Trails project. Iss: “Excess mortality (2.6%) stable in 46 areas at risk monitored. In 56% of cases due to malignant tumors”

The report also highlighted an excess risk of hospitalization which, in the period 2014-2018, for all natural causes in all of the 46 sites, was 3% in both genders. An excess risk of hospitalization is also observed in the pediatric-adolescent age group (0-19 years) for 43% of the areas studied, and in young people (20-29 years) for 15% of the contaminated areas.

22 FEB –

Between 2013 and 2017, an excess of 1668 deaths per year occurred in the total of 46 national sites monitored by the Sentieri epidemiological surveillance. The percentage of deaths in excess of the total is almost constant over time, going from 2.7% in 2006-2013 (Fifth Sentieri Report) to 2.6% in the most recent period (2013-2017).

The estimate is contained in the Sixth Report on the project, which will be presented tomorrow at the Higher Institute of Health (ISS) and published on the website of the scientific journal Epidemiology & Preventionin open access mode.

Malignant tumors contribute more than half (56%) of the observed excesses. Going into detail on the link between pathologies and exposure factors, the mortality rate for total mesotheliomas is three times higher in the sites with the presence of asbestos and that for pleural mesotheliomas is more than two times higher in the set of sites with asbestos and port areas. Lung cancer is in excess of 6% among males and 7% among females. In addition, mortality from colorectal cancer in sites characterized by the presence of chemical implants is in excess of 4% among males and 3% among females, and 6% for bladder cancer in men residing in sites with landfills.

The report also highlighted an excess risk of hospitalization which, in the period 2014-2018, for all natural causes in all of the 46 sites, was 3% in both genders. An excess risk of hospitalization is also observed in the pediatric-adolescent age group (0-19 years) for 43% of the areas studied, and in young people (20-29 years) for 15% of the contaminated areas.

“Some exposures, such as those to asbestos, are unfortunately well known to public health precisely because they cause precisely measurable deaths and diseases – he comments Silvio Brusaferro, President of the ISS –; others are less known and it is sometimes difficult to attribute excesses to specific agents. What is certain is that the environmental pressures for these populations are multiple, and often mix with socio-economic disadvantage, producing negative indicators and raising the question of the importance of environmental determinants”.

“The working group led by the ISS researchers analyzed, in particular, the pathologies of interest a priori, i.e. those for which the existing scientific evidence shows an association with the sources of environmental exposure present in each site – he adds Amerigo Zone, scientific director of the Project -. This approach, innovative in the field of research on the subject, allows us to reduce “false positives” and recognize signs of the possible causal and/or concausal contribution of former asbestos-cement quarries and factories, port areas, petrochemical, iron and steel plants, mines , power plants, incinerators, chemical industries and illegal or uncontrolled landfills in determining at least some of the excesses observed”.

The results of the Sixth Sentieri Report underline the importance of continuing the planned remediation activities, of keeping the epidemiological surveillance system active, and of providing comprehensive information to all stakeholders (public administrations, health and environmental authorities, committees, citizens ). For some sites, the Report provides indications of appropriate public health interventions, and suggests scientific insights into particular aspects that emerged during the study.

February 22, 2023
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