INTRODUCTION. The objective of this chapter is to study the health impact of the exposure to fibres with fluoro-edenitic composition on the residents in Biancavilla (Sicily, Italy), in terms of mortality and hospitalization. The diseases which international scientific literature indicates as associated with asbestos exposure were taken into consideration: mesothelioma of pleura, peritoneum, pericardium and tunica vaginalis testis, malignant neoplasm of larynx, malignant neoplasm of trachea, bronchus and lung, malignant neoplasm of ovary, pneumoconiosis; moreover, in order to describe the health profile of the study population, large groups of diseases were taken into consideration. MATERIAL AND METHODS. Current data (available in the Data Bases of the Unit of Statistics of ISS) regarding mortality and hospitalization were analyzed. Standardized Mortality Ratios, Standardized Hospitalization Ratios and Age-standardized Death Rates were calculated. The demographic background of the population residing in Biancavilla was also outlined. Conclusions. Our findings support the etiologic role of fibres with fluoro-edenitic composition in the occurrence of the above mentioned diseases, already observed in other studies.

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.