Objective: to estimate the health impact of ozone in 13 Italian cities over 200,000 inhabitants and to produce basic elements to permit the reproducibility of the study in other urban locations.
Design: the following data have been used: population data (2001), health data (2001 or from scientific literature), environmental data (2002-2004), from urban background monitoring station and concentration/response risk coefficients derived from recent metanalyses. The indicators SOMO35 and SOMO0 have been used as a proxi of the average exposure to calcolate attributable deaths (and years of life lost) and several causes of morbility for ozone concentrations over 70 microg/m3.
Main outcome measure: acute mortality for all causes and for cardiovascular mortality, respiratory-related hospital admissions in elderly, asthma exacerbation in children and adults, minor restricted activity days, lower respiratory symptoms in children.
Results: over 500 (1900) deaths, the 0.6% (2.1%) of total mortality, equivalent to about 6000 (22,000) years of life lost are attributable to ozone levels over 70 microg/m3 in the 13 Italian cities under study. Larger figures, in the order of thousands, are attributable to less severe morbidity outcomes.
Conclusion: The health impact of ozone in Italian towns is relevant in terms of acute mortality and morbidity, although less severe than PM10 impact. Background ozone levels are increasing. Abatement strategies for ozone concentrations should consider the whole summer and not only "peak" days and look at policies limiting the concentration of precursors produced by traffic sources. Relevant health benefits can be obtained also under levels proposed as guidelines in the present environmental regulations.