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  • Andrea Ranzi1

  1. ARPA, Modena
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Ricerca bibliografica periodo dal 16 ottobre 2011 al 27 dicembre 2011

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Stringa: pollution[Title/Abstract] OR pollutant[Title/Abstract] OR pollutants[Title/Abstract] OR climate change[Title/Abstract] AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2011/10/15"[PDAT] : "2011/12/27"[PDAT])
1. Negrini AC, Negrini S, Giunta V, Quaglini S, Ciprandi G. Thirty-year survey on airborne pollen concentrations in Genoa, Italy: Relationship with sensitizations, meteorological data, and air pollution. Am J Rhinol Allergy. 2011 Nov-Dec;25(6):232-41.
Azienda Ospedaliera Universitaria San Martino, Genova, Italy.

Abstract
BACKGROUND: Pollen allergy represents a relevant health issue. Betulaceae sensitization significantly increased in Genoa, Italy, in the last decades. This study investigated possible relationships among pollen count, meteorological changes, air pollution, and sensitizations in this city during a 30-year period.
METHODS: Betulaceae, Urticaceae, Gramineae, and Oleaceae pollen counts were measured from 1981 to 2010 in Genoa. Sensitization to these pollens was also considered in large populations of allergic patients. Meteorological parameters and pollutants were also measured in the same area.
RESULTS: Betulaceae sensitization increased over time. All pollen species significantly increased over this time. Pollen season advanced for Betulaceae and Urticaceae. Only Urticaceae season significantly increased. Temperature increased while rainfall decreased over the time. Pollutants significantly decreased. There were some relationships between pollen changes and climatic and air pollution parameters.
CONCLUSION: This 30-year study conducted in an urbanized area provided evidence that Betulaceae sensitization significantly increased, pollen load significantly augmented, and climate and air pollution changed with a possible influence on pollen release.

2. Migliaretti G, Deltetto F, Delpiano EM, Bonino L, Berchialla P, Dalmasso P, Cavallo F, Camanni M. Spatial Analysis of the Distribution of Endometriosis in Northwestern Italy. Gynecol Obstet Invest. 2011 Nov 22. [Epub ahead of print]
Department of Public Health and Microbiology, Statistical Unit, University of Turin, Turin, Italy.

Abstract
Objective: The aim of this study is to estimate the incidence of endometriosis in a northwestern region of Italy. The potential sources of geographical variations in the incidence of endometriosis within the region are discussed. Methods: The patients selected were women between 18 and 45 years of age, born and residing in Piedmont who had undergone medical or surgical treatment for endometriosis between 2000 and 2005. The data were obtained from official hospital discharge records. Results: The number of women contributed to the study was 3,929. The age-standardized incidence rate of endometriosis was 81.8/100,000 patient-years (95% CI 79.1-84.2). The distribution of relative risks showed some areas with an increased rate of around 30% (southern and central Piedmont), while for other areas the disease risk was lower (southwestern Piedmont). These areas have greater exposure to environmental risk due to the presence of chemical pollutants. Conclusion: In order to achieve reliable data and good management of the disease, there is great need for national registers, as well as networks of excellence for the treatment of endometriosis. Our findings suggest that environmental factors may be associated with the development of the disease, but the observed results need to be cautiously interpreted in the context of ineligible biases.

3. Girardi P, Marcon A, Rava M, Pironi V, Ricci P, de Marco R. Spatial analysis of binary health indicators with local smoothing techniques The Viadana study. Sci Total Environ. 2011 Nov 17. [Epub ahead of print]
Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Italy.

Abstract
INTRODUCTION: When pollution data from a monitoring network is not available, mapping the spatial distribution of disease can be useful to identify populations at risk and to suggest a potential role for suspected emission sources. We aimed at obtaining a continuous spatial representation of the prevalence of symptoms that are potentially associated with the exposure to the pollutants emitted from the wood factories in the children who live in the district of Viadana (Northern Italy).
METHODS: In 2006, all the parents of the children aged 3-14years residing in the Viadana district (n=3854), filled in a questionnaire on respiratory symptoms, irritation symptoms of the eyes and skin, use of health services. The children's residential addresses were also collected and geocoded. Generalized additive models and local weighted regression (LOWESS) were used to estimate the distribution of the symptoms, to test for spatial trends of the symptoms' prevalence and to control for potential confounders. Permutation tests were used to identify the areas of significantly increased risk ("hot spots").
RESULTS: The prevalence of respiratory symptoms, eye symptoms and the use of health services showed a statistically significant spatial variation (p<0.05), but skin symptoms did not. Symptoms' prevalence was lower in the northern part of the district, where no wood factories were present, and it was higher in the southern part, where the two big chipboard industries were located. Hot spots were identified fairly near to one of the two chipboard industries in the district.
CONCLUSIONS: The north-to-south trend in the prevalence of respiratory and eye symptoms, but not of skin symptoms, as well as the location of hot spots, are consistent with the potential exposure to air pollutants both emitted by the wood factories and related to traffic. In these "high risk areas" monitoring of pollution and preventive actions are clearly needed.

4. Baccini M, Biggeri A, Grillo P, Consonni D, Bertazzi PA. Health impact assessment of fine particle pollution at the regional level. Am J Epidemiol. 2011 Dec 15;174(12):1396-405. Epub 2011 Nov 5.

Abstract
Since the year 2000, evaluation of the impact of air pollution on people's health has drawn the attention of the general public and has led decision-makers to develop specific health policies. In most of the health impact assessment literature, investigators have reported on long- and short-term effects of air pollution. Here the authors present results of a health impact assessment of short-term effects of particulate matter ≤10 μm in diameter (PM(10)) in the Lombardy region of Italy (2003-2006). The impact was evaluated in terms of numbers of attributable deaths under several counterfactual scenarios of air pollution reduction based on World Health Organization guidelines and European Union limits. The authors found that annual average PM(10) levels exceeding the World Health Organization threshold of 20 μg/m(3) and the European Union limit of 40 μg/m(3) were responsible for 302 and 109 attributable deaths per year, corresponding to attributable community rates of 13 and 5 deaths per 100,000 inhabitants per year, respectively. A 20% reduction in existing PM(10) levels could reduce by more than 30% the burden of short-term deaths linked to ambient air pollution. Therefore, policies for air pollution reduction appear to be necessary in order to protect and improve individual and community health.

Breve commento a cura di A. Ranzi
Le valutazioni di impatto sulla salute dell’inquinamento atmosferico sono un utile strumento per le valutazioni delle misure di mitigazione dell’inquinamento e una successiva valutazione di efficacia.
Viene qui presentato un modello di valutazione di impatto sanitario dell’inquinamento atmosferico, applicato a 13 aree della regione Lombardia. Nel presente lavoro la valutazione di impatto è applicata, oltre a 11 città con più di 50000 abitanti, anche 1 piccola città e un’area sovra urbana, complessivamente circa il 35% della popolazione dell’intera regione.
Un aspetto di sicuro interesse riguarda la metodologia utilizzata, e i risultati che vengono riportati come numero di casi attribuibili sotto diversi ipotetici scenari di mitigazione dell’inquinamento.

5. Rava M, Marcon A, Girardi P, Pironi V, Silocchi C, Ricci P, de Marco R. Proximity to wood factories and hospitalizations for respiratory diseases in children. Sci Total Environ. 2011 Dec 1;410-411:80-6. Epub 2011 Oct 20.
Unit of Epidemiology & Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy. marta.rava@inserm.fr

Abstract
BACKGROUND: Exposure to air pollutants emitted by wood industries has been associated with increased prevalence of respiratory and irritation symptoms.
OBJECTIVES: To study whether proximity to wood industries was associated with risk of hospitalization for respiratory diseases in children. METHODS: In December 2006, the large majority of the children (3-14 years) living in the Viadana district (Northern Italy) were surveyed through a parental questionnaire (n=3854). Hospital discharge records for respiratory diseases (2002-2006) were obtained from the local Health Unit. The children were geocoded and the distance from their home/school to the wood industries was used as exposure indicator. Poisson regression models were used to assess the association between the distance and hospitalizations.
RESULTS: The hospitalization rates for respiratory diseases increased with proximity to the wood industries: they were 7.55 (95% CI 5.58, 10.22) ×1000 person-year for those who lived far from any wood industry, 11.84 (95% CI 8.87, 15.81) ×1000 person-year for those <2km from the small wood factories and 16.61 (95% CI: 13.57, 20.33) ×1000 person-year for those living within 2km from the two big chipboard industries.
CONCLUSIONS: Proximity to wood industries is associated with a higher risk of hospitalization for respiratory diseases and respiratory symptoms in children. Studies with direct measures of exposure are needed and a follow-up of exposed population is advisable.

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 Nov;111(8):1321-7. Epub 2011 Jul 20.
SourceDepartment of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Via Giuseppe La Masa 19, 20154 Milano, Italy. elena.fattore@marionegri.it

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≤10 μm (PM10) and ≤2.5 μm (PM2.5) 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 PM2.5 as years of life lost. Considering short-term effects, PM2.5 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 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 Nov;111(8):1192-200. Epub 2011 Aug 3.
SourceRegional Agency for Environmental Protection of Emilia-Romagna, Regional Center for Environment and Health, Modena, Italy. ealessandrini@arpa.emr.it

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.

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