abstract: Italy after 30 years of denuclearization: what are the effects on the health? a review of the literature

Italy has developed its own nuclear program from 1963 to 1990, including the most powerful Nuclear Power Plant (NPP) in the world and the second most powerful Magnox central. However, the nuclear growth was interrupted with the 1987 and the 2011 referendums which phased out Italy from the nuclear development: currently, on the Italian ground, there are old nuclear power plants and five reactors still active for various research purposes. However, the inappropriate or inexistent waste disposal caused the arising of the maintenance costs and the occurring of negligent accidents, and the whole system has been heavily criticized during the last years. To understand the possible effects on the health, we reviewed the current literature, evaluating the Italian studies and the European ones. Since in Italy very high levels of radioactivity never occurred, we excluded the literature regarding Chernobyl, Fukushima and other regions affected by nuclear disasters. We found clusters of genetic abnormalities around specific sites associated with NPPs, as well as an increased rate of cancer around some of them. However, those abnormalities might also be explained by the presence of different chemicals or environmental pollutants, but only a few shreds of evidence have been found. Given the current knowledge, we cannot exclude the possibility that living in proximity to NPPs can cause a moderate risk of cancer. We conclude that the risk of cancer caused by NPPs should be better monitored and that larger international studies are needed to assess whether there are any elements of increased genetic abnormalities and pathologies in the surroundings of NPPs

abstract: From Chernobyl to Florida across Garigliano. Analysis of chemical disasters

Background: 215 million gallons of water contaminated by radio-waste of phosphoric fertilizer (called “gypsum stack” or “phosphogypsum”) probably spilled into biggest Florida’s aquifer on August, 27th, but Mosaic society advised Authority only on September, 17th. In the last 20 years, this was the third incident for Mosaic. Phosphogypsum is a waste by phosphoric fertilizer and it is radioactive due to the presence of naturally occurring uranium and thorium. It could also contain cadmium. Methods: Scientific publications in the last 30 years and current evidences were collected. In the first part of review we analyzed history of nuclear Centrale del Garigliano (Italy). In the second part, a meta-analysis regarding Chernobyl incident has been performed, focused on the use of contaminated water. We use data only by Centrale del Garigliano and Chernobyl (and not other, such Fukushima) because in study we considered only spilling in not current water, that is used for agriculture and livestock. To study Floridian pollution, we compare Italian radioactivity/wide from nuclear/population density (and its effects on public health) with Floridian data, and we add to this cadmium toxicity. Findings: Florida is known for sinkholes, but Florida is known also for fertilizer production: is possible combine natural and artificial hazards with people health safety and national security? Review analyzes agricultural/human use of undeclared contaminated water in the past (Chernobyl), and currently (Centrale del Garigliano) to predict which hazards for public health are more likely to occur in Florida. Conclusions: all data confirm importance of communication to Authorities about chemical and nuclear incident (and biological, too) to restrict damage to health and save time for a more synergic effort between private andor public agencies. Use of contaminated water is strictly correlated with increase of cardio-vascular disease, miscarriages/infant malformations and cancer due to DNA pathologies (duplications, deletions, etc)

abstract: is rome ready for CBRNe attacks?

Background: Rome hosts thousands of sensible targets. Healthcare reaction has been guaranteed by 6 advanced Emergency Departments (EDs) and 7 basic ones. Everyday Rome hosts 6 millions of people/die, ± 2 million in particular occasions. About National Stockpile Antidotes (SNA), Rome hosts 3 warehouses. In case of events, stockpiles are activated with a long-time call; then stockpiles are charged in delivering trucks. Methods: Study analyzes PEIMAF (State of emergency plans for massive influx of injures) of advanced EDs in Rome and their adequacy in a possible CBRNe attack. Hypothesis of C/N attack on Saint Peter’s Square during Angelus on Wednesday (at 12.00 AM) or E attack in Trastevere on Saturday (at 9.00 PM). Analysis of activation of SNA and travel times between SNA warehouse and EDs. Comparison with French EDs during Paris attacks. Finding: EDs are chronically undermanned in ordinary conditions already, and would have issues in hosting a very large number of critical patients all at once. Some hospitals do not inform their workers about PEIMAF or they do not consider CBRNe emergencies in their PEIMAF, and even if it has been considered, hardly any simulation/exercitation is ever performed. Moreover, news of the CBRNe attack may not reach immediately the healthcare personal already at work in EDs; this is extremely problematic since they could be at major risk of contamination in case of CBRNe attacks. Furthermore, without a standardize protocol active in the whole city, no cross-hospital organization can be performed. Conclusion: All data point towards the weakness and fragmentation of actual organizative system. Time of activation and charging are crucials for first aid efficacy and efficiency; a smart call system can reduce the activation time of SNA. A better organization of SNA in major Rome hospitals can reduce delivering time and help save more lives