Health Risk of Living near a Coal Electric Power Plant: A Residential Cohort Study in North-Western Italy

: In North-Western Italy, an Electric Power Plant (EPP) has been active since the early 1970s. In 2014, two production sections fed by coal were seized by the Prosecutor's Office, while a section powered by natural gas is still functioning. To evaluate the association between exposures of residents in an area affected by EPP's emissions and the risk of hospitalization and mortality a population-based cohort study was conducted (follow-up 2001-2013, 1,418,000 person-years). Lympho-hematopoietic and lung cancers, nervous system, cardiovascular and respiratory diseases were analysed. The diffusion of SO2 and NOx was estimated for the main sources of pollution (EPP, other industries, roads, port areas and urban heating) using the MOLOCH-ABLE-ADMS model. Modelled concentrations of SO2 were used as proxi of residential exposure to air pollution of EPP (SO2-EPP); NOx was used as proxi of Multi-Source Model including all sources of pollution (NOxMSM). For males (M) and females (F) Hazard Rate Ratios (HRR) adjusted by age, socio-economic deprivation and NOx-MSM were computed according to quartiles of SO2-EPP concentrations. Linear Trend of HRR was performed (THRR). Mortality analysis showed increased risk for all cancers [THRRM 1.15 95%CI (1.11-1.19); THRR-F 1.10 95%CI (1.11-1.19)], lympho-hematopoietic cancers [M 1.30 (1.14-1.48); F 1.17 (1.01-1.35)], nervous system [M 1.10 (1.00-1.22); F 1.12 (1.02-1.22)], cardiovascular [M 1.11 (1.07-1.16); F 1.16 (1.12-1.20)], and respiratory diseases [M 1.23 (1.13-1.33); F 1.17 (1.07-1.27)]. Results of hospitalization analysis were largely consistent with those of mortality analysis. The risk excesses associated to exposures attributed to the coal plant have been obtained for mortality or hospitalization causes for which the evidence of association with atmospheric emissions is persuasive. The results reinforce the knowledge on the dangers of the use of coal for energy production and the consequent indication to decarbonise to protect health.