[Acute effects of air pollution in Brindisi (Italy): a case-crossover analysis].
OBJECTIVE
To evaluate the association between daily air pollutant concentration and daily data regarding mortality and hospital admissions among residents of Brindisi (Southern Italy) in the years 2003-2006.


METHODS
The association between the time series of daily mortality (2003-2005) and hospital admissions (2003-2006) and the time series of daily pollutant concentration were analyzed using a case-crossover method and a conditional logistic regression. Bi-directional control periods were selected using a time-stratified approach. Models include mean temperature, relative humidity, influence of epidemics, summer decrease of resident population and holidays as confounders. Specific models with the following variables: cause of death or hospital admission, gender, age and season have been fitted. As hazard periods the following lags have been considered: single lag (from 0 to five) and cumulative lag (lag 0-1 for mortality and 0-3 for hospital admissions).


METHODS
A total of 1,792 subjects deceased of all natural causes (including cardiovascular and respiratory causes) and 6,925 hospital admissions for acute conditions (cardiac, cerebrovascular and respiratory diseases) were considered. PM10, NO₂ and CO daily pollutant concentration series were examined.


RESULTS
PM10 was associated with mortality from all natural causes (10.36%; 95% CI 1.83-19.61 at lag 0-1). The risk was more pronounced for cardiovascular mortality (14.35%; 95% CI 2.11; 28.07 at lag 1). The association with hospitalization for cerebrovascular diseases was statistically significant for PM10 among females (13.4%; 95% CI 1.7; 26.4 at lag 4) and elderly over 75 years old (13.6%; 95% CI 0.4; 28.6 at lag 4). In specific population groups, increased mortality and hospital admissions have been associated with NO₂.


CONCLUSIONS
This study found strong and consistent associations between outdoor air pollution (coming from both industrial emissions and urban traffic) and short-term increases in both mortality and morbidity. Precautionary measures should be taken.
Serinelli
Maria
M
Istituto di fisiologia clinica, Consiglio nazionale delle ricerche, Lecce. m.serinelli@arpa.puglia.it
Gianicolo
Emilio Antonio Luca
EA
Cervino
Marco
M
Mangia
Cristina
C
Portaluri
Maurizio
M
Vigotti
Maria Angela
MA
D000367:Age Factors; D000368:Aged; D000397:Air Pollution / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000401:mortality; D016001:Confidence Intervals; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D009026:Mortality / Q000639:trends; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D012140:Respiratory Tract Diseases / Q000401:mortality; D012307:Risk Factors; D012621:Seasons; D012737:Sex Factors
D052638:Particulate Matter