CONSIDERATIONS FOR THE NEXT FOUR DAYS ITALIAN MEDICAL ENVIRONMENT
by Maria Grazia Petronio, Vice President of ISDE Italy.
The event, which has become an annual event, was promoted dall'ISDE (International Society of Doctors for the Environment), Italy, together with the Italian Society of Pediatrics, all organizations that collect Practitioners General, Italian Association of Epidemiology at the Italian Association of Medical Oncology of the Italian Society Hygiene and the National Society of Professionals of Prevention, under the patronage and participation of the Ministry of Labor, Health and Welfare and the Ministry of Environment and National Federation of the Associations of doctors.
An important event, then, that brought together many specialists to take stock of the situation of pollution of living environment in all its aspects: the causes, prevention, primary health effects.
The focus is all for them: children. They are, in fact, most who suffer the effects of environmental pollution (WHO, 2008). It is from Salsomaggiore, which are disseminated data on the disturbing increase in childhood cancers in Europe and Italy, these scholars agree that the increase attributable to consider the environment. The data comes from 33 cancer registers of population in 15 European countries and cover the period 1978-1997, were published in 2006 (Kaatsch P. et al, EJC 2006) and have been circulated so far only among officers work.
What is observed is a significant increase in incidence of cancers of children with an average annual percentage change of 1, 2 and 14% between 0 and 1, 4% between 14-19 years. The increase applies in particular in the soft tissue sarcoma, cancer of the brain, the sympathetic nervous system, germ cell lymphomas, leukemias and kidney cancer. No change is instead registered for the bone cancer, liver cancer and neuroblastoma.
In Italy we have observed statistically significant increases in 'incidence of cancer during the observation period (1998-2002), annual standardized rate: 175.4 per million. In particular, in children the annual percentage change was +1.6% for leukemia, + 4.6% for lymphomas, +2.0% for the central nervous system. The highest rates are in the first year and between 1 and 4 years, then decreased between 5 and 9 years old and date back between 10 and 14 years. Overall, the standardized incidence rates seem higher in Central Italy and in males.
The prognosis of children with cancer diagnosed in the first 15 years of life has improved in all countries to Western standards of living over the last 3-4 decades, although it must be remembered that malignant tumors in these populations are still the second leading cause of death after accidents in the age between 1 and 14 years, and that data on survival are not the same for all types of cancer.
Regarding the causes, the data, derived mainly from case-control studies conducted in recent decades have suggested that environmental exposures (chemicals, ionizing and non-ionizing radiation, occupational exposures of parents, passive smoking etc..) well that exposure to drugs and / or diagnostic and therapeutic, or infectious agents, may increase the risk of contracting these diseases. Besides the confirmation of what are now acquired knowledge in the scientific world as the carcinogenic effect of air pollution and cigarette smoke, doctors have provided these data on the association between pesticide use (both for professional reasons or domestic ), the prolonged use of mobile phones and regular (cellular and cordless), the presence of many chemicals in the environment and the excess of cancers in children. In particular, it points out some external pollutants are concentrated in the areas of life, reaching high concentrations in these environments (eg. high concentrations of formaldehyde, a known carcinogen, were found inside the classroom).
On another point, doctors have drawn attention to: the risks caused by exposure, exposure during embryonic life. There are many studies that have linked the professional residence or exposure of the mother during pregnancy and the onset of tumors in children.
The message that is thrown is that today, when it comes to health effects from environmental pollution, not a reference anymore, or at least not limited to a single point source (eg. A busy road, an industrial plant etc..) but at a spread of pollution that covers all environmental media (air, water, soil, food, confined spaces) and all citizens, then a cause-effect relationship difficult to prove with epidemiological studies. This pollution causes significant changes in the entire biosphere with biological effects on ecosystems (in particular micro-biological) and individual bodies (in all their components at all levels: system, organ, tissue, cellular, molecular), and particularly in earliest stages of development (due to alterations in genetic programming, epigenetics and biochemistry during the fetal period).
In this sense, the most important transformations epidemic in recent decades (eg. expanding epi / pandemic of obesity / metabolic syndrome / insulin resistance / diabetes, asthma / allergy and immune-mediated diseases in a broad sense, degenerative diseases of the cardiovascular system and neurological ...) should all be considered as an epiphenomenon of an epochal transformation and environmental epi-genome.
presented in the initiative were also some parents of children who died from cancers that have strongly advocated a commitment by doctors to eliminate the causes of these dramatic increases and the transparency of data and information.
is generally accepted that the doctors present in the coming years, all specialists should make efforts to ensure children the right to a clean environment and that this should be a priority in directing health care resources. In this perspective the information and education in schools about the health risks of children and adolescents caused the most widespread environmental pollutants may contribute to the prevention of such risks by providing guidance for appropriate self-help initiatives by the pupils, the their teachers and parents.
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