Association of Multiple Sclerosis with PM 2.5 levels. Further evidence from the highly polluted area of Padua Province, Italy

Arianna Scartezzini; Fabio Tateo; Paola Perini; Luca Benacchio; Mario Ermani; Antonio Ferro; Morena Cadaldini; Maria Grazia Piccinno; Luisella Colledan; Nicoletta Freddi; Paolo Gallo; Marco Puthenparampil

doi:10.1016/j.msard.2020.102677

Association of Multiple Sclerosis with PM 2.5 levels. Further evidence from the highly polluted area of Padua Province, Italy

Mult Scler Relat Disord. 2021 Feb:48:102677. doi: 10.1016/j.msard.2020.102677. Epub 2020 Dec 6.

Authors

Affiliations

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.

PMID: 33316725
DOI: 10.1016/j.msard.2020.102677

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.

Keywords: Epidemiology; Multiple Sclerosis; PM2.5; Prevalence; Risk factors.

MeSH terms

Cities
Europe
Humans
Italy / epidemiology
Multiple Sclerosis* / epidemiology
Particulate Matter / analysis

Substances

Particulate Matter