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The Health Profile of Populations Living in Contaminated Sites: Sentieri Approach

DOI: 10.1155/2013/939267

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Abstract:

SENTIERI project (Epidemiological Study of Residents in Italian Contaminated Sites) studied mortality in the sites of national interest for environmental remediation (National Priority Contaminated Sites—NPCSs). SENTIERI described mortality of residents in NPCSSs, and it specifically focused on causes of death for which environmental exposure is suspected or ascertained to play an etiologic role. The epidemiological evidence of the causal association was classified a priori into one of these three categories: Sufficient (S), Limited (L), and Inadequate (I). Mortality in the period 1995?2002 was studied for 63 single or grouped causes at the municipal level by computing: crude rate, standardized rate, standardized mortality ratios (SMR), and SMR adjusted for an ad hoc deprivation index. Regional populations were used as references for SMR calculations and 90% CI accompanied SMR values. The deprivation index was constructed using 2001 national census variables for the following socioeconomic domains: education, unemployment, dwelling ownership, and overcrowding. SENTIERI results will allow the priorities setting in remediation intervention so as to prevent adverse health effects from environmental exposure. This paper’s objective is to present the rationale, methods, advantages, and limitations underlying SENTIERI project and to describe data and resources required to apply a similar approach in other countries. 1. Introduction Human health is intimately connected to the surrounding environment. This is particularly the case of the health of people living in contaminated site(s) (CS) which is affected by the legacy of past industrialization and current industrial activities, often in absence of environmental remediation. European Community legislation addresses the concept of CS only in the context of the Thematic Strategy for Soil Protection [1] and the Soil Framework Directive proposed by the European Commission (EC) in 2006 [2]; for details on the legal framework and definitions at EU level refer to WHO 2013 [3]. According to 2007 estimates, soil contamination requiring clean up is present in approximately 250,000 sites in the European Environment Agency (EEA) member countries [4]. Although main polluting sources may vary across Europe, industrial production and commercial activities, oil industry and waste disposal and treatment are reported to be the major ones. National reports indicate that heavy metals and mineral oils are the main soil contaminants, while mineral oils and chlorinated hydrocarbons are the most frequent pollutants found in

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