Italy is not just a country under water, plagued by rain and swept by the floods. Italy is also a country poisoned by the impetuous industrial development that has taken place since the end of World War II until today. The economic miracle brought wealth but also pollution and diseases, primarily in populations living in large industrial centers - from Porto Marghera to Gela, from Taranto to Porto Torres just to name the most famous ones. On Tuesday the results of the study Sentieri, (paths) were in fact released; the study was coordinated by the Italian National Health Institute and published in the Epidemiology & Prevention magazine.

THE RESEARCH - The research, funded by the Ministry of Health, portrays the health status of 44 sites scattered throughout the country where environmental conditions are a cause of disease and death among the population with an higher than the average occurrence, especially in the South. This "Italy that needs to be saved" is made up of 44 of the 57 areas which, by means of several decrees in the past decades, various governments have identified as sites to be reclaimed, see map. By examining the mortality statistics of these areas (for a total of 298 towns with 5.5 million inhabitants) during the period 1995-2002, the ISS study found an excess mortality compared to regional averages: 10 thousand excess deaths in eight years compared to the expected number when all death causes are taken into account. This figure drops to 3,508 deaths if we consider only those diseases that can more clearly be attributable to the fact of living near steel and petrochemical plants, refineries, incinerators, landfills, ports, mines and asbestos quarries. In other words, there is a not insignificant part of Italy, representing one tenth of the population, that is definitely worse off than the rest of the population.

THE VICTIMS - The most obvious case is represented by 416 excess deaths from cancer of the pleura in asbestos-contaminated sites, due to the presence of asbestos quarries or processing factories (such as Balangero, Casale Monferrato and Fibronit in Bari) . Health conditions are also taking a heavy toll close to major petrochemical and steel plants, such as the refineries of Porto Torres and Gela, the Taranto steelworks, the mines of Sulcis-Iglesiente and the chemical factories of Porto Marghera, where mortality from lung cancer and non cancer respiratory diseases is increasing. Or the additional deaths due to kidney failure and other diseases of urinary system caused by heavy metals emissions, hydrocarbons and halogenated compounds of the plants in Piombino, Massa Carrara, Orbetello and the lower valley of the Chienti river. A slight increase in the number of deaths linked to birth defects has also been attributed to pollution by heavy metals and other substances in Massa Carrara, Falconara, Milazzo, and Porto Torres. "It should be noted that, in the case of Massa Carrara, where the most polluting industries were closed in the 80s, but the reclamation has not yet been made, excess mortality due to environmental causes records the highest levels: over 170 excess deaths each year (13 % more than expected deaths)," said another study author, Fabrizio Bianchi, from the CNR of Pisa. Finally, the long history of the Caffaro plant in Brescia, with the PCB contamination of the surrounding land in the middle of the city, has left its mark on mortality data with an increased number of non-Hodgkin's lymphomas.

IT IS NOT ONLY WORKERS WHO DIE - "The study portrays the health status of a significant part of the country caused by the industrial pollution of the 50s and 70s. A toll paid by the local population to the country's industrialization, which has left a heavy mark in the contamination of soils and groundwater, rivers and stretches of sea in front of the most critical areas," says the coordinator Peter Comba, from the National Health Institute."The next steps include an analysis of diseases and hospitalizations in these areas in order to verify if an increased mortality also corresponds - as one might expect - to a higher burden of environmental diseases, and to what extent this situation still exists today."How do we know however whether these deaths especially affect the workers who worked in the industries involved in the study or not? "The fact that for almost all diseases considered, mortality affected both men and women and all age groups, gives us the answer. Therefore the entire population was more or less affected by widespread contamination " says the author of Sentieri Roberta Pirastu of the University of Rome. "A population that already suffers from below average socio-economic conditions, must also come to terms with a higher concentration of polluting activities," adds Francesco Forastiere, from the Department of Epidemiology of the Lazio Region. "They pay with their own deaths and diseases, while the reclamation, in great delay, is paid by the whole community and almost never by the individuals who caused these situations".