"OBJECTIVES: to investigate the increase of PM10 during Saharan dust outbreaks with adverse health effects in Sicily (Southern Italy), the largest Mediterranean Island.
Design: pooled analyses of time series with Poisson regression models to estimate the association between PM10 from different sources (desert and non-desert) and different outcomes.
Setting and participants: the four largest cities of Sicily (Palermo, Catania, Syracuse, and Messina) and three macroareas (North- East, South, and West) Sicily was divided into.
Main outcome measures: daily count of cause-specific (ICD-9 codes) mortality and hospital admissions: natural (0-799), cardiovascular (390-459), and respiratory causes (460-519).
Results: 962 days affected by Saharan dust (30% of all days: 2,257) were identified. Significant associations between desert PM10 and natural mortality both in the cities and in the macro-areas were found, with increases of risk and 95% confidence intervals equal to 1.1% (95%CI 0.1-2.1) and 1.1% (95%CI 0.8-1.5) per 10 μg/m3 increase in lag 0-1 PM10, respectively. Weaker estimates were found for cardiorespiratory mortality. Desert PM10 displayed an association with respiratory hospitalizations, especially in the three macroareas (0.5%; 95%CI 0.1-1.0). In contrast, cardiovascular hospitalizations were associated only with non-desert PM10 in the four cities (1.3%; 95%CI 0.4- 2.1%). Higher desert PM10-related mortality was found during the warmer months (period: April-September): 2.7% (95%CI 0.8-4.5) in the four cities and 2.5% (95%CI 1.8%-3.2%) in the three macroareas. CONCLUSIONS PM10 originating from desert was positively associated with mortality and hospitalizations in Sicily. Policies should aim to reduce anthropogenic emissions even in areas with large contribution from desert sources."