ENEA, National Agency for New technologies, Energy and Sustainable Economic Development, Health Protection Technology Division, Rome, Italy.
ENEA, National Agency for New technologies, Energy and Sustainable Economic Development, Laboratory of Atmospheric Pollution, Bologna, Italy.
Eur J Public Health. 2019 Oct 1;29(5):871-876. doi: 10.1093/eurpub/cky210.
In 2014, the European Environment Agency estimated 59 630 premature deaths in Italy attributable to long-term exposure to PM2.5, 17 290 to NO2 and 2900 to O3. The aim of this study was to test an approach for assessing health impact of the above pollutants analyzing possible associations between annual municipal concentrations, estimated by the national dispersion model developed by ENEA, and mortality rates for trachea, bronchus and lung (TBL) cancer, total respiratory diseases (RD) and chronic obstructive pulmonary diseases (COPD). Tuscany was selected as test case.
For the 287 municipalities, 2009-13 standardized mortality rates (SMRates) for each cause of death were calculated by the ENEA epidemiological database. The SMRates of municipalities, aggregated on the basis of the 2003 or 2010 estimated pollutant concentration tertiles, were also computed.
TBL cancer SMRate in municipalities with 2003 PM2.5 levels >15.2 μg/m3 was significantly higher than the SMRates of the two lowest tertiles and COPD SMRates in the two highest O3 tertiles were significantly higher than that of the lower tertile. No association between PM2.5 or NO2 concentrations and RD and COPD was detected. Approximately 625 TBL cancer deaths attributable to PM2.5 levels above 10 μg/m3 in 2003 were estimated in the region. Smoking habits and deprivation index were homogeneously distributed among municipalities.
This methodological approach allowed detecting associations between mortality and specific air pollutants even at levels below the Italian normative limits and could be employed to evaluate the potential health impact of air pollution in areas where direct measures of concentration are unavailable.
2014 年，欧洲环境署估计，意大利有 59630 人因长期接触 PM2.5、17290 人因接触 NO2 和 2900 人因接触 O3 而过早死亡。本研究旨在测试一种评估上述污染物对健康影响的方法，分析国家分散模型（由 ENEA 开发）估算的年度市浓度与气管、支气管和肺（TBL）癌、总呼吸道疾病（RD）和慢性阻塞性肺疾病（COPD）死亡率之间的可能关联。托斯卡纳被选为测试案例。
对于 287 个城市，每个死因的 2009-13 年标准化死亡率（SMRates）由 ENEA 流行病学数据库计算。还计算了按 2003 年或 2010 年估计的污染物浓度三分位数对城市进行聚合的 SMRates。
PM2.5 水平>15.2μg/m3 的城市的 TBL 癌症 SMRate 明显高于两个最低三分位数的 SMRates，两个最高 O3 三分位数的 COPD SMRates 明显高于较低三分位数的 SMRates。未发现 PM2.5 或 NO2 浓度与 RD 和 COPD 之间存在关联。在该地区，估计有 625 例 TBL 癌症死亡归因于 2003 年 PM2.5 水平高于 10μg/m3。吸烟习惯和贫困指数在城市之间均匀分布。
即使在低于意大利规范限值的水平下，这种方法也可以检测死亡率与特定空气污染物之间的关联，并且可以用于评估在无法直接测量浓度的地区空气污染的潜在健康影响。
