Introduction: Brindisi is a town on the South coast of the Adriatic sea, where many sources of airpollutants are located nearby the urban area. A part from the airport and the harbour, mainly for passenger traffic to Greece, a wide industrial area is present (petrochemical, power plants, chemical pharmaceutical, metallurgical, manufacturing). In seven municipalities, illegal dumps have been found. South west of Brindisi is the province of Taranto, whose industrial area includes steels factory a refinery and a cement factory. In both provinces, an area at "high risk of environmental crisis, has been identified by the Italian Ministry of Environment. In the Brindisi area, mortality from all causes, cancers and respiratory diseases. in 1990-1994 was found to be in excess.
Objectives: to estimate mortality among residents in the twenty municipalities of the province aggregated in four geographic areas: the one at "high risk" including the main town, and the areas located North. West and South of the Brindisi "high risk" area.
Design: descriptive geographical study.
Setting: mortality analysis by gender, specific causes of death and two ten-year periods between 1981 and 2001. Standardised mortality ratios (Puglia region as referent population) and directly as well as age-standardized rates (ref. European population) have been computed.
Main outcome measures: mortality from all causes and from forty selected causes.
Results: about 3,200 annual deaths have occurred in the province. Results for the high risk area confirm previous analyses while excesses in the other areas have appeared. A few municipalities, requiring a deeper investigation have been identified. Such excesses refer to mortality due to all causes, all cancers, stomach and lung cancers, respiratory and ischemic diseases.
Conclusions: this study confirms excesses in the high risk areas and found mortality excesses in other municipality both among males and females. The results suggest to further investigate mortality both in the main town and in the small municipalities where illegal dump have been found and also in those located on the border with Taranto province.