Abstract
<b>Background:</b> epidemiological evidence reports adverse health effects even for exposure levels below air quality standards. <b>Aim:</b> to assess the effects of air pollutants exposure on allergic diseases in an adult general population sample. <b>Methods:</b> 1615 subjects living in an urban/suburban area (Pisa/Cascina, Tuscany) were investigated in 2009-2011. Questionnaire information about risk factors and allergic rhinitis (current diagnosis and current symptoms/rhinitis drugs consumption) and asthma (lifetime diagnosis and current asthma attacks/asthma drugs consumption) was collected. Mean annual PM<sub>10</sub>, PM<sub>2.5</sub>, NO<sub>2</sub> and mean summer O<sub>3</sub> concentrations (µg/m<sup>3</sup>) were estimated at the residential addresses (1-km resolution) for the period 2013-15 within the BIGEPI project (INAIL contract ID 46/2019). The association between allergic diseases and air pollution exposure was assessed by using principal component regression, adjusting for age, sex, education, occupational exposure, smoking habits, and air temperature. <b>Results:</b> mean air pollutants concentrations (µg/m<sup>3</sup>) were: 24.92 (SD=1.00) for PM<sub>10</sub>, 16.47 (0.68) for PM<sub>2.5</sub>, 23.35 (3.81) for NO<sub>2</sub> and 69.99 (2.51) for O<sub>3</sub>. Allergic rhinitis prevalence was associated with exposure to PM<sub>10</sub> (OR 1.36, 95% CI 1.16-1.60 per unit increase (p.u.i.)), PM<sub>2.5</sub> (OR 1.22, 1.11-1.34 p.u.i) and NO<sub>2</sub> (OR 1.02, 0.99-1.04 p.u.i, borderline association). Asthma prevalence was associated with exposure to O<sub>3</sub> (OR 1.10, 1.02-1.17 p.u.i.). <b>Conclusions:</b> use of advanced exposure and statistical methods showed detrimental effects on allergic diseases in areas characterized by air pollution concentration below the EU standards. It confirms the need to further reduce population exposure for achieving a global health benefit.
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