[Epidemiological population-based cohort study on mortality and hospitalization in the area near the waste incinerator plant of San Zeno, Arezzo (Tuscany Region, Central Italy)]. / Studio epidemiologico di coorte residenziale su mortalità e ricoveri ospedalieri nell'area intorno all'inceneritore di San Zeno, Arezzo.

OBJECTIVES: to evaluate whether exposure to an urban waste incinerator plant operating in Arezzo (Tuscany Region, Central Italy) since the 2000 is associated with mortality and morbidity. DESIGN: a population-based cohort study of inhabitants living close to the incinerator in the period 2001-2010 was conducted. The individual exposure histories to the incinerator and other sources in the area were estimated using a dispersion model producing PM10 concentration maps for each source (ADMS-URBAN model). Hazard Ratios (HR) with 95% Confidence Interval (95%CI) adjusted for the other environmental exposures, age and socioeconomic status were estimated for the highest class of exposure using the lowest one as reference. Trends of HR were evaluated too. MAIN OUTCOME MEASURES: mortality and hospitalization causes with induction-latent period overlapping the incinerator activity period were analysed. RESULTS: morbidity analysis showed an increased risk for cardiovascular diseases (No. 732; HR: 1.18; 95%CI 1.06-1.32; trend of HR: 1.08, p=0.006) and a trend of HRs for urinary diseases (trend: 1.13; p=0.063). Mortality analysis showed a trend of HRs for general mortality in males (trend: 1.10; p=0.014), for cardiovascular diseases in males (trend: 1.15; p=0.036), for respiratory diseases in females (trend: 1.30; p=0.098), and an excess of acute respiratory diseases in females with the highest exposure (No. 11; HR=2.54; 95%CI 0.84-7.68). CONCLUSIONS: the cohort study allowed to characterise the environmental exposures considering the most relevant pollution sources and providing estimation of individual environmental exposures. Residual confounding due to the overlapping of concentration maps cannot be excluded and further investigations are needed. However, the increased risks for cardiovascular and respiratory diseases reinforce the limited epidemiological evidence on health effects of incinerators.

[Pollutants from a plant which burns toxic waste in the Province of Arezzo (Tuscany Region, Central Italy): human biomonitoring pilot study to evaluate the possible type of environmental exposure]. / Inquinanti emessi da un impianto di incenerimento di rifiuti speciali nell'area di Arezzo: studio preliminare di monitoraggio biologico umano per identificare la possibile tipologia di esposizione residenziale.

OBJECTIVES: to identify the biomarkers to use in order to evaluate the level and trend of exposure to environmental pollutants from a plant which retrieves and refines precious metals and burns toxic waste. DESIGN: human biomonitoring cross sectional study on a small sample of population resident in the study area. SETTING AND PARTICIPANTS: blood and urinary samples, and questionnaires from volunteers resident at least for 10 years in Civitella in Val di Chiana area (Arezzo Province, Tuscany Region, Central Italy), where the plant is located, and in a control area; they had to be 5-year non-smokers or ex-smokers, in good health status and non occupationally exposed to heavy metals and/or combustion products. MAIN OUTCOME MEASURES: geometric mean and 95th percentile (P95) of mercury (Hg) and cadmium (Cd) blood concentrations, and of the urinary concentrations of antimony (Sb), silver (Ag), arsenic (As), Cd, cobalt (Co), chromium (Cr), Hg, nickel (Ni), platinum (Pt), 1-hydroxypyrene, and trans, trans-muconic acid in the two populations; quantity and pattern of porphyrins in the 24-hour urines of Civitella volunteers. Student's "t" test calculated on the means of data with logarithmic transformation was used to compare the two groups. In case of significant differences linear regression analyses have been performed using questionnaire information. The distribution of observed data was compared with specific reference values. RESULTS: Sb, Cd, and Ni concentrations were significantly higher in Civitella population (39 subjects), while Cr concentration was higher in the control group (18 subjects). No correlations with the individual characteristics have been observed. The 30.3%of subjects who gave their 24- hour urine had a distorted pattern of porphyrins. CONCLUSION: the results confirmed the need to perform human biomonitoring in the Civitella area, increasing the number of samples, using urine as biological matrix, and monitoring at least Sb, Cd, Ni, Pt, Ag, and porphyrins.

Human bio-monitoring study around a plant that recycles and refines precious metals in Central Italy.

In an area characterized by the presence of a plant that recycles and refines precious metals the study aims to evaluate the exposure to the plant emissions of the residents in the neighbourhood using human urinary biomarkers, in comparison with those obtained in a reference and in an urban area and with the data concerning dispersions of plant emissions obtained through a specific diffusional model. 153 subjects in the study area, 95 in the urban area and 55 in the reference area, aged 18-60years, answered to a self-administered questionnaire and collected their 24-h urine. Urinary concentrations of antimony, silver, cadmium, cobalt, chromium, mercury, nickel, platinum, creatinine, and the porphyrin patterns were detected. The results for the 3 areas were compared using parametric and non-parametric tests. Significant higher concentrations of mercury, cadmium, silver and nickel are observed in the study area in comparison with the reference area, but no differential distribution was observed by different levels of environmental pollution defined by the study's diffusion model, and no correlation was found between the concentrations of altered urinary porphyrin and metals. Life styles being equal, residents in the study area as well as residents in the urban area have high urinary levels of mercury, silver and nickel in comparison with the reference area, suggesting common environmental pressures probably related to diffuse gold processing activities, suggesting common environmental pressures. The excess of cadmium only in the study area suggests a role played by exposure to plant emissions, even if a differential distribution was not observed by different levels of environmental pollution.

Adverse reproductive outcomes associated with exposure to a municipal solid waste incinerator.

INTRODUCTION: The association between reproductive health outcomes and exposure to municipal solid waste incinerators (MSWIs) is inconclusive. This study investigates the association between exposure to a MSWI and various reproductive outcomes (preterm birth, low birth weight, small for gestational age, and sex ratio), taking into account other sources of pollution (industrial plants, highway, major roads with high traffic flows) and maternal factors, including the socioeconomic status. METHODS: PM10 concentration maps were used for the exposure assessment to the MSWI and to other sources of pollution in the study area. Information on resident births and maternal covariates were selected from the delivery certificates referred to the period 2001-2010. Mothers' addresses were geocoded in order to attribute the individual level of exposure. Odds ratios (ORs) with a 95% confidence interval (CI) adjusted for maternal covariates and exposure to other pollution sources were calculated. RESULTS: A total of 3153 newborns to 2401 mothers residing in area during the study period were analyzed. A risk of preterm birth associated with increased exposure was detected (OR = 1.61; 95% CI: 0.88-2.94; p test for trend 0.098). When newborns to primiparous women were considered an OR of 2.18 (95% CI: 1.05-4.53) and a significant trend were observed (p = 0.033). No significant results for the other investigated outcomes were observed. CONCLUSIONS: The study detected a slight association between exposure at MSWI and preterm births. The results are in agreement with those of a previous multi-site study with similar design, and they strengthen the recommendation to consider gestational age in studies and surveillance in areas with MSWIs and similar sources of pollution.