Aprilia – Epidemiological study, what’s the health status of the population
A conference on the epidemiological study sponsored by the municipal administration in collaboration with the Department of Epidemiology of the Lazio Regional Health Service was held this afternoon at the Council Chamber of the City of Aprilia.
The conference was attended by the general director of the Latina Asl, Dr. Michele Caporossi. Representing the city administration were Mayor Antonio Terra and Councillor with responsibility for health care Eva Torselli. This was then followed by technical reports by Dr. Fabio Pannozzo (“The Planning of the Epidemiological Study.
Preliminary data on the incidence of cancer in the City of Aprilia”), Dr. Carla Ancona of DEP Lazio (“The population cohort study in the Aprilia area,” Drs. Susanna Busco and Antonio Carraturo of the UOC Epidemiology (“Population and health status, the other diseases under investigation”), by Dr. Roberto Lupelli (“Environmental and occupational risks, mapping the area”), Dr. Silvia Iacovacci (“The PASSI study on behavioral risks”), Drs. Aldo Pastore and Paola Fioravanti (“Mental distress and frailty, hypotheses under study”), Drs. Marilena Rocchi and Angelo Fracassi (“The Arsenic subproject”). The meeting was also attended by Dr. Francesco Forastiere, Director of the UOC Etiological and Occupational Epidemiology of the Department of Epidemiology of the Regional Health Service.
SUMMARY OF THE STUDY AS OF OCTOBER 2015
When studying how the environment can adversely affect human health, it is usually very difficult to identify clear cause-and-effect relationships, because it must always be kept in mind that most chronic diseases have a multiple etiology.
Genetics, diet, lifestyle, occupation, and socioeconomic status can play an important role in both exposure and disease development.
It is well known that in the territory of Aprilia have insisted and still are present chemical, pharmaceutical, mechanical industries, those of waste treatment and an intensive agriculture with extensive use of pesticides is practiced. About one-third of the territory is still not supplied by municipal waterworks, and higher-than-permitted arsenic levels have been detected in private wells in the past.
WHAT WE KNOW TO DATE
Epidemiological assessment of the health status of the population residing in the Municipality of Aprilia
Analysis of the status of residents in the City of Aprilia during 2001-2011 (carried out using data from the Regional Mortality Registry, the Hospital Information System, and the province’s Cancer Registry) showed that the population residing in the City of Aprilia has a mortality picture in excess of that of the region for both males (SMR1=1.04) than for females (SMR=1.08). For men, higher than expected mortality is observed for all cancers (SMR=1.12), especially for cancers of trachea, bronchus, and lung (SMR=1.21) and bladder tumors (SMR=1.48), while among women mortality by cancer site does not show situations different from the regional average except for stomach cancer (SMR=1.39). Incidence data show an excess, compared with the provincial figure, in men for lung (SIR2:1.18) and for stomach cancer (SIR=1.30).
For women, the incidence of thyroid cancer in the period under consideration (2000-2011) is higher than both the province and the rest of the national areas covered by Cancer Registries. Overall, the analysis of hospitalizations showed a hospitalization rate overlapping with that of Lazio for men and higher than expected for women.
With regard to cerebrovascular diseases in both sexes, higher mortality than expected was observed.
The data emerging from the assessment of chronic diseases (diabetes and COPD) are related to the change in the population structure of Aprilia, which over the years has seen an increase in the proportion of people over 65 years old; in fact, these diseases increase proportionally with increasing age. Data, referring to 2012 provided by the Lazio Region and currently being updated show that 22% of women and 27% of men over 65 have diabetes, while 22% of men and 18% of women over 65 have chronic broncho-pneumopathy. Because the complications of these diseases are severely disabling, it will be important to evaluate the care of these patients through some indicators for monitoring the care pathways.
Behavioral and lifestyle factors
Data from the PASSI Population Surveillance show that, in the period 2008-2014, smokers among the adult population (18-69 years) in the City of Aprilia are 32%, those who consume alcohol at risk3 are 11%, while 44% of the population is overweight/obese and sedentary people are 32%. In addition, 38 percent report having been diagnosed with hypercholesterolemia and 23 percent are hypertensive; factors that lead to increased cardiovascular risk.
WHAT WE WOULD LIKE TO EXPLORE. NEXT GOALS
The hypothesis underlying the study that we are going to undertake is that the excesses of mortality and incidence for some diseases detected at the level of the entire municipal territory compared to the rest of the province of Latina and the Lazio Region, may present an unequal distribution both in the municipal subareas already hypothesized (center, suburbs, suburbs), and with respect to the indices of social deprivation measured by Istat (2001 and 2011 census).
The study will be conducted in collaboration with the Department of Epidemiology of the Lazio Regional Health Service, applying the residential cohort approach that allows the evaluation of the
1 SMR: Standardized Mortality Ratio
2 SIR: Standardized Incidence Report
3 Habitual high consumption and/or binge drinker and/or binge drinker
long-term effects of environmental exposure and estimation of the exact time each subject was at risk of developing the event under study (person-time).
As indicated in the National Prevention Plan 2014-2018, in point 2.8, it is only through the intersection of environmental (spatial and urban), epidemiological, demographic, cultural, and social data that a range of possible scenarios can be drawn for a given population.
In order to describe the health status of a fairly large population, as in the case of Aprilia, we correctly started by defining a series of matrices and variables to be investigated, such as demographic aspects, territorial layout, psychic and social discomforts, and above all by involving from the project making all the actors involved in the demand and supply of health and related services. Specifically regarding lifestyles, a survey is planned with oversampling of up to 700 Aprilia residents. From a sample of about 80 residents for at least six months, arsenic intake from food will be assessed, in collaboration with the National Institute of Health.
Today’s conference is a call to develop the necessary synergies from institutions, citizens, professionals and opinion leaders, to learn together about the area, its limitations and its potential, in order to change for the better the environment, the lifestyle and thus the health status of the citizens of Aprilia.
“We are satisfied,” commented the Mayor of Aprilia Antonio Terra, “that we have started this important work, which at present is well underway, taking into account that all those involved are collaborating in order to channel the data necessary for the success of the project, which today awaits data from the Province and Arpa Lazio.”.