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Short-Term Effects of Heat on Mortality and Effect Modification by Air Pollution in 25 Italian Cities

Author

Listed:
  • Matteo Scortichini

    (Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy)

  • Manuela De Sario

    (Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy)

  • Francesca K. De’Donato

    (Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy)

  • Marina Davoli

    (Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy)

  • Paola Michelozzi

    (Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy)

  • Massimo Stafoggia

    (Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Rome, Italy
    Institute of Environmental medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden)

Abstract

Evidence on the health effects of extreme temperatures and air pollution is copious. However few studies focused on their interaction. The aim of this study is to evaluate daily PM10 and ozone as potential effect modifiers of the relationship between temperature and natural mortality in 25 Italian cities. Time-series analysis was run for each city. To evaluate interaction, a tensor product between mean air temperature (lag 0–3) and either PM10 or ozone (both lag 0–5) was defined and temperature estimates were extrapolated at low, medium, and high levels of pollutants. Heat effects were estimated as percent change in mortality for increases in temperature between 75th and 99th percentiles. Results were pooled by geographical area. Differential temperature-mortality risks by air pollutants were found. For PM10, estimates ranged from 3.9% (low PM10) to 14.1% (high PM10) in the North, from 3.6% to 24.4% in the Center, and from 7.5% to 21.6% in the South. Temperature-related mortality was similarly modified by ozone in northern and central Italy, while no effect modification was observed in the South. This study underlines the synergistic effects of heat and air pollution on mortality. Considering the predicted increase in heat waves and stagnation events in the Mediterranean countries such as Italy, it is time to enclose air pollution within public health heat prevention plans.

Suggested Citation

  • Matteo Scortichini & Manuela De Sario & Francesca K. De’Donato & Marina Davoli & Paola Michelozzi & Massimo Stafoggia, 2018. "Short-Term Effects of Heat on Mortality and Effect Modification by Air Pollution in 25 Italian Cities," IJERPH, MDPI, vol. 15(8), pages 1-12, August.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:8:p:1771-:d:164260
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    References listed on IDEAS

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    1. Daniel E. Horton & Christopher B. Skinner & Deepti Singh & Noah S. Diffenbaugh, 2014. "Occurrence and persistence of future atmospheric stagnation events," Nature Climate Change, Nature, vol. 4(8), pages 698-703, August.
    2. Francesca K. De’ Donato & Michela Leone & Matteo Scortichini & Manuela De Sario & Klea Katsouyanni & Timo Lanki & Xavier Basagaña & Ferran Ballester & Christofer Åström & Anna Paldy & Mathilde Pascal , 2015. "Changes in the Effect of Heat on Mortality in the Last 20 Years in Nine European Cities. Results from the PHASE Project," IJERPH, MDPI, vol. 12(12), pages 1-17, December.
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    Cited by:

    1. Elisa Stivanello & Federico Chierzi & Paolo Marzaroli & Sara Zanella & Rossella Miglio & Patrizia Biavati & Vincenza Perlangeli & Domenico Berardi & Angelo Fioritti & Paolo Pandolfi, 2020. "Mental Health Disorders and Summer Temperature-Related Mortality: A Case Crossover Study," IJERPH, MDPI, vol. 17(23), pages 1-11, December.
    2. Lisbeth Weitensfelder & Hanns Moshammer, 2019. "Evidence of Adaptation to Increasing Temperatures," IJERPH, MDPI, vol. 17(1), pages 1-9, December.
    3. Rosa María Cerón Bretón & Julia Griselda Cerón Bretón & Jonathan W. D. Kahl & María de la Luz Espinosa Fuentes & Evangelina Ramírez Lara & Marcela Rangel Marrón & Reyna del Carmen Lara Severino & Mart, 2020. "Short-Term Effects of Atmospheric Pollution on Daily Mortality and Their Modification by Increased Temperatures Associated with a Climatic Change Scenario in Northern Mexico," IJERPH, MDPI, vol. 17(24), pages 1-21, December.

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