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Ann Ig 2016; 28: 208-217 doi:10.7416/ai.2016.2099 Incidence of oncological pathologies 2002-2010 in the southwestern Piedmont area, province of Vercelli, neighbouring municipalities of former nuclear sites C. Salerno*, P. Marciani**, K. Vanhaecht***, L.A. Palin*, M. Panella* Key words: Nuclear power plants; cancer; province of Vercelli; oncological incidence Parole chiave : Centrali nucleari, neoplasie, provincia di Vercelli, incidenza oncologica Abstract The Vercelli Province counts two former nuclear installations: a radioactive waste disposal area in Salug- gia and a former nuclear power plant in Trino. This study takes also into account four other neighbouring municipalities, counting 20,000 total inhabitants. We studied the incidence of neoplastic pathologies in the 2002-2010 period. The data sources were Hospital Discharge Form (SDO), histological reports from the Registry of Hospital Charts (RHC) and Italy’s National Statistics Institute (ISTAT) reports, and the Cancer Register of Turin. The research highlights the excesses for all type of cancers (SIR=1,11; IC 1,04-1,18), including the ones of nervous system (SIR=2,23 IC 1,47-2,98), leukaemia (SIR=1,94 IC 1,35-2,52), and bones (SIR=12,0 IC 9,22-14,7), according to different aggregation levels by age, sex and housing area. Considering such results, previous studies, and the environmental and occupational risk factors in the area, we believe that further epidemiological and environmental studies should be conducted in this area. Introduction morphological and functional alterations. In most cases, the damage is repaired by Ionizing radiations produce different the regular biological defence mechanisms, pathogenic effects in relation to dose, in other cases, the interested cells may be exposure time, exposure area and type of totally compromised, so they die or transform radiation. The interaction of radiations with themselves. In the latter case, exposure may biological tissues may cause phenomena turn into healthcare consequences that can that induce possible cell damage with become clinically relevant (1-9). * Department of Translational Medicine, University of Eastern Piedmont “Amedeo Avogadro, Novara, Italy ** Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy *** Health Services Research Group, School of Public Health Center for Health Services and Nursing Research, Faculty of Medicine, Leuven, Belgium All individuals designated as Authors are qualified for authorship: all of them meet the three required conditions. The present Research Project was not sponsored by any grant/financial support. The Authors declare that they have no conflict of interest. Submitted manuscript is a Qualitative Research. Incidence of oncological pathologies in municipalities neighbouring former nuclear sites 209 Knowledge of the health effects (National Agency for Atomic Energy) in exposed people first derived from Research Centre. epidemiological studies carried on survivors The Avogadro Depot is a depot for of the atomic explosions in Hiroshima elements of irradiated nuclear fuel, placed and Nagasaki (10, 7), on soldiers and the in the pool of the Avogadro RS1 research population exposed to radiations of the reactor that terminated its activities in nuclear tests in the 1950s-1960s, on the 1971. At present, it contains elements of populations exposed after accidents at irradiated nuclear fuel. Until 2004, the Sorin nuclear plants - in particular at Chernobyl installation produced radio-medications. (1, 5, 9, 11) - on the population living close The site includes a depot area for solid to nuclear power plants (Sellafield) and radioactive, category I and II wastes derived radioactive wastes disposal sites, on exposed from both manufacturing activities and workers - mines, nuclear industry (4, 5, previous collections. The depot contains 11, 12) - and the recent data on soldiers also two hot cells that have been used in the exposed to depleted uranium (13). The past to manipulate high-activity sources. In immediate or short-term effects manifest 2009, Sorin Biomedica, according to the themselves after exposure to very high prescriptions of the Ministry of Industry, threshold such as, after a nuclear explosion Commerce, and Artisanship, concluded the or the Chernobyl or Fukushima accidents, adjustments of the depot and began moving on the power plant operators and the people the radioactive wastes into it. who gave first-aid assistance; these effects EUREX - SO.G.I.N. is an installation induce, immediately or in a very short time, for re-processing elements of U-235 high- anatomical lesions and loss of functionality enrichment irradiated fuel, M.T.R. (Material of organs and tissues (8). Testing Reactor) typology. The installation The stochastic effects might show up is not active anymore, during its life it years after irradiation, sometimes decades or produced a great amount of both solid and more, they are probabilistic in nature, and do liquid nuclear wastes, now stored inside not exhibit require a threshold value (8). the area. In June 2004, a partial leakage The Province of Vercelli, and specifically from the storage pool took place. After this its southwestern area on the border with accident, ARPA Piemonte (Regional Agency the Provinces of Alessandria and Turin, for Environmental Protection) immediately hosts two former nuclear sites. The first started an extraordinary radiological one is located in the area of the Saluggia monitoring activity that, in July 2006, municipality and it is active as temporary highlighted a Sr-90 contamination on the storage site for radioactive wastes, the superficial water layer. This situation forced second one is a former nuclear power plant the immediate draining of the pool. Therefore, operating until 1987, in the area of the in May-July 2007, all the irradiated fuel municipality of Trino. stored in the pool nearby Avogadro Depot The Saluggia area is bordered by the was moved. In a second time, a drainage of Farini Canal at East, the Cavour Canal the EUREX pool was performed. at South, Dora Baltea river at West, and The second site is the former “E. Fermi” private properties at North. It can be electronuclear power plant located in divided into two separate areas: the Sorin Trino municipality (13-16), the first Italian installation plus the Avogadro Depot, and industrial activity in the nuclear field. On the EUREX - SO.G.I.N. (Enriched Uranium 21 June 1964, the reactor reached the first Extraction - Company for the Nuclear Plant critical phase and, operating with a 270 Management) installation, inside the ENEA MW power, produced electricity for sale, 210 C. Salerno et al. starting 22 October 1964. The reactor and the previous studies performed in the was stopped in 1967 because of technical area (14-16), we opted for an epidemiological problems concerning the radial shield of study taking into account the two above- the core and it was restarted in 1970, after mentioned municipalities and the nearby repair. A second stop was forced in 1979, to ones belonging to the Vercelli Province and perform the adjustments required after the included in different Local Health Agencies Three Mile Island (USA) accident. These (ASLs): Lamporo, Crescentino, Fontanetto operations caused inactivity until 1982. Po and Palazzolo Vercellese (Figure 1) for After the restart, the Trino reactor operated a total of about 20,000 inhabitants. until 1987. In 1987, after the last stop for This study has to be considered mainly re-fuelling, the Trino power plant was not descriptive; data involved were taken from restarted due to Governmental decision after the Registry of Hospital Charts (RHC) from the changes in the energy policies following 2002 up to 2010, individuals with a record the 1987 referendum. In July 1990, the of multiple hospitalizations were excluded Government ordered its permanent closure, to avoid prevalence (17). The integration assigning to ENEL (National Agency for of the RHC flow with the relative intra- Electrical Power) the decommissioning and extra-regional passive mobility and plan. anatomopathological reports of the main Our study was aimed at verifying the hospitals specialized in cancer diagnosis and oncological incidence in the population treatment, allowed us to calculate incidence resident in the area of the two nuclear sites rates for a large number of oncological or close by. pathologies concerning the inhabitants of the municipalities under investigation. About 70% of cases show a double confirmation of the Materials and methods diagnosis, as the diagnosis specified by RCH was confirmed either by the pathologist report, Considering all problems, the worry of the or by the ISTAT death certificate, in case the population and of the local administrators, patient died. We calculated the Standardized Figure 1. Province of Vercelli and Study Area (author’s image) Incidence of oncological pathologies in municipalities neighbouring former nuclear sites 211 Table 1 - Standardised Incidence Ratios SIR by sex and neoplasia, IC95% Interval of Confidence at 95%. Total area under examination Total surveyed area Neoplasia Sex Obs SIR IC 95% Oral cavity M 17 2.11 1.41-2.80 F 10 2.81 1.80-3.81 Colon-rectum M 106 1.02 0.82-1.21 F 81 0.99 0.77-1.20 Liver/biliary tract M 36 1.05 0.72-1.38 F 22 0.98 0.56-1.39 Larynx M 17 1.18 0.66-1.69 F 3 3.12 1.12-5.11 Leukaemia M 32 1.72 1.26-2.17 F 22 1.94 1.35-2.52 Breast F 182 1.03 0.88-1.17 Melanoma M 9 0.58 0.08-1.08 F 12 0.86 0.33-1.38 Mesothelioma M 21 4.67 3.74-5.59 F (*)4 4.04 2.07-6.00 Myeloma m. M 17 1.72 1.10-2.34 F 9 0.88 0.26-1.49 Bone M 6 12.0 9.22-14.7 F 3 14.3 10.0-18.6 Pancreas M 16 0.93 0.46-1.40 F 22 1.19 0.73-1.64 Lung M 106 0.94 0.76-1.12 F 31 0.77 0.47-1.07 Prostate M 162 0.98 0.83-1.13 Kidney M 24 1.26 0.81-1.50 F 14 1.79 1.09-2.49 Nervous system M 15 2.23 1.47-2.98 F 18 1.89 1.25-2.52 Stomach M 27 1.14 0.73-1.54 F 15 0.90 0.41-1.38 Soft tissues M 9 1.64 0.80-2.47 F 7 1.69 0.72-2.65 Testicle M 3 0.81 0.0-1.82 Thyroid F 20 1.36 0.84-1.87 Bladder M 95 0.98 0.78-1.17 F 15 0.64 0.44-1.04 Ovary F 22 1.10 0.66-1.53 Uterus F 44 1.23 0.90-1.55 Total M 724 1.11 1.04-1.18 F 556 1.14 1.06-1.22 Tot.

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