[Mortality in the population surrounding an aluminum foundry in Eastern Piedmont, Italy, 1980-2017]. / Studio epidemiologico sub comunale nel Comune di Carisio (Piemonte, provincia di Vercelli ) sede di una fonderia di alluminio: analisi della mortalità dal 1980 al 2017.

An aluminum foundry has been present in the area of the district of Carisio (Piedmont region), Italy since 1975. Environmental analyses have shown that toxic emissions (in particular of dioxin) affect the district of Crocicchio and not the remaining municipality of Carisio. A study was therefore conducted to assess mortality in the population of Carisio and in the rest of the municipality, from 1980 to 2017, by using the Piedmont region as standard population. Excess mortality was found in the Crocicchio district for tumors (+ 88%), lung cancer in men (+ 320%) and total digestive tract tumors (+ 85%). Relative risks also show a higher risk of death caused by the above tumors, with two deaths per year being due to the existing environmental risk. An epidemiological and environmental monitoring plan should be implemented for the years to follow, and measures for the containment of polluting emissions from the site should be introduced immediately.

Solid urban wastes and toxicity among residents of Ghemme and Cavaglio (Piedmont region, Italy). Results from a historical cohort 1980 to 2013.

BACKGROUND: There is plenty of evidence for a relation between certain environmental pollutants and ecological damage. Landfills, especially if uncontrolled and located near human settlements, may cause an increase in cancer incidence and in various diseases. METHODS: The area of study is represented by the cities of Ghemme (population 6,139) and Cavaglio (population 2,216), in the province of Novara, northern Italy. A solid urban waste landfill is located between these two cities. We analysed mortality data from 1980 to 2013 among subjects residing in the two cities since at least 6 months, according to distance from the landfill. Mortality data was obtained from the National Statistics Institute ( ISTAT). RESULTS: A mortality increase was shown, according to Cox model, in residential areas closer to the landfill. In Cavaglio D'Agogna the total number of cancer deaths occurring in the 0-44 age group and the total death causes were relevant. A significant increase in leukemia cases was detected in Ghemme city. CONCLUSIONS: Our analysis shows an increased risk of diseases (cancer and other diseases), with a possible environmental etiological link.

Mortality in the district of Ghemme and Cavaglio d'Agogna, site of an urban waste landfill.

INTRODUCTION: Aim this study is to assess anomalous mortality rates from 2002 to 2012, in the municipalities of Ghemme and Cavaglio d'Agogna where a landfill has been active. Before the opening of the landfill (1988), studies highlighted the presence of noxious substances, in the ground layers, and not in the groundwater. Goal of our research is to monitor the health levels of the population in an area, with attention to long/midterm effects. MATERIALS AND METHODS: We performed the analysis on data of the National Institute of Statistics death records, and produced indirect standardized rates (SMR) using the rates of Local Healthcare Agencies (ASL) of Novara and Vercelli as reference population. RESULTS: We found various excesses in the population of the two municipalities, in particular for age 0-44 and congenital malformations but also for urogenital and gastrointestinal tumors that have been linked in letterature to housing in dump prossimity. CONCLUSIONS: Further analysis of morbidity and inferential studies will help to define the health status in the area. Such a study will possible help to reduce the greater risks and meet the demands of better public health policy.

[All-cause mortality from 1970 to 2013 in the municipality of Trino (Piedmont region, Italy), previously home to a nuclear plant]. / Mortalità per tutte le cause dal 1970 al 2013 nel comune di Trino sede di ex centrale nucleare.

Mortality studies conducted to date in the area of Trino (Piedmont Region, northern Italy) have been limited to the years from 2000 onwards. These studies have highlighted an increased frequency of brain tumors, leukemia, mesothelioma, peritoneal, prostate, larynx and total tumors in men in the municipality of Trino while for women the increased risk was limited to melanoma. The present study has allowed us to make more robust epidemiological considerations and to analyze the historical trend in mortality in the municipality (starting from 1970) correlating it also to the social and economic changes reported. We calculated the Standard Mortality Ratio (indirect standardization) by retrieving data on observed cases from the years 1980 to 2013 from the Italian national statistics bureau (ISTAT) and the municipal archives, and using regional specific mortality rates in the Piedmont region from 1980 to 2013 for expected cases. Results show a slowly decreasing trend for brain tumors in the last 10-15 years while for leukemia, we observe a sharp increase in the same time period, affecting both men and women indistinctly.

Carotid stenting versus endarterectomy in the same patient: A "direct" comparison.

The aim of this study was to evaluate outcomes and feasibility of carotid artery stenting versus carotid endarterectomy, both procedures performed in the same patient. Forty-five subjects (33 males, 70 ± 7 years) underwent carotid endarterectomy or carotid artery stenting, the counter procedure on the contralateral carotid performed after a variable period. We evaluated the post-procedural percentage of carotid stenosis at 30, 180 days and one-year follow-up, and the occurrence of acute myocardial infarction, New York Heart Association class progression, stroke, death, cardiovascular death, angina, transient ischemic attack and renal failure. Carotid artery stenting treatment reduced the degree of re-stenosis after 180 days equally to carotid endarterectomy procedure (difference: 0.033%, P = 0.285). No statistically significant differences were observed according to the occurrence of acute myocardial infarction and New York Heart Association class progression, revealing odds ratio (OR) equal to 0.182 ( P = 0.361) for acute myocardial infarction and 0.303 ( P = 0.434) for New York Heart Association class progression. Carotid endarterectomy confirms its efficacy in carotid revascularization, but carotid artery stenting constitutes a good alternative when the procedures are selected based on patient-specific risk factors.

[A geographical and epidemiological analysis of cancer incidence in the city of Vercelli, Italy, 2002-2009]. / Analisi geografica ed epidemiologica dell'incidenza oncologica in un comune italiano del nord ovest: Vercelli anni 2002-2009.

The idea of conducting a geographical analysis of cancer incidence in Vercelli, a city with about 46,000 population in the Province of Vercelli (Piedmont, northern Italy), originated from the need to respond to concerns of the population and local administrators regarding the presence of a solid waste incinerator just a few kilometers from the city, and the ongoing intense agricultural activity in the area. The study also aimed to verify the excess risk identified in a similar study on mortality. We obtained census data and mortality data for the years 2002 to 2009, from the Italian Institute of Statistics (ISTAT) and analysed these from both an epidemiological point of view, through standardised mortality rates, and spatial analysis through the use of Bayesian models. Both approaches highlighted an overall increased risk for cancers and increased risks for colorectal and lung cancer, in persons residing south of the capital. They also identified an increased cancer risk in the young adult population of both sexes, which deserves further investigation.

[Morbidity for congenital malformations. From 2005 to 2009 in Vercelli and neighboring countries]. / Morbosità per malformazioni congenite. Dal 2005 al 2009 a Vercelli e paesi limitrofi.

Special attention is now placed in the diagnosis of congenital malformations, MC, and several recent studies attest to the role of indicators of injury is inherent is extrinsic to the environmental component. In the Vercelli area recognize different sources of environmental pressure can result in damage potential direct and indirect effects on community residents; about, identify plants with high environmental impact on health including a MSW incinerator off in March 2014. The study refers to the morbidity derived from SDO from 2005 to 2009 than the specific rates ASL VC. The main concern the excess female for the area south and central ages 50-69 years old for the rest of the areas considered. Worthy of investigation is the excess of males in the group 5-19 years. Events have been of important insights, but in light of its limitations is certainly worth a discussion in terms expansion is as period of observation that as more data sources for the precise and reliable diagnosis of CD.

[The "Smoke-free hospital" project: prevalence of smokers in a large hospital in Pavia (Italy) from 2006 to 2010]. / Il progetto "Ospedale senza fumo": indagine sulla prevalenza dei fumatori nell'ambito dell'Azienda Ospedaliera di Pavia dal 2006 al 2010.

This study was conducted in the context of the "Smoke-free Hospital" project and its aims were to describe the prevalence of smokers among employees and patients of the Hospital of Pavia from 2006 to 2010, and to evaluate its determinants. The target population was represented by all employees (healthcare and other staff) and patients (inpatients and outpatients) of the Hospital of Pavia. Data collection took place by means of two self-administered and anonymous questionnaires (one for employees and one for patients). Overall, 3,996 employees and 2,301 patients completed the questionnaires. The prevalence of smokers among participating individuals remained largely unchanged in the observed period. The percentage of smokers among employees ranged from 21.88% in 2007 to 23% in 2006, while among patients it ranged from 16.67% in 2006 to 24.05% in 2008. Knowledge about tobacco-related issues was found to be poor and did not change over time. The low response rate did not allow us to generalize results to the entire target population. However, results indicate the need for health promotion campaigns both among hospital employees and among the general population, to raise awareness regarding the risks of tobacco smoking and to reduce the prevalence of smokers.

Cancer morbidity of residents living near an oil refinery plant in North-West Italy.

Cerano is a municipality of the Province of Novara (North-West Italy). To assess the morbidity associated to its proximity to a petrochemical plant, standardized incidence ratios (SIRs) of oncological pathologies in the period 2003-2009 were calculated based on age-sex specific rates for the district of the Local Health Authority of Novara (ASL13) and the main regional city of Turin. For all cancers combined, men showed a significant higher risk (SIR: 1.21; 95% CI: 1.02-1.40) compared to the ASL13 population; significantly lower risks for both men and women were observed in comparison to the Turin population. Among women, a significant excess of mesothelioma cancers was reported; a significantly higher risk for lympho-haematopoietic pathologies was also observed compared to the Turin population only. Several other cancers have significantly lower rates in Cerano for both men and women. Despite some studies' limitations, these findings could suggest potential chemical risk factors and need further investigation.

[Cancer survival in a local health district in Piemonte (Italy): follow up to 2007]. / Sopravvivenza oncologica Asl Vc di Vercelli: follow up al 2007.

The objectives of this study were to compare, in a standardized manner, survival of cancer patients residing in this area and to further verify the quality of baseline incidence and mortality data. The survival analysis presented here refers to cases of primary malignant tumors diagnosed for the first time from 2002 to 2004 and followed until 31 December 2007. Women were found to have lower survival rates for gastric, laryngeal and lung cancer with respect to men while good survival rates were found for cancers for which organized screening programs are available. Overall, results show that women in this health district have substantially lower survival than men, indicating that major efforts in terms of primary prevention and awareness should be geared at this population.

[Health status of residents of the town of Trino Vercellese (Italy): cancer mortality from 2000 to 2010 and other epidemiological indicators]. / Aggiornamento sullo stato di salute della popolazione del comune di Trino Vercellese: mortalità oncologica 2000-2010 e altri indicatori epidemiologici.

The authors evaluated the health status of the population of Trino, a town in the province of Vercelli (Piedmont region, northern Italy) that houses several industries such as cement plants and foundries and that in the past (1964-1987) has been the site of a nuclear power plant. In detail, cancer mortality data for the years 2000 to 2010 was analyzed and the excess mortality with respect to cancer deaths registered in the city of Torino (also in the Piedmont region) from 2006 to 2008 was calculated. Significantly more deaths were observed than expected for cancers of the nervous system, leukemia, mesothelioma and peritoneal cancer. Additional indicators such as standardized years of life lost and the cumulative risk of mortality from birth to 74 years highlight several epidemiological anomalies when compared to the European population, that will be investigated in the future through case-control studies and spatial analyses.

[An update on several indicators of the quality of data flow in a cancer registry in Vercelli (Piedmont, Italy)]. / L'incidenza oncologica nell'ASL VC di Vercelli dal 2002 al 2009: aggiornamento indicatori di qualità del flusso informativo.

The first estimates of cancer incidence in the city of Vercelli in Piedmont (Italy) are now available for the years 2002 to 2005 and preliminary data are also available up to 2009. With respect to previously published results, the cancer database has been integrated with information from additional data sources to ensure that it will become, in the near future, a sound basis of information upon which to build an accredited cancer registry. An evaluation was therefore performed of two indicators of the quality of data flow: the proportion of cases with histological confirmation of diagnosis and cancer mortality to incidence (M/I) ratios. Both show an improvement with respect to 2005 but need to be significantly improved to reach the levels of excellence and accuracy that a registry must necessarily possess. Local health authorities will need to ensure staff availability and facilitate access to key data sources to fully evaluate cancer epidemiology in the area.

[Perceived quality of care in a nursing home in Piedmont (Italy)]. / La qualità dell'assistenza in una casa di cura piemontese: l'opinione dei degenti.

A cross-sectional study was conducted in the years 2003, 2005 and 2006, to assess client satisfaction in a nursing home in Piedmont (Italy). A structured questionnaire was used to evaluate three dimensions of care: interpersonal relationships, clinical care received and room comfort. Six-hundred eighty-four patients participated in the study. Of these, 33.6% were surgical patients, 33.6% were rehabilitation patients and 32.8% were medical patients. Overall, quality of care was reported as being "excellent" by 85% of patients in 2003, 85.3% of patients in 2005 and 66.1% in 2006. The study has made it possible to give a general description of client satisfaction regarding quality of services provided in a nursing home, and to identify the major critical areas. These should be analyzed in more detail, in order to identify which factors are most relevant to the patient and to implement corrective actions.

[Cancer mortality in a local health district of Vercelli (Italy) 2000-2009]. / Andamento della mortalità oncologica nell'Asl Vc di Vercelli. Estensione database al 2006-2009 e analisi decennio 2000-2009.

Cancer mortality data for 2000-2009 in the local health district of Vercelli (northern Italy) were analysed. Overall, standard mortality rates show excess mortality rates in men for colon and rectal cancers, central nervous system cancers, as well as esophageal, laryngeal, renal, lung, skin (non melanoma) and skeletal system cancers. For women, excess mortality rates were found for skin (non melanoma), leukemias, nervous system cancers, lymphomas and skeletal system cancers. Mortality data for the years 2006-2009 were compared to data for 2000-2005. Results show an increased mortality risk for mesothelioma in the period 2006-2009 with respect to the period 2000-2005. On the other hand decreased mortality risks were found for nervous system tumours and leukemia, even though current standard mortality rates remain in excess. In light of these findings, it is advisable to monitor the phenomenon in the coming years and to conduct studies to identify possible risk factors.

[Mortality among the population living near the municipal solid waste landfill site in Barengo (Italy)]. / Studio Epidemiologico nel Comune di Barengo e nei Comuni circondariali sede di una cava di RSU: analisi della mortalità generale e per causa dal 2000 al 2009.

A municipal solid waste landfill site is present in Barengo (northern Italy). The site is located in the centre of an area that includes eight towns: Barengo, Cavaglietto, Momo, Cavaglio, Briona, Vaprio and Fara Sizzano. The total population of the area is 11,122. The authors carried out an analysis of routine mortality data in order to identify any excess mortality in the area. Standardised mortality ratios by sex and cause of death were calculated. The Piemonte regional population and the population of the province of Novara were used as standard populations. Overall mortality data for the years 2000 to 2009 showed excess mortality in both sexes for cardiovascular disease, gastrointestinal disease, nervous system and respiratory system disorders. The frequency of Alzheimer's disease, amyotrophic lateral sclerosis and certain tumours should be monitored.

[Analysis of the incidence of tumours subjected to screening in a local health authority in Vercelli (Italy), 2002-2005: preliminary data]. / Analisi di occorrenza della patologia tumorale di screening nell'Asl di Vercelli negli anni 2002-2005: dati preliminari.

Population screening of selected tumours have been implemented only recently in the local health authority of Vercelli (northern Italy): screening of uterine tumours was implemented in the year 2000, and screening of breast and colon-rectal tumours in 2005. The objectives of this study were firstly, to implement a data collection and management process and secondly, to obtain incidence data of tumours for which screening activities are possible. The study analysed data of 2002-2005, readily available from hospital discharge abstract forms. The findings of this study constitute an important knowledge base that will be useful in the implementation of a program for the evaluation of the quality of screening programs.

[Estimating the incidence of cancer in the VC Local Health Authority in Vercelli (Italy) from 2002 to 2005]. / Stime d'incidenza oncologica nell'Asl Vc di Vercelli dal 2002 al 2005.

The aim of this study was to describe the epidemiology of tumours in a geographical area in Italy devoid of a tumour registry. A descriptive study was conducted in the territory of the VC local health authority. To estimate incidence, hospital discharge forms were analysed together with data from pathology archives. The standardized incidence rate (SIR) was calculated by using age specific rates in the VC local health authority in the years 2002-2005 and the tumour incidence in the city of Turin as the standard population. As regards low mortality tumours, an excess of bladder cancers (SIR=1,2; 1,1-1,3) and melanomas (SIR=1,3; 1,1-1,6) were found in males and of thyroid cancer (SIR=1,9; 1,6-2,2) and non-Hodgkin lymphomas (SIR=1,4; 1,2-1,6) in females. In addition, an excess of rectal and colon cancers, and leukemia were observed in both genders and of central nervous system tumours in women. This preliminary study may be considered as a basis for the creation of a tumour registry which would necessarily need to integrate additional sources of information. In any case the results of this study have identified certain peculiarities regarding the epidemiology of tumours in this area, which should be further studied in terms of a Public Health problem.

[Epidemiology of tumour mortality from 2000 to 2005 in the province of Vercelli (Italy)]. / La mortalità per tumore in provincia di Vercelli dal 2000 al 2005: considerazioni territoriali ed epidemiologiche.

The main aim of this study was to assess the burden of cancer disease in residents of Vercelli (northern Italy), by analysing mortality data and hospital discharge forms. This was done in order to verify whether, as widely suspected among the city's population, an increased risk of cancer exists in the area, due to the large number of existing agricultural and industrial activities. Tumour mortality rates were compared with mortality data from the tumour registries of the province of Biella and of the city of Turin to identify a possible excess number of cases in Vercelli.An increased mortality rate was observed with respect to reference values (mortality registry of the city of Turin) for several tumours; more specifically results revealed a significantly increased mortality rate due to colorectal tumours, leukemias and nervous system tumours in both genders. Excess mortality was detected in males but not in females for esophageal cancer, non melanoma skin cancers, pancreatic, laryngeal, prostatic, renal and bone cancers. Conversely, in females, the standard mortality ratios (SMR) were found to be statistically significant for renal and laryngeal cancers and for Hodgkin's lymphoma.

Former Workers of a Bright Electroplating Factory Located in Vercelli: A Cohort Study From 1974 to 2016: Legal Expertise Results.

BACKGROUND: The mortality risk among former workers of a factory with an adjoining galvanic activity has been assessed; several environmental analyses found in the site the presence of nickel and organochlorinated substances. METHODS: The cohort followed by 1974 to 2016 is represented by 899 individuals in which there were 191 deaths: 140 males and 51 females. A risks analysis with elaboration of SMR between observed cases and the expected one referring to Piemonte region rates was performed. RESULTS: The excesses stratified by gender and task have highlighted enhanced cancer risk (especially lung and liver cancers) among men workers. For females, cancer risk is enhanced especially for pancreas, ovary, and total digestive tract cancers. CONCLUSION: The report confirms an increased risk between nickel and lung cancers and organochlorinated and liver cancer.

An Italian population-based case-control study on the association between farming and cancer: Are pesticides a plausible risk factor?

This population-based case-control study investigated the association between farming (a proxy for pesticide exposure) and cancer in the Vercelli suburban area (northwest Italy). The residents, aged 25 to 79 years, in the above-mentioned area during the period 2002-2009 were considered. Cases were all the first hospital admissions for cancer. Controls were all the subjects not included in the cases and not excluded from the study. Cases and controls were classified according to whether they occupationally resulted farmers or nonfarmers during the period 1965-2009. Cancer odds ratios (ORs) between farmers and nonfarmers were calculated with generalized linear mixed models adjusted by gender and age. Farmers showed higher odds for all cancers (OR=1.459; p < .001), nonmelanoma skin cancer, colorectal cancer, and breast cancer. The results suggest a plausible association between pesticide exposure and cancer occurrence.