Mortality and morbidity in a population exposed to multiple sources of air pollution: A retrospective cohort study using air dispersion models

Environ Res. 2015 Feb;137:467-74. doi: 10.1016/j.envres.2014.10.036. Epub 2015 Feb 18.


Background and aims: A landfill, an incinerator, and a refinery plant have been operating since the early 1960s in a contaminated site located in the suburb of Rome (Italy). To evaluate their potential health effects, a population-based retrospective cohort study was conducted using dispersion modeling for exposure assessment.

Methods: A fixed cohort was enrolled in the Rome Longitudinal Study in 2001, mortality and hospitalizations were followed-up until 2010. Exposure assessments to the landfill (H2S), the incinerator (PM10), and the refinery plant (SOX) were performed for each subject using a Lagrangian dispersion model. Individual and small-area variables were available (including exposures levels to NO2 from traffic and diesel trucks). Cox regression analysis was performed (hazard ratios, HRs, 95% CI) using linear terms for the exposures (5th-95th percentiles difference). Single and bi-pollutant models were run.

Results: The cohort included 85,559 individuals. The estimated annual average exposures levels were correlated. H2S from the landfill was associated with cardiovascular hospital admissions in both genders (HR 1.04 95% CI 1.00-1.09 in women); PM10 from the incinerator was associated with pancreatic cancer mortality in both genders (HR 1.40 95% CI 1.03-1.90 in men, HR 1.47 95% CI 1.12-1.93 in women) and with breast morbidity in women (HR 1.13 95% CI 1.00-1.27). SOx from the refinery was associated with laryngeal cancer mortality in women (HR 4.99 95% CI 1.64-15.9) and respiratory hospital admissions (HR 1.13 95% CI 1.01-1.27).

Conclusions: We found an association of the pollution sources with some cancer forms and cardio-respiratory diseases. Although there was a high correlation between the estimated exposures, an indication of specific effects from the different sources emerged.

Keywords: Cancer; Dispersion model; Industrial sites; Residential cohort; Waste.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Air Movements
  • Air Pollution / adverse effects*
  • Child
  • Child, Preschool
  • Environmental Exposure*
  • Environmental Monitoring
  • Female
  • Humans
  • Italy / epidemiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Morbidity*
  • Mortality*
  • Retrospective Studies
  • Waste Disposal Facilities*
  • Young Adult