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Locatelli F, Martinelli L, Marchetti P, Caliskan G, Badaloni C, Caranci N, de Hoogh K, Gatti L, Giorgi Rossi P, Guarda L, Ottone M, Panunzi S, Stafoggia M, Silocchi C, Ricci P, Marcon A. Residential exposure to air pollution and incidence of leukaemia in the industrial area of Viadana, Northern Italy. ENVIRONMENTAL RESEARCH 2024; 254:119120. [PMID: 38734295 DOI: 10.1016/j.envres.2024.119120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/29/2024] [Accepted: 05/09/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Exposure to air pollution has been proposed as one of the potential risk factors for leukaemia. Work-related formaldehyde exposure is suspected to cause leukaemia. METHODS We conducted a nested register-based case-control study on leukaemia incidence in the Viadana district, an industrial area for particleboard production in Northern Italy. We recruited 115 cases and 496 controls, frequency-matched by age, between 1999 and 2014. We assigned estimated exposures to particulate matter (PM10, PM2.5), nitrogen dioxide (NO2), and formaldehyde at residential addresses, averaged over the susceptibility window 3rd to 10th year prior to the index date. We considered potential confounding by sex, age, nationality, socio-economic status, occupational exposures to benzene and formaldehyde, and prior cancer diagnoses. RESULTS There was no association of exposures to PM10, PM2.5, and NO2 with leukaemia incidence. However, an indication of increased risk emerged for formaldehyde, despite wide statistical uncertainty (OR 1.46, 95%CI 0.65-3.25 per IQR-difference of 1.2 μg/m3). Estimated associations for formaldehyde were higher for acute (OR 2.07, 95%CI 0.70-6.12) and myeloid subtypes (OR 1.79, 95%CI 0.64-5.01), and in the 4-km buffer around the industrial facilities (OR 2.78, 95%CI 0.48-16.13), although they remained uncertain. CONCLUSIONS This was the first study investigating the link between ambient formaldehyde exposure and leukaemia incidence in the general population. The evidence presented suggests an association, although it remains inconclusive, and a potential significance of emissions related to industrial activities in the district. Further research is warranted in larger populations incorporating data on other potential risk factors.
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Affiliation(s)
- Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Luigi Martinelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Gulser Caliskan
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy
| | - Nicola Caranci
- Department of Innovation in Healthcare and Social Services, Emilia-Romagna Region, Bologna, Italy
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Luciana Gatti
- Struttura Complessa Osservatorio Epidemiologico, Agenzia di Tutela della Salute della Val Padana, Mantova, Italy
| | - Paolo Giorgi Rossi
- Servizio di Epidemiologia, Azienda USL-IRCCS di Reggio Emilia, Emilia-Romagna, Reggio Emilia, Italy
| | - Linda Guarda
- Struttura Complessa Osservatorio Epidemiologico, Agenzia di Tutela della Salute della Val Padana, Mantova, Italy
| | - Marta Ottone
- Servizio di Epidemiologia, Azienda USL-IRCCS di Reggio Emilia, Emilia-Romagna, Reggio Emilia, Italy
| | - Silvia Panunzi
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service ASL Roma 1, Rome, Italy
| | - Caterina Silocchi
- Struttura Semplice Salute e Ambiente, Agenzia di Tutela della Salute della Val Padana, Mantova, Italy
| | - Paolo Ricci
- Former Director UOC Osservatorio Epidemiologico, Agenzia di Tutela della Salute della Val Padana, Mantova, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
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Kephart JL, Gouveia N, Rodriguez DA, Indvik K, Alfaro T, Texcalac JL, Miranda JJ, Bilal U, Roux AVD. Ambient nitrogen dioxide in 47,187 neighborhoods across 326 cities in eight Latin American countries: population exposures and associations with urban features. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.02.23289390. [PMID: 37205591 PMCID: PMC10187449 DOI: 10.1101/2023.05.02.23289390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Health research on ambient nitrogen dioxide (NO2) is sparse in Latin America, despite the high prevalence of NO2-associated respiratory diseases in the region. This study describes within-city distributions of ambient NO2 concentrations at high spatial resolution and urban characteristics associated with neighborhood ambient NO2 in 326 Latin American cities. Methods We aggregated estimates of annual surface NO2 at 1 km2 spatial resolution for 2019, population counts, and urban characteristics compiled by the SALURBAL project to the neighborhood level (i.e., census tracts). We described the percent of the urban population living with ambient NO2 levels exceeding WHO Air Quality Guidelines. We used multilevel models to describe associations of neighborhood ambient NO2 concentrations with population and urban characteristics at the neighborhood and city levels. Findings We examined 47,187 neighborhoods in 326 cities from eight Latin American countries. Of the ≈236 million urban residents observed, 85% lived in neighborhoods with ambient annual NO2 above WHO guidelines. In adjusted models, higher neighborhood-level educational attainment, closer proximity to the city center, and lower neighborhood-level greenness were associated with higher ambient NO2. At the city level, higher vehicle congestion, population size, and population density were associated with higher ambient NO2. Interpretation Almost nine out of every 10 residents of Latin American cities live with ambient NO2 concentrations above WHO guidelines. Increasing neighborhood greenness and reducing reliance on fossil fuel-powered vehicles warrant further attention as potential actionable urban environmental interventions to reduce population exposure to ambient NO2. Funding Wellcome Trust, National Institutes of Health, Cotswold Foundation.
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Affiliation(s)
- Josiah L. Kephart
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Nelson Gouveia
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Daniel A. Rodriguez
- Department of City and Regional Planning and Institute for Transportation Studies, University of California, Berkeley, California, USA
| | - Katy Indvik
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Tania Alfaro
- Escuela de Salud Pública, Universidad de Chile, Santiago de Chile, Chile
| | - José Luis Texcalac
- Department of Environmental Health, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Usama Bilal
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Ana V. Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, USA
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Panunzi S, Marchetti P, Stafoggia M, Badaloni C, Caranci N, de Hoogh K, Giorgi Rossi P, Guarda L, Locatelli F, Ottone M, Silocchi C, Ricci P, Marcon A. Residential exposure to air pollution and adverse respiratory and allergic outcomes in children and adolescents living in a chipboard industrial area of Northern Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:161070. [PMID: 36565877 DOI: 10.1016/j.scitotenv.2022.161070] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Chipboard production is a source of wood dust, formaldehyde, and combustion-related pollutants such as nitrogen dioxide (NO2) and particulate matter (PM). In this cohort study, we assessed whether exposures to NO2, formaldehyde, PM10, PM2.5, and black carbon were associated with adverse respiratory and allergic outcomes among all 7525 people aged 0-21 years residing in the Viadana district, an area in Northern Italy including the largest chipboard industrial park in the country. METHODS Data on hospitalizations, emergency room (ER) admissions, and specialist visits in pneumology, allergology, ophthalmology, and otorhinolaryngology were obtained from the Local Health Unit. Residential air pollution concentrations in 2013 (baseline) were derived using local (Viadana II), national (EPISAT), and continental (ELAPSE) exposure models. Associations were estimated using negative binomial regression models for counts of events occurred during 2013-2017, with follow-up time as an offset term and adjustment for sex, age, nationality, and a census-block socio-economic indicator. RESULTS Median annual exposures to NO2, PM10, and PM2.5 were below the European Union annual air quality standards (40, 40, and 25 μg/m3) but above the World Health Organization 2021 air quality guideline levels (10, 15, and 5 μg/m3). Exposures to NO2 and PM2.5 were significantly associated with higher rates of ER pneumology admissions (13 to 30 % higher rates per interquartile range exposure differences, all p < 0.01). Higher rates of allergology and ophthalmology visits were found for participants exposed to higher pollutants' concentrations. When considering the 4-km buffer around the industries, associations with respiratory hospitalizations became significant, and associations with ER pneumology admissions, allergology and ophthalmology visits became stronger. Formaldehyde was not associated with the outcomes considered. CONCLUSION Using administrative indicators of health effects a priori attributable to air pollution, we documented the adverse impact of long-term air pollution exposure in residential areas close to the largest chipboard industries in Italy. These findings, combined with evidence from previous studies, call for an action to improve air quality through preventive measures especially targeting emissions related to the industrial activities.
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Affiliation(s)
- Silvia Panunzi
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service ASL Roma 1, Rome, Italy
| | - Chiara Badaloni
- Department of Epidemiology, Lazio Regional Health Service ASL Roma 1, Rome, Italy
| | - Nicola Caranci
- Regional Health and Social Care Agency, Emilia-Romagna Region, Bologna, Italy
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | | | - Linda Guarda
- UOC Osservatorio Epidemiologico, Agenzia di Tutela della Salute della Val Padana, Mantova, Italy
| | - Francesca Locatelli
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy
| | - Marta Ottone
- Epidemiology Unit, AUSL - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Caterina Silocchi
- UOS Salute e Ambiente, Agenzia di Tutela della Salute della Val Padana, Mantova, Italy
| | - Paolo Ricci
- UOC Osservatorio Epidemiologico, Agenzia di Tutela della Salute della Val Padana, Mantova, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy
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Rocco I, Cilluffo G, Ferrante G, Cibella F, Marcon A, Marchetti P, Ricci P, Minicuci N, La Grutta S, Corso B. Investigating the Relationship between Parental Education, Asthma and Rhinitis in Children Using Path Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14551. [PMID: 36361431 PMCID: PMC9654957 DOI: 10.3390/ijerph192114551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/26/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Parental socioeconomic position (SEP) is a known determinant of a child's health. We aimed to investigate whether a low parental education, as proxy of SEP, has a direct effect on physician-diagnosed asthma, current asthma and current allergic rhinitis in children, or whether associations are mediated by exposure to other personal or environmental risk factors. This study was a secondary data analysis of two cross-sectional studies conducted in Italy in 2006. Data from 2687 adolescents (10-14 years) were analyzed by a path analysis model using generalized structural equation modelling. Significant direct effects were found between parental education and family characteristics (number of children (coefficient = 0.6229, p < 0.001) and crowding index (1.1263, p < 0.001)) as well as with exposure to passive smoke: during pregnancy (maternal: 0.4697, p < 0.001; paternal: 0.4854, p < 0.001), during the first two years of children's life (0.5897, p < 0.001) and currently (0.6998, p < 0.001). An indirect effect of parental education was found on physician-diagnosed asthma in children mediated by maternal smoking during pregnancy (0.2350, p < 0.05) and on current allergic rhinitis mediated by early environmental tobacco smoke (0.2002; p < 0.05). These results suggest the importance of promotion of ad-hoc health policies for promoting smoking cessation, especially during pregnancy.
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Affiliation(s)
- Ilaria Rocco
- Neuroscience Institute (IN), National Research Council (CNR), 35121 Padova, Italy
| | - Giovanna Cilluffo
- Department of Earth and Marine Sciences, University of Palermo, 90123 Palermo, Italy
| | - Giuliana Ferrante
- Department of Surgical Science, Dentistry, Gynecology and Pediatrics, Pediatric Unit, Verona University Medical School, 37134 Verona, Italy
| | - Fabio Cibella
- Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), 90146 Palermo, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, 37134 Verona, Italy
| | - Pierpaolo Marchetti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, c/o Istituti Biologici II, 37134 Verona, Italy
| | - Paolo Ricci
- UOC Osservatorio Epidemiologico, Agenzia di Tutela della Salute della Val Padana, 46100 Mantova, Italy
| | - Nadia Minicuci
- Neuroscience Institute (IN), National Research Council (CNR), 35121 Padova, Italy
| | - Stefania La Grutta
- Institute of Traslational Pharmacology (IFT), National Research Council (CNR), 90146 Palermo, Italy
| | - Barbara Corso
- Neuroscience Institute (IN), National Research Council (CNR), 35121 Padova, Italy
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Marcon A, Ricci P. Answer to comments on "Spatial variability of nitrogen dioxide and formaldehyde and residential exposure of children in the industrial area of Viadana, Northern Italy" by Marcon, Alessandro et al. Environ Sci Pollut Res 28, 28096-28106 (2021), DOI: 10.1007/s11356-020-12015-0. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:46371-46372. [PMID: 35536470 DOI: 10.1007/s11356-022-20733-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - Paolo Ricci
- Former Director of the Unit of Epidemiology, ATS Val Padana, Mantua, Italy
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