Mortality analysis in a city at high risk of environmental crisis, 1970-2004

Introduction: A study is on-going in a city with a high level of air pollution due to heavy industries (steel plant including coke oven shops, oil refinery, cement plant etc.) located very near the residential area, since early ’70. A shipyard and a navy military base are present in the city since the beginning of last century, employing a large number of workers. WHO has defined the area at high risk of environmental crisis, analyzing some mortality causes in the 1980s. Methods: A mortality data set for all residents (200.000 inhabitants) were built for years 1970 –1999, now updating to 2004. Mortality data came from two different sources: 1970 –1994 from National Institute of Statistics and 1998 –99 from LHU Registry. A classical mortality analysis has been conducted, for the period 1970 –99, considering fiveyears periods, crossing censuses used as rate denominators. SMR (ref.pop. Region 1970 –94), and direct standardized rate (DSR) (ref.pop. European), have been computed to investigate on mortality time trend. Analyses have been done only by sex and age, and many causes have been explored. Results: General mortality in the city shows higher values than the regional ones in all periods and in both sexes. This is clearly evident either in males for mortality due to all cancers, cancer of the liver, lung, pleura, bladder, non Hodgkin lymphoma (NHL), multiple myeloma (MM) either in females for mortality due to all cancers, cancer of the lung, pleura, breast, NHL, MM and respiratory diseases. Since 1990–94, in both sexes, mortality for all cancers is increasing rapidly and in 1998–99 males values are higher (DSR:269.2 deaths/ 100.000 inhab) than those for cardiovascular diseases (DSR:242.8 deaths/ 100.000 inhab). Female mortality increases with time for various causes. Discussion and Conclusions: The wide period investigated shows high mortality levels already in the ’70 especially for pathologies linked to workplace exposure, for men, like cancer of lung, pleura and bladder, and likely linked to the presence of the shipyard and the navy military base. In the 1980s the level of air pollution has highly increased and this could be associated with increasing levels of cancers and respiratory diseases mortality observed also among women. Due to the peculiar geographical situation, exposure levels to air pollutants are almost identical in the whole area and no seasonality appears in the daily time trends of air pollutant, as a recent study on short-term effect of air pollution have shown.