Atlante Aria e Salute: metodi per la stima degli impatti sanitari dell'inquinamento atmosferico e applicazione sul territorio nazionale.

Abstract

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