Exposure to airborne pollutants has cost the lives of as many as 76,200 people in Italy in a single year. According to a study published in Lancet, we rank first in Europe for smog-related mortality. The importance of epidemiologists' work.
According to the World Health Organisation, exposure to air pollution worldwide causes 4.2 million deaths across the globe, of which at least 600,000 children are affected by acute respiratory infections caused by toxic air. Each year, almost 500,000 premature deaths are recorded in Europe. Exposure to carcinogenic particulate matter, nitrogen dioxide and tropospheric ozone has cost the lives of as many as 76,200 people in our country in a single year, the European Environment Agency reveals. According to a very recent study published in Lancet, we rank first in Europe for smog-related mortality.
Behind these estimates lies the work of epidemiologists — scientists who study the causes, distribution and frequency of diseases and mortality in the population, in relation to various factors. These are what are defined as health determinants, such as environmental quality, socio-economic conditions, occupational activity and exposure to pollutants. Among them are Fabrizio Bianchi, research director at the Cnr and head of the environmental epidemiology unit at the Institute of Clinical Physiology of the National Research Council, and Francesco Forastiere, now at the Cnr in Palermo and a visiting professor at King's College London.
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Francesco Forastiere himself was coordinator of the Viias study — Valutazione integrata dell'impatto ambientale e sanitario dell'inquinamento atmosferico (Integrated Assessment of the Environmental and Health Impact of Air Pollution) — commissioned by the Ministry of Health, which in 2015 had projected the effects on the health of Italians from fine particulate matter (PM2.5), ozone and nitrogen dioxide, up to 2020. The data confirmed that in 2005, smog had already been responsible for 7 per cent of the mortality observed from natural causes in Italy. "The Viias study already demonstrated that air pollution levels for the Italian population were unacceptable, with a heavy toll in human lives. These findings were confirmed by equivalent estimates from the European Environment Agency," the epidemiologist states. What has changed since then? "Today, compared to four years ago, there is greater awareness and a clearer understanding that air pollution and climate change are closely linked. But even if emissions of some pollutants have fallen, the situation is dramatic. Italy is one of the countries with the most serious health impact from smog."
"In the National Air Plan, the issue of prevention was completely ignored. The Ministry of Health took part in those discussions, but only to agree on communication activities to the public in the event of an alert for exceedance of emissions," Forastiere explains. Yet the health impact is significant. "One need only think of children and pregnant women. Studies confirm that air pollution affects the birth weight of newborns and rates of preterm births." For this reason too, the scientist stresses, "we need not only the intervention of the Ministry of Health but for the entire national health service, from GPs to local health authorities, to engage with environmental issues." Prevention is therefore essential, as is explaining to citizens the environmental consequences of unsustainable lifestyles. And public health research programmes are needed. "Which are currently lacking."
Fabrizio Bianchi shares this view. "The estimates produced by epidemiological studies point to around 60,000 premature deaths in Italy. But these are numbers that must not remain cold statistics or, worse still, morbid ones. They must be read carefully by policymakers as a number of deaths that can be avoided by reducing pollution." To achieve this, Fabrizio Bianchi reiterates, health prevention policies must not be excluded from decision-making tables within the Ministries of the Environment and Health. The same applies to the regions, which in this emergency situation have a critically important decision-making role, with territorial plans that can have an impact on air, water and soil quality. Also because, Bianchi recalls — author of numerous impact studies including those on the Vado Ligure coal-fired power station and on Val d'Agri and Taranto — "today, through satellite systems, we have access to very precise readings of environmental data and pollution in every corner of the country."
All of this would have been unimaginable just a few years ago. "The scientific literature and new monitoring systems allow us to carry out increasingly precise and detailed health impact assessments of pollution on the population — even in a preventive way," Bianchi reiterates. It is therefore essential to act well and act quickly. "The health costs of pollution, in terms of loss of quality of healthy life and premature deaths from disease, are both tangible in the short term and intangible — that is, extended over time. Unfortunately, they are never factored into budgets. The time needed to see results on the health front does not match the timeframe of politics." Is it a matter of time, then, or of will? "Reducing pollution today will bring benefits and save lives within a few years, in terms of healthy life expectancy. Whereas decisions are currently sized to short timeframes tied to politics and legislative terms — instead, we would need scenarios of at least five years to see concrete results."
Both epidemiologists agree: the fossil era has brought unsustainable consequences for the environment and for human, animal and plant health. Every decision towards a sustainable future, with new lifestyles based on renewable and non-polluting energy, must be taken as soon as possible. "Climate change — the other face of pollution — is upending the planet. Climate migrants will not number in the thousands, but in the millions. Changes that, as we doctors are observing, are also bringing back diseases we thought had been eradicated."
A dramatic picture, as outlined by the Ipcc well before Cop 25 in Madrid, which continues to be ignored by the world's powerful. "And yet everything is happening much more quickly than we thought, and action is needed in every country," Forastiere concludes. This is also why the pact between citizens, doctors and scientists becomes essential. "At the Cnr we have intensified studies at smaller scales, covering small portions of territory. Investigations that confirm the high risks of pollution and the great potential of prevention." This information must be disseminated among the population in a conscious and scientific manner.
"Every epidemiological study is designed with the involvement of the exposed populations. Participation must be active and create awareness," Fabrizio Bianchi specifies. "Our role as scientists is not only to carry out rigorous investigations, but to make them accessible to citizens and to younger sections of the population — as we have also begun to do here at the Cnr." A wealth of knowledge available to the Fridays for Future generation.
