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Investigating mortality heterogeneity among neighbourhoods of a highly industrialised Italian city: a meta-regression approach

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

The purpose of this study was to investigate the role of various predictors to explain spatial mortality heterogeneity in Taranto.

Methods

Direct age-adjusted death rates (ADR) at a neighbourhood level for the period 1998–2010 were examined. SO2, PM10, distance from pollution sources, and socioeconomic status (SES) were tested as predictors within a meta-regression framework. We used τ 2 to quantify heterogeneity in ADR and I 2 statistic with 95 % confidence intervals to estimate the proportion of total variation across neighbourhoods attributable to the between-neighbourhood heterogeneity.

Results

High heterogeneity resulted for all and natural causes of death for both genders. One neighbourhood (Paolo VI) was detected as an outlier for all predictors except SO2, among males. After accounting for SES, moderate heterogeneity among residuals was observed for all-causes of death and was correlated with SO2. Higher concentrations of PM10 were observed in neighbourhoods close to the industrial site and higher concentrations of SO2 in neighbourhoods more distant from the industrial site.

Conclusions

SES and air pollutants were predictors of spatial heterogeneity in ADR. Different distributions of SO2 and PM10 in the city suggested two exposure patterns.

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References

  • Andersen ZJ, Olsen TS, Andersen KK, Loft S, Ketzel M, Raaschou-Nielsen O (2010) Association between short-term exposure to ultrafine particles and hospital admissions for stroke in Copenhagen, Denmark. Eur Heart J 31(16):2034–2040. doi:10.1093/eurheartj/ehq188

    Article  CAS  PubMed  Google Scholar 

  • Benach J, Yasui Y, Borrell C, Saez M, Pasarin MI (2001) Material deprivation and leading causes of death by gender: evidence from a nationwide small area study. J Epidemiol Community Health 55(4):239–245

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Benedetti M, Iavarone I, Comba P (2001) Cancer risk associated with residential proximity to industrial sites: a review. Arch Environ Health 56(4):342–349. doi:10.1080/00039890109604466

    Article  CAS  PubMed  Google Scholar 

  • Belsley DA, Kuh E, E. WR (1980) Regression diagnostics: identifying influential data and sources of collinearity. Wiley, New York

  • Buringh E, Fischer P, Hoek G (2000) Is SO2 a causative factor for the PM-associated mortality risks in the Netherlands. Inhal Toxicol 12:55–60. doi:10.1080/089583700196383

    Article  CAS  Google Scholar 

  • Caranci N, Biggeri A, Grisotto L, Pacelli B, Spadea T, Costa G (2010) The Italian deprivation index at census block level: definition, description and association with general mortality. Epidemiol Prevenzione 34(4):167–176

    Google Scholar 

  • Carstairs V (2000) Socioeconomic factors at areal level and their relationship with health. In: Elliott PJW, Best N, Briggs D (eds) Spatial Epidemiology methods and applications. Oxford University Press, Oxford, pp 51–67

  • Cesaroni G et al (2014) Long term exposure to ambient air pollution and incidence of acute coronary events: prospective cohort study and meta-analysis in 11 European cohorts from the ESCAPE Project. BMJ 348:f7412. doi:10.1136/bmj.f7412

    Article  PubMed  PubMed Central  Google Scholar 

  • Dadvand P et al (2013) Maternal exposure to particulate air pollution and term birth weight: a multi-country evaluation of effect and heterogeneity. Environ Health Persp 121(3):267–373

    Article  Google Scholar 

  • Davey Smith G et al (1998) Education and occupational social class: which is the more important indicator of mortality risk? J Epidemiol Community Health 52(3):153–160

    Article  CAS  PubMed  Google Scholar 

  • DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  CAS  PubMed  Google Scholar 

  • Forastiere F, Biggeri A, Triassi M (2012) Perizia conferita il giorno 24 Giugno 2011dal Giudice per le indagini preliminari dott.ssa Patrizia Todisco. Tribunale di Taranto Ufficio per le Indagini Preliminari

  • Franchini M, Rial M, Buiatti E, Bianchi F (2004) Health effects of exposure to waste incinerator emissions:a review of epidemiological studies. ANN I SUPER SANITA 40(1):101–115

    CAS  Google Scholar 

  • Gariazzo C, Papaleo V, Pelliccioni A, Calori G, Radice P, Tinarelli G (2007) Application of a Lagrangian particle model to assess the impact of harbour, industrial and urban activities on air quality in the Taranto area, Italy. Atmos Environ 41(30):6432–6444. doi:10.1016/j.atmosenv.2007.06.005

    Article  CAS  Google Scholar 

  • Greenland S (1987) Quantitative methods in the review of epidemiologic literature. Epidemiol Rev 9:1–30

    CAS  PubMed  Google Scholar 

  • Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558

    Article  PubMed  Google Scholar 

  • Hoek G et al (2013) Long-term air pollution exposure and cardio- respiratory mortality: a review. Environ Health 12(1):43. doi:10.1186/1476-069X-12-43

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Knox EG (2005) Childhood cancers and atmospheric carcinogens. J Epidemiol Community Health 59(2):101–105. doi:10.1136/jech.2004.021675

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Loyo-Berrios NI, Irizarry R, Hennessey JG, Tao XG, Matanoski G (2007) Air pollution sources and childhood asthma attacks in Catano, Puerto Rico. Am J Epidemiol 165(8):927–935. doi:10.1093/aje/kwk088

    Article  PubMed  Google Scholar 

  • Mangia C, Gianicolo EA, Bruni A, Vigotti MA, Cervino M (2013) Spatial variability of air pollutants in the city of Taranto, Italy and its potential impact on exposure assessment. Environ Monit Assess 185(2):1719–1735. doi:10.1007/s10661-012-2663-4

    Article  CAS  PubMed  Google Scholar 

  • Mataloni F, Stafoggia M, Alessandrini E, Triassi M, Biggeri A, Forastiere F (2012a) A cohort study on mortality and morbidity in the area of Taranto, Southern Italy. Epidemiol Prevenzione 36(5):237–252

    Google Scholar 

  • Mataloni F, Stafoggia M, Alessandrini E, Triassi M, Biggeri A, Forastiere F (2012) Studio di coorte sulla mortalità e morbosità nell’area di Taranto. Tabelle aggiuntive. http://www.epiprev.it/articolo_scientifico/studio-di-coorte-sulla-mortalit%C3%A0-e-morbosit%C3%A0-nell%E2%80%99area-di-taranto. Accessed 2 June 2016

  • Pickett KE, Pearl M (2001) Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. J Epidemiol Community Health 55(2):111–122

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pope AJ (1976) The statistics of residuals and the detection of outliers. US Department of Commerce, National Oceanic and Atmospheric Administration, National Ocean Survey, Geodetic Research and Development Laboratory

  • Sanna M, Monguzzi R, Santilli N, Felice R (2012) Perizia conferita il giorno 8 Novembre 2010 dal Giudice per le Indagini Preliminari Dottoressa Patrizia Todisco. Tribunale di Taranto Ufficio per le Indagini Preliminari

  • Thomas B, Dorling D, Smith GD (2010) Inequalities in premature mortality in Britain: observational study from 1921 to 2007. BMJ 341:c3639. doi:10.1136/bmj.c3639

    Article  PubMed  PubMed Central  Google Scholar 

  • Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21(11):1559–1573. doi:10.1002/sim.1187

    Article  PubMed  Google Scholar 

  • Thompson SG, Sharp SJ (1999) Explaining heterogeneity in meta-analysis: a comparison of methods. Stat Med 18(20):2693–2708

    Article  CAS  PubMed  Google Scholar 

  • Vigotti MA, Mataloni F, Bruni A, Minniti C, Gianicolo EA (2014) Mortality analysis by neighbourhood in a city with high levels of industrial air pollution. Int J Public Health 59(4):645–653. doi:10.1007/s00038-014-0554-x

    Article  PubMed  Google Scholar 

  • Wichmann HE et al (2000) Daily mortality and fine and ultrafine particles in Erfurt, Germany part I: role of particle number and particle mass. Res Rep Health Effects Inst (98):5–86 (discussion 87–94)

Download references

Acknowledgments

We acknowledge Claudia Spix, Oliver Bayer, Maria Angela Vigottti and Francesco Forastiere for useful discussions. We wish to thank Francesca Mataloni for supplying data and Katherine Taylor and Derek Jones for helping revise and edit the English. This original article is part of the PhD of Emilio A. L. Gianicolo at the University of Mainz, Institute for Medical Biostatistics, Epidemiology and Informatics and his stay is within the scientific initiative of the Italian National Research Council named “Congedo per motivi di studio”.

Author information

Authors and Affiliations

  1. Institute of Clinical Physiology, National Research Council, Lecce, Italy

    Emilio Antonio Luca Gianicolo

  2. Institute of Medical Biometrics, Epidemiology and Informatics (IMBEI), Johannes Gutenberg University of Mainz, Obere Zahlbacher Str. 69, 55131, Mainz, Germany

    Emilio Antonio Luca Gianicolo

  3. Institute of Atmospheric Sciences and Climate, National Research Council, s.p. Lecce-Monteroni km 1.2, 73100, Lecce, Italy

    Cristina Mangia

  4. Institute of Atmospheric Sciences and Climate, National Research Council, Bologna, Italy

    Marco Cervino

Authors
  1. Emilio Antonio Luca Gianicolo
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  2. Cristina Mangia
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  3. Marco Cervino
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Corresponding author

Correspondence to Emilio Antonio Luca Gianicolo.

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This study did not receive any research grant.

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Emilio Antonio Luca Gianicolo: corresponding author, researcher at the Institute of Clinical Physiology, National Research Council, Lecce, Italy and visiting researcher at Johannes Gutenberg University of Mainz. Institute of Medical Biometrics, Epidemiology and Informatics (IMBEI), Germany.

Cristina Mangia, researcher at the Institute of Atmospheric Sciences and Climate, National Research Council, Lecce, Italy.

Marco Cervino, researcher at Institute of Atmospheric Sciences and Climate, National Research Council, Bologna, Italy.

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Gianicolo, E.A.L., Mangia, C. & Cervino, M. Investigating mortality heterogeneity among neighbourhoods of a highly industrialised Italian city: a meta-regression approach. Int J Public Health 61, 777–785 (2016). https://doi.org/10.1007/s00038-016-0868-y

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  • DOI: https://doi.org/10.1007/s00038-016-0868-y

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