An Update of Mortality in a High Environmental Risk Area of Tuscany Region (Italy)

Abstract

P-038 Introduction: The study area was identified as “at high risk of environmental crisis area” by the Italian Ministry of Environment in 1986. In such a territory relevant chemical plants were operating since the 1950s, some of them were decomissioned after severe accidents happened in the mid 1980s. Critical mortality profile of the area in the period 1990–1994 was reported in a previous descriptive study. Objectives: The epidemiological descriptive study was carried out in order to describe the mortality in the study area at high risk of environmental crisis of Italy, during the period 1995–2000, and to investigate the differences with the mortality reported for the period 1990–1994 in the same area. Material and Methods: Mortality for all causes and for 30 specific causes of death in the period 1995–2000 at the level of municipality were analysed, for causes of death for both sexes, using standardized mortality ratios adjusted for age and deprivation index. The comparison with the mortality observed over the 1990–1994 period in the same municipalities was carried out using ratios between directly standardized rates by age classes. The causes of mortality for which a statistically significant excess was found, were investigated using a spatial analysis on a pool of neighbouring municipalities. Results: The study confirms statistically significant excesses for the total mortality and mortality for several causes, particularly for respiratory system, cirrhosis, tumors of liver and lung in males. New statistically significant excesses emerges for tumors of larynx and pleura. The comparison between the mortality observed over the period 1995–2000 and over the period 1990–1994 has showed statistically significant decreases regarding the mortality for all causes and for several specific causes, but also significant increases for tumors of liver and blood. Conclusions: These results confirm the health impact of occupational and environmental exposures in populations living in areas defined “at high-risk of environmental crisis”, including industrial sites and reclamation area. The health adverse effects are more serious in deprivated areas, and remain critical throughout a large number of years after the closure of polluting industrial plants. The results of the study draw the attention to the need to promote actions addressed to modify life-styles at risk, to ameliorate socio-economic conditions, to mantain a constant control on environment, also through a specific environmental epidemiological surveillance to monitor the impacts of the reclamation procedures in place or already completed.