Residential exposure to air pollution and incidence of leukaemia in the industrial area of Viadana, Northern Italy.

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.

Residential exposure to air pollution and adverse respiratory and allergic outcomes in children and adolescents living in a chipboard industrial area of Northern Italy.

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.

Spatial variability of nitrogen dioxide and formaldehyde and residential exposure of children in the industrial area of Viadana, Northern Italy.

Chipboard production is a source of ambient air pollution. We assessed the spatial variability of outdoor pollutants and residential exposure of children living in proximity to the largest chipboard industry in Italy and evaluated the reliability of exposure estimates obtained from a number of available models. We obtained passive sampling data on NO2 and formaldehyde collected by the Environmental Protection Agency of Lombardy region at 25 sites in the municipality of Viadana during 10 weeks (2017-2018) and compared NO2 measurements with average weekly concentrations from continuous monitors. We compared interpolated NO2 and formaldehyde surfaces with previous maps for 2010. We assessed the relationship between residential proximity to the industry and pollutant exposures assigned using these maps, as well as other available countrywide/continental models based on routine data on NO2, PM10, and PM2.5. The correlation between NO2 concentrations from continuous and passive sampling was high (Pearson's r = 0.89), although passive sampling underestimated NO2 especially during winter. For both 2010 and 2017-2018, we observed higher NO2 and formaldehyde concentrations in the south of Viadana, with hot-spots in proximity to the industry. PM10 and PM2.5 exposures were higher for children at < 1 km compared to the children living at > 3.5 km to the industry, whereas NO2 exposure was higher at 1-1.7 km to the industry. Road and population densities were also higher close to the industry. Findings from a variety of exposure models suggest that children living in proximity to the chipboard industry in Viadana are more exposed to air pollution and that exposure gradients are relatively stable over time.

[Cause-specific mortality in populations exposed and unexposed to outdoor emissions of formaldehyde and wood dust: the Viadana study]. / Confronto dell'esperienza di mortalità per cause specifiche di popolazioni esposte e non esposte a fonti emissive esterne di formaldeide e polveri di legno: lo studio di Viadana.

AIM: to describe the mortality risk for all causes and chronic diseases among people living in the industrial district of Viadana (Mantua), where wooden furniture factories producing formaldehyde and wood dust are situated. DESIGN: mortality for the years 1996-2005 among residents in the municipalities where the industrial plants are located (exposed areas) was compared with the mortality among people living in the areas without plants (non-exposed areas). MAIN OUTCOMES: standardized mortality ratios (SMR), using as reference the total population of the Province of Mantua. RESULTS: overall mortality risk was slightly higher in the non-exposed areas and in the district of Viadana than in the Province of Mantua. Mortality risk for all cancers in the exposed areas was lower than in the Province of Mantua (SMR=0.93; 95% IC 0.87-0.99). Mortality for prostate cancer was significantly increased in the exposed areas compared to non-exposed areas (RR=1.83; 95% IC 1.08-3.09) and to the Province of Mantua as a whole (SMR=1.39; 95% IC 1.06-1.79). Mortality maps suggest a higher mortality risk for prostate cancer, mainly among exposed areas. An excess of mortality for leukaemia (non-statistically significant) and for respiratory diseases (statistically significant) was found in Gazzuolo and Sabbioneta, both located in the exposed area. CONCLUSION: no statistically significant excess risk of mortality for cancer of upper aerodigestive tract was found among residents in municipalities where wood dust and formaldehyde producing factories were active. The increased mortality risk for prostate cancer and leukaemia needs to be deeply analyzed.

Proximity to wood industries and respiratory symptoms in children: a sensitivity analysis.

Increased prevalence of respiratory and irritation symptoms was found in children who live near a large wood industrial park. Proximity to the wood industries was used as indicator of exposure. This study describes a sensitivity analysis for the results of the survey. All the children (3-14 years) living in the area were surveyed through a parental questionnaire (n=3854) and their addresses were geocoded. The distances from each child's home and school to the closest industry were combined, weighted and used as an indicator of exposure. A sensitivity analysis was performed to check 1) the robustness of the results to the choice of weights used for defining the exposure indicator, 2) the effect of outliers on risk estimates and 3) the sensitivity on the functional form used for modeling the dose-response function. The choice of the weights did not influence the association between proximity to the industries and respiratory symptoms. Excluding the subjects who lived far away from the industries showed that in a radius of 5km from the industries the study did not had enough power to estimate a gradient in the dose-response function. Besides, results were sensitive to the choice of the functional form used for modeling the minimum distance. The sensitivity analyses confirmed the overall increasing trend of respiratory symptoms with proximity to the industries and pointed out that all the assumptions made for defining a proxy of exposure need to be carefully checked.

Proximity to wood factories and hospitalizations for respiratory diseases in children.

BACKGROUND: Exposure to air pollutants emitted by wood industries has been associated with increased prevalence of respiratory and irritation symptoms. OBJECTIVES: To study whether proximity to wood industries was associated with risk of hospitalization for respiratory diseases in children. METHODS: In December 2006, the large majority of the children (3-14 years) living in the Viadana district (Northern Italy) were surveyed through a parental questionnaire (n=3854). Hospital discharge records for respiratory diseases (2002-2006) were obtained from the local Health Unit. The children were geocoded and the distance from their home/school to the wood industries was used as exposure indicator. Poisson regression models were used to assess the association between the distance and hospitalizations. RESULTS: The hospitalization rates for respiratory diseases increased with proximity to the wood industries: they were 7.55 (95% CI 5.58, 10.22) ×1000 person-year for those who lived far from any wood industry, 11.84 (95% CI 8.87, 15.81) ×1000 person-year for those <2km from the small wood factories and 16.61 (95% CI: 13.57, 20.33) ×1000 person-year for those living within 2km from the two big chipboard industries. CONCLUSIONS: Proximity to wood industries is associated with a higher risk of hospitalization for respiratory diseases and respiratory symptoms in children. Studies with direct measures of exposure are needed and a follow-up of exposed population is advisable.

Proximity to chipboard industries increases the risk of respiratory and irritation symptoms in children: the Viadana study.

Emissions related to wood production processes are a recognized health hazard for professionally exposed subjects. The health effects of living close to wood industries are not known, particularly in the pediatric population. We aimed at investigating if living close to chipboard industries is a health hazard for the children in the Viadana district (Northern Italy). In December 2006, all the children (3-14 years) living in the Viadana district, where two big chipboard industries are located, were surveyed through a parental questionnaire (n=3854). The children were geocoded, and the distance of their houses/schools from the closest wood plant was computed. Independently of sex, age, nationality, residential area, traffic, parents' education, passive/parental smoking, questionnaire compiler and his/her environmental concern, the children living at <2 km from chipboard industries had a greater prevalence of respiratory (OR=1.33, 95%CI: 1.11, 1.60), cough/phlegm (OR=1.43, 95%CI: 1.08, 1.88), nose/throat/mouth (OR=1.47, 95%CI: 1.23, 1.75), eye (OR=1.24, 95%CI: 1.04, 1.48) symptoms, school-days lost (OR=1.24, 95%CI: 1.04, 1.48), and emergency (OR=2.14, 95%CI: 1.47, 3.11) and hospital (OR=2.21, 95%CI: 1.17, 4.18) admissions. There was an inverse dose-response relationship between the adverse health outcomes considered and the distance from the plants. The attributable fractions for the children living close to the chipboard industries were substantial, ranging from 13% (eye symptoms) to 27% (cough/phlegm). The present findings suggest that emissions from chipboard industries might have a serious impact on children's health status and should therefore be reduced and closely monitored.