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11 July 2019

Italy: industrial pollution boosts health inequality

Carte Sentieri

The 5th SENTIERI report was published in Italy in June 2019. SENTIERI is an ambitious Italian project collecting data on sites with identified industrial pollution.

A study of residents living near to Italian polluted sites, SENTIERI uses a standardised methodology to analyse the health profile of such areas, looking at mortality and hospitalisation rates and the incidence of cancers and birth defects. The study also looks separately at cancers contracted by children and adolescents as well as the hospitalisation rate of this age bracket. The study provides in-depth evidence of the multiple consequences for populations exposed to industrial pollution, enabling preventive measures by public health organisations to be better targeted. It also highlights the trans-generational consequences of industrial pollution.

The study covers a total of 45 sites in 319 municipalities (Italy has some 8 000 municipalities) with a total population of around 5.9 million. The data collected relates to deaths and hospitalisations in the period 2006-2013.

Generally speaking, the study reveals high excess mortality [1] involving 5 267 men and 6 725 women. These figures are calculated on the basis of the average mortality in the regions in which the polluted sites are located. With specific regard to cancers, excess mortality involves 3 375 men and 1 910 women. The most striking excesses of cancer involve mesothelioma, lung cancer, colon cancer and stomach cancer.

The situation among children and adolescents (between 0 and 19) and young adults (between 20 and 29) is also greatly affected by industrial pollution. Looking solely at the first year of life, we see an excess of 7 000 hospitalisations (2 000 of which are linked to perinatal health problems). Among the hospitalisation excesses in the 0 - 14 age range, acute respiratory problems (4 000 cases) and asthma (2 000 cases) play a significant role.

A further finding is a significant excess of cancers in the 0 - 24 age range, due mainly to sarcomas among children, acute myeloid leukaemia among children and young adults, and non-Hodgkin's lymphoma and testicular cancers among young adults.

Fifteen of the sites studied are covered by birth defect registers. In seven of them, significant excesses were found for genital organs, the heart, the limbs, the nervous system, the digestive system and the urinary tract. For example, around the site of the Mantua chemical cluster, a significantly higher incidence of birth defects involving the nervous system (in particular neural tube defects) and the heart was found.

Estimates point to some 342 000 contaminated sites in Europe, of which just 15% have been subjected to remediation. Generally speaking, multiple forms of pollution exist, with both soil and water contaminated. Such pollution is the result of (past and present) industrial activities or the storage and recycling of waste. If we were to include the quality of air, the number of sites to be considered would be much higher.

This situation is contributing greatly to health inequality, especially as the populations living near the contaminated sites generally belong to the least privileged social classes.

Photo credit: Sentieri


  • The SENTIERI Report 2019 (Studio Epidemiologico Territori e Insediamenti Esposti a Rischio da Inquinamento)
  • The website of the Epidemologia e Prevenzione Journal contains data complementing the report
  • Hesamag 9 Waste and recycling
  • Hesamag 18 Work related cancer
  • [1] In epidemiology, excess mortality refers to the difference between the mortality of a given population (in our case, that of people living near a polluted site) and that of a reference population (in our case, the mortality rate in the region in which the sites are located). This excess takes account of the mortality role played by the specific risks to which the studied population is exposed.

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