ArticleMedical sciences (Basel, Switzerland)2026
Where Environment and Healthcare Meet: Air Pollution, Antibiotic Use, and Mortality in an Ageing Population in Southern Italy.
Article in Medical sciences (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
backgroundAir pollution, antimicrobial use, and population ageing are increasingly recognised as co-occurring pressures shaping population health. This study explores their ecological association with mortality patterns in the province of Messina (Southern Italy), within a One Health-informed framework.
methodsAn ecological analysis was conducted using district-by-year data (2015-2024), integrating environmental monitoring (PM
resultsMarked geographic variability in pollutant concentrations was observed, with higher levels in urban-industrial districts. Infectious disease mortality increased from 13.8 to 44.6 per 100,000 inhabitants between the pre-pandemic and post-pandemic periods. In Poisson regression models, particulate matter showed a small and non-significant association with respiratory mortality (RR = 1.02, 95% CI: 0.89-1.18), while antibiotic consumption was not independently associated with mortality (RR = 0.99, 95% CI: 0.94-1.05). The post-2020 period was associated with higher mortality estimates (RR = 1.15, 95% CI: 0.72-1.83), although with wide confidence intervals.
conclusionsThe findings suggest the co-occurrence of environmental, demographic, and pharmaceutical pressures within the same territories, rather than demonstrating formal synergistic interaction. The observed post-pandemic increase in mortality highlights the importance of accounting for COVID-19-related disruption. These results should be interpreted as exploratory, given the ecological design and limited sample size, but support the need for integrated surveillance approaches within a One Health perspective.
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