Health Effects of Air Pollution in the Region of Lombardy, Italy

Transcription

1 The Costs of Air Pollution: A Forgotten Problem Università Commerciale L. Bocconi - Fondazione IRCCS Ca Granda - Peripato Health Effects of Air Pollution in the Region of Lombardy, Italy Pier Alberto Bertazzi Clinica del Lavoro Luigi Devoto Università degli Studi & Fondazione Ca Granda Policlinico, Milan Milan - November 25th, 2014

2 Lombardy Region, Italy - Nearly 10 million people - Area 23,865 km² - Pop. density 412 inh./km² Rank first for: - PopulaFon, - Gross internal Product (20% of the nafonal GP), - GP per capita ( 33,648).

3 Capital city Milan (1.3 million), greater Milan 4.5 millions. Territory: - Alps 40.5%, - River Po plains 47%. Rich agriculture, advanced services, very acfve commercial and industrial sectors (sme). Unfavourable climate: basin with livle rain and poor winds. Lombardy Region, Italy

4 Po River basin is bordered on three sides by mountains and Atlan9c weather disturbances are frequently unable to cross the Alpine barrier, consequently providing no air mass exchange. Unfavourable context and climate characteris9cs favour a high level of air pollu9on

5 Annual Mean Concentra9ons PM 2.5 in EUROPE 2011 EEA, 2013 The red and dark red dots indicate sta9ons repor9ng exceedances of the 2010 annual target value (25μg/m 3 ), as set out in the Air Quality Direc9ve (EU, 2008).

6 Annual Mean Concentra9ons PM 2.5 in ITALY x4Km Model Modello MINNI (Modello Integrato Nazionale). Zanini et al. 2011

7 Predicted Annual Average Concentra9on of PM 10 ( 2007 ) levels in Lombardy, by municipality Milan

8 Predicted Annual Average Concentra9on of NO 2 levels in Lombardy, by municipality (2007) Milan

9 Health Impact of Air Pollu9on in the Lombardy Region - Ra9onale Health impact assessment (HIA): essenfal informafon to decision makers for the development of public health policies. Air pollu9on: small individual risks, considerable public health consequences. Baccini M. et al. Am J Epidem 2011, 2014

10 Number of health events a\ributable to PM 10 exposure ( 2007 Whole Lombardy Region (9,642,406 inhabitants in Cause 40µg/m 3 Limit (EU) 20% reduc9on if >40µg/m 3 20µg/m 3 Limit (WHO) 20% reduc9on if >20µg/m 3 N ACR* N ACR* N ACR* N ACR* Mortality Natural Cardiovascular Respiratory Hospital admissions Cardiac Cerebrovascular Respiratory *ACR: AEributable Community Rate per 100,000

11 A\ributable Community Rate (ACR) x 100,000 Natural mortality under PM 10 <40µg/m 3 scenario ( 2007 Lombardy Region (year

12 Number of health events a\ributable to NO 2 exposure ( 2007 Whole Lombardy Region (9,642,406 inhabitants in Cause 40µg/m3 Limit (EU) 20% reduc9on if >40µg/m 3 N ACR* N ACR* Mortality Natural Cardiovascular Respiratory Hospital admissions Cardiac Cerebrovascular Respiratory *ACR: AEributable Community Rate per 100,000

13 A\ributable Community Rate (ACR) x 100,000 Natural mortality under NO 2 <40 µg/m 3 scenario ( 2007 Lombardy Region (year

14 Health Impact of Air Pollu9on in the Lombardy Region - Conclusions Exceedance of EU 40μg/m 3 limit has a clearly measurable impact on populafon health: PM 10 responsible for 2 deaths (3 H admissions) per 100,000 person/year; NO 2 responsible for 5 deaths (13 H admissions) per 100,000 person/year. A 20% reducfon in the exisfng PM 10 and NO 2 levels could substanfally reduce the burden of short- term deaths associated to ambient air pollufon. Policies for the reducfon of air pollufon appear to be necessary, and their implementafon will be rewarding in terms of the protecfon and improvement of individual and community health.

15 Commu9ng- adjusted short term health impact assessment of airborne fine par9cles allowing uncertainty propaga9on. Annual averages of PM 10 exceeding the WHO recommended threshold of 20µg/m 3 were responsible of 865 (80% CI: 475, 1401) short- term deaths, the 26% of which avributable to averages exceeding the EU limit of 40µg/m 3. A 20% reducfon of the PM 10 level would have saved 36% of these events. The largest impact was along the basin of the Po river and in the largest cifes. CommuFng visibly contributed to the spafal distribufon of the impact. Baccini M. et al. Am J Epidem 2014

16 PM 10 Annual Mean Concentra9ons 2007 Milan ( 2007 Lombardy Region (year Nostra Elaborazione su dak ARPA Lombardia

17 PM 10 Annual Mean Concentra9ons 2013 Nostra Elaborazione su dak ARPA Lombardia

18 PM 10 Annual Mean Concentra9ons 2014 Nostra Elaborazione su dak ARPA Lombardia