Studio di mortalita intorno a sei discariche di rifiuti in Toscana.

OBJECTIVE: Describing mortality of populations residing in the neighbourhoods of selected waste landfill sites and contributing to the definition of their health status. DESIGN: Descriptive study of mortality at municipality and aggregated municipalities level. SETTING AND METHODS: Mortality from 1995 to 2000 in six areas of five provinces of Tuscany Region where municipal and/or hazardous waste landfills are located. Areas considered at higher exposure were those including municipalities where inhabitants mainly reside within 5 km from selected landfills. Comparison was made with rates observed in the five provinces in the same period. Statistical comparisons were perfomed using standardised mortality ratios (SMR) and bayesian mortality ratios (BMR) adjusted for age. MAIN OUTCOMES: Mortality for all causes, groups and specific causes of cancer and non-cancer diseases. RESULTS: Statistically significant mortality excesses were found for circulatory system and cerebrovascular diseases, for lymphohematopoietic system, liver and bladder cancer and non-Hodgkins lymphoma. CONCLUSION: Methods utilized have produced preliminary indications on associations between residence in areas with landfills and mortality. These excesses, also due to the limitations of macrogeographic studies, indicate that further insights at microgeographic level are needed.