[Mortality results in SENTIERI Project].

Area of Science:

• Environmental epidemiology
• Public health
• Occupational and environmental medicine

Context:

• The SENTIERI Project investigated mortality in 44 Italian Polluted Sites (IPS) designated for environmental remediation.
• These sites exhibit diverse environmental exposures, including asbestos, industrial emissions, heavy metals, and chemical pollutants.
• Previous studies often faced challenges due to multifactorial etiologies and co-occurring pollutant sources.

Purpose:

• To evaluate the association between environmental exposures in Italian Polluted Sites and mortality causes.
• To classify epidemiological evidence of causal links between specific exposures and health outcomes (Sufficient, Limited, Inadequate).
• To identify excess mortality patterns and attribute potential etiological roles to environmental factors.

Summary:

• Significant increases in mortality from malignant neoplasms (especially pleural) and respiratory diseases were observed in multiple IPS, particularly those with asbestos contamination.
• Attributable risks were identified for lung cancer, respiratory diseases, congenital anomalies, renal failure, and neurological diseases linked to specific pollutants (e.g., asbestos, industrial emissions, heavy metals, PCBs).
• Overall mortality showed an excess of approximately 1,200 deaths per year across the studied sites, with higher rates in Southern and Central Italy.

Impact:

• Provides robust epidemiological evidence linking environmental pollution in specific Italian sites to increased mortality.
• Highlights the public health burden associated with legacy pollution sites and the need for targeted remediation.
• Informs policy and public health interventions aimed at mitigating the health effects of environmental contamination.