focused on pollutant levels and triggering of acute myocardial infarction (AMI). Data on AMI hospitalizations, air quality, and meteorologic conditions were collected in 6 urban areas of Tuscany (central Italy) during 2002-2005. Levels of particulate matter with an aerodynamic diameter ≤10 μm (PM(10)) (range of 4-year mean values, 28.15-40.68 μg/m(3)), nitrogen dioxide (range, 28.52-39.72 μg/m(3)), and carbon monoxide (range, 0.86-1.28 mg/m(3)) were considered, and increases of 10 μg/m(3) (0.1 mg/m(3) for carbon monoxide) were analyzed. A time-stratified case-crossover approach was applied. Area-specific conditional regression models were fitted, adjusting for time-dependent variables. Stratified analyses and analyses in bipollutant models were performed. Pooled estimates were derived from random-effects meta-analyses. Among 11,450 AMI hospitalizations, the meta-analytical odds ratio at lag(2) (2-day lag) was 1.013 (95% confidence interval (CI): 1.000, 1.026) for PM(10), 1.022 (95% CI: 1.004, 1.041) for nitrogen dioxide, and 1.007 (95% CI: 1.002, 1.013) for carbon monoxide. More susceptible subgroups were elderly persons (age ≥75 years), females, and older patients with hypertension and chronic obstructive pulmonary disease. This study adds to evidence for a short-term association between air pollutants and AMI onset, also evident at low pollutant levels, suggesting a need to focus on more vulnerable subjects.
4. Mallone S, Stafoggia M, Faustini A, Gobbi GP, Marconi A, Forastiere F.
Saharan Dust and Associations between Particulate Matter and Daily Mortality in Rome, Italy.
Environ Health Perspect. 2011 Jun 17.

Abstract
BACKGROUND: Outbreaks of Saharan-Sahel dust over Euro-Mediterranean areas frequently induce exceedances of the 50µg/m3- EU 24h standard for PM10. Objectives: We evaluated the effect of Saharan dust on the association between different particulate matter fractions and daily mortality in Rome, Italy.
METHODS: 80,423 adult residents who died in Rome between 2001-2004 were studied. We performed a time-series analysis to explore the effects of PM2.5, PM2.5-10, PM10 on natural, cardiac, cerebrovascular and respiratory mortality. We defined Saharan dust days by combining Lidar observations and analyses from operational models. We tested a Saharan dust-PM interaction term to evaluate the hypothesis that PM effect, especially coarse, on mortality would be enhanced on dust days.
RESULTS: Interquartile range (IQR) increases in PM2.5-10 (10.8 μg/m3) and PM10 (19.8 μg/m3) were associated with increased mortality due to natural, cardiac, cerebrovascular, and respiratory causes, with estimated effects ranging from 2.64% up to 12.65% [95% confidence interval (CI) 1.18, 25.42] for the association between PM2.5-10 and respiratory mortality (0-5 day lag). Associations of PM2.5-10 with cardiac mortality were stronger on Saharan dust days (9.73%, 95% CI 4.25, 15.49) than on dust free days (0.86%, 95% CI -2.47, 4.31, p = 0.005). Sarahan dust days also modified associations between PM10 and cardiac mortality (9.55% increase, 95% CI 3.81, 15.61 compared to 2.09%, 95% CI -0.76, 5.02 on dust free days, p = 0.02).
CONCLUSION: We found evidence of effect of PM2.5-10 and PM10 on natural and cause-specific mortality, with stronger estimated effects on cardiac mortality during Saharan dust outbreaks. Toxicological and biological effects of particles from desert sources need to be further investigated and taken into account in air quality standards.

5. Alessandrini E, Zauli Sajani S, Scotto F, Miglio R, Marchesi S, Lauriola P.
Emergency ambulance dispatches and apparent temperature: A time series analysis in Emilia-Romagna, Italy.
Environ Res. 2011 Aug 2.
Regional Agency for Environmental Protection of Emilia-Romagna, Regional Center for Environment and Health, Modena, Italy; University of Bologna, Department of Statistics, Bologna, Italy.

Abstract
INTRODUCTION: Increases in mortality associated with oppressive weather have been widely investigated in several epidemiological studies. However, to properly understand the full public health significance of heat-related health effects, as well as to develop an effective surveillance system, it is also important to investigate the impact of stressful meteorological conditions on non-fatal events. The objective of our study was to evaluate the exposure-response relationship of ambulance dispatch data in association with biometeorological conditions using time series techniques similar to those used in previous studies on mortality.
METHODS: Daily data of emergency ambulance dispatches for people aged 35 or older in the summer periods from 2002 to 2006 were collected for the major towns in the Emilia-Romagna region. In the first stage of the analysis, the city-specific relationship between daily ambulance dispatches and increasing apparent temperature was explored using Generalized Additive Models while controlling for air pollution, seasonality, long-term trend, holidays and weekends. The relationship between ambulance dispatches and apparent temperature was approximated by linear splines. The effects of high temperatures on health were evaluated for respiratory and cardiovascular diseases as well as for all non-traumatic conditions. In the second stage of the analysis, city-specific effects were combined in fixed or random effect meta-analyses.

RESULTS: The percent change in the ambulance dispatches associated with every 1°C increase in the mean apparent temperature between 25 and 30°C was 1.45% (95% confidence interval: 0.95, 1.95) for non-traumatic diseases and 2.74% (95% CI: 1.34, 4.14) for respiratory diseases. The percent increase in risk was greater on days in which the mean apparent temperature exceeded 30°C (8.85%, 95% CI: 7.12, 10.58 for non-traumatic diseases). In this interval of biometeorological conditions, cardiovascular diseases became positively associated with the apparent temperature. The risks increased with age. The increase in risk for the non-traumatic diseases reached 13.34% for people aged 75 or older compared to 4.75% for those aged 35-64.

CONCLUSION: Time series analysis techniques were adopted for the first time to investigate emergency ambulance dispatches to evaluate the risks associated with biometeorological discomfort. Our findings show a strong relationship between biometeorological conditions and ambulance dispatches.

6. Fattore E, Paiano V, Borgini A, Tittarelli A, Bertoldi M, Crosignani P, Fanelli R. Human health risk in relation to air quality in two municipalities in an industrialized area of Northern Italy.
Environ Res. 2011 Jul 15.
Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Via Giuseppe La Masa 19, 20154 Milano, Italy.

Abstract
Air quality is one of the major environmental issues related to human health, and people and authorities are increasingly aware and concerned about it, asking to be involved in decisions whose fallout can have consequences on their health. The objectives of the present study were to provide quantitative data on the impact of air pollution on the health of people living in two small municipalities in a highly industrialized, densely populated area of Northern Italy. We applied the approach proposed by the World Health Organization (WHO) using the AirQ 2.2.3 software developed by the WHO European Centre for Environment and Health, Bilthoven Division. Daily concentrations of ozone, nitrogen dioxide, and particulate matter of aerodynamic diameter ≤10μm (PM(10)) and ≤2.5μm (PM(2.5)) were used to assess human exposure and health effects in terms of attributable proportion of the health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases. Long-term effects were estimated for PM(2.5) as years of life lost. Considering short-term effects, PM(2.5) had the highest health impact on the 24,000 inhabitants of the two small towns, causing an excess of total mortality of 8 out of 177 in a year. Ozone and nitrogen dioxide each caused about three excess cases of total mortality. Results on long-term effects showed, respectively, 433, 180, and 72 years of life lost for mortality for all causes, cardiopulmonary diseases and lung cancer, in a year. These results are consistent with other reports of the impact of air quality on human health and the AirQ software seems an effective and easy tool, helpful in decision-making.

7 Bastonini E, Verdone L, Morrone S, Santoni A, Settimo G, Marsili G, La Fortezza M, Di Mauro E, Caserta M. Transcriptional modulation of a human monocytic cell line exposed to PM(10) from an urban area.
Environ Res. 2011 Aug;111(6):765-74. Epub 2011 Jul 8.
Dipartimento di Biologia e Biotecnologie "Charles Darwin", Sapienza University of Rome, 00185 Rome, Italy.

Abstract
Insight into the mechanisms by which ambient air particulate matter mediates adverse health effects is needed to provide biological plausibility to epidemiological studies demonstrating an association between PM(10) exposure and increased morbidity and mortality. In vitro studies of the effects of air pollution on human cells help to establish conditions for the analysis of cause-effect relationships. One of the major challenges is to test native atmosphere in its complexity, rather than the various components individually. We have developed an in vitro system in which human monocyte-macrophage U937 cells are directly exposed to filters containing different amounts of PM(10) collected in the city of Rome. Transcriptional profiling obtained after short exposure (1h) of cells to a filter containing 1666μg PM(10) (77.6μg/cm(2)) using a macroarray panel of 1176 genes reveals a significant change in the mRNA level (>2 fold) for 87 genes relative to cells exposed to a control filter. Overall, 9 out of 87 modulated genes were annotated as "lung cancer". qRT-PCR confirmed the induction of relevant genes involved in DNA repair and apoptosis, specifically: ERCC1, TDG,DAD1 and MCL1. In cells exposed for 10min, 1h and 3h to different amounts of
PM(10), transcription of TNFα and TRAP1, which code for a key pro-inflammatory cytokine and a mitochondrial protein involved in cell protection from oxidative stress, respectively, was shown to be modulated in a time-dependent, but not a dose-dependent manner. Taken together, these data indicate that it is possible to analyze the effects of untreated particulate matter on human cells by the direct-exposure approach we have developed, possibly providing new clues to traffic-related health hazard.

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