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

Abstract 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 (H 2 S), the incinerator (PM 10 ), and the refinery plant (SO X ) were performed for each subject using a Lagrangian dispersion model. Individual and small-area variables were available (including exposures levels to NO 2 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. H 2 S from the landfill was associated with cardiovascular hospital admissions in both genders (HR 1.04 95% CI 1.00–1.09 in women); PM 10 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). SO x 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.