Sottoscrizione documento Medici trentini Document of Trentino
Doctors INCINERATION AND HEALTH
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The decision of the provincial government to build the incinerator at thirty Ischia is Podetti una decisione che rischia di «trasformare un problema di igiene pubblica in un grave problema sanitario, specie per le giovani generazioni” [i] .
Implicazioni di ordine sanitario. Ogni inceneritore emette un gran numero di sostanze pericolose per la salute, di cui molte non conosciute, che vengono prodotte dallo stesso processo di combustione che, notoriamente, trasforma sostanze inerti in sostanze pericolose ed altamente tossiche (classico esempio la sigaretta). Anche le scorie (ceneri pesanti e ceneri leggere) costituiscono un grande potenziale rischio ambientale-sanitario di cui va tenuto conto.
Among the pollutants are found certain carcinogenic to humans by the Agency for Research on Cancer (IARC) places on the 1st level of carcinogenicity. This is the reason for which the law classifies an incinerator Industry unhealthy 1st class ", and the European Commission for the Environment does not recommend the implementation in the Alpine valleys.
Far from being, as expected, incinerators of hazardous waste incinerators - including a "last generation" - have proved, in short, real multipliers and speakers of geno-toxic and carcinogenic substances, such as heavy metals, polycyclic aromatici (IPA), molecole diossino-simili e particolato fine e ultrafine, «trasformando un semplice problema di igiene pubblica in un grave problema sanitario» [ii] .
Studi epidemiologici e danni da incenerimento. In molti studi sono emersi dati significativi di effetti dannosi per la salute, sia neoplastici che non, tanto nelle popolazioni residenti nei dintorni di impianti di incenerimento che nei lavoratori addetti.
Particolarmente solide sono le evidenze concernenti le patologie neoplastiche: una revisione di 46 studi, condotti con particolare rigore, ha evidenziato un incremento statisticamente significativo in 2/3 degli studi che hanno analizzato incidenza, prevalenza e mortalità per cancro [iii] . In particolare sono ben documentate le associazioni con linfomi non Hodgkin [iv] , cancro al polmone [v] , neoplasie infantili [vi] e sarcomi [vii] . Di grandissimo interesse risulta il recente studio sui sarcomi in provincia di Venezia [viii] che ha dimostrato un rischio triplicato di sviluppare la malattia fra i soggetti con più lungo periodo e più alto livello di esposizione.
Il 2 aprile 2008 sono stati resi noti i risultati definitivi della ricerca condotta dal francese Institut de Veille Sanitarie [ix] nella popolazione adulta residente in prossimità di impianti di incenerimento [x] . I risultati definitivi, conteggiati a marzo 2008, evidenziano i seguenti incrementi: sarcomi +22%, linfomi non Hodgkin +12% in entrambi i sessi, +18% nelle femmine, cancro al fegato +16%, mieloma multiplo +16% in entrambi sessi e +23% nei maschi e tutti i cancri nelle donne +6%.
Ricordiamo anche such as the recent study on the population of a district of Forlì (Coriano) exposed to two incineration plants (municipal and hospital waste) has shown serious damage to health, especially in females, with statistically significant increased risk of death all causes and especially for all cancers (particularly breast, colon, stomach) [xi] .
Do not forget the physical law of the principle of conservation of matter: "Nothing is created nor destroyed, but everything is transformed" is clear. Specifically, do we burn 100,000 tons of waste and remains about 30%, in the form of slag, the rest where it ends?
Conclusions . The need to contribute to building a sustainable future for future generations can not fail to stimulate research and involving people virtuous leading up to self-respect and the environment: in this sense, in accordance with Art. 5 of the new Code of Conduct [xii] , we reiterate, as a doctor, our role not only as operators but also of "educators" to health.
We believe, therefore, that the epidemiological evidence, experimental and toxicological related to the pollutants emitted from incineration of waste accumulated in recent years and the many skilled and knowledge emerged about the accumulation of the main pollutants in the environment, food chains and in the human body and the maternal-fetal transmission of the same, with the subsequent risk a trans-generational transmission and amplification of genetic damage, do not allow exceptions to the obligation of prevention (precautionary principle).
In this context, primary prevention is not a utopia at all, since there is a real chance to recover, in almost all the materials at the end of a correct chain, by rejecting the alleged need for their disposal by harmful pollutants and solutions for the collective health as a dumping ground, and above all incinerators.
We reiterate, therefore, the importance of the fact that men of science, and doctors in particular, should not merely study and explain the pathogenic mechanisms associated with chronic exposure of women and children to the different pollutants and to try to quantify the damage on the people directly or indirectly exposed, present and future, but assert their role as guardians and promoters of health and environment, which is determinant of health (Art. 5 Code of Conduct). This was the teaching of Lorenzo Tomatis [xiii] that for decades has committed to a drug based on primary prevention. In this light must be interpreted and understood his and our request for a permanent ban on unnecessary and harmful plants such as municipal solid waste incinerators.
[i] . Our Common Future is the main report of the WCED, 1987, relates specifically to the Stockholm Conference ( United Nations Conference on the Human Environment , 1972) which introduced a formal environmental issues within the international legal officers.
[ii] . Tarchi P., S. Morandini: waste crisis. Italian Missionary Editrice, Bologna, 2007, p. 121.
[iii] . Franchini M. Health effects of exposure to waste incinerator Emissions: a review of Epidemiological Studies , Ann. ISS 2004, 40 (1) :101-115.
[iv] . Floret N. Dioxin Emissions from a solid waste incinerator and risk of non-Hodgkin's lymphoma Epidemiology 2003, 14 (4) :392-98; Floret N. A municipal solid waste incinerator as the single dominant point source of PCDD/Fs in an area of increased non – Hodgkin’s lymphoma incidence Chemosphere 2007; 8: 1419-26; Biggeri A. Mortality for non Hodgkin lymphoma and soft-tissue sarcoma in the surrounding area of an urban waste incinerator. Campi Bisenzio (Tuscany, Italy) 1981-2001 Epidem Prev 2005; 29: 156-9; Minichilli F. A study on mortality around six municipal solid waste landfills in Tuscany Region Epidemiol Prev 2005;29:53-6; Bianchi F. Mortality for non Hodgkin lymphoma in the period 1981-2000 in 25 Italian municipalities with urban solid waste incinerators Epidemiol Prev 2006 ; 30:80-1.
[v] . Vineis P. Air pollution and risk of lung cancer in a prospective study in Europe, Int J Cancer . 2006; 119:169-74; Barbone F. Comparison of epidemiological methods in a case control study of lung cancer and air pollution in Trieste Italy Epidemiol Prev 1995; 19: 193-200; Biggeri A. Pollution and lung cancer in Trieste; Italy spatial analysis of risk as a function of distance from sources Environ Health Perspect 1996; 104: 750-54.
[vi] . Knox EG. Hazard proximities of childhood cancers Journal of Epidemiology and Community Health 1995; 51: 1151-9; Knox EG. Childhood cancer, birthplaces, incinerators and landfill sites Int. J Epidemiology, 2000; 29: 391-7; Knox EG Childhood cancers and atmospheric carcinogens Journal of Epidemiology and Community Health 2005; 59: 101-105.
[vii] . Viel JF. Soft-tissue sarcoma and Non Hodgkin’s Lymphoma clusters around a municipal solid waste incinerator with high dioxin emission levels Am. J Epidemiol. 2000; 152:13-9; Comba P. Risk of soft tissue sarcomas and residence in the neighbourghood of an incinerator of industrial wastes Occup.Environ.Med 2003; 60: 680-683.
[viii] . Zambon P, Ricci P, Bovo E, Casula A, Gattolin M, Fiore AR, Chiosi F, Guzzinati S. Sarcoma risk and dioxin emissions from incinerators and industrial plants: a population based case-control study (Italy) Environmental Health 2007; 16;6:19.
[ix] . Ente pubblico, direttamente collegato al Ministero della Salute francese, l’ Institut de Veille Sanitaire (InVS) riveste un ruolo fondamentale di sorveglianza e vigilanza in tutti settori della salute pubblica. http://www.invs.sante.fr/presentations/default.htm.
[x] . P. Fabre Etude d'incidence des cancers a proximité des usines d'incineration d'ordures menagères http://www.cniid.org/espace_mailing/cp_20080402.html.
[xi] . Final report EU project "Enhance Health" Interreg IIIC East Program www.arpa.emr.it / moniter.
[xii] . Code of Conduct - Article 5 - Health education and relations with the environment - The doctor is obliged to consider the environment in which man lives and works as a fundamental determinant of health. To this end, the doctor is required to promote a civic culture tense appropriate use of natural resources, in order to guarantee future generations the use of a livable environment. The doctor supports and participates in efforts of prevention, health protection in the workplace and promote individual and collective health.
[xiii] . Tomatis L. Prenatal exposure to chemical carcinogens and Its effect on subsequent generations . Natl Cancer Inst monographs. 1979 May; (51) :159-84. Review; Tomatis, L., Narod, S. and Yamasaki, H. Transgeneration transmission of carcinogenic risk. Carcinogenesis , 1992; 13, 145–151; Yamasaki,H., Loktionov A. and Tomatis L. Perinatal and multigeneration effect of carcinogens: possible contribution to determination of cancer susceptibility . Environ. Health Perspect., 1992; 98, 39–43; Tomatis L. Transgeneration carcinogenesis: a review of the experimental and epidemiological evidence . Jpn. J. Cancer Res., 1994; 85, 443–454.