The health impact of hazardous waste landfills and illegal dumps contaminated sites: An epidemiological study at ecological level in Italian Region

Background and aim: The implementation of idoneous management of hazardous waste, in contrast to illegal practices, is one of the environment and health priorities of the WHO. The aim of the present study, based on a collaborative agreement between the Italian National Health Institute and a Prosecution Office located in Naples North, was to evaluate the health effects of illegal landfills and burning of urban and hazardous waste in the territory of the Prosecution Office. Methods: The municipalities included in the study territory were investigated with respect to the regional population. Regression analyses were performed in the study area between four classes of an environmental municipal indicator of waste risk (MRI) previously defined, computing the relative risks (RRs) in 2–4 MRI classes, with respect to the first MRI class (the least impacted). The prevalence of reproductive outcomes and cause-specific mortality and hospitalization were analyzed in the general population and in the 0–19-year-old population using SAS software. Results: An increase of mortality and hospitalization risk in both the genders of the whole area, with respect to regional population, were found for overall all cancer cases, cancer of the stomach, the liver, the lung and the kidney, and ischemic heart diseases. An increase of mortality for leukemias in the 0-19-year-old population and in hospitalization risk for certain conditions originating in the perinatal period were observed. Correlation between MRI and the risk of mortality from breast tumors in women (MRI class 2: RR = 1.06; MRI class 3: RR = 1.15; MRI class 4: RR = 1.11) and between MRI and the risk of hospitalization from testis tumors (MRI class 2: RR = 1.25; MRI class 3: RR = 1.31; MRI class 4: RR = 1.32) were found. The hospitalization risk from breast tumors and asthma exceeded significantly in both genders of three and four MRI classes. Among the 0-19-year-old population, correlation between MRI and hospitalization from leukemias (MRI class 2: RR = 1.48; MRI class 3: RR = 1.60; MRI class 4: RR = 1.41) and between MRI and the prevalence of preterm birth (MRI class 2: RR = 1.17; MRI class 3: RR = 1.08; MRI class 4: RR = 1.25) were found. Conclusion: A correlation between health outcomes and the environmental pressure by uncontrolled waste sites was found. Notwithstanding the limitation of the study, the results promote implementing the actions of environmental remediation and the prosecution of illegal practices

Cancer incidence in Italian contaminated sites

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, gallblad-der, 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

Monitoring of people and workers exposure to the electric, magnetic and electromagnetic fields in an Italian national cancer Institute

<p>Abstract</p> <p>Background</p> <p>The paper reports the electric, magnetic and electromagnetic fields (<it>emf</it>) measurements carried out in the <it>Regina Elena National Cancer Institute (NCI)</it>. Several devices, used in diagnostics and in medical cures, can represent sources of <it>emf </it>for the workers and for the public subjected to the treatments. The aim is to evaluate their exposition, in order to assess the compliance with the law.</p> <p>Methods</p> <p>The investigations have been carried out in the departments of: intensive care, physiotherapy, MR presstherapy and in the surgical rooms. The measurements have been performed using broad band probes in the frequency ranges 5 Hz÷30 kHz and 100 kHz-3 GHz.</p> <p>Results</p> <p>The variability of the magnetic induction (B(μT)) levels is between 0,05 μT and 80 μT. The statistical distribution shows that most of the measurements are in the range 0,05<B = 0,5 μT and the 89% of the B(μT) levels are within the 3 μT.</p> <p>Conclusion</p> <p>The measurement of the <it>emf </it>levels in the <it>NCI </it>is recommended because of the presence of the oncological patients; their long stay near the equipments and their day-long exposure represent additional risk factors for which a prudent avoidance strategy have to de adopted.</p

A review of exposure assessment methods for epidemiological studies of health effects related to industrially contaminated sites

BACKGROUND: this paper is based upon work from COST Action ICSHNet. Health risks related to living close to industrially contaminated sites (ICSs) are a public concern. Toxicology-based risk assessment of single contaminants is the main approach to assess health risks, but epidemiological studies which investigate the relationships between exposure and health directly in the affected population have contributed important evidence. Limitations in exposure assessment have substantially contributed to uncertainty about associations found in epidemiological studies. OBJECTIVES: to examine exposure assessment methods that have been used in epidemiological studies on ICSs and to provide recommendations for improved exposure assessment in epidemiological studies by comparing exposure assessment methods in epidemiological studies and risk assessments. METHODS: after defining the multi-media framework of exposure related to ICSs, we discussed selected multi-media models applied in Europe. We provided an overview of exposure assessment in 54 epidemiological studies from a systematic review of hazardous waste sites; a systematic review of 41 epidemiological studies on incinerators and 52 additional studies on ICSs and health identified for this review. RESULTS: we identified 10 multi-media models used in Europe primarily for risk assessment. Recent models incorporated estimation of internal biomarker levels. Predictions of the models differ particularly for the routes ‘indoor air inhalation’ and ‘vegetable consumption’. Virtually all of the 54 hazardous waste studies used proximity indicators of exposure, based on municipality or zip code of residence (28 studies) or distance to a contaminated site (25 studies). One study used human biomonitoring. In virtually all epidemiological studies, actual land use was ignored. In the 52 additional studies on contaminated sites, proximity indicators were applied in 39 studies, air pollution dispersion modelling in 6 studies, and human biomonitoring in 9 studies. Exposure assessment in epidemiological studies on incinerators included indicators (presence of source in municipality and distance to the incinerator) and air dispersion modelling. Environmental multi-media modelling methods were not applied in any of the three groups of studies. CONCLUSIONS: recommendations for refined exposure assessment in epidemiological studies included the use of more sophisticated exposure metrics instead of simple proximity indicators where feasible, as distance from a source results in misclassification of exposure as it ignores key determinants of environmental fate and transport, source characteristics, land use, and human consumption behaviour. More validation studies using personal exposure or human biomonitoring are needed to assess misclassification of exposure. Exposure assessment should take more advantage of the detailed multi-media exposure assessment procedures developed for risk assessment. The use of indicators can be substantially improved by linking definition of zones of exposure to existing knowledge of extent of dispersion. Studies should incorporate more often land use and individual behaviour

A systematic review and meta-analysis of haematological malignancies in residents living near petrochemical facilities

Background The petrochemical industry is a major source of hazardous and toxic air pollutants that are recognised to have mutagenic and carcinogenic properties. A wealth of occupational epidemiology literature exists around the petrochemical industry, with adverse haematological effects identified in employees exposed to ‘low’ concentrations of aromatic hydrocarbons (benzene, toluene, ethylbenzene, and xylene). Releases from the petrochemical industry are also thought to increase the risk of cancer incidence in fenceline communities. However, this emerging and at times inconclusive evidence base remains fragmented. The present study’s aim was to conduct a systematic review and meta-analysis of epidemiological studies investigating the association between incidences of haematological malignancy and residential exposure to the petrochemical industry. Methods Epidemiological studies reporting the risk of haematological malignancies (Leukaemia, Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma, and Multiple myeloma) were included where the following criteria were met: (i) Cancer incidence is diagnosed by a medical professional and coded in accordance to the International Classification of Diseases; (ii) A clear definition of fenceline communities is provided, indicating the proximity between exposed residents and petrochemical activities; and (iii) Exposure is representative of normal operating conditions, not emergency events. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks and their 95% confidence intervals were pooled across studies for the four categories of haematological malignancy, using a random effects meta-analysis. Results The systematic review identified 16 unique studies, which collectively record the incidence of haematological malignancies across 187,585 residents living close to a petrochemical operation. Residents from fenceline communities, less than 5 km from a petrochemical facility (refinery or manufacturer of commercial chemicals), had a 30% higher risk of developing Leukaemia than residents from communities with no petrochemical activity. Meanwhile, the association between exposure and rarer forms of haematological malignancy remains uncertain, with further research required. Conclusions The risk of developing Leukaemia appears higher in individuals living near a petrochemical facility. This highlights the need for further policy to regulate the release of carcinogens by industry

Alexander of Aphrodisias

The Greek Aristotelian commentator par excellence, Alexander of Aphrodisias (fl. c 200 CE) shaped the reception and fortuna of Aristotle\u2019s corpus for centuries to come, summing up centuries of Aristotelian tradition before him. Alexander is the first who is known to have composed running commentaries on whole works, dealing with most of Aristotle\u2019s corpus as it stands now. He is also the last distinctively Aristotelian commentator, bridging the legacy of Aristotle\u2019s ancient school to other schools in late Antiquity and to Middle Age Scholastics, whether in Greek, Syriac, Arabic, or Latin. His running commentaries on Aristotle\u2019s works in logic, physics, and metaphysics have been a source, a model, and a starting point for subsequent Aristotelian scholarship as a whole. Studies on Alexander traditionally developed firstly on a narrower set of topics, including themes in noetics and in logic (see Latin Reception). They then developed on Alexander\u2019s independent treatises. Among his alleged works, On Fate, On Providence, On the Soul, On the Principles of the Universe, and On Mixture, are certainly his; all of them were meant to rebuild the missing parts of Aristotelianism as an all-comprehensive system, and to contrast concurrent Stoic theories (see also Studies of Alexander\u2019s Independent Works). Yet Alexander\u2019s normalizing impact on Aristotle\u2019s system largely escaped attention until the second half of the 20th century, embedded as it is in the whole reception of Aristotle\u2019s works (see Bibliographies). Only recently has scholarship focused on how Alexander\u2019s commentaries, even if lost, still provide the standard understanding for Aristotle\u2019s Organon and theoretical philosophy

Il contributo dei Registri tumori negli studi su ambiente e salute

Lo studio dell’incidenza delle malattie oncologiche rientra nelle finalità degli studi relativi all’impatto sanitario dei siti inquinati, come è, ad esempio, nel Progetto SENTIERI, la cui descrizione è contenuta in un Supplemento dedicato, pubblicato nel 2010, di Epidemiologia & Prevenzione. L’incidenza si caratterizza per tre principali elementi di interesse: qualità diagnostica superiore a quella della certificazione necroscopica; maggiore informatività rispetto alla mortalità in quanto l’incidenza non è influenzata dai fattori determinanti della sopravvivenza; possibilità di accesso a centri d’eccellenza per la diagnosi e la terapia. Il terzo è la possibilità di studiare tumori a bassa letalità (ad es. tumori pediatrici) e/o a bassa incidenza (ad es. tumori rari) per i quali gli studi di incidenza, rispetto a quelli di mortalità, non solo sono maggiormente informativi, ma anche più appropriati. Nell’ultimo decennio si sono avute in Italia alcune significative esperienze di utilizzo dei dati dei Registri Tumori negli studi su ambiente e salute. Illustrazioni dell’importanza dei dati prodotti dai Registri Tumori nella caratterizzazione dei siti inquinati sono costituite dal caso di Biancavilla e dall’indagine relativa al territorio dell’ASL Napoli 4 (35 comuni, dei quali 19 inclusi nel sito di interesse nazionale (SIN) Litorale Domizio Flegreo e Agro Aversano). In questo quadro, l’Istituto Superiore di Sanità ha avviato collaborazioni con il Registro Tumori di Siracusa in relazione al sito di Priolo, con il Registro Tumori di Mantova per il SIN Polo Chimico e Laghi di Mantova, con il Registro Tumori di Ferrara per un sito inquinato corrispondente al Quadrante Orientale della città, per il quale il riconoscimento di SIN è tuttora in corso. Da questa esperienza è maturato un accordo di collaborazione ISS-AIRTUM relativo allo studio della patologia oncologica in tutti i siti di interesse nazionale