Spatio-Temporal Patterns of Pollutants-Mortality Associations: A Comprehensive Analysis Using Distributed Lag Models and Seasonal Stratification in Urban Areas of Southern Italy

Spatio-Temporal Patterns of Pollutants-Mortality Associations: A Comprehensive Analysis Using Distributed Lag Models and Seasonal Stratification in Urban Areas of Southern Italy | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Spatio-Temporal Patterns of Pollutants-Mortality Associations: A Comprehensive Analysis Using Distributed Lag Models and Seasonal Stratification in Urban Areas of Southern Italy Maria Longobardi, Massimiliano Giacalone, Gianfranco Piscopo, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8521095/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The analysis of mortality represents a critical epidemiological tool for understanding the effects of environmental pollution on public health. This study utilizes comprehensive daily mortality data from ISTAT for all Italian municipalities spanning from January 1, 2011, to Dicember 31, 2024, integrated with high-resolution air quality data from ARPA Puglia's monitoring network. Through an advanced multi-model statistical framework incorporating Distributed Lag Nonlinear Models (DLNM), Cox proportional hazards models, and Gompertz mortality models, we systematically analyze associations between atmospheric pollutants (PM10, PM2.5, NO2, SO2, O3) and daily mortality across Apulia region. Our comprehensive methodological approach includes seasonal stratification, municipality-level comparative analyses, and focused investigation of SO2 impacts in the industrial city of Taranto. Results reveal statistically significant associations between pollutant concentration peaks and increased mortality rates, particularly for respiratory and cardiovascular diseases, with notable spatial heterogeneity across municipalities and temporal variations across seasons. The study provides robust epidemiological evidence supporting the implementation of targeted air quality interventions in southern Italian urban areas. Applied Statistics daily mortality distributed lag nonlinear models Cox proportional hazards seasonal stratification spatio-temporal analysis Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8521095","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":569533108,"identity":"0d5b90aa-3f43-48f2-9de7-34c1a5bd2941","order_by":0,"name":"Maria Longobardi","email":"","orcid":"","institution":"University of Napoli","correspondingAuthor":false,"prefix":"","firstName":"Maria","middleName":"","lastName":"Longobardi","suffix":""},{"id":569533347,"identity":"7d9f6547-e5a9-4a57-8050-b4c7dd8ebeab","order_by":1,"name":"Massimiliano Giacalone","email":"data:image/png;base64,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","orcid":"","institution":"University of Campania","correspondingAuthor":true,"prefix":"","firstName":"Massimiliano","middleName":"","lastName":"Giacalone","suffix":""},{"id":569533353,"identity":"0778e826-8797-4cf8-a83e-356ce3fe8482","order_by":2,"name":"Gianfranco Piscopo","email":"","orcid":"","institution":"University of Napoli","correspondingAuthor":false,"prefix":"","firstName":"Gianfranco","middleName":"","lastName":"Piscopo","suffix":""},{"id":569533433,"identity":"88cf1c44-25c6-47cb-8793-1a811c902bbd","order_by":3,"name":"Carlo Cusatelli","email":"","orcid":"","institution":"University of Bari","correspondingAuthor":false,"prefix":"","firstName":"Carlo","middleName":"","lastName":"Cusatelli","suffix":""}],"badges":[],"createdAt":"2026-01-05 12:07:57","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8521095/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8521095/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":99794290,"identity":"fc22982e-1923-47c3-addb-9a7ae9a571ab","added_by":"auto","created_at":"2026-01-08 13:34:29","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2367839,"visible":true,"origin":"","legend":"","description":"","filename":"SpatioTemporalPatternsofPollutantsMortalityAssociations.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8521095/v1_covered_f33b704c-b51f-4535-bfd4-876d72253117.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eSpatio-Temporal Patterns of Pollutants-Mortality Associations: A Comprehensive Analysis Using Distributed Lag Models and Seasonal Stratification in Urban Areas of Southern Italy\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"University of Bari Aldo Moro","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"daily mortality, distributed lag nonlinear models, Cox proportional hazards, seasonal stratification, spatio-temporal analysis","lastPublishedDoi":"10.21203/rs.3.rs-8521095/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8521095/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe analysis of mortality represents a critical epidemiological tool for understanding the effects of environmental pollution on public health. 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