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[意大利南部西西里岛地区国家重点污染场地公共卫生干预项目中的流行病学监测:死亡率、住院率和癌症发病率的更新]

[The epidemiological surveillance in the programme of public health intervention in the national priority contaminated sites of Sicily Region (Southern Italy): update of mortality, hospitalization, and cancer incidence].

作者信息

Cernigliaro Achille, Santangelo Omar Enzo, Maniglia Marialuisa, Pollina Addario Sebastiano, Usticano Antonella, Marras Antonello, Ciranni Paolo, Dardanoni Gabriella, Saporito Laura, Tavormina Elisa, Fantaci Giovanna, Scondotto Salvatore

机构信息

Dipartimento per le attività sanitarie e Osservatorio epidemiologico, Assessorato della salute, Regione Siciliana, Palermo;

Dipartimento di scienze per la promozione della salute e materno-infantile "G. D'Alessandro", Università degli Studi di Palermo.

出版信息

Epidemiol Prev. 2019 Mar-Jun;43(2-3):132-143. doi: 10.19191/EP19.2-3.P132.052.

Abstract

OBJECTIVES

to update the health profile of populations residing in the national priority contaminated sites (NPCSs) in Sicily Region (Southern Italy) through a description of mortality and hospitalization for causes and through cancer incidence. This new profile is part of the implementation of the epidemiological surveillance system within the new Programme of care intervention for health protection in these populations and in the new Regional Prevention Plan.

DESIGN

geographic population survey providing, for each NPCS considered in this study, a comparison between the local population and the populations of the neighbouring areas.

SETTING AND PARTICIPANTS

the study population included the residents in the municipalities residing in the NPCSs of Augusta-Priolo, Gela, Milazzo, and Biancavilla.

MAIN OUTCOME MEASURES

the standardized mortality ratio (SMR), morbidity (SHR), and tumour incidence (SIR), with the respective 95% confidence intervals, were estimated using the Mortality Registry as source for the mortality index, the database of the hospital discharged as source for the morbidity index, and the data from the Regional Network of Tumour Registers as source for the incidence index.

RESULTS

in the local comparison, excess of hospitalization in both sexes was reported in Augusta-Priolo for liver cirrhosis, mental disorders, and digestive tract disease, and an excess of incidence and mortality for leukaemia in women and prostate cancer in men. In the NPCS of Gela, there was an excess of hospitalization in both sexes for blood and hematopoietic diseases, circulatory and nervous system diseases, coupled with the same excess of mortality. Excess of incidence and mortality of stomach tumours in men and incidence of lung cancer in women were observed. The area of ​​Milazzo was characterized by an excess of incidence and mortality for melanoma in men. In the municipality of Biancavilla, there is evidence of excess of hospitalization for respiratory diseases and endocrine glands diseases in both sexes, while a mortality excess for circulatory system diseases was highlighted. The excess of incidence of mesothelioma in both men and women was confirmed.

CONCLUSION

data from the new surveillance system help to define the health profile in the NPCSs of Sicily. Even using the local level of comparison, that was added to the traditional approach in geographic studies for the NPCSs available to date, the particular impact of some chronic diseases in these populations has been confirmed also in recent years.

摘要

目的

通过对病因导致的死亡率和住院率以及癌症发病率的描述,更新居住在意大利南部西西里岛地区国家重点污染场地(NPCSs)的人群的健康状况。这一新的健康状况描述是在针对这些人群的新的健康保护护理干预计划和新的地区预防计划中实施流行病学监测系统的一部分。

设计

地理人口调查,为本研究中考虑的每个国家重点污染场地提供当地人口与邻近地区人口之间的比较。

地点和参与者

研究人群包括居住在奥古斯塔 - 普廖洛、杰拉、米拉佐和比安卡维拉国家重点污染场地所在市镇的居民。

主要观察指标

使用死亡率登记处作为死亡率指数的来源、医院出院数据库作为发病率指数的来源以及肿瘤登记区域网络的数据作为发病率指数的来源,估计标准化死亡率(SMR)、发病率(SHR)和肿瘤发病率(SIR)及其各自的95%置信区间。

结果

在本地比较中,奥古斯塔 - 普廖洛报告了男女肝硬化、精神障碍和消化道疾病的住院率过高,以及女性白血病和男性前列腺癌的发病率和死亡率过高。在杰拉的国家重点污染场地,男女血液和造血系统疾病、循环和神经系统疾病的住院率过高,同时死亡率也过高。观察到男性胃肿瘤的发病率和死亡率过高以及女性肺癌的发病率过高。米拉佐地区的特点是男性黑色素瘤的发病率和死亡率过高。在比安卡维拉市镇,有证据表明男女呼吸系统疾病和内分泌腺疾病的住院率过高,同时突出显示了循环系统疾病的死亡率过高。男女间皮瘤发病率过高得到证实。

结论

新监测系统的数据有助于确定西西里岛国家重点污染场地的健康状况。即使采用本地层面的比较,这是对迄今为止国家重点污染场地地理研究中传统方法的补充,近年来也证实了一些慢性病对这些人群的特殊影响。

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