Hellenic Statistical Authority Research Articles

Asbestos ban policies and mesothelioma mortality in Greece

BackgroundMalignant mesothelioma is a rare form of cancer that mostly affects the pleura and has a strong link to asbestos exposure. Greece banned the use of asbestos in 2005, however, the public was already aware of this substance in the 1980s. This research aims to present an overview of Greece’s mesothelioma age-standardized mortality rates (ASMR) from 1983 to 2019 by age, gender, and geographic region and to determine whether the actions to ban asbestos impacted these rates.MethodsData were retrieved by the Hellenic Statistical Authority (HSA) from death certificates that mentioned mesothelioma as the cause of death from 1983 to 2019 with details on the residence, gender, and age. Statistical analysis was performed using PRISM 6.0 software, a two-way ANOVA test, Trend analysis was conducted using Joinpoint Regression Program 5.0 software. The linear and non-linear model was used to calculate the age-standardized rates of annual percentage change (APC) and its 95% confidential interval (95% CI).ResultsFrom 1983 to 2019, 850 total mesothelioma deaths were recorded, the majority of whom were males (634). A rate of 74.6% accounts for males and 25.4% for females, and the ratio of Males: Females was 3:1. Males’ ASMR and the whole population’s ASMR reached their highest levels in 2011 (0.93/100000person-years and 0.53/100000person-years, respectively). To look for potential changes between the first two decades of the 21st century, we compared the mean ASMR of each geographic region in Greece between two different 10-year subperiods (2000–2009 and 2010–2019). Except for Epirus, all regions of Greece had elevated regional ASMRs, particularly in those with the highest asbestos deposits. Notably, the ASMR in Epirus decreased from 0.54/100000person-years (2000–2009) to 0.31/100000person-years (2010–2019). After 2011, the ASMR for men and the general population stabilized. This stability is important since mesothelioma in men is associated with occupational asbestos exposure. The intriguing discovery of a lower ASMR in Epirus emphasizes the need to raise awareness of the condition and implement effective public health measures.ConclusionsIn Greece, the annual ASMR for males and the whole population reached its highest level in 2011, which is positive and encouraging and may be a sign that the rate will stabilize during the following years. Moreover, this study showed that the actions made in the 1980s regarding public awareness and surveillance directly impacted the decrease in Epirus rates. Future research, continual awareness, information, and recording are needed to monitor the mesothelioma epidemic. The possible benefit of a mesothelioma registry and the epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, need to be addressed.Trial registrationNot applicable.

The Contribution of Multiple Pregnancies in Stillbirths in Greece: A Time-Trend Analysis.

Introduction Multiple pregnancy is an established risk factor for fetal death. This study aimed to examine the impact of multifetal pregnancies on stillbirth rates (SBRs) in the Greek population. Methods Data on live births and stillbirths by multiplicity were derived from the Hellenic Statistical Authority, covering a 65-year period from 1957 to 2021. The SBRfor multiple and single gestations, and the population attributable risk (%) (PAR (%)) stillbirth attributable to multifetal gestationswere calculated, and temporal trends were assessed using joinpoint regression analysis, with annual percentage changes (APC) and 95% confidence interval (95% CI). Results In the period 1957-2021, multiple pregnancies accounted for 9.4% of total stillbirths in Greece and the overall relative risk of fetal death among multifetal gestations was 3.34, in comparison with singletons. The SBR in multiple births remained unchanged from 1957 to 1976 and showed downward trends from 1976 to 2021 (APC = -3.0, 95% CI: -3.4 to -2.7, p < 0.001). PAR (%), after two decades of stability, showed an increasing trend over the period 1975-2011 (APC = 3.4, 95% CI: 2.8 to 4.0, p < 0.001), which was reversed in the more recent decade 2011-2021 (APC = -6.1, 95% CI: -9.6 to -2.5, p = 0.001), with PAR (%) decreasing from a historical high of 19.3% in 2012 to 8.6% in 2021. Conclusion The high incidence of multiple births has a considerable impact on stillbirth rates in the Greek population. The recent downward trends of SBR and PAR (%) of multiple gestations are encouraging, however more measures and targeted interventions are needed to improve perinatal outcomes in multifetal gestation.

Estimating Tax Evasion in the Medical Sector in Comparison with Other Human-to-human (Η2Η) Life Services

This paper attempts to measure and report the extent and magnitude of tax evasion in the medical sector and to be compared with other selected human-to-human (Η2Η) life services in the Greek economy. Specific household expenditures for human (Η2Η) services for the period 2011–2017 were analysed, using data from the annual ‘Household Budget Survey (HBS)’ of the Hellenic Statistical Authority (ELSTAT) and were compared with the financial administrative data from the ‘Statistical Business Register (SBR)’, which is updated on an annual basis with data provided by the tax authority, depending on the case-specific characteristics of each sector under study that have been taken into account in the calculations. The research showed that the participation of doctors in the phenomenon of tax evasion as a whole has been declining in recent years while other human economic activities are responsible many times over for the perpetuation and exacerbation of the phenomenon. The annual tax evasion on average for the period 2011–2017, for the medical sector, is estimated to amount to €565.6 million (0.31% of the Greek GDP – mean value of the same period), while for the ‘accommodation services (hotels)’ sector, it is estimated to €3.3 billion (1.84% of GDP), to €6.8 billion for the catering sector (3.76% of GDP), to €2.1 billion for the education sector (1.18% of GDP), to €87.3 million for the hairdressing/other beauty treatment services of the personal service sector and finally to €50.3 million for the funeral and related services sector.

Anchored Ambitions

Greek shipping is the world’s leading power and is well known for its efficiency and performance. The Greek fleet represents almost 21% of the global fleet in terms of capacity (deadweight tonnes – dwt) and 60% of the European Union’s one (Union of Greek Shipowners, 2023). Apart from the entrepreneurship competence of Greek shipowners, the contribution of Greek seafarers to the development of the so-called “Greek maritime miracle" has been decisive. Greek seafarers are known for their seamanship, qualities as well as their skills. However, according to data from the Hellenic Statistical Authority, the number of Greek seafarers is diachronically decreasing. Indicative of this trend is the fact that from 2000 to 2020, the number of Greek seafarers employed in Greek-owned vessels reduced by 45% (18.450 in 2000 vs. 10.087 in 2020). The aim of this research is twofold: first, to identify the reasons for the decreasing trend in the number of the Greek seafarers and, second, to highlight the initiatives and other actions the Greek shipping community could adopt in order to attract highly qualified seafarers to the Greek-owned fleet. In this context, a qualitative study was conducted, the purpose of which was to investigate the views of industry's stakeholders, in respect to the factors that shape the downward trend of seafarers figures. The outcome of this study sheds light on the reasons affecting the attractiveness of seafaring profession and further actions required for addressing promotion gaps.

The Increasing Turnover Intention of Professional Nurses in Greek Public Hospitals: Factors and Motivation

All over the world, the shortages in the field of public nursing constitute a major challenge among health systems, not only due to the increasing life expectancy but also to emerging diseases that require sufficient staff for qualitative and equitable health services. This study aims to explore the increasing turnover intention of Professional Nurses (PN) in Greece, mainly in public hospitals as a multidimensional phenomenon, and to also highlight the factors that contribute either positively or negatively to this intention. To better understand the determinants of PN‘s turnover intention, and to explore the place of Greece concerning other European countries, data from Organisation for Economic Co-operation and Development (OECD), Eurostat and Hellenic Statistical Authority (ELSTAT) were analyzed in terms of the proportion of PN per population, the proportion of PN to doctors, the average remuneration level, and the ratio nurse to hospital bed. Low job satisfaction, burnout, emotional exhaustion, rotating hours, low remuneration levels, unjustified transfers, feelings of injustice, and bureaucracy are the main factors that contribute to the turnover intention of Greek PN. After the pandemic crisis and significant reductions in nursing staff, many measures are required, not only by the Greek government but also by hospital managers to strengthen the nursing sector.

Development of a Transition Matrix Model of Credit Rating of Companies based on Forecasted Macro Factors: the Case of Greece

Abstract In this paper, we develop a model for the rating transition matrices for corporates. These matrices quantify the credit quality of the business sector and, hence, they are related to the financial stability and growth of the economy. The main objective is to estimate how a corporate portfolio behaves under various macroeconomic conditions and (to show the link between the quality of a corporate portfolio with macro variables) and to build a new transition matrix based on specific forecasted macroeconomic variables according to IFRS 9 requirements for the calculation of ECL. The model has been developed based on historical transition rates of credit risk assessments provided by ICAP SA and historical values of various macro factors provided by Hellenic Statistical Authority (ΕΛΣΤΑΤ). JEL classification numbers: G2, M1. Keywords: Rating transition matrices, Credit quality, Business sector, Macroeconomic factors.

Energy performance assessment of building stocks using earth observations

In Europe, about 40% of the final energy consumption and 30% of the total CO2 emissions are attributed to the operation of buildings. National energy and climate plans focus on large scale implementation of different renovation scenarios in existing buildings to meet the 2030 and 2050 targets for energy efficiency and decarbonization. Building stock modeling (BSM) offers a useful tool for the assessment of scenarios to support decision makers in setting up effective strategies for meeting European and national targets. One of the challenges faced for the reliable application of this modeling approach is the limited availability of detailed data for the investigated stocks. In the framework of the European project – EIFFEL there is ongoing work to complement data from Earth Observations with in-situ and statistical data from different sources (e.g. Hellenic Statistical Authority, energy performance certificate registry) in order to derive a bottom-up BSM of increased reliability for applications in medium scale (municipality) to large scale (prefecture) areas. The enhanced BSM is based on the representation of the entire building stock by a set of building types defined in line with the TABULA methodology according to their use, size and age of the buildings. The results presented herein come from a pilot application for a municipality in northern Attica.

Temporal Trends in Stillbirth in Greece: A Longitudinal Population-Based Study.

Stillbirths are a major public health issue and a key population health indicator. The aim of this study was to comprehensively investigate and present time trends in stillbirth in Greece. Data on all live births and stillbirths were derived from the Hellenic Statistical Authority, covering a 65-year period from 1957 to 2021 and the annual stillbirth rate (SBR) was calculated, defined as the number of stillbirths per 1,000 live births and stillbirths (total births). Trends in the SBR were assessed using joinpoint regression analysis with calculation of the annual percent change (APC) with a 95% confidence interval (95% CI) and level of statistical significance p<0.05. The SBR in Greece, after an initial increasing trend (1957-1965: APC=2.6, 95% CI: 0.5 to 4.7, p=0.016), and an all-time high of 15.8 per 1,000 births in 1966, recorded a four decades period of continuous improvement (1965-2003: APC=3.0, 95% CI: -3.2 to -2.8, p<0.001) and reached a historic low in 2008 (3.3 per 1,000 births) (a decrease by 79%). However, the SBR stagnated at an elevated level during the decade 2006-2016 and showed a steeply upward trend during the most recent period 2016-2021 (APC=7.4, 95% CI: 3.0 to 12.1, p=0.001). In 2021, the SBR was 5.3 per 1,000 births, 60% up from 2008. It was estimated that the SBR improvement for the 1967-2021 period resulted in 50,914 stillbirths averted (7.9 per 1,000 births), but the recent increase in the SBR has led to 1,200 additional fetal deaths (1.0 per 1,000 births) during 2009-2021. After an impressive decline for almost four decades the SBR gradually deteriorated during the economic crisis and finally showed an alarming rising trend after 2015, resulting in an increasing burden of fetal deaths in Greece. Further public health interventions are needed to address preventable risk factors and ensure access to optimized antenatal monitoring.

Developing and hosting web data apps in R programming for official statistics

Official statistics place particular emphasis on communication and dissemination of surveys’ results to citizens and stakeholders. This is typically done through the publication of press releases and presentation of aggregated data of statistical surveys. The use of web services and software that allow users to interact with the results of official statistics comes to further enhance communication, dissemination, literacy and overall quality of official statistics. This paper is related to the objectives and context of reaching a wider audience through engaging users and explains how an NSO (National Statistical Office) member without specialized knowledge of frontend-backend programming techniques can create such web services in R programming environment through “Shiny” library. The paper also reviews the issue of hosting “Shiny” apps and presents existing approaches. For demonstration purposes, an experimental version of such an application was constructed that presents in an interactive way the quarterly results of the new statistical product of the Hellenic Statistical Authority (ELSTAT) on Greek business demography.

Cesarean section rates in each region of Greece: A retrospective analysis

Introduction: There is a national trend in increasing cesarean section rates in Greece. The purpose of this study was to determine the frequency of cesarean sections per district of the Greek territory. Materials and Methods: In this retrospective observational study, the records of all births in Greece between 2019-2020 from the official archives of the Hellenic Statistical Authority were processed and analyzed. The NUTS-1 classification according to the EUROSTAT was used for the division of the Greek territory into districts. Based on this classification, Greece is divided into four major districts: Northern Greece, Central Greece, Attica and Aegean Islands-Crete. Results: In total, 169,417 births were recorded in Greece during the two-year period from 1/1/2019 to 31/12/2020. Of these, 55.79% were performed by cesarean section, 40.24% by vaginal delivery, 0.02% by a combination of vaginal delivery and cesarean section, while the mode of procedure was not reported in 3.95% of all deliveries. The highest frequency of cesarean sections was observed in Attica with a rate of 58.86%. The corresponding rates in the other districts were 55.50% (Aegean Islands and Crete), 53.55% (Northern Greece) and 51.49% (Central Greece). Notably, the mode of delivery was not reported in 13.75% of births in Central Greece, while the respective rates in the other districts ranged between 1.02% and 2.1%. Conclusions: The frequency of cesarean sections in Greece was high, with a rate of 55.79% of all births, during the study period. The district with the highest frequency of cesarean section was Attica, with a rate over 58%.

Temporal Trends in Multiple Births in Greece: The Evolution of an Epidemic.

Introduction Multiple births constitute the dominant adverse effect of fertility treatments and are associated with increased perinatal risks. The aim of this study was to comprehensively examine and present time trends in multiple births in Greece. Methods Data on live births by multiplicity were derived from the Hellenic Statistical Authority, covering a 65-year period from 1957 to 2021. Temporal trends in multiple birth rates (MBR), twin birth rates (TwBR), as well as in triplet and higher-order birth rates (Tr+BR)were assessed using joinpoint regression analysis, and the annual percentage changes (APC) were calculated with a 95% confidence interval (95% CI) and level of statistical significance (p < 0.05). Results The MBR in Greece showed a downward trend from 1957 to 1979 (APC = -1.7, 95% CI: -2.0 to -1.4, p < 0.001). However, the rate started to climb in the 1980s, accelerated during the 1990s, and continued to rise in the two most recent decades, reaching a historic high and a world record of 57.2 per 1,000 births in 2021, i.e., a 3.4-fold increase since 1985. The TwBR increased from an all-time low of 16.5 per 1,000 births in 1978 with APC = 1.4 (95% CI: 0.2 to 2.5, p = 0.021) during 1979-1989, APC = 6.3 (95% CI: 5.5 to 7.2, p < 0.001) during 1989-2001, and APC = 1.2 (95% CI: 0.8 to 1.5, p < 0.001) during the last two decades (2001-2021). The Tr+BR, after an all-time low of 17.5 per 100,000 births in 1966, increased dramatically from 1982 to 2000 (APC = 12.4, 95% CI: 9.6 to 15.2, p < 0.001), leveled off during 2000-2011, and after reaching a historic maximum of 351.1 per 100,000 births in 2010, there was a sharp decreasing trend during the last decade (2011-2021: APC = -12.1, 95% CI: -16.8 to -7.2, p < 0.001). Conclusion The dramatic increases in maternal age as well as in medically assisted conceptions have resulted in an epidemic increase in MBR in Greece reaching world record levels. During the last decade, there was an encouraging decline in the Tr+BR; however, the TwBR has continued to trend upwards.

Tracing Time Trends of Births in Greece.

Introduction The aim of this study was to comprehensively investigate and present time trends in births in Greece over the last seven decades. Methods Data on live births were derived from the Hellenic Statistical Authority, covering a 72-yearperiodfrom 1950 to 2021. Trends in the number of births were assessed using joinpoint regression analysis. The annual percentage change (APC) and the average annual percent change (AAPC) were calculated with a 95% confidence interval (95% CI) and level of statistical significance p<0.05. Results The overall trend during 1950-2021 was clearly downward (AAPC = -0.9, 95% CI: -1.2 to -0.7). Over the first three decades, births fluctuated to a record high of 162,839 in 1967, with an overall slight downward trend (1950-1981: APC = -0.2, 95% CI: -0.4 to -0.1, p<0.001). During the 1980 decade, the trend was sharply downward (1981-1988: APC = -4.7, 95% CI: -6.2 to -3.2, p<0.001), followed by a stabilization in the 1990s (1988-2001: APC = -0.1, 95% CI: -0.7 to 0.4, p=0.586). The first decade of the 21st century was the only period during the last seven decades with an increasing trend in births in the Greek population (2001-2008: APC = 1.9, 95% CI: 0.3 to 3.5, p = 0.021), but it was followed by plummeting trends during the recent years (2008-2021: APC = -2.7, 95% CI: -3.2 to -2.3, p<0.001), leading to the historic low of 83,756 births in 2019. Conclusion The time trend analysis of births in Greece indicated a dramatic plummet in natality in Greece, predominantly attributed to the large decline in births in the 1980s, which could not be reversed in the 1990s and 2000s. The recent decrease in births was associated with the financial recession and has put the Greek population in a disastrous low-fertility spiral.

Association Rule Mining for Island and Mainland Road Crash Injuries in Greece

The objective of this paper is to implement association rule mining in order to identify the underlying patterns in road crash injuries recorded in Greece, after separating them into subsets concerning the mainland and the island areas. To that end, an analysis of disaggregated data from the Hellenic Statistical Authority data file for killed, seriously and slightly injured road users was implemented for 2017-2019. The apriori rule was developed and a variety of association rules were obtained. Results indicated a strong association or concurrent presence of the contributory factors at various percentages in both mainland and island road crash injuries. It was also revealed that clear weather, urban area and male road users were dominant interconnected conditions that simultaneously exist in injury crashes.

Institutional challenges and prospects regarding the 2021 Population-Housing Census in Greece

The Hellenic Statistical Authority (ELSTAT) worked towards the introduction of a designated Law governing the 2021 General Censuses in Greece. It was the first time that the General Censuses were conducted by virtue of a legal act which underwent extensive deliberations and legal scrutiny. This kind of strengthening of the statistical legislation demonstrates the wide recognition of the professional independence ELSTAT has established and it provided a solid basis for the Hellenic Statistical System (ELSS) to be able to adequately respond to both current and future challenges. These straightforward institutional arrangements ensured ELSTAT’s ability to effectively conduct the Censuses in accordance with the International Recommendations and Standards, while, at the same time, strengthened its capacity to an immediate response to arising needs and challenges. It was then no mystery how ELSTAT was able to immediately adapt to the developing operational conditions by creating a plan for a hybrid census system for all households. At the same time the legal instruments used laid the foundations for the establishment and maintenance of Statistical Registers for Population and Buildings, introducing two unique identifiers (“keys”) in the Census variables and creating the institutional infrastructure for linkage to other administrative registers.

Development of a Geodemographic System for Attica, Greece

Recent years have witnessed fundamental changes in the financial and retail service sector, with competition among companies intensifying as a result of changing markets. The need to address the specific requirements of the customer groups has become the guiding principle behind the business strategies adopted by companies. These customer needs and, subsequently, the provision of the appropriate products and services to the customer, are dependent on where they live, their personal characteristics (e.g., age, education, income, households etc.). Geodemographic systems take advantage of information technology to analyze these types of data for a better understanding of the consumer characteristics and improved performing of marketing strategies. In the present study, a geodemographic system is implemented utilizing geographic information systems (GIS) technology and artificial intelligence (AI). GIS technology offers a powerful set of tools for the input, management, and visualization of data, while AI provides advanced analytical tools such as the unsupervised fuzzy classification through the Fuzzy C-Means algorithm. The proposed methodology is applied to the Attica region in Greece. It uses the official socioeconomic data of the Hellenic Statistical Authority. The relevant database uses 78 socio-economic variables. The study area consists of 2500 area units, each one with more than 1000 inhabitants. The results, ten socio-economic classes, are analyzed and discussed. The project is funded by the Athens Chamber of Commerce and Industry (ACCI) and the results of the analysis are open to all users by the official site of ACCI.

Geographical Variation in Mental Hospital Discharges in Greece: A Nationwide Study (1999–2012)

Background: The primary goal of this study is to estimate the pattern of hospital discharges throughout Greece due to mental disorders between 1999 and 2012. Methods: Data for discharges were obtained from the Hellenic Statistical Authority. A sex- and age-adjusted proportional hospitalization ratio (PHR) was used to estimate the ratio between the hospitalizations in each prefecture and the overall hospitalizations. Additionally, age-adjusted admission rates and hospitalization days were calculated for each sex. Descriptive and time series analysis were conducted to understand the epidemiological characteristics and to investigate the trend of annual PHR, respectively. Correlation between disorders and sociodemographic characteristics was also tested. Global and local spatial analysis was conducted to assess the spatial homogeneity of disorders and to detect any clusters of similar values. Results: More males (55%) were hospitalized. Schizophrenic and other psychoses were stated as the primary diagnosis of discharges (54.3%) for mental disorders, contributing to the highest annual mean number of hospitalization-days for male (296.9) and female patients (341.0). Most patients were out of the workforce, and most patients with drug dependence (74.5%) and schizophrenia and other psychoses (55.9%) remained unmarried. Higher PHRs were discovered in the north, while schizophrenic and other psychoses (R = 0.492), affective psychoses (R = 0.534), senile and presenile organic psychotic conditions (R = 0.543) were correlated with alcohol consumption (p &lt; 0.001). Conclusions: The study provides evidence of geographical variation of discharges due to mental disorders and a significant association between disorders and alcohol consumption, marriage status and absence of the workforce.

Investigating the relationship among seasonality, socioeconomic risk factors and suicides in Greece.

Globally, there has been growing evidence pointing to a relationship among suicides, seasonality and socioeconomic factors. This study aims at investigating the seasonal suicide patterns, the effect of gender on these patterns, the trend of these patterns and whether the suicides are associated with economic and social risk factors. The objects of the current study have been the seasonal suicide patterns in Greece during 1980-2018 (39 years), as well as their interrelation with a variety of socioeconomic risk factors, however for a shorter period (21 years) due to unavailability of aggregated data provided by the Hellenic Statistical Authority (ELSTAT). The Walter-Elwood test was applied in order to investigate seasonality. Poisson regression models were applied to investigate the relationship amongst seasonality, socioeconomic risk factors and monthly suicides. The best variable subset was selected according to the leaps and bounds algorithm. A total of 15,692 suicides were recorded. In the total sample, as well as, in men, a peak was documented in May - June, whereas females mostly peaked in July. Among the risk factors under investigation, an increase in marriage rates appeared to have significantly lowered the number of suicides, while a rise in unemployment rates exhibited a statistically non-significant increase in suicides.. The findings of the study suggest distinct sex-oriented seasonal patterns and a protective effect of marriage.

The COVID-19 Pandemic and Its Effects on the Greek Tourism Sector: A Case Study of the Region of Eastern Macedonia - Thrace

The recent novel coronavirus pandemic (COVID-19 pandemic) has led to a new, multi-faceted societal, healthcare and generalized economic crisis, both at national and international levels. The measures taken to deal with the pandemic have resulted in unprecedented situations in almost all sectors of the Greek economy. This article attempted to investigate the extent of the impact of this new crisis on Greek tourism companies, focusing on the case of tourist accommodation and food services by region, since the tourism industry has been greatly afflicted. The main variable examined was the degree of decline in the turnover of the tourism businesses under discussion over the last two years, at regional and national levels. This was supplemented with comparative analyses of similar measurable data. Secondary and statistical data were obtained from the Hellenic Statistical Authority, the Hellenic Tourism Organization and databases of other related institutions.&#x0D; Keywords: COVID-19, tourism industry, Greek companies, tourist product, region οf Eastern Macedonia - Thrace

Natural radiation and high metal soil content are linked with higher cancer mortality rates

Abstract Background General population is at continuous risk of exposure to both natural and anthropogenic pollutants via the oral, respiratory and dermal routes. In Greece, there are areas where the geological background is rich in both radioactivity and toxic elements, whereas anthropogenic activities, like lignite or metal mining, augment the general population exposure. The aim of the study was to compare cancer mortality rates among neighboring prefectures that share similar demographic and socio-economic characteristics, but differ in natural radioactivity and in carcinogenic metals' burden in soils. Methods Based on radiological and geochemical maps, five prefectures of North Greece with high radioactivity and metal's content in soil were chosen. Two similar prefectures with low radioactivity and metals' content served as control areas. Data about population structure and number of deaths due to neoplasms were obtained from the Hellenic Statistical Authority for a 15-year interval (1999-2015). Cancer mortality rates were calculated and compared between areas by Poisson regression. Results The total population in burdened areas was 660.091, while in the control areas was 207.117 (2011 Census). Mortality rates from burdened areas were higher than those in the control areas. Odds ratios ranged from 1.42 (95% CI: 1.35-1.49) to 1.79 (95% CI 1.71-1.88) for males and from 1.27 (95% CI: 1.19-1.35) to 1.85 (95% CI: 1.74-1.96) for females. For both sexes, the odds ratios ranged from 1.35 (95% CI: 1.30-1.41) to 1.80 (95% CI: 1.74-1.87). Conclusions Undoubtedly, our preliminary results reveal that residents in burdened areas are at higher risk for cancer death due to exposure to naturally occurring metals and radiation. Both the general population and the health authorities are unaware of these possible threats and no protective measures have been taken so far. Viable strategies to minimize or prevent these unintentional risks are of high priority in these areas. Key messages Population should be informed about the unintentional environmental exposures that pose health risks. Appropriate mitigation strategies should be implemented by the health authorities.

Analysis of the impact of COVID-19 on collisions, fatalities and injuries using time series forecasting: The case of Greece

The current study aims to investigate the impact of the COVID-19 pandemic on road traffic collisions, fatalities, and injuries using time series analyses. To that aim, a database containing road collisions, fatalities, and slight injuries data from Greece were derived from the Hellenic Statistical Authority (HSA) and covered a ten-year timeframe (from January 2010 to August 2020. The chosen time period contained normal operations, as well as the period of the first COVID-19-induced lockdown period in Greece. Three different Seasonal Autoregressive Integrated Moving Average (SARIMA) time series models were implemented in order to compare the observed measurements to forecasted values that were intended to depict assumed conditions; namely, without the appearance of the COVID-19 pandemic. Modelling results revealed that the total number of road collisions, fatalities, and slightly injured were decreased, mainly due to the sharp traffic volume decrease. However, the percentage reduction of the collision variables and traffic volume were found to be disproportionate, which probably indicates that more collisions occurred with regard to the prevailing traffic volume. An additional finding is that fatalities and slightly injured rates were significantly increased during the lockdown period and the subsequent month. Overall, it can be concluded that a worse performance was identified in terms of road safety. Since subsequent waves of COVID-19 cases and other pandemics may reappear in the future, the outcomes of the current study may be exploited for the improvement of road safety from local authorities and policymakers.