Mortality and hospitalization associated to emissions of a coal power plant: A population-based cohort study

Fabrizio Minichilli; Francesca Gorini; Elisa Bustaffa; Liliana Cori; Fabrizio Bianchi

doi:10.1016/j.scitotenv.2019.133757

Mortality and hospitalization associated to emissions of a coal power plant: A population-based cohort study

Sci Total Environ. 2019 Dec 1:694:133757. doi: 10.1016/j.scitotenv.2019.133757. Epub 2019 Aug 3.

Authors

Fabrizio Minichilli¹, Francesca Gorini², Elisa Bustaffa², Liliana Cori², Fabrizio Bianchi²

Affiliations

¹ Unit of Environmental Epidemiology and Diseases Registries, Institute of Clinical Physiology, National Research Council, IFC-CNR, via Moruzzi 1, Pisa 56124, Italy. Electronic address: fabrizio.minichilli@ifc.cnr.it.
² Unit of Environmental Epidemiology and Diseases Registries, Institute of Clinical Physiology, National Research Council, IFC-CNR, via Moruzzi 1, Pisa 56124, Italy.

PMID: 31756804
DOI: 10.1016/j.scitotenv.2019.133757

Abstract

Background: Coal-fired thermal power plants represent a significant source of air pollutants, especially sulfur dioxide (SO₂) that has been associated with an increased risk of mortality and morbidity for respiratory and cardiovascular disease. A coal power plant in Vado Ligure (Italy) (CPP_VL) started in 1970 was stopped in 2014 by the Prosecutor's Office on the grounds of environmental and health culpable disaster.

Objective: To investigate the association between the exposure of residents to atmospheric pollutants emitted by CPP_VL and the risk of mortality and hospitalization, considering both cancer and non-cancer causes in a population-based cohort study.

Methods: SO₂ and nitrogen oxides (NO_x), estimated using the ABLE-MOLOCH-ADMS-Urban dispersion model, were selected as representative surrogates of exposure to CPP_VL emissions (SO₂-CPP_VL) and cumulative emissions from other sources of pollution (NO_x-MS), respectively. The relationship between each health outcome and categories of exposure to SO₂-CPP_VL was estimated by the Hazard Ratio (HR) using multiple sex-specific Cox regression models, adjusted for age, exposure to NO_x-MS, and socio-economic deprivation index using SO₂-CPP_VL first quartile as a reference.

Results: 144,019 individuals were recruited (follow-up 2001-2013). An excess of mortality was found for all natural causes (men: 1.49; 95% CI 1.38-1.60; women: 1.49; 95% CI 1.39-1.59), diseases of the circulatory system (men: 1.41; 95% CI 1.24-1.56; women: 1.59; 95% CI 1.44-1.77), of the respiratory system (men: 1.90; 95% CI 1.47-2.45; women: 1.62; 95% CI 1.25-2.09), and of the nervous system and sense organs (men: 1.34; 95% CI 0.97-1.86; women: 1.38; 95% CI 1.03-1.83), and in men for trachea, bronchus, and lung cancers (1.59; 95% CI 1.26-2.00). Results of hospitalization analysis were consistent with those of mortality.

Conclusion: Results obtained, also when considering multiple sources of exposure, indicate that exposure to CPP emissions represents a risk factor for selected health outcomes as well as the urgently adoption of primary prevention measures and of a specific surveillance programme.

Keywords: Coal power plant; Dispersion model; Hospitalization; Mortality; Population-based cohort study.

MeSH terms

Air Pollutants / analysis
Air Pollution / statistics & numerical data*
Cardiovascular Diseases / mortality
Environmental Exposure / statistics & numerical data*
Hospitalization / statistics & numerical data
Humans
Italy / epidemiology
Power Plants*
Respiratory Tract Diseases / mortality

Substances

Air Pollutants