Geographical and epidemiological analysis of oncological incidence in paediatric and adolescent ages in a municipality of North-Western Italy: Vercelli, years 2002-2009.

INTRODUCTION: This study of the geographical incidence on the oncological mortality in young age (0-44 years) in the City of Vercelli, was aimed to address the concerns of the population and the request of municipal administrators. A detailed and sophisticated study for a City of medium-small size is due for the presence of various sources of pressure, such as a MSW incinerator just a few kilometres from the city and an intensive agricultural activity that characterizes the entire area. MATERIALS AND METHODS: The study is based on the census analysis of the population, and of the hospital admission cards, and it considers epidemiological standardized estimators and spatial analysis through Bayesian models, as well. RESULTS: Both approaches highlight Major risks for the area south of the city for major tumours such as total cancer in women (SIR / SMR significant excess of about 50%), colorectal (mean increments SMR / SIR between 3 and 4 times), ovary (mean increments SMR / SIR between 3:04 and times), and nervous system (increases 3 times for both indicators). CONCLUSION: These results deserve further studies through inferential case-control and cohort analysis, given the marginal role of the possible occupational hazards in the aetiology of juvenile cancer disorders.

Incidence of oncological pathologies 2002-2010 in the southwestern Piedmont area, province of Vercelli, neighbouring municipalities of former nuclear sites.

The Vercelli Province counts two former nuclear installations: a radioactive waste disposal area in Saluggia and a former nuclear power plant in Trino. This study takes also into account four other neighbouring municipalities, counting 20,000 total inhabitants. We studied the incidence of neoplastic pathologies in the 2002-2010 period. The data sources were Hospital Discharge Form (SDO), histological reports from the Registry of Hospital Charts (RHC) and Italy's National Statistics Institute (ISTAT) reports, and the Cancer Register of Turin. The research highlights the excesses for all type of cancers (SIR=1,11; IC 1,04-1,18), including the ones of nervous system (SIR=2,23 IC 1,47-2,98), leukaemia (SIR=1,94 IC 1,35-2,52), and bones (SIR=12,0 IC 9,22-14,7), according to different aggregation levels by age, sex and housing area. Considering such results, previous studies, and the environmental and occupational risk factors in the area, we believe that further epidemiological and environmental studies should be conducted in this area.

Exploration study on mortality trends in the territory surrounding an incineration plant of urban solid waste in the municipality of Vercelli (Piedmont, Italy) 1988-2009.

BACKGROUND: The places, where the incinerators are located, often present problems of heterogeneous people having different environmental factors. It becomes important to evaluate the possible etiologic role of various environmental risk factors and try to quantify as they affect in the excess epidemiological. METHODS: This study considers the ISTAT index mortality due to all causes occurred from 1988 to 2009 referred to ten municipalities at south of Vercelli (Piedmont, North Western Italy) placed nearby the active incinerator from 1977 (10 latent years). The risks were calculated considering this area at risk versus the municipalities placed at North of Vercelli and versus the Vercelli. RESULTS: Some significant statically excesses emerged in the South area such as neoplasia of nervous system, liver and total of tumours. CONCLUSIONS: The study presents some drawbacks, but it is a work creditable of widening by specific research ad hoc such as cohort and/or control where it is possible to verify various environmental, occupational and occasional factors.

Geographical and epidemiological analysis of oncological mortality in a Municipality of North-Western Italy Vercelli years 2000-2009.

BACKGROUND: We performed a geographic analysis study on mortality in the town of Vercelli, in order to respond to the concerns of the population and some local administrators. Main reason to carry out a detailed and sophisticated study for a city of medium-small size was represented by the presence of various sources of environmental and industrial pressure (i.e. old-generation incinerator for solid urban waste, industrial site for chemicals production, intense agricultural activity of rice production…). METHODS: The study analyzed census, ISTAT death cards, both from the epidemiological point of view with admirers that SMR standardized spatial analysis using Bayesian models. RESULTS: Overall, both approaches highlighted major risks for the area south of the capital for major cancers such as colorectal and lung and increases worthy of investigation for the young-adult age groups in both genders. And being processed a similar study that considers the incidence oncology. CONCLUSIONS: The imminent elaboration of the cartography by oncological incidence will allow us to confirm, or less, the areas in excess for the death data, and in the meanwhile observe any excesses for low mortality pathologies (e.g., thyroid) or neoplasies whose present therapies allowed complete recovery and/or very long survivals (e.g. leukaemia, lymphomas and testicle).

Cancer risk among farmers in the Province of Vercelli (Italy) from 2002 to 2005: an ecological study.

BACKGROUND: As the link between agricultural pesticides and numerous types of human cancers is wellknown. Farmers living in the Province of Vercelli (Italy) were observed to verify if they have a higher cancer risk than the rest of the local employed population. Literature showed a well-known excess of cancer morbidity and mortality in the Province of Vercelli, but only few studies focused on cancer incidence in local farmers. Studying farmers could allow to assess the causal importance respectively of environmental pressure and professional exposure factors in explaining cancer excesses in the above-mentioned area. MATERIALS AND METHODS: The present ecological study considered all cancer new cases recorded among the mean employed population with a range of age from 25 to 84 years and resident in the Province of Vercelli during the four-year period 2002-2005. Cancer odds ratios, by gender and type of cancer, between farmers and non-farmers were calculated. RESULTS: Farmers showed a higher risk for the following tumors: colorectal (OR 2.38, IC95%: 1,76-2,87), leaukaemia (OR 2.65, IC95%:2,12-2,89), digestive system (OR 2.16, IC95% 1,92-2,33), lymphoma OR 2.08, IC95%:1,99-2,23), melanoma (OR 2.90, IC95%:2,54-3,15), myeloma OR 3.55, IC95%:3,23-3,70), pancreas OR 3.38, IC95%:3,14-3,61), lung (1.59, IC95%:1,12-2,38) and kidney (2.70, IC95%:2,41-2,99). Males showed a higher risk for lung cancer, females for liver neoplasm, melanoma and lymphoma. CONCLUSIONS: Farmers showed a higher risk for several cancers. Further studies are needed, in order to examine in detail the issue, to encourage the use of personal protective equipment and to promote a more responsible pesticides use.

[Assessment of the impact of cancer in the Vercelli Local Health Authority from 2002 to 2009]. / Incidenza oncologica nell'ASL VC di Vercelli dal 2002 al 2009.

The object of the study is to provide an epidemiological overview of the impact of neoplasms in an area that has no cancer registry. A descriptive study was conducted within the Local Health Authority of Vercelli. To estimate the number of cases, hospital discharge documents (including passive mobility) were used and integrated with the archives of pathology. The number of cases was calculated on the basis of SIR (specific rates of the Vercelli Local Health Authority divided by age in the years 2002-2009 in comparison with new cases of cancer in the city of Turin from 2005 to 2007, used as standard population). All readings were expressed including intervals of confidence at 95%. For tumors of low lethality for males, extending the period of observation confirms the excess for bladder cancer (SIR = 1.1, 1.07 to 1.21) and lymphoma aggregate (SIR = 1.4, 1.2 to 1.6). for females: thyroid (SIR = 1.5, 1.3 to 1.65) and lymphomas (SIR = 1.25, 1.1 to 1.4). In addition to these tumors in both sexes is observed to decrease colorectal cancer but excess for leukemias and brain. The extension of the study is intended as the base for the creation of a cancer register that will be established, naturally integrating further sources of information. In all cases, data observed indicated several epidemiological peculiarities in the region, probably linked to specific characteristics of local exposure, which should be addressed in terms of Public Health.

[State of health of the population residing in the town of Barengo and in surrounding communities, site of a field used as landfill for MSW: analysis of the general incidence and causes from 2003 to 2009]. / Stato di salute della popolazione residente nel Comune di Barengo sede di una cava adibita a discarica di RSU e nei Comuni circondariali: analisi dell'incidenza generale e per causa dal 2003 al 2009.

The research provides an observational epidemiological study to detect whether there is a cluster or a local excess morbidity rate in Barengo, site of a solid waste quarry, as well as to define the initial hypothesis of causal relationships and then trigger if necessary, more stringent and specific inferential assessments. The population studied consists of all the residents in the eight municipalities that make up the area next to the dump site with Barengo as the central point, site of the plant; the reference population in Barengo, Cavaglietto, Momo, Cavaglio, Briona, Vaprio, Fara and Sizzano add up to about 11,122 residents. The overall mortality data for the years 2000-2009 show excesses for cardiovascular diseases, digestive system as well as nervous and respiratory systems for both sexes; to monitor next would be the frequency of some cancers such as, bone, kidney, small intestine and ovary. Given the current epidemiological considerations, today we cannot derive the determining conditions of health levels observed. The viability of a health risk identification can be achieved only in a second intervention capable of inferring random links in regards to the presence of specific risk situations.

[State of health of the population of Trino (Vercelli): cancer mortalities 2000-2007 and historical analysis of all causes of death from 1980 to 2000]. / Stato di salute della popolazione del comune di Trino Ver- cellese: mortalità oncologica 2000-2007 e analisi storica per tutte le cause di morte dal 1980 al 2000.

The survey takes an in-depth look at the state of health of the inhabitants of Trino, in the province of Vercelli. The presence of various industries like cement factories, foundries and the placing of a nuclear plant (E.FERMI) in past decades, led to the carrying out of several surveys in order to reveal possible epidemiological excesses. In the survey in question, a detailed analysis of cancer mortalities occurring from 2000 to 2007 was carried out, examining the results in comparison with the Local Health Authorities of Vercelli and data from the Rencam Registry of the city of Turin from 2004 to 2006. The results highlight and confirm significant excesses for cancers like the nervous system, leukaemia, mesothelioma and peritoneum. Subsequent historical analysis (1980 - 2000) with data from the BDM Piedmont with regards to cancer mortalities confirms part of our data, while for all other causes we highlight the anomaly of amyotrophic lateral sclerosis in both sexes after the age of 65. The combination of these related results and our previous study of cases in Trino certainly require an in-depth epidemiological analysis through etiological studies.

Air quality biomonitoring: assessment of air pollution genotoxicity in the Province of Novara (North Italy) by using Trifolium repens L. and molecular markers.

Mixed air pollutants are considered a major cause of DNA damage in living species. In this study Trifolium repens L. cv Regal was used as a bioindicator to assess the genotoxicity of air stressors in the Italian province of Novara. Two on-site biomonitoring experiments were performed during the spring and autumn of 2004. Test plants were exposed at 19 monitoring sites distributed homogeneously throughout the province, and each experiment lasted for a period of 6 weeks. Genotoxicity was evaluated with Amplified Fragment Length Polymorphism (AFLP) molecular markers. The results show the predominantly rural central-west region of the Novara Province to have the worst air quality with regard to genotoxicity. Analyses of geomorphology, land use and climatic factors suggest that the compromised air quality in the region could be attributed to wind strength and direction, transporting pollution from vehicular traffic on the A4 highway and from the urban/industrialized centres of Novara and Vercelli. Plant growth, changes in plant photochemical efficiency and the presence of ozone related leaf injuries were also measured to better interpret the results of genotoxicity. Statistical analyses show that although climatic factors such as light intensity and temperature influence plant growth, they do not contribute to atmospheric stressor-induced DNA damage. Further analyses indicated that, as expected, a mixture of genotoxic and non-genotoxic pollutants coexist in the Novara Province troposphere, and that the elevated ozone concentrations experienced during the study may have contributed to the DNA damage in the tested plants by enhancing genotoxicity via interaction with other air stressors.

Use of leaded gasoline and volatile halogenated hydrocarbon emission from automotive exhaust.

The presence of volatile halogenated hydrocarbons (VHH) in the atmosphere of the urban areas of Piedmont and its possible correlation with traffic has been studied. Automotive exhausts of leaded and unleaded gasoline were tested, according to the "European Cycle" of the EEC guidlines N.C. 181/89, 7/9/1982, for the presence of seven VHH. The results show that VHH are produced in concentrations roughly proportional to the number of kilometres covered by each car. Cars filled with unleaded gasoline were substantially free of VHH. Thus, some of the VHH found in the atmosphere may arise from automotive (leaded petrol) exhausts.

[Epidemiologic study on the performance of a smoking prevention program in an adolescent population]. / Studio epidemiologico per la realizzazione di un programma di prevenzione del tabagismo in una popolazione di adolescenti.

In the last few years, the relative number of adolescent smokers has increased, which indicates the need to boost the adoption of new preventive strategies aimed at this part of the population. In order to be effective, preventive actions should be put in the local setting thoroughly knowing the target population and any specific-predictive factors of the insurgence of smoking addiction. To this purpose, we conducted a study aimed at describing the prevalence of smoking addiction in a population of 2472 adolescents and at identifying any predisposing factors. From the analysis of the results, both predisposing and protective factors emerged, together with many formative requests from the adolescents. On the basis of such results, we were able to create ad hoc preventive interventions. The proposed strategy seems to be potentially valid; however, we will be able to express a more precise judgment only at the end of the implementation phase.

[Exposure to phenol: analysis of environmental and urinary concentrations of phenol in a group of exposed subjects]. / Esposizione al fenolo: analisi delle concentrazioni ambientali e delle concentrazioni urinarie di fenolo in un gruppo di soggetti esposti.

Urinary excretion of phenol has been valuated in 80 subjects exposed to low concentrations released during a hot pressing process on phenol resins. The subjects belonged to three different work shifts and the study was carried out on the fifth day of exposure. An attempt is made to relate environmental concentrations of phenol and urinary concentrations expressed by reference to creatinine volume and mg. Analysis of results also considers a number of individual variables.

[Air pollution in the daily environment: study of a school-children population]. / L'inquinamento atmosferico nei luoghi di vita quotidiana. Studio di una popolazione di bambini in etá scolare.

BACKGROUND: To evaluate the annual distribution of personal exposure to NO2 in a sample of school children and to study the determinants of such exposure. METHODS: Exposure to NO2 has been evaluated using Palmes Tubes in 310 school-children (aged 5-14) in Novara. The possible differences in personal measurements by means of ANOVA and Tuckey test were evaluated. Information on the sources of potential exposure and on respiratory symptoms have been collected through a questionnaire and a clinical diary. The relative risk for these variables has been assessed using a multiple regression model (Logit). RESULTS: The annual mean of the 6,200 measurements was 42.3 microgram/m3, with a significant difference among seasons and with higher values in winter. The only factor associated with a high exposure was identified for maternal school children living in houses close to high traffic density roads. Respiratory symptoms were non-related to NO2. CONCLUSIONS: The use of gas cookers and heaters is not enough to explain the variability of personal exposure. Between other specific determinants, the importance of living along busy streets, of ETS and of seasons explains the level of personal exposure. The opportunity of personal, rather than environmental, monitoring is confirmed, even if we stress the necessity of studying the short-term exposure to rapidly find clinical damages in the general population.