A second mortality analysis of 15 areas of Italy identified in 1986 by the Italian Ministry of Environment as areas at high risk of environmental crisis has confirmed and extended the findings of the first. In regional comparisons, these areas, in which potentially hazardous industries are located, show excesses of deaths from almost all cancers and other diseases, particularly among men. Although more information is needed to identify corrective public health measures, the official recognition of areas in need of cleaning up, which appears to be unique to Italy and which fostered the study, is a promising beginning.