In Italy 30,000 people die every year because of air pollution caused by fine particulate matter (PM2.5) only – which corresponds to 7% of all deaths (excluding accidents). In terms of life expectancy this means that, on average, air pollution shortens the life of every Italian citizen by 10 months; 14 months for those living in Northern Italy; 6.6 months for those living in Central Italy and 5.7 for the inhabitants of Southern Italy and the islands of the country. Northern Italy is the most affected area. Respecting laws would save 11,000 lives every year.

 These are the most important findings of the “Progetto VIIAS” – VIIAS project (the Italian acronym stands for: “Integrated Evaluation of the Impact of Air Pollution on the Environment and Health”), coordinated by the Department of Epidemiology of the Lazio Region Health Service within the initiatives of the Centro Controllo Malattie (CCM), the Centre for Disease Control of the Italian Ministry of Health. The results will be presented on 4^th June 2015 at the Auditorium of the Ministry (via Giorgio Ribotta, 5 – Rome). The meeting will take place only few days after the resolution on air pollution adopted by the 68^th World Health Assembly, a resolution that reiterates the negative impact of pollution on health and that calls upon all Governments to act on the issue with immediate and urgent measures.

 The VIIAS project is the very first, tangible, answer to this warning.

Besides providing a detailed map of the environmental and health impact of air pollution, it actually stresses how proper policies could help gains for the reduction of disease and mortality rates, decreasing inequalities on the territory and saving public resources. Also, the analysis put together by the VIIAS project enables us also to perceive clearly how the nature of air pollution has changed over the past ten years, by identifying biomass combustion for heating and diesel exhaust fumes as the two main culprits prevention should focus on. 

The new map of pollution in Italy

Using sophisticated statistical methods of modelling the concentration of pollutants on the whole national territory, the VIIAS project has estimated both the exposure risk for the Italian population and the total mortality rate – as well as the mortality rate connected to respiratory disease; cardiovascular disease and lung cancer in Italy and in each and every Italian Region. 

The picture emerging from the study provides worrying numbers: 29% of the Italian population lives in areas where the concentration of pollutants is constantly higher than the legal limit. In addition, there are considerable inequalities in the health impact on the Italian territory. As one may expect, pollution affects mostly the Northern part of the country (65% of the total) where there is a high concentration of urban areas with congested traffic and busy industrial belts. Biomass combustion (mainly wood and pellet) is also responsible for a higher mortality and morbidity rates caused by fine particulate matter.

The reckonings carried out during the project show clearly the evolution of the effects of pollution on health throughout time. In 2005 the number of deaths linked to pollution was distributed as follows: 34,552 due to PM2.5; 23,387 due to NO2 and 1,707 due to  O3.  However, 2010 marked a great decrease for the numbers related to PM2.5 (21,524) and NO2 (11,993) especially in view of less emissions in connection with the economic recession.

Whereas, in 2020, despite the technological improvements and the policies implemented, seemingly the situation will be far from better if compared to 2010 (28,595 deaths because of PM 2.5; 10,117 because of NO2).

Improving is possible but it is a complex challenge

For 2020, the VIIAS project contemplates two alternative scenarios:

 1.     The full compliance of Italy with all the laws, limits and regulations set at the national and European level.

2.     An even reduction by 20% of the concentration of pollutants on the national territory.

Both scenarios would translate into many lives saved: 11,000 for PM2.5 and 14,000 for NO2 for scenario number 1 and 16,000 for PM2.5 and 18,000 for NO2 for scenario number 2 – always in comparison with the 2005 values.

This perspective shows how the full compliance with the legal limits set by the current laws and, moreover, the further reduction by 20% of the average yearly concentration would be incredibly beneficial for public health. And for the Economy in turn: official WHO statistics show that 10,000 deaths less a year equal to more or less 30 billion euros saved.

Health in all policies

However, this is a very complex challenge. The VIIAS study has in fact proved how the considerable reduction in emissions happened over the past ten years has not led to a proportional decrease in the level of exposure – especially in those areas of the Country (e.g. the Po valley) whose geographical and weather conditions are particularly complicated.

Thus, it is of paramount importance to design an effective plan for the air quality at the national level in coordination with the regional planning – placing Health at the centre of all policies, in agreement with what WHO has been advocating for a long time now. New measures are a must to mitigate the growing impact of the biomass combustion: biomasses are surely useful to counteract climate change but are also incredibly damaging in terms of pollution created by particulate.

The commitment to sustainable mobility (pedestrian, bicycle, eco-friendly public transportation systems) is a priority - with a reduction of diesel fuelled vehicles, which are responsible for the 91% of all nitrogen dioxide emissions and for a high percentage of particulate in the transport sector. The emissions coming from the agriculture (ammonia) should be carefully monitored and limited too. In addition, focused forestation interventions in urban zones could mitigate the effects of pollution in metropolitan areas.

The VIIAS project is coordinated by the Department of Epidemiology of the Lazio Region Health Service and is the result of an extensive collaboration involving Italian Universities and Research centres (e.g. ENEA, ISPRA, the ARPA of Piedmont, Emilia Romagna and Lazio; the statistics dept. of the University of Florence, the University of Urbino and the Dept. of Environmental Biology of the La Sapienza University in Rome). On the www.viias.it website – updated by the project’s partner Zadig all the relevant data and materials / resources are available.