title: [Global burden of mortality in Italian polluted sites].
abstract: SENTIERI Project has assessed the overall mortality profile in all the IPSs combined, and performed IPS-specific analyses. The epidemiological evidence of the causal association between cause of death and exposure was classified into one of these three categories: Sufficient (S), Limited (L) and Inadequate (I). The procedures and results of the evidence evaluation have been presented in a 2010 Supplement of Epidemiology & Prevention devoted to SENTIERI. Mortality for causes of death with a priori Sufficient or Limited evidence of association with the environmental exposure exceeds the expected figures, with a SMR of 115.8 for men (90%CI 114.4-117.2; 2 439 extra deaths) and 114.4 for women (90% CI 112.4-116.5; 1 069 extra deaths). These excesses are also observed when analysis is extended to all the causes of death (i.e. with no restriction to the ones with a priori Sufficient or Limited evidence): for a total of 403 692 deaths (men and women combined), an excess of 9 969 deaths is observed, with an average of around 1 200 extra deaths per year. Most of these excesses are observed in IPSs located in Southern and Central Italy. The distribution of the causes of deaths shows that the excesses are not evenly distributed: cancer mortality accounts for 30%of all deaths, but is 43.2%of the excess deaths (4 309 cases of 9 969). Conversely, the percentage of excesses in non cancer causes, 19%, is lower than their share of total mortality (42%). Consistently with previous studies, the results suggest that the health status of populations living in the IPSs is worse than what regional averages show. Compared to previous studies, the analysis of the causes selected in SENTIERI, on the basis of a priori Sufficient or Limited evidence of association with the environmental exposures, provides additional information on their role, though some limitations, due to methodology and data used, should be considered.
authors.affiliation: World Health Organization Regional Office for Europe, Rome, Italy. mam@ecr.euro.who.int
authors.forename: M
authors.initials: M
authors.lastname: Martuzzi
authors.forename: F
authors.initials: F
authors.lastname: Mitis
authors.forename: R
authors.initials: R
authors.lastname: Pirastu
authors.forename: I
authors.initials: I
authors.lastname: Iavarone
authors.forename: R
authors.initials: R
authors.lastname: Pasetto
authors.forename: Loredana
authors.initials: L
authors.lastname: Musmeci
authors.forename: Amerigo
authors.initials: A
authors.lastname: Zona
authors.forename: Susanna
authors.initials: S
authors.lastname: Conti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bianchi
authors.forename: Francesco
authors.initials: F
authors.lastname: Forastiere
authors.forename: Pietro
authors.initials: P
authors.lastname: Comba
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D000013:Congenital Abnormalities / Q000401:mortality; D004066:Digestive System Diseases / Q000401:mortality; D004781:Environmental Exposure; D004787:Environmental Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D052776:Female Urogenital Diseases / Q000401:mortality; D015386:Hazardous Substances / Q000009:adverse effects; D006256:Hazardous Waste / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D007220:Industrial Waste / Q000009:adverse effects* / Q000706:statistics & numerical data; D007558:Italy / Q000453:epidemiology; D008297:Male; D052801:Male Urogenital Diseases / Q000401:mortality; D009026:Mortality; D009369:Neoplasms / Q000401:mortality; D011159:Population Surveillance; D012140:Respiratory Tract Diseases / Q000401:mortality; D014504:Urban Health
chemical_list: D015386:Hazardous Substances; D006256:Hazardous Waste; D007220:Industrial Waste