S-29B6-3 Background/Aims: Soil contamination requiring clean-up occurs in approximately 250,000 sites in the European Environment Agency-EEA member countries; several thousand sites qualify for remediation in Italy, 57 of them are defined as “of national concern” for the entity of the documented contamination. SENTIERI project, funded by the Italian Ministry of Health, aims at describing sources of environmental pollution in Italian contaminated sites and health status of resident populations using mortality data. Methods: In all, 44 sites were selected for analyses (298 municipalities, 5.5 million inhabitants, about 10% of Italian population at 2001 census). These sites were classified based on the presence of environmental exposure/s as documented in the Ministerial Decrees, namely presence of chemical/petrochemical plants, refineries, asbestos/other mineral fibers, steel plants, thermoelectric-power factories, mines/quarries, landfills/incinerators. Standardized mortality ratios, crude, and adjusted for deprivation (taking into account unemployment, education, house ownership, and overcrowding) were computed for 54 groups of causes of death (reference: regional populations, 1995–2002). Besides analyses of the health status, biomonitoring programs are in progress to improve exposure assessment and surveillance. Results: As an example, Taranto area, affected by a large industrial facility, including one of the largest European steel factories, showed significantly increased mortality for all causes, all cancers (namely esophagus, liver, pancreas, larynx, lung, and pleura), circulatory and respiratory diseases, and liver cirrhosis. Where applicable, cancer registry data are used to evaluate departures of observed incidence rates from expectation; thus, improving accuracy of outcome indicators and avoiding bias from differential survival by geographic area. In Taranto, an exploratory study on the body burden of dioxins and metals in a sample of residents is also ongoing. Conclusion: SENTIERI is the first project describing the health impact of residence in polluted sites at national level, it aims at identifying priorities in planning environmental remediation. International cooperation is desirable both for improving methodological approaches and for evaluating replicability of findings.