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Mortality and hospitalization in Italian contaminated sites of national concern for remediation: the global evaluation
1
Italian national Institute for Health - Istituto Superiore di Sanità, Dept of Environment and Health, Istituto Superiore di Sanità, Italy
2
National Research Council
3
Italian national Institute for Health - Istituto Superiore di Sanità, Statistical Service, Istituto Superiore di Sanità, Italy
4
Italian national Institute for Health - Istituto Superiore di Sanità
5
Fondazione IRCCS Istituto Nazionale dei Tumori, Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
6
Agenzia di Tutela della Salute della Val Padana, Unit of Epidemiology, Agenzia di Tutela della Salute della Val Padana, Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A179
ABSTRACT
Backgrounds and Objective:
In Italy, an epidemiological surveillance of the populations living in the 46 contaminated sites of national concern for remediation (CSs) has been underway, since 2011 (SENTIERI Project). CSs are defined of national concern for their contamination due to the presence of pollution sources, such as chemical industries, petrochemical plants and refineries, landfills. We aimed at estimating the global mortality (2013-2017) and hospitalization (2014-2018) among the populations living in the 46 CSs (316 municipalities; 6,227,531 inhabitants).
Methods:
The excess deaths (observed-expected) for the main groups of diseases were calculated for the 46 sites combined. A random effects meta-analysis of the Standardized Mortality and Hospitalization Ratios (SMR/SHR) of each CS was performed for all the sites and their groupings, based on the typology of pollution sources. 90% Confidence Intervals and I2 value complemented SMR/SHR pooled value. The analyses were performed in general population and age-subgroups.
Results:
In the 46 sites, 8,342 exceeding deaths (1,668/year) were estimated, 4,353 in males and 3,989 in females. Pooled SMR and SHR for all causes exceeded in both genders: males: SMRpooled=1.02 (90%CI:1.00-1.04); SHRpooled=1.03 (90%CI:1.01-1.04); females: SMRpooled=1.02 (90%CI:1.00-1.04), SHRpooled=1.03 (90%CI:1.01-1.05). These excesses are mainly attributable to malignant tumours. In subgroups of sites, exceeding SMRs were observed for all malignant mesotheliomas (MM) and pleural MM, lung and colorectal cancers in both genders. SHRs for all causes were in excess in the first year of live (males: SHRpooled=1.08, 90%CI:1.03-1.13; females: SHRpooled= 1.08, 90%CI:1.03-1.14); the hospitalization for all causes exceeded also in 0-19 and 20-29 groups (+3-5%); no excesses of mortality were observed in 0-29 years age-classes.
Conclusion:
The results suggest that living in CSs is a risk factor for cause-specific mortality and hospitalization, even if the ecological approach and the mixtures of environmental exposures sources do not allow conclusions on specific etiological hypothesis.
In Italy, an epidemiological surveillance of the populations living in the 46 contaminated sites of national concern for remediation (CSs) has been underway, since 2011 (SENTIERI Project). CSs are defined of national concern for their contamination due to the presence of pollution sources, such as chemical industries, petrochemical plants and refineries, landfills. We aimed at estimating the global mortality (2013-2017) and hospitalization (2014-2018) among the populations living in the 46 CSs (316 municipalities; 6,227,531 inhabitants).
Methods:
The excess deaths (observed-expected) for the main groups of diseases were calculated for the 46 sites combined. A random effects meta-analysis of the Standardized Mortality and Hospitalization Ratios (SMR/SHR) of each CS was performed for all the sites and their groupings, based on the typology of pollution sources. 90% Confidence Intervals and I2 value complemented SMR/SHR pooled value. The analyses were performed in general population and age-subgroups.
Results:
In the 46 sites, 8,342 exceeding deaths (1,668/year) were estimated, 4,353 in males and 3,989 in females. Pooled SMR and SHR for all causes exceeded in both genders: males: SMRpooled=1.02 (90%CI:1.00-1.04); SHRpooled=1.03 (90%CI:1.01-1.04); females: SMRpooled=1.02 (90%CI:1.00-1.04), SHRpooled=1.03 (90%CI:1.01-1.05). These excesses are mainly attributable to malignant tumours. In subgroups of sites, exceeding SMRs were observed for all malignant mesotheliomas (MM) and pleural MM, lung and colorectal cancers in both genders. SHRs for all causes were in excess in the first year of live (males: SHRpooled=1.08, 90%CI:1.03-1.13; females: SHRpooled= 1.08, 90%CI:1.03-1.14); the hospitalization for all causes exceeded also in 0-19 and 20-29 groups (+3-5%); no excesses of mortality were observed in 0-29 years age-classes.
Conclusion:
The results suggest that living in CSs is a risk factor for cause-specific mortality and hospitalization, even if the ecological approach and the mixtures of environmental exposures sources do not allow conclusions on specific etiological hypothesis.
| ISSN: | 2654-1459 |
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