Mortality trend In Apulia Provinces, Italy, 1949-2008

Background Since the late 60s, in Apulia, in South-East of Italy, huge (in size and harmfulness) industrial sites have settled in close proximity to some cities. InLecce province, less heavily industrialized, male lung cancer mortality is a serious problem Aims To estimate mortality trends by total and specific causes covering the time frame 1949-2008, to evaluate the possible loss in health advantage of Southern Italy residents . Methods. Data come from historical publications of National Institute of Statistics: total number of deaths, by province, by specific causes but not by sex; national data instead disaggregated by sex, age and cause since 1927. Causes chosen after a careful evaluation of theICD codes ranging from ICD-5 up to ICD-10. SMR% (Standardized Mortality Ratio) have been computed. At the moment only mortality by all causes, respiratory cancers and pneumonia have been investigated since 1949. Results General mortality is on average lower than national levels, except in Taranto. In Lecce respiratory cancer mortalityshows higher values (+ 3 up to +6% ) since early seventies and Relative- SMR% (ratio to SMR by all causes) is growing with time (from +5% up to +10%) , while in Taranto it declines rapidly. Pneumonia mortality is clearly declining with time. The ratio with Apulia SMR% shows in Taranto high mortality (since 1981 for total and pneumonia mortality, since 1961 for respiratory cancer), in Lecce higher respiratory cancer mortality since 1971, while Bari shows higher mortality by pneumonia in all period. Conclusions As already known mortality in Apulia province is still lower than the national levels, but inside the region Taranto province shows higher mortality for the causes investigated. Bari emerges for high values of pneumonia deaths, while high respiratory cancers mortality is confirmed in Lecce since 40 years, and this corroborate the hypothesis of a local risk factor, as e.g. tobacco cultivation and manufactures