Characterization of a Population Living in Highly Contaminated Settlement in Campania Region
Condition: Environmental-Pollution-Related Condition
Study type: Observational

Summary: 
      some areas in the Campania region (southern Italy) have attracted media coverage in the past
      15 years, and are considered a dramatic example of an extremely polluted area. The
      environmental pollution issue has become a significant concern in the Campania Region as a
      result of the "waste management crisis" that mainly affects the northern part of the region,
      encompassing 91 municipalities. As a consequence, in the last few decades, a large rural area
      between the provinces of Naples and Caserta, primarily used for agriculture and livestock
      breeding, was considered to be at high risk of contamination due to the illegal disposal of
      urban and industrial waste. In these landfills, a broad range of hazardous wastes from
      different parts of Italy has been found. In addition, the wastes have often been open-air
      burned, leading to this area being named the "Land of Fires". Senior and Mazza first
      highlighted the high incidence of cancer deaths in a specific area of the Campania region
      (compared to regional and national rates), which was identified by the authors as the
      "triangle of death". Afterwards, several studies reported a link between illegal waste
      disposal and an increased risk of cancer for the population, potentially associated with
      human exposure to carcinogenic substances such as dioxins, dioxin-like compounds, or
      polycyclic aromatic hydrocarbons, which can be released into air, soil, and water bodies
      through the illegal dumping and burning of waste. Within this study, 4,227 subjects were
      enrolled in the SPES trial, considering healthy subjects living in several regional areas
      with different environmental pressures. Blood dioxins and heavy metals were analyzed. Gut
      microbiome was analyzed on a subset of 359 subjects from the three different exposure area.
    

Detailed description: 
      This study involved a screening of healthy adults from Campania region recruited in the human
      biomonitoring study SPES (http://spes.campaniatrasparente.it), promoted by the Istituto
      Zooprofilattico Sperimentale del Mezzogiorno (IZSM) of Portici (Italy) in collaboration with
      the National Tumor Institute IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) "G.
      Pascale" in Naples. Considering different source of environmental pressure (e.g., land use
      and population density, presence of contaminated sites, quality of air, soil and water
      bodies, closeness to waste management plants and illegal waste spills and fires), Pizzolante
      and colleagues developed an integrated model to compute the Municipality Index of
      Environmental Pressure (MIEP). The MIEP takes into account all factors involved in the
      pollution processes, including the sources of contaminants and their migration pathways. The
      MIEP enables the identification of 21 homogeneous sub-clusters, which include several
      municipalities based on their environmental pressure scores. This categorization has resulted
      in three macro-areas with increasing levels of impact pressure: LOW, MEDIUM and HIGH, as
      described by Pierri and colleagues. In 2016, a total of 4,227 subjects were enrolled in the
      SPES trial, considering healthy subjects living in several regional areas with different
      environmental pressures. A subgroup of 359 subjects residing in the three impact areas was
      randomly selected from the entire SPES cohort for gut microbiome analysis, in order to define
      the impact of environmental pollution on gut microbial communities.
    

Intervention name(s): Determination of dioxins (PCDD/Fs), polychlorinated biphenyls (PCBs) and trace elements
Intervention type(s): Other
Intervention description(s): Peripheral blood (about 100 mL in several aliquots) was collected from the volunteers, in the early morning, in blood collection tubes (SST II Advance Tubes, BD Vacutainer). The samples were left for approximately 50 min, then the serum was separated from whole blood by centrifugation at 2,000 rcf for 10 min at 4 °C and then aliquots were stored at -80°C until analysis.
Intervention MeSH terms: Trace Elements; Micronutrients
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Healthy adults (20-50 years/old) resident in one of the municipalities under study for at
        least 5 years (Campania Region, Italy) grouped according to the environmental impact (high,
        medium and low) (as reported in http://www.campaniatrasparente.it)
      
Biospecimen description: 
      Fecal samples were self-collected and frozen at -80°C for microbial DNA extraction;
      peripheral blood (about 100 mL in several aliquots) was collected from the volunteers, in the
      early morning, in blood collection tubes
    
Keywords: dioxins; persistent organic pollutants; heavy metals; gut microbiome