Department of Medical Sciences and Public Health, University of Cagliari; Cittadella Universitaria di Monserrato - 09042 Monserrato, CA, Italy; National Heart and Lung Institute, Imperial College London, UK; 1b Manresa road, SW3 6LR London, UK.
Environmental Research Group, School of Public Health, Imperial College London, Michael Uren Biomedical Engineering Hub; White City Campus, Wood Lane, W12 0BZ London, UK; CNR Institute of Translational Pharmacology (IFT), Via U. La Malfa, 153, 90146 Palermo, Italy.
Pulmonology. 2022 Jul-Aug;28(4):284-296. doi: 10.1016/j.pulmoe.2021.12.008. Epub 2022 Feb 10.
to summarize the main updated evidence about the health effects of air pollution and to focus on Italian epidemiological experiences on the respiratory effects.
the recent literature indicates that there is strong evidence for causal relationships between PM air pollution exposure and all-cause mortality as well as mortality from acute lower respiratory infections, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer. A growing body of evidence also suggests causal relationships with type II diabetes and impacts on neonatal mortality from low birth weight and short gestation as well as neurologic effects in both children and adults. Italy, a Southern European country, faces a more threatening air pollution challenge because of the effects of both anthropogenic pollutants and natural dust (particulate matter, PM). The 2020 Report of the European Environment Agency highlighted the number of premature deaths in Italy attributable to main pollutants: 52,300 for PM, 10,400 for NO and 3,000 for O in 2018. In Italy, original time series and analytical epidemiological studies showed increased cardio-respiratory hospital admissions and mortality and increased risk of respiratory diseases in people living in urban areas.
adverse health effects of air pollutants, even at low levels, have been confirmed by recent epidemiological studies. Further studies should focus on the potential link between air pollution exposure and respiratory infections. This topic has become particularly important in the current SARS-COV-2 pandemic. Based on strong scientific evidence, the Italian government, which hosts the Global Alliance against Chronic Respiratory Diseases (GARD)-Italy at the Ministry of Health, the scientific respiratory societies and the patients' associations, as well as others in the health sector and civil society, must increase their engagement in advocacy for clean air policies, especially in light of the new Air Quality Guidelines of the World Health Organization.
总结有关空气污染对健康影响的主要最新证据，并重点关注意大利在呼吸道影响方面的流行病学经验。
最近的文献表明，有强有力的证据表明，PM 空气污染暴露与全因死亡率以及急性下呼吸道感染、缺血性心脏病、中风、慢性阻塞性肺疾病和肺癌的死亡率之间存在因果关系。越来越多的证据还表明，空气污染与 2 型糖尿病之间存在因果关系，并对低出生体重和早产导致的新生儿死亡率以及儿童和成人的神经系统影响产生影响。意大利作为一个南欧国家，由于人为污染物和自然尘埃（颗粒物，PM）的影响，面临着更具威胁性的空气污染挑战。2020 年欧洲环境署的报告强调了意大利主要污染物导致的过早死亡人数：2018 年，PM 为 52300 人，NO 为 10400 人，O 为 3000 人。在意大利，原始时间序列和分析性流行病学研究表明，城市地区居民的心肺住院和死亡率增加，以及呼吸道疾病的风险增加。
最近的流行病学研究证实了空气污染物对健康的不利影响，即使在低水平下也是如此。进一步的研究应侧重于空气污染暴露与呼吸道感染之间的潜在联系。在当前 SARS-COV-2 大流行的情况下，这一主题变得尤为重要。基于强有力的科学证据，意大利政府（在卫生部主办全球慢性呼吸系统疾病联盟（GARD）-意大利、科学呼吸协会和患者协会以及卫生部门和民间社会的其他成员）必须加强倡导清洁空气政策的力度，特别是鉴于世界卫生组织新的空气质量指南。
