Cancer mortality in an area of Campania (Italy) characterized by multiple toxic dumping sites.

Several recent studies have documented that a widespread practice of dumping toxic wastes has taken place for many years in the Provinces of Naples and Caserta. Extensive programs of environmental monitoring are currently ongoing in the area. In this frame, the Department of Civil Defence of the Italian Government has appointed an ad hoc study group in order to assess the health status of the population resident in the area of interest. The first investigation performed by the study group has been a geographic study on cancer mortality and occurrence of malformations in 196 municipalities constituting the two Provinces. The study detected an area located in the southeastern part of the Province of Caserta and in the northwestern part of the Province of Naples, where cancer mortality and congenital malformations show significantly increased rates with respect to expected figures derived from the regional population. The area highlighted by the study is, in general terms, overlapping with the area where most illegal dumping of toxic wastes took place. It is now recommended that mortality studies be extended to take into account other health outcomes, to search for correlations with environmental exposures, and consider possible confounding factors.

Mortality from chronic obstructive pulmonary disease and pleural mesothelioma in an area contaminated by natural fiber (fluoro-edenite).

OBJECTIVES: The purpose of the present study was to investigate the association between mortality from chronic obstructive pulmonary disease (COPD) and exposure to fluoro-edenite, a newly discovered amphibolic fiber found in Biancavilla (Sicily), a municipality on the slope of the Etna volcano, where a high mortality from malignant mesothelioma had been previously observed. METHODS: Thirty-six municipalities located in the volcanic area of mount Etna were selected for study. An ecological regression model was applied with mortality from COPD as the dependent variable, mortality from mesothelioma as a proxy for exposure to fluoro-edenite, and lung cancer mortality, an urban-rural index, a deprivation index and an aging index as the predictors of COPD mortality. For each municipality, risk classes were determined for the continuous variables with the use of a finite mixture model. RESULTS: A significant association was found between COPD mortality and pleural neoplasm mortality among the women in this study. The association was less consistent for the men. CONCLUSIONS: Despite the limitations of this ecological study, the results cohere with the results of toxicologic and observational studies and suggest an etiologic role for fluoro-edenite in nonmalignant respiratory diseases.

[Geographical distribution of mortality from malignant pleural neoplasms and of former asbestos-exposed workers in the Campania Region]. / Distribuzione geografica della mortalità per tumore maligno della pleura e dei soggetti ex esposti professionalmente ad amianto in Campania.

AIM: The purpose of the present paper is to describe the geographical distribution at municipality level of mortality from malignant pleural neoplasms in the Campania Region, along with the distribution of former asbestos-exposed workers. A GIS (Geographical Information System) application has been developed to integrate exposure and mortality data. STUDY DESIGN: The number of asbestos workers by municipality has been estimated by merging data provided by the National Institute for Insurance against Occupational Accidents (INAIL), the Ministry of Labour and an association of formerly exposed workers (AUSER Flegrea). The number of deaths from malignant pleural neoplasms by municipality has been derived from published studies regarding two consecutive periods: 1988-1994 and 1995-1997. RESULTS: In the first period most deaths occurred in areas with a high number of formerly exposed asbestos workers, whilst in the second period mesothelioma mortality increased extending to other areas without registered exposed workers. CONCLUSION: This finding may be attributable to the presence of atypical occupational exposures, not reported by the current information systems, or to environmental, non occupational exposure patterns.

[Mortality from malignant pleural neoplasms in Broni (Pavia), 1980-1997]. / La mortalità per tumore maligno della pleura a Broni (Pavia), 1980-1997.

Mortality for malignant pleural neoplasms (1980-97) was studied in Broni (Pavia) and in the surrounding area in order to update previous studies indicating a high incidence of pleural mesothelioma, due to the presence of an asbestos-cement factory. Observed mortality for pleural neoplasms was compared to expected figures derived from mortality rates of the population resident in Province of Pavia. A significant increase was found in Broni (SMR 825, CI 95%: 604-1, 100, 46 observed). An increased risk of death from malignant pleural neoplasms was evident in both genders, especially in the most recent years, and in younger age groups; this increase in pleural neoplasm mortality also involves some neighbouring municipalities.

[Cause-specific mortality in an area of Campania with numerous waste disposal sites]. / Mortalità per causa in un'area della Campania con numerose discariche di rifiuti.

OBJECTIVE: To investigate cause-specific mortality in an area of Campania region, in the surroundings of Naples, characterized by many toxic waste dumping grounds sites and by widespread burning of urban wastes. DESIGN: The study area was characterized by examining the spatial distribution of waste disposal sites and toxic waste dumping grounds, using a geographic information system (GIS). Mortality (1986-2000) was studied in the three municipalities of Giugliano in Campania, Qualiano and Villaricca, encompassing a population of about 150,000 inhabitants. Mortality rates of the population resident in the Campania region were used in order to generate expected figures. OUTCOMES: Causes of death of a priori interest where those previously associated to residence in the neighbourhood of (toxic) waste sites, including lung cancer, bladder cancer, leukemia and liver cancer. RESULTS: Overall 39 waste sites, 27 of which characterized by the likely presence of toxic wastes, were identified in the area of interest. A good agreement was found between two independent surveys of the Regional Environmental Protection Agency and of the environmentalist association Legambiente. Cancer mortality was significantly increased, with special reference to malignant neoplasm of lung, pleura, larynx, bladder, liver and brain. Circulatory diseases were also significantly in excess and diabetes showed some increases. CONCLUSIONS: Mortality statistics provide preliminary evidence of the disease load in the area. Mapping waste dumping grounds provides information for defining high risk areas. Improvements in exposure assessment together with the use of a range of health data (hospital discharge cards, malformation notifications, observations of general practitioners) will contribute to second generation studies aimed at inferring causal relationships.

The impact measure of solid waste management on health: the hazard index.

The risk associated with waste exposure depends on the level of emissions arising from waste disposal and from the effects of these emissions on human health (dose-response). In 2007 an epidemiological study was conducted in two Italian provinces of the Campania Region, namely Naples and Caserta, with the aim of assessing the health effects deriving from exposure to waste. In these studies, the important aspect is the population exposure assessment, in relation to the different types of waste disposal. The Regional Agency for Environmental Protection (ARPA Campania) has identified and characterized the various authorized/unauthorized dumping sites in the provinces of Naples and Caserta. Most of the waste disposal used are illegal and invisible (sunken or buried); thus, the toxic substances therein contained are unknown and difficult to identify. In order to locate the possible areas exposed to a higher waste-related health risk, a synthetical "hazard index" (at the municipality level) was designed. By means of GIS, the number of waste impact areas was identified for each of the 196 municipalities in the two provinces; then, Census data (ISTAT 2001) was used to estimate the proportion of the population living in the impact areas. The synthetical hazard index at municipality level accounts for three elements: a) the intrinsic characterization of the waste disposal, determining the way in which the pollutant is released; b) the impact area of the dumping site (within 1 km radius), same areas are influenced by more than one site; c) the density of the population living in the "impact area" surrounding the waste disposal site.