Pasetto Roberto, Zengarini Nicolás, Caranci Nicola, De Santis Marco, Minichilli Fabrizio, Santoro Michele, Pirastu Roberta, Comba Pietro
Dipartimento ambiente e salute, Istituto superiore di sanità, Roma.
WHO Collaborating centre for environmental health in contaminated sites, Istituto superiore di sanità, Roma.
Epidemiol Prev. 2017 Mar-Apr;41(2):134-139. doi: 10.19191/EP17.2.P134.033.
descriptive evaluation of distributional justice in the epidemiological surveillance system of populations residing in Italian National priority Contaminated Sites (NPCSs) of SENTIERI project. Analysis of the feasibility of monitoring different Environmental Justice dimensions in SENTIERI.
descriptive study and ecological meta-analysis. SETTING AN PARTICIPANTS: residents in 298 municipalities included in 44 NPCSs in SENTIERI. Description of their level of deprivation and mortality analysis by deprivation level in the first period evaluated in SENTIERI, years 1995-2002.
an index of multiple deprivation at municipality level DI-SENTIERI, built using 4 indicators based on variables from the Italian 2001 Census, was used to describe deprivation in communities living in NPCSs. The risk of mortality for all causes and all tumors in the pool of NPCSs municipalities by deprivation level was assessed using meta-Standardized Mortality Ratios (meta-SMRs).
sixty percent of municipalities (No. 179) in NPCSs belong to the two more deprived quintiles. The socioeconomic disadvantage of communities resident in NPCS has a North-South gradient: the proportion of municipalities belonging to the two more deprived quintiles is 29% in the North, 68% in the Centre, 92% in the South. Meta-SMRs for all causes in less deprived municipalities were 98 (90%CI 95-100) in men e 101 (90%CI 97-104) in women, the values for all cancers were 99 (90%CI 94-103) in men and 100 (90%CI 95-105) in women. The corresponding estimates in more deprived municipalities were, respectively in men and women, 103 (90%CI 101- 104) and 102 (90%CI 100-104) for all causes, 104 (90%CI 102-106) and 102 (90%CI 100-104) for all cancers.
residents in NPCSs are exposed to environmental stressors and are generally more deprived. The socioeconomic disadvantage is mostly affecting Central and Southern Italy populations. Furthermore, in these deprived communities the risk of mortality for all diseases and all cancers is higher. Populations living in NPCSs are affected by distributional injustice. To monitor the different dimensions of Environmental Justice, the DI-SENTIERI should be developed and other socioeconomic indicators implemented.
对SENTIERI项目中意大利国家重点污染场地（NPCS）居民的流行病学监测系统中的分配公平性进行描述性评估。分析在SENTIERI中监测不同环境公平维度的可行性。
描述性研究和生态荟萃分析。
SENTIERI项目中44个NPCS所涵盖的298个市镇的居民。描述他们的贫困水平，并在SENTIERI评估的第一阶段（1995 - 2002年）按贫困水平进行死亡率分析。
使用基于2001年意大利人口普查变量的4个指标构建的市镇层面的多重贫困指数DI - SENTIERI，来描述居住在NPCS社区的贫困状况。使用荟萃标准化死亡率（meta - SMRs）评估NPCS市镇群体中按贫困水平划分的所有原因和所有肿瘤的死亡风险。
NPCS中60%的市镇（179个）属于最贫困的两个五分位数。居住在NPCS社区的社会经济劣势存在南北梯度：属于最贫困两个五分位数的市镇比例在北部为29%，中部为68%；南部为92%。贫困程度较低市镇中所有原因的meta - SMRs在男性中为98（90%CI 95 - 100），女性中为101（90%CI 97 - 104）；所有癌症的相应值在男性中为99（90%CI 94 - 103），女性中为100（90%CI 95 - 105）。贫困程度较高市镇中男性和女性的相应估计值，所有原因分别为103（90%CI 101 - 104）和102（90%CI 100 - 104），所有癌症分别为104（90%CI 102 - 106）和102（90%CI 100 - 104）。
NPCS的居民面临环境压力源且普遍更为贫困。社会经济劣势主要影响意大利中部和南部人口。此外，在这些贫困社区中，所有疾病和所有癌症的死亡风险更高。居住在NPCS的人群受到分配不公的影响。为监测环境公平的不同维度，应开发DI - SENTIERI并采用其他社会经济指标。
