[The epidemiological surveillance in the regional public health program of intervention in the National Priority Contaminated Sites of Sicily: an update of mortality and hospitalization].
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OBJECTIVES: to update the health profile of the residents in the national priority contaminated sites (SIN) in Sicily Region (Southern Italy), through a description of mortality and hospitalisation by causes, as implementation of the epidemiological surveillance included in the Programme of health intervention in these populations and in the new Regional Prevention Plan. DESIGN: ecological study which uses two levels of comparison for each SIN: a local level including the populations of SIN neighbouring areas and a regional level including people residing in Sicily. SETTING AND PARTICIPANTS: the population in the study is residents in the municipalities included in the following SIN: Augusta-Priolo (presence of industrial areas); Gela (presence of industrial areas); Milazzo (presence of industrial areas); Biancavilla (presence of natural asbestos-like material). MAIN OUTCOME MEASURES: using the information from the mortality registry for the mortality index, the hospital discharge data for the morbidity index, the standardised mortality ratio (SMR), and the standardised hospitalisation ratio (SHR) with the corresponding 95% confidence intervals were calculated. RESULTS: in the local comparison, an excess of hospitalisation in both sexes is reported in Augusta-Priolo for liver cirrhosis, mental disorders, and digestive tract disease, and an excess of mortality for leukaemia in women and prostate cancer in men. In the SIN of Gela, there is an excess of hospitalisation in both sexes for blood and haematopoietic diseases, circulatory and nervous system diseases, sustained by the same excess of mortality. There are also excesses of hospitalisation and mortality of stomach tumours in men and hospitalisation of lung cancer in women. The area of Milazzo is characterised by an excess of hospitalisation and mortality for melanoma in men. In the municipality of Biancavilla, there is evidence of an excess of hospitalisation for respiratory diseases and endocrine glands diseases in both sexes, while a mortality excess for circulatory system diseases. CONCLUSIONS: the data derived from the new surveillance system help to define the health profile in the SINs of Sicily. Even by using the local level of comparison that was added to the traditional approach in geographic studies in the national priority contaminated sites for the reclamation available until today, the particular impact of some chronic diseases in these populations has also been confirmed in recent years.