Time-Trends in Air Pollution Impact on Health in Italy, 1990–2019: An Analysis From the Global Burden of Disease Study 2019

<b>Objectives:</b> We explored temporal variations in disease burden of ambient particulate matter 2.5 μm or less in diameter (PM_2.5) and ozone in Italy using estimates from the Global Burden of Disease Study 2019. <b>Methods:</b> We compared temporal changes and percent variations (95% Uncertainty Intervals [95% UI]) in rates of disability adjusted life years (DALYs), years of life lost, years lived with disability and mortality from 1990 to 2019, and variations in pollutant-attributable burden with those in the overall burden of each PM_2.5- and ozone-related disease. <b>Results:</b> In 2019, 467,000 DALYs (95% UI: 371,000, 570,000) were attributable to PM_2.5 and 39,600 (95% UI: 18,300, 61,500) to ozone. The crude DALY rate attributable to PM_2.5 decreased by 47.9% (95% UI: 10.3, 65.4) from 1990 to 2019. For ozone, it declined by 37.0% (95% UI: 28.9, 44.5) during 1990-2010, but it increased by 44.8% (95% UI: 35.5, 56.3) during 2010-2019. Age-standardized rates declined more than crude ones. <b>Conclusion:</b> In Italy, the burden of ambient PM_2.5 (but not of ozone) significantly decreased, even in concurrence with population ageing. Results suggest a positive impact of air quality regulations, fostering further regulatory efforts.