title: Congenital Anomalies in Contaminated Sites: A Multisite Study in Italy.
abstract: The health impact on populations residing in industrially contaminated sites (CSs) is recognized as a public health concern especially in relation to more vulnerable population subgroups. The aim of this study was to estimate the risk of congenital anomalies (CAs) in Italian CSs. Thirteen CSs covered by regional CA registries were investigated in an ecological study. The observed/expected ratios (O/E) with 90% confidence intervals (CI) for the total and specific subgroups of CAs were calculated using the regional areas as references. For the CSs with waste landfills, petrochemicals, and refineries, pooled estimates were calculated. The total number of observed cases of CAs was 7085 out of 288,184 births (prevalence 245.8 per 10,000). For some CSs, excesses for several CA subgroups were observed, in particular for genital and heart defects. The excess of genital CAs observed in Gela (O/E 2.36; 90% CI 1.73-3.15) is consistent with findings from other studies. For CSs including petrochemical and landfills, the pooled risk estimates were 1.10 (90% CI 1.01-1.19) and 1.07 (90% CI 1.02-1.13), respectively. The results are useful in identifying priority areas for analytical investigations and in supporting the promotion of policies for the primary prevention of CAs. The use of short-latency effect indicators is recommended for the health surveillance of the populations residing in CSs.
authors.affiliation: Institute of Clinical Physiology, National Research Council, Unit of Environmental Epidemiology and Disease Registries, 56124 Pisa, Italy. michele.santoro@ifc.cnr.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Santoro
authors.affiliation: Institute of Clinical Physiology, National Research Council, Unit of Environmental Epidemiology and Disease Registries, 56124 Pisa, Italy. fabrizio.minichilli@ifc.cnr.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Minichilli
authors.affiliation: Institute of Clinical Physiology, National Research Council, Unit of Environmental Epidemiology and Disease Registries, 56124 Pisa, Italy. apier@ifc.cnr.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Pierini
authors.affiliation: Registro IMER, Dipartimento di Scienze Biomediche e Chirurgico Specialistiche dell'Università di Ferrara, 44100 Ferrara, Italy. asg@unife.it.
authors.forename: Gianni
authors.initials: G
authors.lastname: Astolfi
authors.affiliation: Agenzia Regionale Sanitaria della Puglia, 70100 Bari, Italy. l.bisceglia@arespuglia.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Bisceglia
authors.affiliation: National Center for Rare Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy. pietro.carbone@iss.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Carbone
authors.affiliation: Unit of Statistics, Istituto Superiore di Sanità, 00161 Rome, Italy. susanna.conti@iss.it.
authors.forename: Susanna
authors.initials: S
authors.lastname: Conti
authors.affiliation: Osservatorio Epidemiologico Regionale, Assessorato Salute Regione Siciliana, 90145 Palermo, Italy. gabriella.dardanoni@regione.sicilia.it.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Dardanoni
authors.affiliation: Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy. ivano.iavarone@iss.it.
authors.forename: Ivano
authors.initials: I
authors.lastname: Iavarone
authors.affiliation: Epidemiological Unit, NHS Mantua, 46100 Mantua, Italy. paolo.ricci@ats-valpadana.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ricci
authors.affiliation: Program Director Birth Defects Registry of Campania, UO Genetica Medica, Azienda Ospedaliera G.Rummo, 82100 Benevento, Italy. gioacchino.scarano@ao-rummo.it.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Scarano
authors.affiliation: Institute of Clinical Physiology, National Research Council, Unit of Environmental Epidemiology and Disease Registries, 56124 Pisa, Italy. fabriepi@ifc.cnr.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bianchi
authors.affiliation: Institute of Clinical Physiology, National Research Council, Unit of Environmental Epidemiology and Disease Registries, 56124 Pisa, Italy.
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology*; D064371:Hazardous Waste Sites; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D015995:Prevalence; D012042:Registries; D012306:Risk
keywords: congenital anomalies; contaminated sites; epidemiological surveillance