[Environment and health status of the population in areas with high risk of environmental crisis in Italy].

The Italian Ministry of Environment identified 15 areas throughout the country as at "high risk of environmental crisis". The areas host industrial activities that may entail noxious exposures, through occupation and the environment. An epidemiological descriptive study on the residents was carried out using routinely collected mortality data. Mortality data for the period 1981-1994 at the level of municipality were analysed, for around 30 causes of death for both sexes. Methods for small area analysis and disease mapping were used. Rates and SMRs (also adjusted for socio-economic factors) were tabulated for residents and restricted to people born locally. The geographical distribution within areas, time trends, and birth cohort effects were also investigated. Results for some specific areas indicate excesses that can be ascribed to known exposures. The mortality of the residents of areas taken together is substantially higher than expected; significant excesses are more than can be predicted by chance. Due to the heterogenous nature of the risk factors, no common patterns of mortality were observed, but for example 50% of the SMRs for total mortality calculated in the areas, for men and women separately, were significantly greater than unity, and so were 37% of the SMRs for all cancers and 30% for lung cancer. Relative risks were in general of small magnitude, but as populations are large (the areas include some 3.5 million people) and mortality is increased for common causes, absolute numbers of excess deaths were large. These results indicate the occurrence of important risk factors, some of which are related to the industrial activities, but more detailed data are needed for the identification of corrective public health actions.