Effects of outdoor air pollution on adult respiratory health.
| Study | Population/Area | Exposure | Outcomes | Effect estimation (95% CI) |
|---|---|---|---|---|
| Mortality and hospitalizations for respiratory causes | ||||
| Alessandrini et al., 2013 [40] | 25 Italian citiesn = 31,008 deaths (7.3% of the total) | PM10 (10 μg/m3 increase) | Mortality from respiratory causes | Increase 1.41% (–0.23–3.08) (Lag 2–5) |
| NO2 (10 μg/m3 increase) | Increase 1.67% (0.23–3.13) (Lag 2–5) | |||
| Gariazzo et al., 2023 [43] | Italyn = 131,389 deaths (7.4% of the total) | PM10 (10 μg/m3 increase) | Mortality from respiratory causes | Increase 3.54% (2.13–4.97) (Lag 0–5) |
| PM2.5 (10 μg/m3 increase) | Increase 4.55% (1.78–7.40) (Lag 0–5) | |||
| NO2 (10 μg/m3 increase) | Increase 6.68% (1.04–12.62) (Lag 0–5) | |||
| Scarinzi et al., 2013 [41] | 25 Italian citiesn = 331,289 hospitalizations (14.7% of the total) | PM10 (10 μg/m3 increase) | Hospitalization for respiratory causes | Increase 0.75% (0.25–1.25) (Lag 0–5) |
| PM2.5 (10 μg/m3 increase) | Increase 1.23% (0.58–1.88) (Lag 0–5) | |||
| NO2 (10 μg/m3 increase) | Increase 1.29% (0.52–2.06) (Lag 0–5) | |||
| Renzi et al., 2022 [44] | Italyn = 4,154,887 hospitalizations (period 2006–2015) | PM10 (10 μg/m3 increase) | Hospitalization for respiratory causes | Increase 0.65% (0.38–0.92) (Lag 0–5) |
| PM2.5 (10 μg/m3 increase) | Increase 1.22% (0.76–1.68) (Lag 0–5) | |||
| COPD and airway obstruction | ||||
| Marchetti et al., 2023 [45] | Pavia, Turin, Verona, Terni, Pisa, Ancona, Palermo, Sassarin = 4,111 | NO2 (10 μg/m3 increase) | Chronic bronchitis/COPD | OR 1.23 (1.03–1.46) |
| Maio et al., 2025 [46] | Ancona, Pavia, Pisa, Sassari, Turin, Veronan = 14,420 | PM10 (10 μg/m3 increase) | COPD (diagnosis and symptoms)Dyspnea | OR 1.26 (1.03–1.54)OR 1.21 (1.05–1.39) |
| PM2.5 (10 μg/m3 increase) | COPD (diagnosis and symptoms)Dyspnea | OR 1.31 (1.03–1.65)OR 1.24 (1.05–1.47) | ||
| NO2 (10 μg/m3 increase) | COPD (diagnosis and symptoms)Dyspnea | OR 1.07 (1.00–1.15)OR 1.06 (1.01–1.11) | ||
| Nuvolone et al., 2011 [48] | Pisa/Cascinan = 2,062 | Distance from main roads:< 100 m (a)100–250 m (b) | COPD | (a) OR 1.80 (1.03–3.08) in males |
| GOLD Airway Obstruction | (a) OR 2.07 (1.11–3.87) in males(b) OR 2.53 (1.42–4.53) in males | |||
| Maio et al., 2016 [47] | Pisa/Cascinan = 4,848 | Exposure to traffic | COPD | OR 1.54 (1.25–1.90) |
| Maio et al., 2019 [49] | Pisa/Cascinan = 970 | Exposure to traffic | Incidence of COPD | OR 2.40 (1.10–5.20) |
| Fasola et al., 2020 [50] | Pisan = 305 | PM10 (1 μg/m3 increase) | Incidence of COPD | OR 2.96 (1.50–7.15) |
| Asthmatic/Allergic symptoms and diseases | ||||
| Maio et al., 2023 [51] | Ancona, Pavia, Pisa, Sassari, Turin, Veronan = 14,420 | PM10 (10 μg/m3 increase) | Allergic rhinitis (diagnosis or symptoms or medications) | OR 1.16 (1.06–1.26) |
| Asthma (diagnosis or symptoms or medications) | OR 1.23 (1.08–1.40) | |||
| Nocturnal awakenings due to difficulty breathing | OR 1.30 (1.16–1.46) | |||
| PM2.5 (10 μg/m3 increase) | Allergic rhinitis (diagnosis or symptoms or medications) | OR 1.17 (1.06–1.30) | ||
| Asthma (diagnosis or symptoms or medications) | OR 1.26 (1.08–1.47) | |||
| Nocturnal awakenings due to difficulty breathing | OR 1.33 (1.16–1.52) | |||
| NO2 (10 μg/m3 increase) | Allergic rhinitis (diagnosis or symptoms or medications) | OR 1.07 (1.04–1.10) | ||
| Asthma (diagnosis or symptoms or medications) | OR 1.07 (1.03–1.12) | |||
| Nocturnal awakenings due to difficulty breathing | OR 1.12 (1.08–1.17) | |||
| Marchetti et al., 2023 [45] | Pavia, Turin, Verona, Terni, Pisa, Ancona, Palermo, Sassarin = 4,111 | PM10 (10 μg/m3 increase) | Rhinitis | OR 1.62 (1.19–2.20) |
| PM2.5 (10 μg/m3 increase) | OR 1.80 (1.16–2.81) | |||
| NO2 (10 μg/m3 increase) | OR 1.22 (1.07–1.38) | |||
| Nuvolone et al., 2011 [48] | Pisa/Cascinan = 2,062 | Distance from main roads:< 100 m (a) | Persistent wheezing | (a) OR 1.76 (1.08–2.87) in males |
| Dyspnea | (a) OR 1.61 (1.13–2.27) in females | |||
| Skin prick tests positive | (a) OR 1.83 (1.11–3.00) in females | |||
| Maio et al., 2016 [47] | Pisa/Cascinan = 4,848 | Exposure to traffic | Allergic rhinitis | OR 1.19 (1.05–1.35) |
| Maio et al., 2019 [49] | Pisa/Cascinan = 970 | Exposure to traffic | Incidence of asthma attacks | OR 2.20 (1.00–4.50) |
| Incidence of allergic rhinitis | OR 1.80 (1.20–2.80) | |||
| Fasola et al., 2020 [50] | Pisan = 305 | PM2.5 (1 μg/m3 increase) | Incidence of allergic rhinitis | OR 2.25 (1.07–4.98) |
| Maio et al., 2020 [54] | Pisa/Po Deltan = 452 | Exposure to traffic | Asthma with persistent/incident symptoms | OR 1.86 (1.02–3.38) |
| Maio et al., 2022 [53] | Pisa/Cascinan = 2,070 | 10% increase in grey spaces around the residential address | Skin prick test positivity | OR 1.07 (1.02–1.13) |
| Polysensitization | OR 1.11 (1.04–1.19) | |||
| Allergic rhinitis | OR 1.10 (1.04–1.17) | |||
| Asthma/allergic rhinitis | OR 1.06 (1.00–1.12) | |||
| Respiratory infections | ||||
| Faustini et al., 2013 [56] | Bologna, Florence, Milan, Palermo, Rome and Turinn = 9,886 | PM10 (10 μg/m3 increase) | Hospitalization for Lower Respiratory Tract Infections in Patients With COPD | Increase 1.91% (0.06–3.79) (Lag 0–3) |
| Renzi et al., 2022 [44] | Italyn = 1,204,917 hospitalizations (period 2006–2015) | PM10 (10 μg/m3 increase) | Hospitalization for lower respiratory tract infections | Increase 0.84% (0.40–1.28) (Lag 0–5) |
| PM2.5 (10 μg/m3 increase) | Increase 1.34% (0.72–1.95) (Lag 0–5) | |||
| Ranzi et al., 2023 [57] | Italyn = 3,995,202 cases | PM10 (1 μg/m3 increase) | Diagnosis of SARS-CoV-2 | Increase 0.30% (0.20–0.40) |
| PM2.5 (1 μg/m3 increase) | Increase 0.30% (0.10–0.40) | |||
| NO2 (1 μg/m3 increase) | Increase 0.90% (0.80–1.00) | |||
| Stafoggia et al., 2023 [58] | Italyn = 124,346 deaths | PM10 (1 μg/m3 increase) | Mortality from SARS-CoV-2 | Increase 0.30% (0.20–0.50) |
| PM2.5 (1 μg/m3 increase) | Increase 0.70% (0.50–0.90) | |||
| NO2 (1 μg/m3 increase) | Increase 0.60% (0.50–0.80) | |||
Lag: time interval in days between peak exposure to pollutant and health event. CI: confidence interval; COPD: chronic obstructive pulmonary disease; NO2: nitrogen dioxide; OR: odds ratio; PM2.5: atmospheric particulate matter with a diameter ≤ 2.5 μm; PM10: atmospheric particulate matter with a diameter ≤ 10 μm.
Supplementary materials for this article are available at: https://www.explorationpub.com/uploads/Article/file/1009135_sup_1.pdf.
This document represents a virtuous example of national scientific collaboration, born from the joint commitment of experts of nine scientific societies, which have shared skills, data and strategic vision to address one of the most urgent challenges of contemporary public health.
We thank the Presidents of the nine Scientific Societies that have joined the initiative with promptness and conviction, recognizing its urgency and strategic value: Prof. Vincenzo Patella, President of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC); Prof. Lorenzo Richiardi, President of the Italian Association of Epidemiology (AIE); Prof. Francesco Murzilli, President of the Association of Italian Territorial and Hospital Allergists and Immunologists (AAIITO); Prof. Raffaele Scala, President of the Italian Association of Hospital Pulmonologists (AIPO); Prof. Gian Luigi Marseglia, President of the Italian Society of Paediatric Allergology and Immunology (SIAIP); Prof. Augusto Arsieni, President of the Italian Society of Aerobiology, Medicine and Environment (SIAMA); Prof. Maurizio Coggiola, President of the Italian Society of Occupational Medicine (SIML); Prof. Stefania La Grutta, President of the Italian Society for Childhood Respiratory Diseases (SIMRI); Prof. Paola Rogliani, President of the Italian Society of Pneumology (SIP).
The experts of the inter-society Task Force are: Manuela De Sario, Silvia Maritano (AIE); Paolo Borrelli, Gabriele Cortellini (AAIITO); Carlo Barbetta, Francesco Menzella (AIPO); Manlio Milanese, Giovanni Viegi (SIAAIC); Cristiana Indolfi, Giovanni Traina (SIAIP); Augusto Arsieni, Emma Tedeschini (SIAMA); Massimo Corradi, Nicola Murgia (SIML); Giuliana Ferrante, Raffaella Nenna (SIMRI); Laura Carrozzi, Sara Maio (SIP).
GV: Conceptualization, Writing—original draft, Writing—review & editing, Supervision. SM: Writing—original draft, Writing—review & editing. AA: Writing—original draft, Writing—review & editing. CB: Writing—original draft, Writing—review & editing. PB: Writing—original draft, Writing—review & editing. LC: Writing—original draft, Writing—review & editing. MC: Writing—original draft, Writing—review & editing. GC: Writing—original draft, Writing—review & editing. MDS: Writing—original draft, Writing—review & editing. GF: Writing—original draft, Writing—review & editing. CI: Writing—original draft, Writing—review & editing. SM: Writing—original draft, Writing—review & editing. FM: Writing—original draft, Writing—review & editing. MM: Writing—original draft, Writing—review & editing. NM: Writing—original draft, Writing—review & editing. RN: Writing—original draft, Writing—review & editing. ET: Writing—original draft, Writing—review & editing. GT: Writing—original draft, Writing—review & editing. VP: Supervision. All authors read and approved the submitted version.
Vincenzo Patella, who is the Editorial Board Member and Guest Editor of Exploration of Asthma & Allergy; Manlio Milanese, who is the Guest Editor of Exploration of Asthma & Allergy. The remaining authors declare that they have no conflicts of interest.
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