BACKGROUND: An epidemic of asbestos-related disease is ongoing in most industrialized countries, mainly attributable to past occupational exposure but partly due to environmental exposure. In this perspective, the incidence of pleural mesothelioma close to a former asbestos-cement plant in a national contaminated site was estimated. METHODS: The census-tracts interested by atmospheric dispersion of facilities in the contaminated site were identified. Two subareas with different estimated environmental asbestos impact were distinguished. An ecological study at micro-geographic level was performed. The standardized incidence ratios (SIR) for study area and the two subareas, in comparison with region and municipality were computed. The standardized incidence rate ratio (IRR) between the two subareas was computed. RESULTS: Mesothelioma incidence in the study area was increased: 46 cases were observed with respect to 22.23 expected (SIR: 2.02). The increase was confirmed in analysis considering only the subjects without an occupationally exposure to asbestos: 19 cases among men (SIR = 2.48; 95% CI: 1.49-3.88); 11 case among women (SIR = 1.34; 95% CI: 0.67-2.40). The IRR between the two subareas is less than one in overall population considering all age-classes and of 3 fold (IRR = 3.14, 95% CI: 0.65-9.17) in the age-classes below 55 years. CONCLUSIONS: The findings indicate an increased incidence of pleural mesothelioma in the neighbourhood of asbestos-cement plant, and a possible etiological contribution of asbestos environmental exposure in detected risks.

Objectives. Adverse effects of waste management represent a public health issue. Mortality meta-analysis in Italian National Priority Contaminated Sites (NPCSs) with industrial waste landfills or illegal dumps is presented. Methods. 24 NPCSs include industrial waste landfills or illegal dumps. Class 1 (10 NPCSs with industrial waste landfills) and Class 2 (14 NPCSs with illegal dumps) were categorized. Random-effects model meta-analyses of Standardized Mortality Ratios non-adjusted (SMRs) and adjusted for Deprivation (DI-SMRs) computed for each CS (1995-2002) were performed for overall 24 NPCSs and the two classes. The North-Southern gradient was considered. Results. 24 CSs pooled-SMRs are significantly increased in both genders for cancer of liver (men: SMR = 1.13; women: SMR = 1.18), bladder (men: SMR = 1.06; women: SMR = 1.11), and for cirrhosis (men: SMR = 1.09; women: SMR = 1.13). In Class 2 the increase is confirmed in both genders for liver and bladder cancers and for cirrhosis and in men only for lung cancer. Congenital anomalies and adverse perinatal conditions are not increased. Conclusion. The results are consistent with the hypothesis of adverse health effects of non-adequately managed hazardous waste. Causal interpretation is not allowed, but the meta-analytic approach provides more confidence in the findings.

INTRODUCTION. The incidence of cancer among residents in sites contaminated by pollutants with a possible health impact is not adequately studied. In Italy, SENTIERI Project (Epidemiological study of residents in National Priority Contaminated Sites, NPCSs) was implemented to study major health outcomes for residents in 44 NPCSs. METHODS. The Italian Association of Cancer Registries (AIRTUM) records cancer incidence in 23 NPCSs. For each NPCSs, the incidence of all malignant cancers combined and 35 cancer sites (coded according to ICD-10), was analysed (1996-2005). The observed cases were compared to the expected based on age (5-year period,18 classes), gender, calendar period (1996-2000; 2001-2005), geographical area (North-Centre and Centre-South) and cancer sites specific rates. Standardized Incidence Ratios (SIR) with 90% Confidence Intervals were computed. RESULTS. In both genders an excess was observed for overall cancer incidence (9% in men and 7% in women) as well as for specific cancer sites (colon and rectum, liver, gallbladder, pancreas, lung, skin melanoma, bladder and Non Hodgkin lymphoma). Deficits were observed for gastric cancer in both genders, chronic lymphoid leukemia (men), malignant thyroid neoplasms, corpus uteri and connective and soft-tissue tumours and sarcomas (women). DISCUSSION. This report is, to our knowledge, the first one on cancer risk of residents in NPCSs. The study, although not aiming to estimate the cancer burden attributable to the environment as compared to occupation or life-style, supports the credibility of an etiologic role of environmental exposures in contaminated sites. Ongoing analyses focus on the interpretation of risk factors for excesses of specific cancer types overall and in specific NPCSs in relation to the presence of carcinogenic pollutants.

INTRODUCTION. Amphibolic fibres with fluoro-edenitic composition characterize Biancavilla soil, including the major quarry from which building materials have been extensively extracted. These fibres induce mesothelioma in experimental animals and their in vitro biological action is similar to that of crocidolite. MATERIALS AND METHODS. Malignant mesothelioma case series and incidence were examined to evaluate the disease burden on Biancavilla inhabitants. RESULTS. The incidence of pleural mesothelioma in Biancavilla is steadily higher than in the Sicilian Region, risk estimates are more elevated in women than in men, the most affected age class is constituted by subjects aged less than 50. DISCUSSION AND CONCLUSIONS. Environmental exposure to fibres with fluoro-edenitic composition appears to be causally related to the elevated mesothelioma occurrence in Biancavilla. In this frame, environmental clean-up is the main goal to be pursued in public health terms. A contribution of scientific research to public health decision making with respect to priority setting for environmental clean-up can derive from some further selected epidemiological investigations.

INTRODUCTION: Spatial distribution of mortality from pleural mesothelioma (which in the ICD-10 Revision has a specific code: C45.0) in Italy for the period 2003-2009 is described. Previous mortality studies at national level employed the topographic code "Malignant neoplasms of pleura", because of unavailability of a specific code in ICD-9 Revision for pleural mesothelioma. METHODS: Standardized mortality ratios were computed for all municipalities, using each regional population as reference; for municipalities in Regions with rate higher than the national rate, the latter has been used as reference. SMRs were computed specifically also for each Italian Polluted Sites "of national concern for environmental remediation" (IPS) with asbestos exposure sources, composed by one or more municipalities, using regional rate as reference. Spatial Scan Statistics procedure, using SatScan software, was applied in cluster analysis: the country was divided into geographic macro-areas and the relative risks (RR) express the ratio of risk within the cluster to the risk of the macro-area outside the cluster. Clusters with p-value < 0.10 were selected. RESULTS: The national standardized annual mortality rate was 1.7 cases per 100 000. Several areas with evident burden of asbestos-related disease were detected. Significant clusters were found in correspondence to asbestos-cement industries (e.g. Casale Monferrato, women: RR = 28.7), shipyards (e.g. Trieste, men: RR = 4.8), petrochemical industries (e.g. Priolo, men: RR = 6.9) and a stone quarry contaminated by fluoro-edenite fibres (Biancavilla, women: RR = 25.9). Some of the increased clusters correspond to IPS. CONCLUSIONS: The results may contribute to detect asbestos exposure and to set priorites for environmental remediation.

INTRODUZIONE: Viene illustrata la distribuzione spaziale in Italia della mortalitá per mesotelioma pleurico (che nella decima revisione ICD ha un codice specifico: C45.0) per gli anni 2003-2009. Studi precedenti a livello nazionale avevano invece utilizzato il codice topografico "Tumori maligni della pleura", in assenza di un codice specifico in Nona Revisione ICD per il mesotelioma pleurico. METODI: I rapporti standardizzati di mortalitá (SMR) sono stati calcolati per tutti i comuni, utilizzando la popolazione regionale come riferimento; per i comuni in Regioni con un tasso maggiore di quello nazionale, é stato utilizzato quest'ultimo come riferimento. SMR sono stati calcolati anche specificatamente per i siti di interesse nazionale per le bonifiche (SIN) con sorgenti di esposizione ad amianto, composti da uno o piú comuni, rispetto al tasso regionale. Il software Spatial Scan Statistic SatScan é stato utilizzato per l'analisi dei cluster: il territorio nazionale é stato suddiviso in macro-aree regionali e i rischi relativi (RR) esprimono il rapporto del rischio all'interno del cluster rispetto al rischio del resto della macro-area. Cluster con un valore di p < 0,10 sono stati selezionati. RISULTATI: Il tasso standardizzato nazionale annuo é di 1,7 casi per 100 000. Cluster significativi sono stati trovati in corrispondenza di industrie del cemento-amianto (ad es. Casale Monferrato, donne: RR = 28,7), aree portuali (ad es. Trieste, uomini: RR = 4,8) e poli petrolchimici (ad es. Priolo, uomini: RR = 6,9); un cluster é stato identificato a Biancavilla (donne: RR = 25,9), dove é presente una cava di materiale contaminato da fluoro-edenite. Alcuni cluster significativi corrispondono a SIN. CONCLUSIONI: I risultati contribuiscono a identificare esposizioni ad amianto prioritarie per la bonifica ambientale.

Cancer incidence was investigated in an area which has been affected by the illegal practices of dumping hazardous waste and setting fire to mismanaged waste. For the 35 municipalities of this area that are served by a Cancer Registry, municipal standardized incidence ratios (SIR) and hierarchical Bayesian estimators (BIR) were computed. Moreover, municipal spatial clustering and a Poisson regression by municipality index of waste-related exposure were performed for 10 cancer types. Increased municipality SIRs were found for some cancer types. The BIRs confirmed the increases for liver cancer in two municipalities. Statistically significant clusters were detected for liver, lung, leukaemia and soft tissue sarcomas. In the regression analysis, testis cancer showed significant trend with the index of waste-related exposure (RR = 1.18).

È stata investigata l'incidenza oncologica in un'area interessata da pratiche illegali di smaltimento e di combustione incontrollata di rifiuti. Per i 35 comuni di quest'area serviti da un Registro Tumori sono stati calcolati i rapporti standardizzati di incidenza (standardized incidence ratios, SIR) e gli stimatori bayesiani (BIR). Per 10 sedi tumorali sono state eseguite, inoltre, analisi di cluster spaziali e di regressione con un indice municipale di esposizione a rifiuti. SIR in eccesso sono stati osservati per diverse sedi tumorali; i BIR hanno confermato gli eccessi di tumore epatico in due comuni. I tumori epatici e polmonari, le leucemie e i sarcomi dei tessuti molli hanno mostrato cluster significativi. Nell'analisi di regressione il tumore del testicolo ha mostrato un trend in eccesso significativo (RR = 1,18).