Sustainability of Italian seaports located near contaminated sites: results of an exploratory analysis.

INTRODUCTION: Ports are strategic areas of economic importance, but they are also very critical contexts. Many Italian ports are included in contaminated sites of concern for remediation, with the presence of pressure factors that overload the burden capacity of local ecosystems and communities. AIM: The aim of this study is to characterize Italian seaport areas through a general theoretical path on the theme of ports-sustainability-local communities, identifying the ports located in municipalities included in contaminated sites studied by the SENTIERI Project (Epidemiological Study of Residents in Italian Contaminated Sites). Many of the selected ports, are being part of complex industrial areas, where, in addition to the port area, there are other sources of environmental contamination potentially harmful to health. RESULTS: Excesses risk were observed for mesothelioma and for respiratory diseases, pathologies for which there is epidemiological evidence of an excess of risk associated with residence in port areas. DISCUSSION: The strong environmental pressures that characterize these areas make it necessary to adopt adequate environmental and health protection measures.

Efeitos de um tratamento baseado em exercícios em grupo para pessoas com osteoartrite sobre as variáveis dor, funcionalidade, qualidade de vida e flexibilidade / Effects of a treatment based on group exercises for people with osteoarthritis on the variables pain, functionality, quality of life and flexibility

Introdução: Estudos têm mostrado que a prática de exercícios físicos é recomendada para diminuição dos sintomas de indivíduos com osteoartrite (OA). Objetivo: O objetivo do presente estudo foi avaliar o efeito da utilização de um protocolo de intervenção realizado em grupo, sobre as variáveis dor, função, qualidade de vida e flexibilidade em indivíduos com OA de joelho e/ou quadril. Métodos: Foram incluídos no estudo 15 participantes, com idade igual ou superior a 50 anos com diagnóstico de OA de quadril e/ou joelho. O protocolo foi realizado duas vezes por semana, totalizando 10 sessões, com objetivos pré-definidos para cada semana, sendo realizada uma avaliação antes e após a intervenção. Para a avaliação foi utilizada EVA para dor, questionário LEFS e TSL para avaliar funcionalidade, teste de sentar e alcançar para flexibilidade e questionário SF-12 para avaliação da qualidade de vida. Resultados: Observou-se melhora significativa nos valores da dor em movimento (p = 0,005) e na funcionalidade pelo TSL (p = 0,003). Conclusão: É possível observar o efeito do protocolo aplicado sobre os parâmetros de dor em movimento e funcionalidade, destacando redução significativa da dor em atividades que envolvam o movimento, e maior independência.

[SENTIERI Project: air pollution and health impact of population living in industrial areas in Italy]. / Valutazione dell'impatto dell'inquinamento atmosferico sulla salute della popolazione residente nelle aree industriali italiane incluse nel Progetto SENTIERI.

OBJECTIVES: to estimate the impact of PM2.5 and PM10 in the Italian industrial areas included in the SENTIERI project characterized by industrial plants with combustion processes deriving from point emissions. DESIGN: using satellite data, the Population Weighted Exposure (PWE) to PM2.5 and PM10 for 2011 and 2015 was estimated. The concentration-response functions available were used to estimate the number of premature deaths attributable to exposure to industrial emissions. The counterfactual levels recommended by the new WHO Air Quality Guidelines were used. SETTING AND PARTICIPANTS: for the selection of industrial plants, the European database on emissions of the European Pollutant Release and Transfer Register was used. Residents in areas of 1 km x 1 km and 4 km x 4 km around the selected industrial plants were considered. MAIN OUTCOME MEASURES: the number of premature deaths from non-accidental causes, cardiovascular and respiratory diseases, and lung cancer was estimated. RESULTS: residents were exposed to PM2.5 values of 17.3 µg/m3 (Northern Italy: 23.3) and to 24.3 µg/m3 (Northern Italy: 30.3) of PM10. PWE for both pollutants tends to increase as the size of the area under study is reduced and it is generally higher everywhere in 2011 than in 2015, with values that are always higher than the average (overall) in the Norther Italy. In 2011, 1,709 (IC95% 1,309-1,903) and 1,611 (IC95% 1,225-2,353) non accidental premature deaths were estimated attributable to PM2.5 and PM10, respectively, in residents close to the industrial plants (1 km x 1 km). Deaths attributable to exposure to PM2.5 and PM10 tend to follow a North-Central-South&Islands gradient for all observed causes and for both years of analysis. CONCLUSIONS: although exposure assessment of the population by using random-forest model does not allow to disentangle the contribution of the industrial component, the results of the study are suggestive of an impact on health from PM exposure in the industrial areas considered, with a greater impact in the vicinity of the plants, recommending the implementation of urgent impact reduction actions.

[The concept map of SENTIERI Project: a communication interactive digital tool of the national epidemiological surveillance system of Italian contaminated sites]. / La mappa concettuale: uno strumento digitale interattivo per la comunicazione del sistema di sorveglianza epidemiologica SENTIERI nei siti contaminati.

This paper describes the development and the envisioned use of concept maps in the framework of the SENTIERI communication strategies as an information and scientific communication tool applied to epidemiological surveillance in contaminated sites. The concept map of SENTIERI 2019-2022 was designed and implemented to foster access to complex scientific information ensuring usability of the contents and communication with the various stakeholders. The concept map aims to promote environmental health literacy in contaminated sites. The methodology adopted to create the map includes the following phases: 1. choice of a dynamic focus question; 2. selection of the representative terms of the addressed topics; 3. elaboration of the glossary of the selected terms; 4. representation of the links among the selected terms; 5. identification of the significant propositions that make explicit the meaning of each link. Online access to the map is guaranteed by the Mindomo software. The use of the concept map promotes active learning of the topics that characterize SENTIERI 2019-2022 through knowledge paths chosen because of the specific interests and learning purposes. The concept map derives from the integration of specific approaches of the epidemiological discipline with those of the social sciences and offers the possibility of developing site-specific maps through the interactions with local actors and the integration of elements related to emerging problems as well as institutional and local interests.

Distributive justice in environmental health hazards from industrial contamination: A systematic review of national and near-national assessments of social inequalities.

Communities where polluting human activities are sited often show disadvantage in terms of social and economic variables. Environmental distributive justice studies seek to identify common characteristics in exposed populations and highlight the presence of environmental inequalities. We have conducted a review of the existing literature about justice in the distribution of health hazards from industrial pollution. We included papers investigating associations between social disadvantage and contamination through assessments at national or macro-area level. From each study we extracted: indicators for the social determinants of exposed communities (classified according to PROGRESS-plus categories); definition and measurement of environmental hazard (as either proximity to contamination sources, exposure to emissions or health impacts from pollutants); study design and methods; significant results. We retrieved 45 eligible articles. Most publications were from USA and had a nationwide scope with data at municipal/sub-municipal scale. Socioeconomic position and race/ethnicity were the social determinants most often explored, followed by occupation and education; air pollution was the commonest sort of contamination, while proximity prevailed as measurement of hazard. All papers found significant associations between social dimensions and health hazard from industrial contamination: the majority of associations supported an increased burden on vulnerable categories, especially ethnic minorities and unemployed - however, several relationships were found in the opposite direction or in both ways, particularly with wealth and education, reflecting a mixed reality where potential discrimination in siting decisions coexists with socioeconomic benefits for nearby communities due to industrial development. Assessments of environmental distributive justice are lacking in most countries and those that are conducted show vast methodological heterogeneity. We recommend consistency in models and indicators, the inclusion of female-led households among indicators of social disadvantage, and the adoption of a small scale to elicit significant findings and provide meaningful policy action.

[Environmental justice promotion in industrially contaminated sites]. / Promozione della giustizia ambientale nei siti industriali contaminati.

The communities residing close to industrially contaminated sites are often affected by several fragilities, particularly of a socioeconomic nature. The disadvantaged conditions have often resulted from their marginalization in the decision-making related to the industrialization processes and may persist even when action is taken to limit the harmful consequences for the natural and social environment. Exposure to contaminants and the resulting health risks often regard socioeconomic deprived communities or the most disadvantaged subgroups, generating conditions of environmental injustice. This paper reports the results of a multidisciplinary reflection focusing on the Italian context. It describes how the national epidemiological surveillance system of communities residing close to industrially contaminated sites (named SENTIERI) and local epidemiological surveillance systems can be implemented to document local conditions of distributive injustice (inequalities in harmful exposures and consequent health risks). Furthermore, it analyses the mechanisms for generating and maintaining marginalities that prevent local communities from participating in decision-making processes (procedural injustice). Finally, after having identified and described the dimensions of community capacity, which concern both to the understanding of the adverse effects of environmental contamination and to the capability of promoting interventions against environmental injustices, it proposes an environmental justice promotion approach that starts from mapping the dimensions of community capacity as a premise to the identification of interventions for community empowerment.

The ISS National Inventory of Chemical Substances (INSC).

The INSC (Inventario Nazionale delle Sostanze Chimiche), a factual data bank, produced by Istituto Superiore di Sanità (ISS), consists of an electronic tool on chemical information developed for routine and emergency purposes. Historical background, current status and future perspectives of INSC are discussed. The structure and the feature of INSC are briefly examined. Aspects of information retrieval and the criteria for inclusion of data and priority selection are also considered.

The ISS Carcinogens Data Bank (BDC).

The Data Bank on Carcinogens (Banca Dati Cancerogeni, BDC) is a factual data bank, available on the Istituto Superiore di Sanità website, aimed at supporting the risk management decision making of central and local administrators. It can also represent a valuable tool for industry. The available information on carcinogenicity evaluations/classifications produced by European Union and by other institutions (IARC, USEPA, NTP, CCTN) is presented in a concise form accompanied by bibliographic references enabling the users to consult the original sources and, in some cases, to be directly connected to the relevant website. The classifications carried out by each organization in accordance with its own criteria assign the examined agents to specific qualitative categories and do not include quantitative assessment. BDC intends to provide an easy tool for experts, researchers and risk managers dealing with carcinogenic agents.

The ISS Sensitizing Agents Data Bank (BDS).

The Istituto Superiore Sanità has developed a data bank on sensitizing substances (Banca Dati Sensibilizzanti, BDS), available on website (www.iss.it/bdse/), sharing complete, controlled and updated information coming from different sources, such as scientific publications, international agencies and governmental or non governmental organizations. It is worthwhile that the main objective of the BDS is not the classification of sensitizing or potentially sensitizing agents within specific risk classes, but it is essentially to provide concise and non confidential information related to this endpoint. At present, the BDS includes: all the substances officially classified by European Union, (Annex I to Directive 67/548/EEC), some substances listed in I (Directive 67/548/EEC) for endpoints different than "sensitization" but indicated as sensitizers by other relevant institutions, all the substances indicated as sensitizers by relevant agencies or institutions (ACGIH, DFG), some substances indicted as sensitizers by industry and other non-governmental organizations (ETAD and HERA), all the substances regarded as "potentially sensitizing dyes" by the Commission of the European Community for the award of the eco-label to textile products, some substances for which, even in the absence of any categorization by Union, ACGIH or DFG, it is not possible to exclude a sensitizing potential on the basis of reliable documents.

The ISS Reclamation Data Bank.

Since the issue of the first regulations concerning the remediation of contaminated sites, the Istituto Superiore di Sanità, on the basis of specific requests, has drawn up various technical opinions regarding the proposed reference values (quality standards) for soils and underground waters, to be achieved when remediating contaminated sites, for substances for which no standard limit values did not exist at that time. These reference values, widely used throughout the country and accepted and adopted as "remediation aim" values by various territorial bodies responsible for the approval and monitoring of remediation projects, have been collected in a specific reclamation oriented data bank known as the "Banca Dati Bonifiche (BDB)" (Reclamation Data Bank). The BDB contains the related standardized "rationale" for each reference value, in order to serve as a useful reference for the national bodies concerned with the remediation of contaminated sites.