[Descriptive study of cancer incidence in the area around the Ispra Joint Research Centre (JCR)]. / Studio descrittivo sull'incidenza di tumori maligni nell'area circostante al Centro comune di ricerca (CCR) di Ispra.

OBJECTIVE: to assess the effects of radioactive emissions from the EU Joint Research Centre (JRC) (nuclear) at Ispra, the Local Health Authority (ASL) of Varese carried out an ecological study to measure any excess incidence of cancer in the surrounding population. DESIGN AND SETTING: after estimation of historical exposure levels in the surrounding population, the incidence rates of leukaemia and other exposure-related tumours were calculated from data in the population based Lombardy Cancer Registry (Varese Province). By indirect standardization, the expected cases (based on incidence rate in the Province) were compared with observed cases in the close-by municipality of Ispra, in municipalities within a 5 km radius of the JRC (5kmArea) and in the area covered by the District of Sesto Calende (DistrictArea). RESULTS: in the period 1982-1998, mean populations were 4,687 (Ispra), 32,120 (5kmArea) and 43,707 (DistrictArea); the population of the Province was 793,752. The numbers of cancers registered were 374, 2,920, 4,099 and 72,246 respectively. Significant excesses of leukaemia were not found in Ispra (SIR 0.33, 95% CI 0.07-0.96) or the 5kmArea (SIR 0.83, 95% CI 0.63-1.08). For all cancers combined and for the commonest cancers (breast, colo-rectal) the numbers of incident cases were lower than expected. CONCLUSIONS: consistent with the low levels of exposure detected, and despite the fears of the local people, no incidence excesses of cancers was found in Ispra, the town closest to the JRC, or inforin the surrounding areas. It may be worth searching for excess cancer among exposed workers.

[Use of healthcare services by elderly people in a local health authority in Varese (Italy)]. / I consumi di prestazioni sanitarie negli anziani dell'ASL della provincia di Varese.

Older people use more healthcare than younger people and aging of the population is considered to be one of the main factors leading to consumption of healthcare resources. The aim of this study was to evaluate rates of hospitalization, use of out-patient services and medicine confections among the elderly population (>65 years) in the local health authority of Varese (Italy), in the three-year period from 2003-2005, and to calculate the trend for the years 2006 and 2007. Rates of hospitalization and drug use remained stable while use of out-patient services showed an increasing trend. In spite of the influence of aging on consumption of healthcare resources, the use of medical services is determined mainly by the health state of the population: monitoring of the burden of morbidity in the population should therefore be improved.

Longitudinal study on hypertension control in primary care: the Insubria study.

BACKGROUND: Hypertension control is still unsatisfactory. The study was aimed to evaluate blood pressure (BP) control rate and the impact of training general practitioners (GPs) about hypertension 1999 World Health Organization/International Society of Hypertension guidelines. METHODS: After a training session on the hypertension guidelines, 588 GPs consecutively enrolled 5524 known hypertensive patients. During the first and follow-up visits (after 3, 6, and 9 months) GPs recorded BP, lifestyle habits, and drug therapy. RESULTS: The BP was controlled in 33.4%, with systolic BP less controlled than diastolic BP. The BP control rate decreased (P < .001) from low to very high cardiovascular risk group and from lean to overweight and obese subjects. At the first visit 97.3% of the patients were already on drug treatment: 40.3% with 1 drug, 38.9% with 2 drugs, 17.2% with 3 drugs and 3.6% with 4 or 5 drugs. The adherence to correct dietary and lifestyle habits was low. The drugs most often used were the angiotensin-converting enzyme inhibitors (3009 patients, 56%). During follow-up body weight and BP decreased; 1 or more drugs were added in 17.8% and the adherence to healthier lifestyle habits significantly increased. At the end of the survey BP control rate was significantly improved (52.7%). CONCLUSIONS: In primary care the hypertension control rate was still unsatisfactory, and our data suggest that it may be due to a not aggressive enough drug treatment and a low adherence to recommended lifestyle and dietary habits. Increasing the knowledge of GPs about guidelines was associated with an improvement of hypertension control rate.

[Epidemiologic study Salus domestica: evaluation of health damage in a sample of women living near the Malpensa 2000 airport]. / Studio epidemiologico Salus domestica: valutazione dei danni di salute in un campione di donne residenti nei pressi dell'aeroporto Malpensa 2000.

The opening of the new Malpensa 2000 Airport worried people living in the neighbouring towns about possible effects of acoustic and air pollution on health status. For this reason, Varese Health Unit set up a study involving housewives and General Practitioners. This study has been carried out in 3 Areas: A Area, bordering the airport, B Area, at intermediate distance, and C Area, at long distance. On the whole, 932 housewives (18 to 64 years old) and 92 General Practitioners, were involved. The questionnaire, distributed to housewives between May 1st and November 30th 2000, was filled out in the doctor's surgery who furthermore added clinical data. Chi-square statistics were calculated to test the association between living area and personal data, behavioural and environmental characteristics, and reported disorders. To describe possible interrelationships between living Area and the answers supplied by housewives and General Practitioners the multiple correspondence multivariate analysis technique was applied. The housewives living next to the airport (A area) frequently report insomnia, nocturnal waking, anxiety and difficulty in hearing words. The multivariate analysis has shown a relationship between recently increasing noise noted by the housewives, and the area where they live, as well as a noticeable coherence between the answers given by the housewives and those given by the General Practitioners, who reported higher frequencies of cephalgy, allergies, anxiety neurosis, medical consultation, benzodiazepine's and sleeping disorder's prescriptions in A Area compared to C Area. The airport's presence seems to be associated with the onset of subjective disorders in neighbouring population. Some of these disorders, in particular neuropsychological ones, are clinically confirmed by General Practitioners, and are consistent with different noise exposure levels.