Chellini Elisabetta, Pieroni Stefano, Martini Andrea, Carreras Giulia, Nuvolone Daniela, Torraca Francesca, Aragona Ida
Istituto per lo studio, la prevenzione e la rete oncologica, Firenze;
Dipartimento di prevenzione, Azienda unità sanitaria locale Toscana Nord Ovest, zona Versilia.
Epidemiol Prev. 2020 Sep-Dec;44(5-6):367-377. doi: 10.19191/EP20.5-6.P367.012.
to evaluate the health impact of the emissions of two waste incinerators located in the same area in Pietrasanta (Tuscany Region, Central Italy) at the border with the municipality of Camaiore, especially for diseases suggested in previous studies to be related to those emissions.
epidemiological geographic study.
the study population was defined on the basis of residence in the two municipalities and in the areas characterized by Particulate Matter with diameter equal or less than 2.5 µm (PM2.5) and poli-chloro-dibenzo-dioxin / poli-chloro-dibenzo-furans (PCDD/F) pollution defined with a dispersion model. From the resident population, for each cancer case it was sampled a control, matched to case by gender and age at case's diagnosis, and for each premature and low-weight newborn a control matched was sampled by year of birth, gender, and mother's residence.
standardized (standard: European population) mortality and hospitalization rates in the residents of the two municipalities were calculated for liver, larynx, lung cancer, soft tissue sarcoma (STM), non-Hodgkin lymphoma (NHL), multiple myeloma, leukaemia, flu-excluded respiratory diseases, and circulatory diseases. The risk related to each PM2.5 and PCDD/F pollution level from the old incinerator for cancer and from the new plant for reproductive outcomes was analysed using logistic conditional regression model adjusted by gender and age.
the mortality and hospitalization rates observed in the study area are similar to those calculated for the Versilia area excluded the two municipalities under study. There is a higher case distribution in the higher pollution levels, with significant increases in the highest level: • liver cancer: PM2.5 OR 2.3 (95%CI 1.5-3.6); PCDD/F OR 4.4 (95%CI 2.8-7.0); • larynx cancer: PCDD/F OR 3.2 (95%CI 1.5-6.7); • lung cancer: PCDD/F OR 1.5 (95%CI 1.1-2.0); • NHL: PCDD/F OR 8.5 (95%CI 3.1-23.5); • leukaemia: PCDD/F OR 4.1 (95%CI 1.8-9.3). The risks estimated for STM, although non significant, are consistent with those obtained in previous studies undertaken in areas characterized by dioxin pollution. There is a deficit of premature births in the area under study compared to the regional area, and no differences are observed among the different pollution areas.
it cannot be excluded that the emissions from the old incinerator had a health impact on the population living in the neighbourhood. Nevertheless, it is possible that other risk factors (occupations and life styles) could have had a role on the obtained results. Better estimates could be obtained also taking into consideration the residential histories of the subjects under study.
评估位于意大利中部托斯卡纳大区皮耶特拉桑塔同一区域、与卡马约雷市接壤处的两座垃圾焚烧厂排放物对健康的影响,尤其关注先前研究中表明与这些排放物相关的疾病。
流行病学地理研究。
根据居住在两个市镇以及通过扩散模型确定的直径小于或等于2.5微米的颗粒物(PM2.5)和多氯二苯并二恶英/多氯二苯并呋喃(PCDD/F)污染区域来界定研究人群。从常住人口中,对于每例癌症病例,抽取一名对照,对照在病例诊断时按性别和年龄进行匹配;对于每例早产和低体重新生儿,抽取一名对照,对照按出生年份、性别和母亲居住地进行匹配。
计算两个市镇居民中肝脏、喉、肺癌、软组织肉瘤(STM)、非霍奇金淋巴瘤(NHL)、多发性骨髓瘤、白血病、排除流感的呼吸道疾病和循环系统疾病的标准化(标准:欧洲人群)死亡率和住院率。使用经性别和年龄调整的逻辑条件回归模型分析旧焚烧厂各PM2.5和PCDD/F污染水平与癌症风险以及新厂与生殖结局风险之间的关系。
研究区域观察到的死亡率和住院率与排除所研究的两个市镇后的韦尔西利亚地区计算得出的死亡率和住院率相似。在污染水平较高的区域病例分布较多,在最高污染水平有显著增加:• 肝癌:PM2.5比值比(OR)2.3(95%可信区间[CI]1.5 - 3.6);PCDD/F OR 4.4(95%CI 2.8 - 7.0);• 喉癌:PCDD/F OR 3.2(95%CI 1.5 - 6.7);• 肺癌:PCDD/F OR 1.5(95%CI 1.1 - 2.0);• NHL:PCDD/F OR 8.5(95%CI 3.1 - 23.5);• 白血病:PCDD/F OR 4.1(95%CI 1.8 - 9.3)。尽管STM的估计风险不显著,但与先前在二恶英污染地区进行的研究结果一致。与该地区相比,研究区域早产数量不足,不同污染区域未观察到差异。
不能排除旧焚烧厂排放物对周边居民健康产生影响。然而,其他风险因素(职业和生活方式)可能对所得结果也有作用。考虑研究对象的居住史或许能得到更准确的估计。