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危险废物填埋场和非法倾倒场污染场地对健康的影响:意大利地区的生态水平上的流行病学研究。

The health impact of hazardous waste landfills and illegal dumps contaminated sites: An epidemiological study at ecological level in Italian Region.

机构信息

Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy.

World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy.

出版信息

Front Public Health. 2023 Feb 27;11:996960. doi: 10.3389/fpubh.2023.996960. eCollection 2023.

Abstract

BACKGROUND AND AIM

The implementation of idoneous management of hazardous waste, in contrast to illegal practices, is one of the environment and health priorities of the WHO. The aim of the present study, based on a collaborative agreement between the Italian National Health Institute and a Prosecution Office located in Naples North, was to evaluate the health effects of illegal landfills and burning of urban and hazardous waste in the territory of the Prosecution Office.

METHODS

The municipalities included in the study territory were investigated with respect to the regional population. Regression analyses were performed in the study area between four classes of an environmental municipal indicator of waste risk (MRI) previously defined, computing the relative risks (RRs) in 2-4 MRI classes, with respect to the first MRI class (the least impacted). The prevalence of reproductive outcomes and cause-specific mortality and hospitalization were analyzed in the general population and in the 0-19-year-old population using SAS software.

RESULTS

An increase of mortality and hospitalization risk in both the genders of the whole area, with respect to regional population, were found for overall all cancer cases, cancer of the stomach, the liver, the lung and the kidney, and ischemic heart diseases. An increase of mortality for leukemias in the 0-19-year-old population and in hospitalization risk for certain conditions originating in the perinatal period were observed. Correlation between MRI and the risk of mortality from breast tumors in women (MRI class 2: RR = 1.06; MRI class 3: RR = 1.15; MRI class 4: RR = 1.11) and between MRI and the risk of hospitalization from testis tumors (MRI class 2: RR = 1.25; MRI class 3: RR = 1.31; MRI class 4: RR = 1.32) were found. The hospitalization risk from breast tumors and asthma exceeded significantly in both genders of three and four MRI classes. Among the 0-19-year-old population, correlation between MRI and hospitalization from leukemias (MRI class 2: RR = 1.48; MRI class 3: RR = 1.60; MRI class 4: RR = 1.41) and between MRI and the prevalence of preterm birth (MRI class 2: RR = 1.17; MRI class 3: RR = 1.08; MRI class 4: RR = 1.25) were found.

CONCLUSION

A correlation between health outcomes and the environmental pressure by uncontrolled waste sites was found. Notwithstanding the limitation of the study, the results promote implementing the actions of environmental remediation and the prosecution of illegal practices.

摘要

背景与目的

与非法行为相比,危险废物的妥善管理是世界卫生组织(WHO)环境和健康优先事项之一。本研究的目的是基于意大利国家卫生研究所与那不勒斯北部的一个检察机关之间的合作协议,评估非法倾倒和焚烧城市及危险废物对检察机关管辖范围内的卫生影响。

方法

根据研究区域的地区人口,对纳入研究的城镇进行了调查。在研究区域中,对之前定义的环境市政废物风险指标(MRI)的四个等级进行了回归分析,计算了相对于第一级 MRI(受影响最小)的 2-4 级 MRI 类别的相对风险(RR)。使用 SAS 软件分析了一般人群和 0-19 岁人群的生殖结局以及特定原因的死亡率和住院率。

结果

与区域人口相比,整个地区两性的所有癌症病例、胃癌、肝癌、肺癌和肾癌以及缺血性心脏病的死亡率和住院率均升高。在 0-19 岁人群中,白血病死亡率增加,围产期起源的某些疾病住院率增加。观察到 MRI 与女性乳腺癌死亡率之间的相关性(MRI 等级 2:RR = 1.06;MRI 等级 3:RR = 1.15;MRI 等级 4:RR = 1.11)和 MRI 与睾丸肿瘤住院风险之间的相关性(MRI 等级 2:RR = 1.25;MRI 等级 3:RR = 1.31;MRI 等级 4:RR = 1.32)。在三个和四个 MRI 等级中,两性的乳腺癌和哮喘住院率均显著升高。在 0-19 岁人群中,观察到 MRI 与白血病住院率(MRI 等级 2:RR = 1.48;MRI 等级 3:RR = 1.60;MRI 等级 4:RR = 1.41)和早产发生率(MRI 等级 2:RR = 1.17;MRI 等级 3:RR = 1.08;MRI 等级 4:RR = 1.25)之间的相关性。

结论

发现健康结果与未受控制的废物场的环境压力之间存在相关性。尽管研究存在局限性,但结果还是推动了实施环境补救和起诉非法行为的行动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/176b/10010672/28de2599605e/fpubh-11-996960-g0001.jpg

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