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  • Andrea Ranzi1

  1. Arpa, Modena

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Ricerca bibliografica periodo dal 1 novembre 2012 al 15 gennaio 2013

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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 ("2012/11/01"[PDAT] : "2013/01/15"[PDAT])
1. Gianicolo EA, Bruni A, Mangia C, Cervino M, Vigotti MA. Acute effects of urban and industrial pollution in a government-designated "Environmental risk area": the case of Brindisi, Italy. Int J Environ Health Res. 2013 Jan 15. [Epub ahead of print]
National Research Council, Institute of Clinical Physiology , Monteroni , Italy.

Abstract
Exposure to air pollutants has been associated with increased hospital admissions (HAs) for respiratory and cardiovascular diseases. This work describes a short-term epidemiological study in Brindisi, a highly industrialized town in Southern Italy. The effects of daily exposure to PM(10) and NO(2) on daily HAs for cardiac, respiratory, and cerebrovascular diseases were investigated by means of a case-crossover design in the period 2001-2007. Results showed positive associations between PM(10) and HAs for cardiac and respiratory diseases and between NO(2) and HAs for all the categories of diseases considered, particularly among females. Although not statistically significant, increased risk was observed for wind blowing from the port and the industrial area. Findings confirm the health risks associated with ambient air pollution exposure, even though NO(2) and PM(10) concentrations were below the legal limits. This may be due to the complex scenario of emissions in the area, which should be better investigated.

Breve commento a cura di Andrea Ranzi
Interessante articolo sugli effetti a breve termine dell’inquinamento sulle patologie cardiache, respiratorie e cerebrovascolari, con un approfondimento sull’effetto della direzione del vento. L’analisi ristretta ai giorni in cui la direzione del vento era tale da interessare la città dell’inquinamento proveniente dalla zona industriale e dal porto, il rischio aumenta, anche se il termine di interazione non raggiunge livelli significativi. L’effetto di trasporto dell’inquinamento dovuto a particolari condizioni meteorologiche è rilevante in città portuali come Brindisi, dove l’intensità e direzione del vento sono rilevanti e possono cambiare la composizione percentuale delle sorgenti del particolato (traffico, industria, riscaldamento,...). Questo aspetto (unito alla considerazione già riscontrata altrove della presenza di associazioni anche per livelli di inquinamento al di sotto dei limiti di legge) induce gli autori a suggerire la sempre più necessaria introduzione di informazioni sulle componenti del particolato negli studi di associazione fra inquinamento e salute.

2. Cesaroni G, Badaloni C, Gariazzo C, Stafoggia M, Sozzi R, Davoli M, Forastiere F. Long-Term Exposure to Urban Air Pollution and Mortality in a Cohort of More than A Million Adults in Rome. Environ Health Perspect. 2013 Jan 8. [Epub ahead of print]
Department of Epidemiology, Lazio Regional Health Service, Rome, Italy.

Abstract
BACKGROUND: Few European studies have investigated the effects of long-term exposure to both fine particulate matter (PM2.5) and nitrogen dioxide (NO2) on mortality. OBJECTIVES: To analyze the association of exposure to NO2, PM2.5 and traffic indicators on cause-specific mortality; to evaluate the form of the concentration-response relationship. METHODS: We analyzed a population-based cohort enrolled at 2001 Census with 9 years of follow-up. We selected all 1,265,058 subjects, aged ≥ 30 years, who had been living in Rome for at least 5 years at baseline. Residential exposures included annual NO2 (from a land use regression model), annual PM2.5 (from a Eulerian dispersion model), traffic intensity and distance to roads with >10,000 vehicles/day. We used Cox regression models to estimate associations with cause-specific mortality adjusted for individual (sex, age, place of birth, residential history, marital status, education, occupation) and area (socioeconomic status, clustering) characteristics. RESULTS: Long-term exposures to both NO2 and PM2.5 were associated with an increase in non-accidental mortality (Hazard Ratio, HR=1.03; 95% CI: 1.02, 1.03 per 10 µg/m3NO2; HR = 1.04; 95% CI: 1.03, 1.05 per 10 µg/m3 PM2.5). The strongest association was found for ischemic heart diseases (IHD, HR = 1.10; 95% CI: 1.06, 1.13 per 10 µg/m3 PM2.5), followed by cardiovascular diseases and lung cancer. The only association showing some deviation from linearity was that between NO2 and IHD. In a bi-pollutant model, the estimated effect of NO2 on mortality was independent of PM2.5. CONCLUSIONS: This large study strongly supports an effect of long-term exposure to NO2 and PM2.5 on mortality, especially from cardiovascular causes. The results are relevant for the next European policy decisions regarding air quality.

Breve commento a cura di Andrea Ranzi
La Commissione europea (CE) ha dichiarato il 2013 "Year of Air", per sottolineare ancora di più l'importanza di azioni atte a migliorare la qualità dell'aria in tutta l'UE. A partire dall’anno passato, la Commissione europea, in collaborazione con l'Organizzazione Mondiale della Sanità (OMS) - Ufficio Regionale Europeo, ha formato un panel di esperti che sta rivedendo la letteratura più recente riguardo le associazioni fra esiti di salute e esposizione ai principali inquinanti atmosferici (particolato, l'ozono troposferico, biossidi di azoto): obiettivo del gruppo di lavoro la revisione dei limiti per gli inquinanti atmosferici. Questo articolo offre sicuramente un contributo italiano importante alla discussione in atto; le dimensioni dello studio (più di 1.200.000 adulti sopra i 30 anni, è il più grande studio europeo di coorte che analizza gli effetti sia dell’NO2 che del PM2.5) lo pongono all’attenzione della comunità internazionale, con risultati che si pongono in linea con quanto già osservato in altri studi europei e americani. Le patologie cardiovascolari sembrano dare i risultati più consistenti nell’associazione fra mortalità e esposizione cronica ad inquinamento atmosferico.

3. Cordioli M, Vincenzi S, De Leo GA. Effects of heat recovery for district heating on waste incineration health impact: A simulation study in Northern Italy. Sci Total Environ. 2012 Dec 29;444C:369-380. doi: 10.1016/j.scitotenv.2012.11.079. [Epub ahead of print]
Department of Environmental Sciences, University of Parma, Parco Area delle Scienze 33/A, I-43100 Parma, Italy. Electronic address: mik.cordioli@gmail.com.

Abstract
The construction of waste incinerators in populated areas always causes substantial public concern. Since the heat from waste combustion can be recovered to power district heating networks and allows for the switch-off of domestic boilers in urbanized areas, predictive models for health assessment should also take into account the potential benefits of abating an important source of diffuse emission. In this work, we simulated the dispersion of atmospheric pollutants from a waste incinerator under construction in Parma (Italy) into different environmental compartments and estimated the potential health effect of both criteria- (PM(10)) and micro-pollutants (PCDD/F, PAH, Cd, Hg). We analyzed two emission scenarios, one considering only the new incinerator, and the other accounting for the potential decrease in pollutant concentrations due to the activation of a district heating network. We estimated the effect of uncertainty in parameter estimation on health risk through Monte Carlo simulations. In addition, we analyzed the robustness of health risk to alternative assumptions on: a) the geographical origins of the potentially contaminated food, and b) the dietary habits of the exposed population. Our analysis showed that under the specific set of assumptions and emission scenarios explored in the present work: (i) the proposed waste incinerator plant appears to cause negligible harm to the resident population; (ii) despite the net increase in PM(10) mass balance, ground-level concentration of fine particulate matter may be curbed by the activation of an extensive district heating system powered through waste combustion heat recovery and the concurrent switch-off of domestic/industrial heating boilers. In addition, our study showed that the health risk caused by waste incineration emissions is sensitive to assumptions about the typical diet of the resident population, and the geographical origins of food production.

Breve commento a cura di Andrea Ranzi
Esempio di valutazione del rischio sanitario ante-operam, applicato al futuro (oggi quasi presente) inceneritore di Parma. L’approccio utilizzato è duplice: di tipo tossicologico per i microinquinanti (diossine, IPA Cd e Hg) e di tipo epidemiologico (rischio attribuibile) per il PM10 emesso dall'impianto. Per quest'ultimo inquinante sono valutati diversi scenari, compreso quello legato alla possibilità di riduzione delle emissioni da caldaie domestiche nell'area urbana legato alla creazione di una rete di teleriscaldamento. Le cronache recenti pongono sempre di più la questione del confronto (e utilizzo in parallelo) tra l’approccio tossicologico ed epidemiologico nella valutazione degli impatti sulla salute di sorgenti puntuali di inquinamento, quali gli inceneritori.

4. Faustini A, Stafoggia M, Colais P, Berti G, Bisanti L, Cadum E, Cernigliaro A, Mallone S, Scarnato C, Forastiere F; on behalf of the EPIAIR collaborative Group. Air pollution and multiple acute respiratory outcomes. Eur Respir J. 2013 Jan 11. [Epub ahead of print]
Regional Health Service, Lazio Region, Rome, Italy.

Abstract
Short-term effects of air pollutants on respiratory mortality and morbidity have been consistently reported but usually studied separately.To more completely assess air pollution effects, we studied hospitalisations for respiratory diseases together with out-of hospital respiratory deaths.A "time-stratified" case-crossover study was carried out in six Italian cities from 2001-2005. Associations between daily particulate matter (PM10) and nitrogen dioxide (NO2) and hospitalisations for respiratory diseases (n. 100,690), chronic obstructive pulmonary disease (COPD) (n. 38,577), lower respiratory tract infections (LRTI) among COPD patients (n. 9,886) and out-of-hospital respiratory deaths (n 5,490) were estimated for 35+year-old residents.For 10 μg•m(-3) PM10, we found an immediate 0.59% (lag 0-1) increase in hospitalisations for respiratory diseases and a 0.67% increase for COPD; the 1.91% increase in LRTI hospitalisations lasted longer (lag 0-3) and the 3.95% increase in respiratory mortality lasted six days. Effects of NO2 were stronger and lasted longer (lag 0-5). Age, gender, and previous ischemic heart disease acted as effect modifiers for different outcomes.Analysing multiple more than single respiratory events shows stronger air pollution effects. The temporal relationship between the pollutants' increases and hospitalizations or mortality for respiratory diseases differs.

5.Sario MD, Katsoujanni K, Michelozzi P. Climate change, extreme weather events, air pollution and respiratory health in Europe. Eur Respir J. 2013 Jan 11. [Epub ahead of print]
Lazio Regional Health Service, Roma, Italy.

Abstract
Due to climate change, air pollution patterns are changing in several urbanized areas of the world, with a significant effect on respiratory health both independently and synergistically with weather conditions; climate scenarios show Europe as one of the most vulnerable regions. European studies on heat wave episodes have consistently shown a synergistic effect of air pollution and high temperatures, while the potential weather-air pollution interaction during wildfires and dust storms is unknown. Allergens patterns are also changing in response to climate change and air pollution can modify the allergenic potential of pollens especially in presence of specific weather conditions. The underlying mechanisms of all these interactions are not well known; the health consequences vary from decreases in lung function to allergic diseases, new onset of diseases, exacerbation of chronic respiratory diseases, and premature death. These multidimensional climate-pollution-allergen effects need to be taken into account in estimating both climate and air pollution-related respiratory effects in order to set up adequate policy and public health actions to face both the current and future climate and pollution challenges.

6. Vandini S, Corvaglia L, Alessandroni R, Aquilano G, Marsico C, Spinelli M, Lanari M, Faldella G. Respiratory syncytial virus infection in infants and correlation with meteorological factors and air pollutants. Ital J Pediatr. 2013 Jan 11;39(1):1. [Epub ahead of print]

Abstract
ABSTRACT: BACKGROUND: Respiratory Syncytial Virus (RSV) is the most important cause of severe respiratory infections in infants with seasonal epidemics. Environmental factors (temperature, humidity, air pollution) could influence RSV epidemics through their effects on virus activity and diffusion. METHODS: We conducted a retrospective study on a paediatric population who referred to our Paediatric Emergency Unit in order to analyze the correlation between weekly incidence of RSV positive cases during winter season in Bologna and meteorological factors and air pollutants concentration. RESULTS: We observed a significant correlation between the incidence of RSV infections and the mean minimum temperature registered during the same week and the previous weeks.The weekly number of RSV positive cases was also correlated to the mean PM10 concentration of the week before. CONCLUSIONS: RSV epidemic trend in Bologna (Italy) is related to the mean minimum temperature, and the mean PM10 concentration.

7. Migliaretti G, Berchialla P. Observational approaches in the study of the effects of Total Suspended Particulates (TSP) exposure. Int J Environ Health Res. 2012 Nov 23. [Epub ahead of print]
Department of Public Health and Microbiology , University of Turin , Turin , Italy.

Abstract
Literature contains mainly reports of observations based on time-series, or those of a case-crossover analysis design or, although less frequently, case control studies. However, data obtained by different approaches are difficult to compare based on different and non-homogenous population. The principal aim of this research was to compare the estimated risks obtained by differing approaches based on the same population study in the period 2006-2009. The data were based on a total of 44,200 residents in the city of Turin, hospitalised for respiratory diseases (ICD 460-519) in the period 2006-2009. Total suspended particulates (TSP), measured in µg/m(3), are the most commonly used predictors of urban pollution. The association between hospital admission for respiratory diseases and TSP exposure was investigated using at the same time the time-series, case-crossover and case-control approaches. The analyses show a general comparability of the case-crossover design stratified for time and the time-series approach, and the case control approach provided a more unstable estimation of risks. In conclusion, our results seem to indicate that the different approaches studied seem to offer comparable results.

8. Morabito M, Crisci A, Moriondo M, Profili F, Francesconi P, Trombi G, Bindi M, Gensini GF, Orlandini S. Air temperature-related human health outcomes: current impact and estimations of future risks in Central Italy. Sci Total Environ. 2012 Dec 15;441:28-40. doi: 10.1016/j.scitotenv.2012.09.056. Epub 2012 Nov 4.
Interdepartmental Centre of Bioclimatology, University of Florence, Piazzale delle Cascine 18, 50144 Florence, Italy. marco.morabito@unifi.it

Abstract
The association between air temperature and human health is described in detail in a large amount of literature. However, scientific publications estimating how climate change will affect the population's health are much less extensive. In this study current evaluations and future predictions of the impact of temperature on human health in different geographical areas have been carried out. Non-accidental mortality and hospitalizations, and daily average air temperatures have been obtained for the 1999-2008 period for the ten main cities in Tuscany (Central Italy). High-resolution city-specific climatologic A1B scenarios centered on 2020 and 2040 have been assessed. Generalized additive and distributed lag models have been used to identify the relationships between temperature and health outcomes stratified by age: general adults (<65), elderly (aged 65-74) and very elderly (≥75). The cumulative impact (over a lag-period of 30 days) of the effects of cold and especially heat, was mainly significant for mortality in the very elderly, with a higher impact on coastal plain than inland cities: 1 °C decrease/increase in temperature below/above the threshold was associated with a 2.27% (95% CI: 0.17-4.93) and 15.97% (95% CI: 7.43-24.51) change in mortality respectively in the coastal plain cities. A slight unexpected increase in short-term cold-related mortality in the very elderly, with respect to the baseline period, is predicted for the following years in half of the cities considered. Most cities also showed an extensive predicted increase in short-term heat-related mortality and a general increase in the annual temperature-related elderly mortality rate. These findings should encourage efforts to implement adaptation actions conducive to policy-making decisions, especially for planning short- and long-term health intervention strategies and mitigation aimed at preventing and minimizing the consequences of climate change on human health.

9. Faustini A, Stafoggia M, Cappai G, Forastiere F. Short-term effects of air pollution in a cohort of patients with chronic obstructive pulmonary disease. Epidemiology. 2012 Nov;23(6):861-79. doi: 10.1097/EDE.0b013e31826767c2.
Department of Epidemiology, Regional Health Service of Lazio, Rome, Italy. a.faustini@deplazio.it

Abstract
BACKGROUND: Although damage to the respiratory system from air pollutants has been recognized, research on susceptibility to air pollution in patients with chronic obstructive respiratory disease (COPD) has produced contradictory results. We studied the short-term effects of particulate matter (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3) on cardiac and respiratory mortality in a COPD cohort. We assessed age, sex, and previous diseases as effect modifiers. METHODS: Using hospital data (1998-2009) and pharmaceutical data (2005-2009), we enrolled 145,681 COPD subjects, aged 35+ years and residents of Rome, and followed them from 2005 to 2009. A comparison group of people without COPD (1,710,557 subjects) was also studied. We analyzed deaths due to all natural causes (International Classification of Diseases - Ninth Revision codes 1-799). Statistical analyses were carried out using Poisson regression and a case-crossover approach. RESULTS: PM10, PM2.5, and NO2 (0- to 5-day lag) were associated with daily mortality, with stronger effects in people with COPD. The mortality associated with PM10 (per interquartile range [IQR] = 16 μg/m) was five times more in COPD patients (3.5% [95% confidence interval = -0.1% to 7.2%]) than in other subjects (0.7% [-0.8% to 2.2%]). Effects on respiratory mortality among COPD subjects were particularly elevated from PM2.5 (IQR = 11 μg/m) (11.6% [2.0% to 22.2%]) and NO2 (IQR = 24 μg/m) (19.6% [3.5% to 38.2%]). Older age, male sex, preexisting heart conduction disorders, and cerebrovascular diseases were associated with stronger effects in COPD subjects. CONCLUSIONS: COPD patients are more susceptible to air pollutants, especially PM10 and NO2. These results suggest a need for more protective air pollution standards for susceptible groups.

10. De Feo G, De Gisi S, Williams ID. Public perception of odour and environmental pollution attributed to MSW treatment and disposal facilities: A case study. Waste Manag 2013 Jan 12. pii: S0956-053X(12)00581-8. doi: 10.1016/j.wasman.2012.12.016. [Epub ahead of print]
Department of Industrial Engineering, University of Salerno, via Ponte don Melillo 1, 84084 Fisciano (SA), Italy. Electronic address: g.defeo@unisa.it.

Abstract
If residents' perceptions, concerns and attitudes towards waste management facilities are either not well understood or underestimated, people can produce strong opposition that may include protest demonstrations and violent conflicts such as those experienced in the Campania Region of Italy. The aim of this study was to verify the effects of the closure of solid waste treatment and disposal facilities (two landfills and one RDF production plant) on public perception of odour and environmental pollution. The study took place in four villages in Southern Italy. Identical questionnaires were administered to residents during 2003 and after the closure of the facilities occurred in 2008. The residents' perception of odour nuisance considerably diminished between 2003 and 2009 for the nearest villages, with odour perception showing an association with distance from the facilities. Post closure, residents had difficulty in identifying the type of smell due to the decrease in odour level. During both surveys, older residents reported most concern about the potentially adverse health impacts of long-term exposure to odours from MSW facilities. However, although awareness of MSW facilities and concern about potentially adverse health impacts varied according to the characteristics of residents in 2003, substantial media coverage produced an equalisation effect and increased knowledge about the type of facilities and how they operated. It is possible that residents of the village nearest to the facilities reported lower awareness of and concern about odour and environmental pollution because the municipality received economic compensation for their presence.

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