Acute Effects of Particulate Matter on All-Cause Mortality in Urban, Rural, and Suburban Areas, Italy

Matteo Renzi, Stefano Marchetti, Francesca de' Donato, Marilena Pappagallo, Matteo Scortichini, Marina Davoli, Luisa Frova, Paola Michelozzi and Massimo Stafoggia
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Matteo Renzi: Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy
Stefano Marchetti: Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00184 Rome, Italy
Francesca de' Donato: Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy
Marilena Pappagallo: Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00184 Rome, Italy
Matteo Scortichini: Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy
Marina Davoli: Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy
Luisa Frova: Division of Integrated Systems for Health, Social Assistance and Welfare, Italian National Institute of Statistics, 00184 Rome, Italy
Paola Michelozzi: Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy
Massimo Stafoggia: Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, 00147 Rome, Italy

IJERPH, 2021, vol. 18, issue 24, 1-12

Abstract: Background: Short-term exposure to particulate matter (PM) has been related to mortality worldwide. Most evidence comes from studies conducted in major cities, while little is known on the effects of low concentrations of PM and in less urbanized areas. We aim to investigate the relationship between PM and all-cause mortality at national level in Italy. Methods: Daily numbers of all-cause mortality were collected for all 8092 municipalities of Italy, from 2006 to 2015. A satellite-based spatiotemporal model was developed to estimate daily PM 10 (inhalable particles) and PM 2.5 (fine particles) concentrations at 1-km resolution. Multivariate Poisson regression models were fit to estimate the association between daily PM and mortality at province level, and then, results were pooled with a random-effects meta-analysis. Associations were estimated by combination of age and sex and degree of urbanization of the municipalities. Flexible functions were estimated to explore the shape of the associations at low PM concentrations. Results: We analyzed 5,884,900 deaths (40% among subjects older than 85 years, 60% occurring outside the main urban areas). National daily mean (interquartile range) PM 10 and PM 2.5 concentrations were 23 (14) μg/m 3 and 15 (11) μg/m 3 , respectively. Relative increases of mortality per 10 μg/m 3 variation in lag 0–5 (average of last six days since death) PM 10 and PM 2.5 were 1.47% (95% Confidence Intervals (CI): 1.15%, 1.79%) and 1.96% (1.33%, 2.59%), respectively. Associations were highest among elderly and women for PM 10 only, similar between rural and urbanized areas, and were present even at low concentrations, e.g., below WHO guidelines. Conclusions: Air pollution was robustly associated with peaks in daily all-cause mortality in Italy, both in large cities and in less urbanized areas of Italy. Current WHO Air Quality Guidelines (2021) for PM 10 and PM 2.5 are not sufficient to protect public health.

Keywords: air pollution; mortality; nationwide; urbanization; geographical differences; low concentrations (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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