Objective: to describe the mortality profile of the population resident in the polluted area of national concern (SIN) "Laguna di Grado e Marano" Friuli-Venezia-Giulia region, in the period 1997-2001 and to examine mortality temporal trends between 1981 and 2001.
Design: a small-area epidemiological study based on descriptive statistics, socioeconomic deprivation variables, analysis of spatial heterogeneity disease mapping and time trend analysis was carried out.
Main outcome measures: age-standardised rate, standardised mortality ratios (SMRs), SMRs adjusted by socioeconomic deprivation, spatial heterogeneity test results, empirical and hierarchical Bayesian estimators, and temporal trends of selected causes are shown.
Results: compared to regional averages, SMRs in the SIN were significantly higher for lung (25.3%) and stomach (54.1%) cancer in men and for ovarian cancer (82.6%) in women. SMRs were instead significantly lower for all causes of death (8.7%), respiratory (26.6%) and cardiovascular (13.7%) diseases, liver (51.3%) and pancreas (46.9%) cancer in men and for cardiovascular diseases (22.1%) in women. These results did not change after adjustment by socioeconomic status. Spatial distribution of risks was homogeneous among municipalities and no groups of high risk municipalities were identified. A significant increasing temporal trend was observed for ovarian cancer.
Conclusion: following these results, we suggest to carry out a cohort incidence and mortality study to verify the potential role of occupational exposures on cancer mortality in men. We also recommend an in depth analysis in women to clarify the role of potential iron replacement by pollutants, such as cadmium and lead that are present in the area.