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

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.