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Int. J. Environ. Res. Public Health 2017, 14(3), 292;

Congenital Anomalies in Contaminated Sites: A Multisite Study in Italy

Institute of Clinical Physiology, National Research Council, Unit of Environmental Epidemiology and Disease Registries, 56124 Pisa, Italy
Registro IMER, Dipartimento di Scienze Biomediche e Chirurgico Specialistiche dell’Università di Ferrara, 44100 Ferrara, Italy
Agenzia Regionale Sanitaria della Puglia, 70100 Bari, Italy
National Center for Rare Diseases, Istituto Superiore di Sanità, 00161 Rome, Italy
Unit of Statistics, Istituto Superiore di Sanità, 00161 Rome, Italy
Osservatorio Epidemiologico Regionale, Assessorato Salute Regione Siciliana, 90145 Palermo, Italy
Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy
Epidemiological Unit, NHS Mantua, 46100 Mantua, Italy
Program Director Birth Defects Registry of Campania, UO Genetica Medica, Azienda Ospedaliera G.Rummo, 82100 Benevento, Italy
Author to whom correspondence should be addressed.
Academic Editor: Helena Solo-Gabriele
Received: 13 January 2017 / Accepted: 8 March 2017 / Published: 10 March 2017
(This article belongs to the Section Environmental Health)
Full-Text   |   PDF [304 KB, uploaded 13 March 2017]


The health impact on populations residing in industrially contaminated sites (CSs) is recognized as a public health concern especially in relation to more vulnerable population subgroups. The aim of this study was to estimate the risk of congenital anomalies (CAs) in Italian CSs. Thirteen CSs covered by regional CA registries were investigated in an ecological study. The observed/expected ratios (O/E) with 90% confidence intervals (CI) for the total and specific subgroups of CAs were calculated using the regional areas as references. For the CSs with waste landfills, petrochemicals, and refineries, pooled estimates were calculated. The total number of observed cases of CAs was 7085 out of 288,184 births (prevalence 245.8 per 10,000). For some CSs, excesses for several CA subgroups were observed, in particular for genital and heart defects. The excess of genital CAs observed in Gela (O/E 2.36; 90% CI 1.73–3.15) is consistent with findings from other studies. For CSs including petrochemical and landfills, the pooled risk estimates were 1.10 (90% CI 1.01–1.19) and 1.07 (90% CI 1.02–1.13), respectively. The results are useful in identifying priority areas for analytical investigations and in supporting the promotion of policies for the primary prevention of CAs. The use of short-latency effect indicators is recommended for the health surveillance of the populations residing in CSs. View Full-Text
Keywords: contaminated sites; congenital anomalies; epidemiological surveillance contaminated sites; congenital anomalies; epidemiological surveillance
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Santoro, M.; Minichilli, F.; Pierini, A.; Astolfi, G.; Bisceglia, L.; Carbone, P.; Conti, S.; Dardanoni, G.; Iavarone, I.; Ricci, P.; Scarano, G.; Bianchi, F.; Group, R.W. Congenital Anomalies in Contaminated Sites: A Multisite Study in Italy. Int. J. Environ. Res. Public Health 2017, 14, 292.

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