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[意大利南部塔兰托地区死亡率和发病率的队列研究]

[A cohort study on mortality and morbidity in the area of Taranto, Southern Italy].

作者信息

Mataloni Francesca, Stafoggia Massimo, Alessandrini Ester, Triassi Maria, Biggeri Annibale, Forastiere Francesco

机构信息

Dipartimento di epidemiologia del Servizio sanitario regionale, Lazio.

出版信息

Epidemiol Prev. 2012 Sep;36(5):237-52.

Abstract

INTRODUCTION

the area of Taranto has been investigated in several environmental and epidemiological studies due to the presence of many industrial plants and shipyards. Results from many studies showed excesses of mortality and cancer incidence for the entire city of Taranto, but there are no studies for different geographical areas of the city that take into account the important confounding effect of socioeconomic position.

OBJECTIVE

to assess mortality and hospitalization rates of residents in Taranto, Statte and Massafra through a cohort study,with a particular focus on residents in the districts closest to the industrial complex, taking into account the socioeconomic position.

METHODS

a cohort of residents during the period 1998-2010 was enrolled. Individual follow-up for assessment of vital status at 31.01.2010 was performed using municipality data. The census-tract socioeconomic position level and the district of residence were assigned to each participant, on the basis of the geocoded addresses at the beginning of the follow- up. Standardized cause specific mortality/ morbidity rates, adjusted for age, were calculated by gender and districts of residence. Mortality and morbidity Hazard Ratios (HR, CI95%) were calculated by districts and socioeconomic position using Cox models. All models were adjusted for age and calendar period, and were done separately for men and women.

RESULTS

321.356 people were enrolled in the cohort (48.9%males).Mortality/morbidity risks for natural cause, cancers, cardiovascular and respiratory diseases were found to be higher in low socioeconomic position groups compared to high ones. The analyses by districts have shown several excess mortality/morbidity risks for residents in Tamburi (Tamburi, Isola, Porta Napoli and LidoAzzurro), Borgo, Paolo VI and the municipality of Statte.

CONCLUSIONS

The results of this study showed a significant relationship between socioeconomic position and health status of people resident in Taranto. People living in the districts closest to the industrial zone have higher mortality/morbidity levels compared to the rest of the area also taking into account the socioeconomic position.

摘要

引言

由于塔兰托地区存在众多工厂和造船厂,该地区已在多项环境和流行病学研究中得到调查。许多研究结果显示,塔兰托全市的死亡率和癌症发病率均过高,但尚未有针对该城市不同地理区域且考虑社会经济地位这一重要混杂因素的研究。

目的

通过队列研究评估塔兰托、斯塔特和马萨夫拉居民的死亡率和住院率,特别关注最靠近工业园区的地区居民,并考虑社会经济地位。

方法

纳入了1998年至2010年期间的居民队列。利用市政数据对个体进行随访,以评估2010年1月31日的生命状况。根据随访开始时的地理编码地址,为每位参与者确定普查区社会经济地位水平和居住地区。按性别和居住地区计算经年龄调整的标准化特定病因死亡率/发病率。使用Cox模型按地区和社会经济地位计算死亡率和发病率风险比(HR,95%CI)。所有模型均按年龄和日历期进行调整,并分别对男性和女性进行分析。

结果

该队列共纳入321,356人(男性占48.9%)。发现社会经济地位较低群体的自然病因、癌症、心血管疾病和呼吸系统疾病的死亡率/发病率风险高于高社会经济地位群体。按地区分析显示,坦布里(坦布里、伊索拉、那不勒斯门和利多阿祖罗)、博尔戈、保罗六世和斯塔特市的居民存在若干超额死亡率/发病率风险。

结论

本研究结果表明,塔兰托居民的社会经济地位与健康状况之间存在显著关系。考虑到社会经济地位,居住在最靠近工业区地区的居民的死亡率/发病率水平高于该地区其他地方。

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