OBJECTIVES: to evaluate the health status of the residents in the Manfredonia municipality (Apulia Region, Southern Italy) in the period 1970-2013. DESIGN: ecological study on general and cause-specific mortality by gender, age-class, calendar period, and birth cohort. SETTINGS AND PARTICIPANTS: demographic and mortality data came from the Italian National Institute of Statistics (Istat); 55 causes of death were analysed. All analyses were specific for gender and calendar period. OUTCOMES: Direct standardized mortality rates (TSD) (European standard population), indirect standardized mortality ratios (SMR%) (regional and provincial reference rates for each calendar period considered), with 90% confidence intervals (90%CI). RESULTS: health status (general mortality) of the residents in Manfredonia improved. Between the periods 1970-1974 and 2012-2013, direct age-standardized rates x10,000 decreased from 92 to 52 among men, and from 70 to 39 among women. However, from 1970 (first year for which data are available) Manfredonia progressively lost its advantage over the regional average (men: from -20% to -10%; women: from -20% to +1.5%). This loss of advantage is most evident for cardiovascular diseases. No differences from the reference populations (regional and provincial) emerged for malignant tumours. In the last period analysed (2006-2011), mortality for myocardial infarction Regiwas higher than the regional average (men: +35%; women: +54%). SMR% for lung cancer showed and increasing trend among men, in particular with regard to the provincial reference. In the period 2006- 2011 we observed 22 death per year vs. 19 expected (SMR%: 117.2; 90%CI: 101.1-135.2). Among women, SMRs% were above the provincial reference on the last calendar periods (2012-2013: 7 deaths/ year vs. 4.2 expected; SMR%: 116.4; 90%CI 97.0-260.7). CONCLUSIONS: mortality among the residents in Manfredonia showed a smaller improvement than the regional and provincial reference populations. The advantage observed in the Sixties was gradually lost in recent years. This trend was evident since the late Seventies. Since 2000, mortality for myocardial infarction was above the regional and provincial references. The literature documents an increased cardiovascular mortality at short-medium latency period in populations suffering from both natural and man-made catastrophes. Mortality for lung cancer showed an increase with respect to the reference populations (vs. the province standard, in particular) since the year 2000, which is consistent with the latency period from the exposure to arsenic in the Seventies.
OBIETTIVI: valutare lo stato di salute della popolazione residente nel comune di Manfredonia dal 1970 al 2013. DISEGNO: analisi descrittiva dell'andamento temporale della mortalita generale, per gruppi di cause, dal 1970 al 2013. SETTING E PARTECIPANTI: i dati di mortalita e le popolazioni residenti sono di fonte Istat. Sono state esaminate 55 cause di decesso. Le analisi sono disaggregate per sesso e periodo. PRINCIPALI MISURE DI OUTCOME: sono stati elaborati i rapporti standardizzati di mortalita (SMR%), con i rispettivi intervalli di confidenza al 90% (IC90%), e i tassi di mortalita standardizzati col metodo diretto (TSD ). RISULTATI: lo stato di salute misurato dal tasso di mortalita per tutte le cause migliora nel tempo: i TSD passano da 92 x10.000 negli anni 1970-1974 a 52 x10.000 nel biennio 2012-2013 negli uomini, da 70 x10.000 a 39 x10.000 nelle donne. Tuttavia, rispetto alla media regionale Manfredonia perde progressivamente il suo vantaggio, passando da -20% a -10% negli uomini, e da -20% a +1,5% nelle donne. Questo andamento e molto evidente per il complesso delle cause cardiovascolari, mentre i tumori maligni sono in generale nella media regionale. Nell'ultimo periodo disponibile per causa di decesso (2006-2011), la mortalita per infarto miocardico e stata pio alta della media regionale (uomini: +35%; donne: +54%). I rapporti standardizzati di mortalita (SMR) mostrano tra gli uomini valori in crescita, in particolar modo rispetto al riferimento provinciale, con un eccesso a cominciare dal periodo 2006-2011 (22 decessi/anno e 19 attesi; SMR%: 117,2; IC90% 101,1-135,2; riferimento: provincia di Foggia). Anche tra le donne gli SMR% superano i riferimenti provinciali negli ultimi periodi esaminati (nel 2012-2013: 7 decessi/ anno e 4,2 attesi; SMR%: 116,4; IC90% 97,0-260,7; riferimento: provincia di Foggia). CONCLUSIONI: la mortalita a Manfredonia e diminuita in misura minore rispetto a quella osservata nei riferimenti provinciali e regionali. Il vantaggio che si osservava negli anni Sessanta si e, infatti, ridotto nel tempo, fino ad annullarsi negli ultimi anni. Dal 1970, Manfredonia ha progressivamente perso il vantaggio che aveva. Dagli anni Duemila, la mortalita per infarto del miocardio e in eccesso sulla media regionale e provinciale. Da casi documentati in letteratura si osserva che le popolazioni che sperimentano catastrofi di origine naturale o antropica possono fronteggiare un aumento di patologie cardiovascolari. La mortalita per tumore polmonare mostra un eccesso sulla media regionale, in particolare provinciale, a cominciare dal 2000, coerentemente con i tempi di latenza legati all'esposizione ad arsenico negli anni Settanta.
Studio ecologico sulla mortalita dei residenti a Manfredonia dal 1970 al 2013.
Gianicolo Emilio Antonio Luca;Mangia Cristina;Cervino Marco;Bruni Antonella;
2016
Abstract
OBJECTIVES: to evaluate the health status of the residents in the Manfredonia municipality (Apulia Region, Southern Italy) in the period 1970-2013. DESIGN: ecological study on general and cause-specific mortality by gender, age-class, calendar period, and birth cohort. SETTINGS AND PARTICIPANTS: demographic and mortality data came from the Italian National Institute of Statistics (Istat); 55 causes of death were analysed. All analyses were specific for gender and calendar period. OUTCOMES: Direct standardized mortality rates (TSD) (European standard population), indirect standardized mortality ratios (SMR%) (regional and provincial reference rates for each calendar period considered), with 90% confidence intervals (90%CI). RESULTS: health status (general mortality) of the residents in Manfredonia improved. Between the periods 1970-1974 and 2012-2013, direct age-standardized rates x10,000 decreased from 92 to 52 among men, and from 70 to 39 among women. However, from 1970 (first year for which data are available) Manfredonia progressively lost its advantage over the regional average (men: from -20% to -10%; women: from -20% to +1.5%). This loss of advantage is most evident for cardiovascular diseases. No differences from the reference populations (regional and provincial) emerged for malignant tumours. In the last period analysed (2006-2011), mortality for myocardial infarction Regiwas higher than the regional average (men: +35%; women: +54%). SMR% for lung cancer showed and increasing trend among men, in particular with regard to the provincial reference. In the period 2006- 2011 we observed 22 death per year vs. 19 expected (SMR%: 117.2; 90%CI: 101.1-135.2). Among women, SMRs% were above the provincial reference on the last calendar periods (2012-2013: 7 deaths/ year vs. 4.2 expected; SMR%: 116.4; 90%CI 97.0-260.7). CONCLUSIONS: mortality among the residents in Manfredonia showed a smaller improvement than the regional and provincial reference populations. The advantage observed in the Sixties was gradually lost in recent years. This trend was evident since the late Seventies. Since 2000, mortality for myocardial infarction was above the regional and provincial references. The literature documents an increased cardiovascular mortality at short-medium latency period in populations suffering from both natural and man-made catastrophes. Mortality for lung cancer showed an increase with respect to the reference populations (vs. the province standard, in particular) since the year 2000, which is consistent with the latency period from the exposure to arsenic in the Seventies.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.