The “Outdoor Air and Health Atlas”: Methods for estimating the health impact of air pollution and their application on a national scale

IF 0.8 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Epidemiologia & Prevenzione Pub Date : 2026-07-01 DOI:10.19191/EP26.4-5.S1.A1030.092

Andrea Ranzi, Simone Agostini, Serena Broccoli, Simone Giannini, Nicola Caranci, Laura Bonvicini, Matilde Fondriest, Daniela Fortuna, Massimo Bressan, Gisella Pitter, Giulia Capodaglio, Federica Nobile, Elisa Borroni, Paolo Chiodini, Orazio Valerio Giannico, Michele Carugno, Lucia Bisceglia, Massimo Stafoggia, Paola Angelini, Paolo Giorgi Rossi

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引用次数: 0

Abstract

Objectives: to describe the methodological framework of the 'Air and Health Atlas', an interactive web platform that integrates PM2.5 and NO2 concentrations, demographic and mortality data to estimate the burden-of-disease attributable to outdoor air-pollution in Italy.

Design: methodological study with an illustrative application based on real-world data from the Air and Health Atlas.

Setting and participants: annual PM2.5 and NO2 concentrations were modelled at 1×1 km spatial resolution for 2016-2024 using a random forest machine-learning approach combining airquality monitoring data, satellite observations, and spatiotemporal covariates. Population-weighted exposure (PWE) was estimated at municipality level by combining modelled concentrations with census-block population counts (Istat 2021). Mortality rates for natural (ICD-10 A00-R99), cardiovascular (ICD-10 I00-I99), respiratory causes (ICD-10 J00-J99), and for trachea, bronchus, and lung cancer (ICD-10 C33-C34) were obtained from death-certificate national database at provincial level, and for municipalities with >=500,000 residents, for 2016-2024.

Main outcome measures: attributable cases (AC) and attributable fractions (AF%) were estimated at municipality level using concentration-response functions based on epidemiological evidence (HRAPIE-2). The WHO counterfactual scenarios (5 μg/m³) were used. Atlas estimates are provided from 2017 onwards.

Results: using 2019 as an illustrative application, the Atlas showed marked geographical differences in health impacts attributable to air pollution. National PWE were 16.0 μg/m³ for PM2.5 and 21.0 μg/m³ for NO2, with lower exposures in Southern Italy and higher levels in the Po Valley (Northern Italy). Under WHO counterfactual scenarios, estimated natural-cause AF% were 9.9% for PM2.5 and 5.2% for NO2. Northern regions experienced the highest burdens, reflecting the combination of elevated pollution and high population density. The platform supports both retrospective analysis and prospective scenario evaluation, allowing users to explore potential health benefits of alternative air-quality standards or emissionreduction policies.

Conclusions: the Atlas integrates advanced exposure modelling with an intuitive web interface to support evidence-based health policies and communication in Italy. Its design allows for annual updates and future expansions to morbidity outcomes and economic assessments.

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空气与健康地图集:评估空气污染对健康影响的方法和在国家领土上的应用。

目标：描述“空气与健康地图集”的方法框架，这是一个交互式网络平台，整合了PM2.5和二氧化氮浓度、人口和死亡率数据，以估计意大利室外空气污染造成的疾病负担。设计：基于空气与健康地图集的真实世界数据的说明性应用的方法学研究。环境和参与者：使用随机森林机器学习方法，结合空气质量监测数据、卫星观测和时空协变量，以1×1公里空间分辨率模拟2016-2024年PM2.5和NO2的年度浓度。人口加权暴露（PWE）通过将模拟浓度与人口普查区人口计数相结合，在城市一级进行估计（Istat 2021）。2016-2024年，从省级死亡证明国家数据库和拥有50万居民的城市中获得自然死亡（icd - 10a00 - r99）、心血管死亡（icd - 10i00 - i99）、呼吸原因死亡（icd - 10j00 - j99）以及气管、支气管和肺癌死亡（icd - 10c33 - c34）的死亡率。主要结果测量：利用基于流行病学证据的浓度-反应函数（HRAPIE-2），在市一级估计归因病例（AC）和归因分数（AF%）。采用WHO反事实情景（5 μg/m³）。地图集估计从2017年开始提供。结果：以2019年为例，地图集显示，空气污染对健康的影响存在显著的地理差异。全国PWE PM2.5为16.0 μg/m³，NO2为21.0 μg/m³，意大利南部较低，波河流域（意大利北部）较高。根据世卫组织的反事实情景，估计PM2.5的自然原因AF%为9.9%，二氧化氮为5.2%。北方地区的负担最重，反映了污染加剧和人口密度高的结合。该平台支持回顾性分析和前瞻性情景评估，使用户能够探索替代空气质量标准或减排政策的潜在健康效益。结论：地图集将先进的暴露建模与直观的网络界面相结合，以支持意大利的循证卫生政策和沟通。其设计允许年度更新和未来扩展到发病率结果和经济评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epidemiologia & Prevenzione 医学-公共卫生、环境卫生与职业卫生

CiteScore

2.60

自引率

14.30%

发文量

审稿时长

>12 weeks

期刊介绍： Epidemiologia & Prevenzione, oggi organo della Associazione italiana di epidemiologia, raccoglie buona parte delle migliori e originali esperienze italiane di ricerca epidemiologica e di studio degli interventi per la prevenzione e la sanità pubblica. La rivista – indicizzata su Medline e dotata di Impact Factor – è un canale importante anche per la segnalazione al pubblico internazionale di contributi che altrimenti circolerebbero soltanto in Italia. E&P in questi decenni ha svolto una funzione di riferimento per la sanità pubblica ma anche per i cittadini e le loro diverse forme di aggregazione. Il principio che l’ha ispirata era, e rimane, che l’epidemiologia ha senso se è funzionale alla prevenzione e alla sanità pubblica e che la prevenzione ha ben poche possibilità di realizzarsi se non si fonda su valide basi scientifiche e se non c’è la partecipazione di tutti i soggetti interessati. Modalità di comunicazione aggiornate, metodologia statistica ed epidemiologica rigorosa, validità degli studi e solidità delle interpretazioni dei risultati sono la solida matrice su cui E&P è costruita. A questa si accompagna una forte responsabilità etica verso la salute pubblica, che oggi ha ampliato in forma irreversibile il suo orizzonte, e include in forma sempre più consapevole non solo gli esseri umani, ma l’intero pianeta e le modificazioni che l’uomo apporta all’universo in cui vive. L’ambizione è che l’offerta di nuovi strumenti di comunicazione, informazione e formazione, soprattutto attraverso l''uso di internet, renda la rivista non solo un tradizionale veicolo di contenuti e analisi scientifiche, ma anche un potente strumento a disposizione di una comunità di interessi e di valori che ha a cuore la salute pubblica.