Association between PM10 concentrations and school absences in proximity of a cement plant in northern Italy

Dusts are one of the main air pollutants emitted during cement manufacturing. A substantial part of these are breathable particles that are less than 10 μm in diameter (PM10), which represent a potential threat for the health of the exposed population. This study aimed at evaluating the short-term effects of PM10 concentrations on the health of children, aged 6–14 years, who attended the schools in Fumane (Italy), in proximity (1.2 km) to a large cement plant. School absenteeism was used as a proxy indicator of child morbidity. Time series of daily school absences and PM10 concentrations were collected for 3 school-years from 2007 to 2010 (541 school-days, 462 children on average). The associations between PM10 concentrations and school absence rates in the same day (lag0) and in the following 4 days (lag1 to lag4) were evaluated using generalised additive models, smoothed for medium/long term trends and adjusted for day of the week, influenza outbreaks, daily temperature and rain precipitations. The average concentration of PM10 in the period was 34 (range: 4–183) μg/m3. An average 10 μg/m3 increase of PM10 concentration in the previous days (lag0–4) was associated with a statistically significant 2.5% (95%CI: 1.1–4.0%) increase in the rate of school absences. The highest increase in the absence rates (2.4%; 95%CI: 1.2–3.5%) was found 2 days after exposure (lag2). These findings provide epidemiological evidence of the acute health effects of PM10 in areas with annual concentrations that are lower than the legal European Union limit of 40 μg/m3, and support the need to establish more restrictive legislative standards.