title: Association between PM10 concentrations and school absences in proximity of a cement plant in northern Italy.
abstract: Dusts are one of the main air pollutants emitted during cement manufacturing. A substantial part of these are breathable particles that are less than 10 μm in diameter (PM10), which represent a potential threat for the health of the exposed population. This study aimed at evaluating the short-term effects of PM10 concentrations on the health of children, aged 6-14 years, who attended the schools in Fumane (Italy), in proximity (1.2 km) to a large cement plant. School absenteeism was used as a proxy indicator of child morbidity. Time series of daily school absences and PM10 concentrations were collected for 3 school-years from 2007 to 2010 (541 school-days, 462 children on average). The associations between PM10 concentrations and school absence rates in the same day (lag0) and in the following 4 days (lag1 to lag4) were evaluated using generalised additive models, smoothed for medium/long term trends and adjusted for day of the week, influenza outbreaks, daily temperature and rain precipitations. The average concentration of PM10 in the period was 34 (range: 4-183) μg/m(3). An average 10 μg/m(3) increase of PM10 concentration in the previous days (lag0-4) was associated with a statistically significant 2.5% (95%CI: 1.1-4.0%) increase in the rate of school absences. The highest increase in the absence rates (2.4%; 95%CI: 1.2-3.5%) was found 2 days after exposure (lag2). These findings provide epidemiological evidence of the acute health effects of PM10 in areas with annual concentrations that are lower than the legal European Union limit of 40 μg/m(3), and support the need to establish more restrictive legislative standards.
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy. Electronic address: alessandro.marcon@univr.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marcon
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy. Electronic address: giancarlo.pesce@univr.it.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pesce
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy. Electronic address: paolo.girardi@regione.veneto.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy. Electronic address: pierpaolo.marchetti@univr.it.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Marchetti
authors.affiliation: Department of Public Health, Azienda ULSS 22 Regione Veneto, Via S.M. Crocifissa di Rosa, 37067 Valeggio sul Mincio, VR, Italy. Electronic address: gblengio@ulss22.ven.it.
authors.forename: Gianstefano
authors.initials: G
authors.lastname: Blengio
authors.affiliation: Regional Environmental Protection Agency of Veneto, Department of Verona, Via A. Dominutti 8, 37135 Verona, Italy. Electronic address: sdezolt@arpa.veneto.it.
authors.forename: Simona
authors.initials: S
authors.lastname: de Zolt Sappadina
authors.affiliation: Department of Public Health, Azienda ULSS 22 Regione Veneto, Via S.M. Crocifissa di Rosa, 37067 Valeggio sul Mincio, VR, Italy. Electronic address: sfalcone@ulss22.ven.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Falcone
authors.affiliation: General Practitioner, Azienda ULSS 22 Regione Veneto, Via Brugnoli 14, 37022 Fumane, VR, Italy. Electronic address: memofrappo@gmail.com.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Frapporti
authors.affiliation: Regional Environmental Protection Agency of Veneto, Department of Verona, Via A. Dominutti 8, 37135 Verona, Italy. Electronic address: fpredicatori@arpa.veneto.it.
authors.forename: Francesca
authors.initials: F
authors.lastname: Predicatori
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Strada Le Grazie 8, 37134 Verona, Italy. Electronic address: roberto.demarco@univr.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: de Marco
mesh_terms: D000041:Absenteeism; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects / Q000032:analysis; D002648:Child; D003252:Construction Materials / Q000009:adverse effects*; D004391:Dust; D004781:Environmental Exposure / Q000009:adverse effects*; D006262:Health; D006801:Humans; D007221:Industry; D007558:Italy; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D012574:Schools
chemical_list: D000393:Air Pollutants; D004391:Dust; D052638:Particulate Matter
keywords: Air pollution; Cement industry; Paediatric; Particulate matter; Short-term effects; Time-series analysis