Elsevier

Environmental Research

Volume 111, Issue 8, November 2011, Pages 1321-1327
Environmental Research

Human health risk in relation to air quality in two municipalities in an industrialized area of Northern Italy

https://doi.org/10.1016/j.envres.2011.06.012Get rights and content

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.

Highlights

► We assessed the impact on mortality of atmospheric pollution in two small municipalities. ► The methodology developed by the World Health Organization was used for this purpose. ► We found an excess of total mortality of 8 out of 177 in a year and a reduction of life expectancy. ► Particulate matter of aerodynamic diameter ≤2.5 μm had the highest health impact.

Introduction

The acute effects of air pollution on human health were amply proven in the 20th century, when severe air pollution in Europe (Meuse Valley and London) and in the United States (Donora, Pa) caused deaths and disease in hundreds of thousands of people (Ciocco and Thompson, 1961, Logan, 1956, Nemery et al., 2001). Much lower concentrations of air pollutants, however, also have adverse effects on human health (Bell et al., 2006, Downs et al., 2007, Gauderman et al., 2007, Jerrett et al., 2008, Kunzli et al., 2005, Kunzli et al., 2000, Miller et al., 2007, Pope et al., 2002) and air quality standards may not be protective enough for the most sensitive groups (USEPA, 1996). In addition, even though pollution due to combustion fuels has fallen dramatically in recent years, emerging pollutants such as ozone (O3) and nitrogen oxides, and changes in the composition and size distribution of particulate matter, have become important in the health effects of air pollution (Brunekreef and Holgate, 2002). In the last two decades epidemiological studies have shown that outdoor air pollution is a cause of morbidity (cardiovascular and respiratory symptoms, decrease in lung function, chronic bronchitis, etc.) and mortality. The biological mechanisms by which these pollutants affect human health are not all clarified but probably involve their potent oxidant action, both directly against the cellular components of the airways, and through activation of intracellular oxidant pathways.

We assessed the health impact of air quality on the residents of Mazzano and Rezzato, two small towns in the Po Valley – the Pianura Padana – in the Lombardy region (Fig. 1). This is the most industrialized area in Italy, with heavy traffic and high population density. In addition it is enclosed by mountains on three sides and the wind speeds are usually low (very often <1 m/s) making for very frequent thermal inversions, trapping air pollutants in the lower layers of the atmosphere. These concomitant conditions make this valley one of the worst areas in the world for atmospheric pollution, with a large number of days exceeding air quality standards during the year, and some very strong pollution episodes (de Meij et al., 2009). As an example, in 2007 in almost the whole of the Lombardy region, the guidelines for daily and annual averages of PM10 were never met (Giudici et al., 2008).

The local authorities in these municipalities, with a view to planning further expansion of industrial activities in the area, asked us to make a quantitative assessment of the impact of air pollutants on human health for people living in this area. The pollutants selected were nitrogen dioxide (NO2), O3 and particulate matter because these had the highest concentrations in relation to air quality standards.

NO2 is mainly derived from oxidation of nitrogen oxide by atmospheric oxidants such as O3. The main sources are combustion (heating, industrial plants and vehicles) where NO2 is formed after oxidation of atmospheric nitrogen. Tropospheric O3 is a secondary pollutant arising from a very complex chain of reactions involving sunlight, nitrogen dioxide and hydrocarbons. The concentration of this compound generally follows different patterns from other related atmospheric pollutants, since it peaks during the summer and not in urban areas but in the suburbs. Finally, particulate matter differs from the other compounds since it is not a substance by itself but a complex mixture of different components condensed in a liquid or solid phase. We examined the fractions smaller than 10 μm (PM10), and 2.5 μm (PM2.5) in diameter. Generally the smaller particulate fraction arises from combustion and the coarser one from mechanical and re-suspension processes.

Section snippets

AirQ software

We adopted the approach proposed by the World Health Organization (WHO) using the Air Quality Health Impact Assessment (AirQ 2.2.3) software developed by the WHO European Centre for Environment Health, Bilthoven Division. This program is used to estimate the impact of exposure to specific atmospheric pollutants on the health of people living in a certain period and area. The assessment is based on the attributable proportion (AP), defined as the fraction of the health outcome in a certain

Results

For O3 the maximum 1 h average concentration was 174 μg/m3, detected as expected in summer, while the maximum NO2 concentration, 76 μg/m3, was detected in winter. The highest PM2.5 and PM10 concentrations were also detected in the winter campaign with maximum values of 187 and 224 μg/m3, respectively. Fig. 2a–d illustrates the concentrations of different pollutants and the percentage of time to which people were exposed to these concentrations. The data were used to estimate the short-term effects.

Discussion

This paper offers a study case using the WHO approach to assess the impact of atmospheric pollution on human health for people living in two small towns in the Po Valley, one of the most densely populated and industrialized areas in Europe, where the geographical features make the air quality among the worst in the world. The impact was estimated as the increase in all-causes, cardiovascular and respiratory mortality, for short- and long-term exposure, assuming that concentrations remain

Acknowledgments

We thank the mayors of Mazzano and Rezzato Municipalities for the financial support and Mr. Roberto Carrara for his helpful comments and coordinating work. We also thank the laboratories of Consulenze Ambientali S.p.A, Scanzorosciate, Italy, for chemical analysis.

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