Arianna Scartezzini1, Fabio Tateo2, Paola Perini1, Luca Benacchio3, Mario Ermani1, Antonio Ferro4, Morena Cadaldini5, Maria Grazia Piccinno6, Luisella Colledan7, Nicoletta Freddi8, Paolo Gallo1, Marco Puthenparampil9. 1. Multiple Sclerosis Centre of the Veneto Region, Neurology Clinic, Department of Neurosciences (DNS), University of Padua, Via Giustinaini 2, 35128, Italy. 2. Institute of Geosciences and Earth Resources, National Research Council of Italy, Department of Geosciences, University of Padua, Italy. 3. Epidemiology Unit, ULSS-6 Padua, Veneto Region, Italy. 4. Department of Disease Prevention, Public Health Organization of Trento Province, Italy. 5. Unit of Neurology, General Hospital of Schiavonia-Monselice, Italy. 6. Unit of Neurology, General Hospital of Cittadella, Italy. 7. Unit of Neurology, General Hospital of Camposampiero, Italy. 8. Unit of Neurology, Saint Antony Hospital, ULSS-6 Padua, Italy. 9. Multiple Sclerosis Centre of the Veneto Region, Neurology Clinic, Department of Neurosciences (DNS), University of Padua, Via Giustinaini 2, 35128, Italy. Electronic address: marco.puthenparampil@studenti.unipd.it.
Abstract
BACKGROUND: Fifty years of epidemiological survey and intra-regional differences in prevalence suggest that environmental factors may be associated with increased multiple sclerosis (MS) risk in Northern Italy. Based on the findings of a previous study carried out in the highly polluted Padan Plain, we further explored the relationship between PM2.5 levels and MS prevalence by comparing bordering areas characterized by quite different environmental conditions, namely the Municipality of Padua and the special protected zone (SPZ) of the Euganean Hills Regional Park, located 15 km from the City. METHODS: Three territories were identified; 1) the SPZ, extending over an area of 15.096 hectares and having a total population of 23,980 inhabitants, 2) the urban area of Padua, with a total population of 210,440 inhabitants and repeatedly recognized by the European Invironmental Agency as one of the most polluted Cities of Europe, 3) the Intermediate Zone (IZ), i.e., the area in between the previous two, including part of the urban territories of eight villages adjacent to the SPZ. Demographic and socio-economical data were obtained from official government sources (www.istat.it and www.regione.veneto.it). All Italian MS patients residing in these three areas on December 31, 2018, were registered. PM2.5 concentrations (annual average 1998-2018, μg/m3) were measured by satellite. The correlation between PM2.5 concentrations and MS prevalence was analysed. RESULTS: MS prevalence was significantly higher in Padua City (265/100.000) compared to both the SPZ of the Euganean Hills Park (160/100,000; p < 0.0001) and the IZ (194.4/100,000). Prevalence strongly associated with the annual average concentration of PM2.5 (r = 0.89 p < 0.00001). CONCLUSION: In the Province of Padua, one of the most polluted areas of Europe, MS prevalence is strongly associated with PM2.5 exposure. Our findings suggest that air pollutants may be one of the possible environmental risk factors for MS in the Veneto Region of Italy.
BACKGROUND: Fifty years of epidemiological survey and intra-regional differences in prevalence suggest that environmental factors may be associated with increased multiple sclerosis (MS) risk in Northern Italy. Based on the findings of a previous study carried out in the highly polluted Padan Plain, we further explored the relationship between PM2.5 levels and MS prevalence by comparing bordering areas characterized by quite different environmental conditions, namely the Municipality of Padua and the special protected zone (SPZ) of the Euganean Hills Regional Park, located 15 km from the City. METHODS: Three territories were identified; 1) the SPZ, extending over an area of 15.096 hectares and having a total population of 23,980 inhabitants, 2) the urban area of Padua, with a total population of 210,440 inhabitants and repeatedly recognized by the European Invironmental Agency as one of the most polluted Cities of Europe, 3) the Intermediate Zone (IZ), i.e., the area in between the previous two, including part of the urban territories of eight villages adjacent to the SPZ. Demographic and socio-economical data were obtained from official government sources (www.istat.it and www.regione.veneto.it). All Italian MS patients residing in these three areas on December 31, 2018, were registered. PM2.5 concentrations (annual average 1998-2018, μg/m3) were measured by satellite. The correlation between PM2.5 concentrations and MS prevalence was analysed. RESULTS: MS prevalence was significantly higher in Padua City (265/100.000) compared to both the SPZ of the Euganean Hills Park (160/100,000; p < 0.0001) and the IZ (194.4/100,000). Prevalence strongly associated with the annual average concentration of PM2.5 (r = 0.89 p < 0.00001). CONCLUSION: In the Province of Padua, one of the most polluted areas of Europe, MS prevalence is strongly associated with PM2.5 exposure. Our findings suggest that air pollutants may be one of the possible environmental risk factors for MS in the Veneto Region of Italy.