A nationwide study of particulate matter and daily hospitalizations for respiratory diseases in Italy - Progetto BEEP
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ERS2019 Pagina 1 di 2
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1712
A nationwide study of particulate matter and daily hospitalizations for
respiratory diseases in Italy.
M renzi1, M Scortichini1, F De' Donato1, C Gariazzo2, F Forastiere3, S Fasola4, S Maio5, P
Michelozzi1, G Viegi4, M Stafoggia1, - On Behalf Of Beep Collaborative Group6
1
Department of Epidemiology of Lazio Region, ASL Rome 1, Rome, Italy
2
INAIL-Research Center, Monteporzio Catone, Italy
3
King's College, London, Italy
4
Institute of Biomedicine and Molecular Immunology „Alberto Monroy“, National Research Council,,
Palermo, Italy
5
CNR Institute of Clinical Physiology, Pisa, Italy
6
BEEP Collaborative Group, Italy, Italy
Introduction: The relationship between air pollution and respiratory morbidity has been widely
addressed in urban and metropolitan areas but little is known about the effects in non-urban
settings.
Aims: To assess the short-term effects of PM10 and PM2.5 on respiratory admissions in whole
country of Italy during 2006-2015.
Methods: We estimated daily PM concentrations at the municipality level (n 8,092) using a
machine learning method based on satellite data and spatiotemporal predictors. We collected
daily counts of respiratory hospital admissions for each Italian municipality. We considered five
different outcomes: all respiratory, asthma, chronic obstructive pulmonary disease (COPD),
lower and upper respiratory tract infections (LRTI and URTI). We ran municipality-specific time-
series models and we meta-analyzed individual effects to obtain national estimates for the
above outcomes. Finally, we tested for effect modification by sex, age classes and degree of
urbanization.
Results: A total of 4,154,887 non-scheduled acute respiratory admission were registered during
2006-2015, of which 29%, 12%, 6%, and 3% were for LRTI, COPD, URTI and asthma,
respectively. Daily mean PM10 and PM2.5 concentrations over the study period were 23.3 and
17 mg/m3. For each 10 mg/m3 increases in PM10 and PM2.5 at lag 0-5 days, we found excess
risks of total respiratory diseases equal to 1.10% (95% confidence intervals: 0.82, 1.39) and
0.82 (0.35, 1.30), respectively. Higher effects were found in the elderly and in areas less
urbanized.
Conclusions: Short-term exposure to PM is harmful for the respiratory system, especially in
elderly patients. Strong effects were found also in rural areas.
Session:
Epidemiology, genetics, air pollution and sleep (Thematic poster)
Date/Time:
Tuesday, September 1, 2019 / 12:50-14:40
Room:
http://127.0.0.1:9000/index.html? 03/10/2019ERS2019 Pagina 2 di 2
TP-25
Category:
Epidemiology
Keywords:
Air pollution, Environment
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2058
Health effects of self-reported risk factors and estimated PM10 levels:
a cross-sectional study.
S Fasola1, S Maio2, S Baldacci2, C Gariazzo3, F Forastiere1, S La Grutta1, M Stafoggia4, G
Viegi1, . Beep Collaborative Group5
1
Institute of Biomedicine and Molecular Immunology (CNR-IBIM), Palermo, Italy
2
Institute of Clinical Physiology (CNR-IFC), Pisa, Italy
3
INAIL- Department of Occupational & Environmental Medicine, Monteporzio Catone, Rome, Italy
4
Department of Epidemiology, Lazio Regional Health Service / ASL Roma 1, Rome, Italy
5
Beep Collaborative Group, Rome, Italy
Background : A former cross-sectional study on health effects of air pollution in Pisa was
based on a proxy of traffic-related exposure. PM10 exposure estimates available from the
BEEP project allow a better assessment of health effects. Aim : To assess health effects of self-
reported risk factors and PM10 estimates in a sub-sample of long-term residents. Methods :
305 Pisan subjects (mean age 64 years) living at the same address from 1991-1993 to 2011
were selected. Questionnaire information on occurrence of respiratory diseases/symptoms and
risk factors was available. Mean PM10 concentrations (µg/m3, year 2011) were estimated at
residential address (1-km2 resolution) using a Random Forest Machine Learning Approach
(RFMLA). Data were analysed through multivariable logistic regression models. Results :
Chronic obstructive pulmonary disease (COPD) was associated with increasing age (years)
(OR=1.06 [95% CI: 1.03, 1.11] per unit increase [p.u.i.]), and with increasing PM10
concentrations (OR=2.19 [1.27, 4.27] p.u.i.). Chronic cough was linked to increasing PM10
concentrations (OR=2.27 [1.09, 5.99] p.u.i.) and current active smoking (OR=5.29 [1.47, 22.81]
vs never smoking). Chronic phlegm was related to increasing age (OR=1.04 [1.01, 1.07] p.u.i.),
current active smoking (OR=4.33 [1.44, 14.74] vs never smoking) and occupational exposure
(OR=2.34 [1.09, 5.5] vs not exposed). No significant association was found for current asthma.
Gender and socio-economic status were not associated with disease/symptom occurrence.
Conclusions : Estimating PM10 concentrations through RFMLA may provide new insights
about respiratory health effects of long-term air pollution exposure in epidemiological studies.
Session:
Epidemiology, genetics, air pollution and sleep (Thematic poster)
Date/Time:
Tuesday, September 1, 2019 / 12:50-14:40
Room:
TP-25
Category:
Epidemiology
Keywords:
Air pollution, COPD, Health policy
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3299
The short-term effects of air temperature on respiratory mortality and
hospital admissions using high resolution data in Italy. Results from
BEEP project.
F K de'Donato1, M Scortichini1, P Michelozzi1, C Gariazzo2, L Bisceglia3, A Cernigliaro4, F
Forastiere5, E Migliore6, M Ottone7, G Viegi5, M Stafoggia1, . Beep Collaborative Group8
1
Department of Epidemiology of the Lazio Region Health Service / ASL Roma 1, Rome, Italy
2
INAIL, Department of Occupational & Environmental Medicine, Monteporzio Catone, Italy
3
Strategic Regional Agency for Health and Welfare of Puglia, Bari, Italy
4
Department of Health Activities and Epidemiological Observatory, Health Authority Sicily region,
Palermo, Italy
5CNR – Institute of Biomedicine and Molecular Epidemiology „Alberto Monroy“, Palermo, Italy
6
Città della Salute e della Scienza di Torino University Hospital, Center for cancer prevention (CPO)
Piedmont, Turin, Italy
7
Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
8
BEEPgroup, Rome, Italy
Introduction:Health effects of heat and cold in urban areas are well known, while evidence on
suburban and rural areas is scarce.
Aim:To estimate the short-term effects of heat and cold on respiratory mortality (5 regions) and
hospital admissions for respiratory disease (nationwide) over 10years in Italy. We evaluated
possible changes in the effects by gender, age (75 years) and level of urbanization.
Methods:Daily mean air temperature with a spatial resolution of 1x1km was derived using
satellite land surface temperature(LST), observed temperature data and spatio-temporal land
use and land cover predictors. Non-linear distributed lag (DLNM) models, adjusted for temporal
trends, PM10 and influenza were used to estimate the association between temperature and
respiratory mortality/hospitalizations at municipal level. The percent increase in risk(IR%), for
temperature increases between the 75th and 99th percentile (heat) and decreases from the
25th to the 1st percentile (cold) are reported. Risk estimates by age, gender and urbanization
(high, medium, low) were also calculated.
Results:The pooled effect estimates for heat and cold on respiratory mortality were 1.52%(95%
CI:1.35-1.71%) and 1.43%(95%CI:1.24-1.65%) respectively. A greater risk in mortality was
found among the very old(75+) and in suburban and rural areas. For hospital admissions,
significant risks were only observed for heat (IR:95%CI=1.08%:1.06-1.11%) with some
heterogeneity among regions. Heat-related admissions were greater among the elderly and in
urban areas.
Conclusions:Extreme temperatures are a risk factor in both urban and rural areas.
Session:
Epidemiology, genetics, air pollution and sleep (Thematic poster)
Date/Time:
http://127.0.0.1:9000/index.html? 03/10/2019ERS2019 Pagina 2 di 2
Tuesday, September 1, 2019 / 12:50-14:40
Room:
TP-25
Category:
Epidemiology
Keywords:
Environment, Chronic diseases, Elderly
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