Ondate di calore, picchi di inquinamento e salute ... · Ondate di calore, picchi di inquinamento e...

Ondate di calore,

picchi di inquinamento

e salute respiratoria

dei bambini

Stefania La Grutta, MD, PhD

Primo Ricercatore

Istituto di Biomedicina e Immunologia Molecolare, IBIM

Consiglio Nazionale delle Ricerche

Palermo

1

Ondate di calore & salute respiratoria dei bambini

Stefania La Grutta 23.06.2017

Number of papers /year in MEDLINE using search terms for

heat wave and respiratory and children 1966 -2016

0

1

2

3

4

5

6

7



Association (RR) estimate

and 95% CI between total

mortality and extremely hot days (those that

exceeded the weather station-specific 95th percentile of maximum temperature)

stratified by age and sex.

Basagaña X, et al. Epidemiology 2011;22: 765–772.

warm seasons of 1983–2006 (503,389 deaths) Three consecutive hot days increased

total daily mortality by 19%.

6% of all deaths were attributable to heat.


Analitis A, et al. Epidemiology. 2014;25:15-22.

Not consistent

modification pattern of the

HW effects on respiratory

mortality during low and

high pollution days.

HW effect on respiratory

mortality is larger than on

other causes of death.


Percent increase in the daily number of deaths in days with

a heat wave (HW) and a “low” or “high” level of PM10


Analitis A, et al. Epidemiology. 2014;25:15-22.


Percent increase in the daily number of deaths in days with

a heat wave (HW) and a “low” or “high” level of ozone

Not consistent

modification pattern of the

HW effects on respiratory

mortality during low and

high pollution days.

HW effect on respiratory

mortality is larger than on

other causes of death.



Son JY, et al. Biometereology 2016; 60:113-21.

Relationship between temperature and risk of mortality, comparing various temperature

levels with a reference temperature of 20.5°C for RESPIRATORY MORTALITY

lag 0-1 days for heat effect, May 1996- Dec 2010

90th–99th50th–90th




Percentage change in mortality risk on HW days

compared with non-HW days by cause of death

HW effects were estimated based on the HW definition of temperatures ≥96th (25.6°C) for ≥2 days,

27 HW occurred in the study period (average 1.8 heat waves/year) percentile for ≥ 2 days.




Percentage change in total mortality risk for heat effect by age

1.8

3.3

6.1

8

1.6

4.2

6.6

8.8

0

1

2

3

4

5

6

7

8

9

10

0-14 15-64 65-74 >74

90th percentile (24.1℃) to 50th percentile 99th percentile (26.2℃) to 50th percentile



Knowlton K, et al. Environ Health Perspect. 2008;117:61–67.

RRs (95% CIs) for HEAT-RELATED ILLNESSES in California during the 2006 HW

(15 July to 1 August 2006) vs the reference period (8–14 July and 12–22 August 2006)



Son JY, et al. Int J Biometeorol. 2014;58:1893-903.

Overall absolute heat effects, percent change in risk (95 % interval)

Lag 0 for heat effect. The values represent percent change

in risk comparing the 25°C (90th) and 15°C (50th)

2003 to 2008

Selected respiratory disease

Croup

Pneumonia

Bronchiolitis

Respiratory infection (bronchitis)

COPD

Asthma



Xu Z, et al. Int J Biometeorol. 2014;58:239-47.

Potentially relevant studies in the initial searching (n= 628)

Studies included in final review (n=12)

Literature published up to August 2012

Future research:

define a heat wave from a children’s health perspective

identify the best measure of exposure to heat waves

explore sensitive outcome measures

quantify the impact on children’s birth outcomes

understand age differences in vulnerability to heat waves



PEDIATRICS Volume 136, number 5, November 2015



RECOMMENDATIONS TO PEDIATRICIANS

PEDIATRICS Volume 136, number 5, November 2015

1. Promote medical educational opportunities.

2. Discuss climate change with families.

3. Educate children, families, and communities

on emergency.

4. Advocate for local, national, policies

for adaptation strategies.

5. Build a broader coalition across disciplines

to address climate change at the local and

national levels.

Picchi di inquinamento & salute respiratoria dei bambini


0

5

10

15

20

25

30

Number of papers /year in MEDLINE using search terms for

outdoor pollution and respiratory and children 1977 -2017



O’Connor GT et al. JACI 2008; 121: 1133-9.



Chen CH, et al. Environmental Research 2015;137:40–48.

Comparison of the effects of short-term and sub-chronic

ambient air pollutant exposure on children's lung function



Colais P, et al. Epidemiol Prev. 2009; 33(6)suppl 1:75:92.



Silverman, et al.J Allergy Clin Immunol. 2010;125:367-73.



Sheffield PE, et al. Am J Prev Med . 2011;41(3):251–257.



Fan J, et al. Environ Sci Pollut Res. 2016; 23:843–850.



Lim H, et al. J Prev Med Public Health. 2016;49:205-219.

Children’s hospital admissions and

emergency department visits for

asthma are positively associated with a

short-term 10 μg/m3 increase in PM2.5

(RR, 1.048; 95% CI, 1.028-1.067)

26 time-series and case-crossover design studies

2017Salerno, 29 AprileStefania La Grutta 23.06.2017

all’effetto della esposizione.

Fattore di per declino della funzione e

riacutizzazioni.

Necessita di molteplicità di per la

riduzione della esposizione in età pediatrica.

Ondate di calore, picchi di inquinamento

e salute respiratoria dei bambini

2017Salerno, 29 Aprile

Ondate di calore, picchi di inquinamento

e salute respiratoria dei bambini


Sergio BonomoGiovanna CilluffoSalvatore Fasola

Velia MaliziaLaura Montalbano

Grazie per l’attenzione

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