Introduction: Environmental exposure to heavy metals, in particular to cadmium, arsenic and lead, has been associated with kidney disease. The aim of the present study is to investigate the occurrence of kidney disease in the Italian contaminated site (CS) of Taranto, characterized by an industrial area with the presence of various plants including a major steel mill. Methods: This is an exploratory ecological study. The cases were all subjects residing in the CS with a first hospital discharge diagnosis (primary or secondary) of kidney diseases (ICD-9-CM codes 580-586) in the years 2006-2010. Kidney disease cases associated with other disorders were excluded. Hospital discharge rates for kidney disease were compared to those of the regional population using the Standardized Hospitalization Ratio (SHR). All the subjects’ residences at the time of diagnosis were then geocoded, and SHRs were computed separately for areas at high and low exposure as per available environmental monitoring data. Moreover, the study took into account historical exposure levels and modelling for current levels of fine particulate matter (PM2.5) and cadmium. Results: SHRs for kidney disease of the CS, when compared to the regional population, showed a significant excess of 17% in males and of 8% in females. The excess was mainly explained by males (age group 60+). When focusing on the microgeographic study within the CS, the SHRs showed a significant excess of 28% in males (age group 20-59) and a non-significant excess of 25% in females (age group 20-59) residing at diagnosis in the areas at higher exposure. No correlation was found between residence and current spatial distribution of PM2.5 and cadmium. Conclusion: The excess of hospitalization for renal disease observed in the CS of Taranto does not affect children and adolescents, but rather mainly concerns adult males. This possibly suggest an occupational component, and correlates with historical patterns of atmospheric pollution.
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