BackgroundThe aims of this study were to estimate the existence of clusters of AROs in the municipalities of the Marches Region (Central Italy) after complaints from residents living near an abandoned landfill site.MethodsCases of AROs (i.e., congenital malformation, chromosomal abnormalities, and low birth weight) were retrieved from hospital discharge data. SaTScan and GeoDa were used to check for the presence of clusters at a regional and a small area level. Moreover, at a small area/neighborhood level, smoothed rates were calculated, and a case–control approach was used to assess the residence in proximity to the abandoned landfill as an independent risk factor for AROs.ResultsAROs were associated with the price per square meter of the accommodations in the area of residence (OR 2.53, 95 % CI 2.06-3.10). On the other hand, residence within one kilometer of the landfill (OR 0.04, 95 % CI 0.01-0.23) and maternal age greater than 35 years (OR 0.96, 95 % CI 0.92-0.99) were protective.ConclusionsResidency in proximity to the abandoned landfill was not a risk factor for the occurrence of AROs. The results show that basic information, such as the price of accommodations in different neighborhoods, could be of interest in order to target training programs for women living in difficult conditions and highlights the potential role of the building environment in perinatal health. However, we note that aside from the data provided by Geographic Information Systems in public health, collection of the patient’s residential address was unreliable for selected conditions. Future efforts should emphasize the patient’s residential address as information important for evaluating the health of individuals instead of being merely administrative data.
Neural tube defects (NTDs) have a complex and imperfectly understood etiology, in which both genetic and environmental factors might be involved. The aim of the study was to describe an excess of cases of NTDs in a small area in central Italy. Over a 2-wk period in autumn 2002, three diagnoses of anencephaly were made in a 2773-km(2) area. As a consequence of these events, information on known risk factors as well as data on environmental changes, or epidemics of infectious diseases, in 2002-2004, were collected. The NTD rate was estimated for 10,000 births (live and stillborn) in this area. The 95% confidence intervals of rates were estimated assuming Poisson distribution of cases. Six cases of NTD were observed, with an NTD prevalence rate of 18.5 per 10,000 births (95% CI 17.0, 20.12). No evidence of known risk factors was reported. During summer 2002, the local service for environmental surveillance observed that the threshold level of drinking-water bacterial contamination had been exceeded, which probably resulted in an adjustment in the amount of chlorine added. The major difficulty in making hypotheses regarding the causes of birth defects is linking environmental risk factors exposure to fetal outcome. The prompt gathering of data may be essential. Thus, we emphasize the need for the activation of a population-based congenital malformation registry in order to achieve a deeper understanding of these events etiology.
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