Assessment of mortality attributable to air pollution in the urban area of Pisa (central Italy) characterized by multi-source exposures

Air pollution is one of the main risk factors for human health. The aim of this study was to provide an Integrated Environmental and Health Impact Assessment (IEHIA) tool to estimate the impacts on both environment and human health in Pisa municipality (central Italy). For each pollutant considered (PM2.5, PM10, and NO2 ), both Population-Weighted Exposure (PWE) and Attributable Deaths (ADs) were calculated considering the difference between the PWE and the latest air quality guidelines suggested by the World Health Organization. The PWEs were 16.1 µg/m3 , 24.9 µg/m3 , and 25.9 µg/m3 for PM2.5, PM10, and NO2 , respectively. The ADs from natural causes due to exposure to PM2.5, PM10, and NO2 were 63, 29, and 51, respectively. The AD distribution was mainly concentrated in urban areas for particulate matter and in urban and suburban areas for NO2 . The results highlighted significantly higher levels of air pollution than the reference levels, with a percentage of ADs from natural causes of approximately 6% of the total mortality in Pisa. IEHIA offers support for environmental and health policies and territorial planning. The authors recommend the adoption of prevention measures aimed at mitigating air pollution in critical areas, with a consequent reduction in avoidable mortality.