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

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. 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 (H2S), the incinerator (PM10), and the refinery plant (SOX) were performed for each subject using a Lagrangian dispersion model. Individual and small-area variables were available (including exposures levels to NO2 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. The cohort included 85,559 individuals. The estimated annual average exposures levels were correlated. H2S from the landfill was associated with cardiovascular hospital admissions in both genders (HR 1.04 95% CI 1.00–1.09 in women); PM10 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). SOx 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). 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. •A residential cohort approach in an Italian industrial contaminated site was conducted.•Health status of 85,559 residents nearby a municipal solid waste landfill, an incinerator and a refinery was studied.•Dispersion modeling technique for population exposure was carried out.•Pancreatic and laryngeal cancer and cardio-respiratory diseases were detected.