The death toll in Taranto shows a dramatic increase according to the updated data of the Sentieri Study- for the 2003-2009 period - on the "causes of death, the biomonitoring and health risk related to air quality." The study was presented this week by Minister Renato Balduzzi, with the participation of the authors and the attendance of environmental associations' representatives.The first Sentieri study contained data up to 2002 and now we know that, in the Puglia capital only, overall death cases due to pollution increased by 1% compared to previous statistics, against the whole cohort of the Puglia population. The new study analyzed current mortality data, using the same methodology of the first project and considering deaths cases over time, for each cause, occurred in Taranto, the Puglia region and Italy. And thanks to published data on biomonitoring of the area where the facilities are located, we can identify the substances that define the relation between pollutants and health.
The updated Sentieri Study for Taranto (2003-2008)
The updated Sentieri Project, which was recently presented, examined mortality at the municipal level for 63 individual causes or groups of causes in 44 of the 57 sites of national interest for environmental remediation, defined as Italian Polluted Sites (IPS).The study adopted a multidisciplinary approach: in assessing risk the epidemiological data were integrated with those of environmental matrices.There is a large part of Italy that is poisoned by industrial development.There are more cases of cancers and lung diseases around petrochemical and steel plants, more birth defects and kidney diseases where heavy metal processing is carried out.The analysis of mortality was conducted for both genders and all ages for the periods 1995-2002 and 2003-2009.Mortality from the major causes of death shows, in both periods, excesses of between 7% and 15% for all-cause mortality and all cancers. Analyzing the individual diseases, we note that those related to the circulatory, respiratory and digestive systems, show death rates that exceed expected death rates both for the years 1995-2002 and the years 2003-2009; even taking into account socio-economic factors, these results do not change substantially. In the Taranto IPS, the situation is very different and far more worrying. Between 2003 and 2009 in fact, in Taranto, mortality in men increased by 14% and by 8% in women for all causes. Lung cancer in men shows an excess of about 20%, the corresponding values in women show excesses that are around 30%. For cancer of the pleura excesses are, respectively, in the two periods, 193% and 167% in men and 90% and 103% in women. In the 2003-2009 period, observed mortality for chronic lung diseases in men shows instead an excess of 37%. A large part of the study focuses on child health in IPS. The most worrying fact is that children are involuntarily exposed to contaminants. Given a certain level of environmental contamination, children have a higher exposure, rapidly growing organs are more susceptible to mutagens and the immune system is still immature. In Taranto, there is a 20% excess mortality in the first year of life compared to the rest of Puglia.
Mortality trends in Italy, Puglia and Taranto for the 1980-2008 period
In the attempt to provide a more complete picture of the mortality of population residing in IPS, an analysis was carried out on mortality levels observed in Puglia, Taranto and Italy over thirty years; the period in question in fact spans the years from 1980 to 2008.
According to the study, male mortality in Italy has been decreasing for several decades; in the thirty years under review the decrease was 44% in Italy and 45% in Puglia. Also in Taranto overall mortality among men is decreasing, but this decrease has been slowing down in the last six years. Since the late '80s Taranto's values are significantly higher than those of Puglia.
In Italy the overall cancer mortality has shown a significant decrease since the late 90's; both in Taranto and in Puglia, however, if the first period is compared to the last period, there was a slight increase: in Taranto cancer mortality was up from 387.4 per 100,000 to 397.0 and in Puglia it was up from 326.1 per 100,000 to 348.4. Deaths related to lung cancer are increasing among Italian women; the observed rate in Italy in the period under review increased by 59%; this phenomenon also occurred in Puglia and more markedly in the Taranto site (from 8.9 to 15.8 per 100,000, a 78% increase).
Mortality from cardiovascular diseases
Until the 90s, mortality rates in Taranto for diseases of the circulatory system were significantly lower compared to both Italian values and those of Puglia. Considering ischemic heart diseases, mortality in Taranto follows the same general decreasing trend observed in Italy and in Puglia. Mortality from ischemic heart disease among women shows an historically declining trend in Italy, which is observed both in Puglia and Taranto, the latter's levels, however, are consistently higher than those in Puglia and in Italy (in a significant manner as from the 1998 to 2000 period).
Mortality from respiratory diseases
Diseases of the respiratory system as a whole show a decreasing trend in mortality in the three geographical areas, with the values for Taranto and Puglia always significantly higher than the national average. Mortality from chronic respiratory diseases shows a decreasing trend across Italy.
Incidence of cancer in Taranto: 2006 -2007
In order to complete the epidemiological observation, data on cancer incidence, obtained from the the local Cancer Registry, were added to the mortality data. After testing, between 1999 and 2001, the Puglia Cancer Registry was established along with the "Jonico-Salentino" Cancer Registry. Following the Cancer Registry integration (AIRTUM), approximately 50% of the population living in IPS is now covered. In the Umbria region and in central Italy generally, this percentage is lower (26% Center, 41% North, 32% South). The use of cancer registry data provides many advantages compared to using mortality data only. It is indeed more likely that when the diagnosis is made, the person lives in the same place where he/she was exposed to the pollution. In addition the period of latency - i.e. the time elapsing between the beginning of the exposure and the occurrence of cancer -is also shortened, and this means that the risk measure is more up to date. The Registry findings for the years 2006-2007 for the Taranto IPS show a 30% excess for men, compared to the rest of the province, for all cancers. In men, mesothelioma and malignant tumors of the kidney and other urinary tract (excluding bladder) show a 100% excess. For women living in the municipalities of Taranto and Statte, again in comparison with the rest of the province, cancer incidence, for all cancers, shows an excess of about 20%.
In particular, the excess of liver tumors for women is 75%; +43% for non-Hodgkin's lymphoma; +80% for the upper part of the uterus; +48% for lung; + 24% for breast cancer; the incidence of stomach cancer in women is over 100%. For children, the data show significant increases in all causes in the first year of life.
Mortality of children in the pediatric age group
The situation for child mortality is also a cause of concern. In the Taranto IPS, neonatal death in the first year of life is 20% higher than the regional average, for all causes and more particularly for asthma and allergies. This excess becomes even more significant when considering pathologies that, while being of perinatal origin, occur after the first year of life: statistics even show a range between 30 and 50%. This data - which confirms the existing danger of exposure to pollutants in Taranto - depends on a greater vulnerability of children due to higher respiratory rates and a greater ratio of food consumption to body weight. These characteristics are typical of the early years of life and contribute to the inhalation and ingestion of contaminants.
Trends in children mortality -pediatric age group - from all causes - Italy, Puglia, Taranto IPS - (1980 -2008)
In short, Ilva makes no allowances for those who reside near the steel plant, subjecting the population to higher percentage concentrations of PAHs (polycyclic aromatic hydrocarbons), the substances emitted from coke ovens. While within a 15 km radius, dioxin is the main concern due to land contamination and the consequent risk of affecting the food chain. The updated environmental data on the Taranto IPS confirm the findings included in last ISPRA report on the quality of the urban environment, in which respect Taranto ranks in the average with the other Italian cities in terms of PM10 and PM2.5 concentrations, but high on the list of the most polluted cities in terms of presence of benzo (a) pyrene, which is classified as a carcinogen by IARC (International Agency for Research of Cancer).
The monitoring stations indicate that benzo (a) pyrene is out of control, especially in the Tamburi district. In 2012, the B (a) P concentration recorded in Via Machiavelli, in the neighborhood of the plant, was 1.8 nanograms/cubic meter. Which means it exceeded the 1 ng/m3 emission threshold established by law, and in some periods the B (a) P concentration reached a monthly average four times higher than authorized limits. For example, making a comparison with the measurements carried out in Rome, in an area of high car traffic, it turned out that in Tamburi the presence of benzo (a) pyrene is six times higher.
ARPA Puglia also identified the main emission sources responsible for the presence of benzo (a) pyrene:
- specific and areal sources
Ilva steel plant, ENI Refinery, ENIPOWER and EDISON power plants, CEMENTIR cement factory, APPIA ENERGY and AMIU Incinerators
- areal sources
urban areas, port
- linear sources
PAH emissions of the ILVA steelworks plants
ILVA is therefore the major emitter, in terms of areal and specific emissions, at that site, with a percentage that reaches 99.75% of PAHs emitted each year. It is also important to remember that given the proximity of the various plants within the polluted area, it is essential to provide details about the primary source of emission, differentiated by type of plant. Of the six production processes carried out at the steel mill, coke oven, blast furnace and sinter plant are the most involved in PAH and benzoapyrene emissions. These are precisely the processes located in the southern area of the plant, i.e. the nearest to the Tamburi district (75% of benzoapyrene is released by the coke ovens and 25% by the blast furnaces, with emissions of 424 and 140 kg/year).
The report is available at the following address:
Environment and Health in Taranto: available evidence and public health guidelines