XXXVIII National Congress of the Italian Association of Epidemiology

November 6th, 2014, during the XXXVIII National Congress of the Italian Association of Epidemiology, a Satellite Seminar took place with the title: “Environmental Public Health Tracking”: a tool for prevention oriented to sustainability and development”. INPHET was introduced, and some proposals were put forward to share some of EPHT’s features with the implementation of the Italian Prevention Plan.

Naples, 6th November, 2014 

Satellite Seminar Minutes

Environmental Public Health Tracking:
a tool for prevention oriented to sustainability and development

The meeting opened with a short introduction to the Environmental Public Health Tracking (EPHT) concept and the initiatives which led to the establishment of an International network named INPHET (International, Public Health & Environment) (Lauriola,  ARPA ER ,Environmental Protection Agency of Emilia-Romagna Region)

This was followed by an outline of the Italian Public Health Prevention National Plan 2014-18 (in Italian, PNP), with emphasis on the section dedicated to “Environment and Health” with particular regard to the procedures of its implementation and the links with environmental health surveillance. It was pointed out that this PNP, unlike the previous ones, pays specific attention to environmental issues although not always with due thoroughness. A particular emphasis is given to strategies promoting an intersectorial approach according to the WHO “Health in all policies”. Italian Regions are expected to put into practice its general objectives, strategies and indicators. In any case, as in the past, the plan probably will not be funded with ad hoc additional resources, but through the allocation of an amount from the National Health Fund, which will not be paid if the expected results are not attained (Angelini, Emilia-Romagna Region).

No answer was given by the Health Ministry to Assoarpa (Association of the Regional Protection Agencies) and ISPRA (Institute for Environmental Protection and Research,) which offered their expertise  in defining strategies and indicators. In order to overcome this division within the environmental  and health sectors, a mandatory and legally acknowledged training course with various levels of complexity in the field of epidemiology, toxicology and Risk Assessment could be implemented (Assenato, Arpa Puglia).

The importance of the involvement of GPs and Local Paediatricians (Peds) to understand and to manage environmental health risks was emphasized.  Particularly important is the relevance given to the role of GPs and Peds in view “to contribute in sensitizing and informing the general public, but also in retrieving and forwarding information on critical events”. As a matter of fact Italian Federal Association of Physicians, Surgeons and Dentists (in Italian FNOMCeO) is committed to finalizing a proposal aimed at the implementation of the Italian Network of Environmental Sentinel Practitioners (in Italian RIMSA) (Di Bellucci, FONMCeO)

Terracinini  (E&P) referred to the commitment of the working group dealing with Asbestos to induce (through the Italian Association of Epidemiology) the Italian Government to promote a European initiative in favour of a specific Law in this field.

Sinisi (Institute for Environmental Protection and Research, in Italian ISPRA), underlined the importance of the INPHET request to foster the establishment of a European Environment and Health working group/committee. Indeed since 2010  is lacking  at EU level an E&H reference group established inside workplan framework of competent EU  DGs (Sanco and Environment). This it might have contributed to the missed opportunity  of the 2004-2010 European Environment and Health Action Plan review and,nowadays,  it may hamper adequate EU Member States  contribution to  the pan European discussion on the preparation of the WHO E&H Ministerial Conference to be held in 2017.

Pirastu (Sapienza Rome University and National Institute of Health, in Italian ISS) referred that the ISS  has been dealing with EPHT since 2012, with the presentation  of Biancavilla case on the occasion of the XXIV Conference of the International Society for Environmental Epidemiology  (ISEE) held in Columbia (South Carolina).
In the current version of the overall objective 2.8 of the PNP, the Italian Contaminated  Sites (in Italian SIN) issue is absent, despite the relevance of the topic in terms of inhabitants living in those areas (5.5 million in 2001, among whom 1 million were children) and despite the fact that SENTIERI  Project (Studio Epidemiologico Nazionale dei Territori e degli Insediamenti Esposti a Rischio da Inquinamento) assessed the health impact due to residence in those areas (SIN). It is necessary to reconcile the PNP objective 2.8 “to reduce the potentially hazardous environmental exposure” in accordance with the Italian commitments for the VI Interministerial Conference on Environment and Health. On the occasion of the preparatory Conference held in Bruxelles (December 10^th-11^th, 2013), the Italian ISS representatives, appointed as members of the European Environment and Health Task Force (EHTF ), proposed as a priority issue the theme  “Environment and health in contaminated sites with a focus on children”. This proposal has been supported by many European countries. Owing to a need to strengthen the integration at national level (as in the case of SENTIERI) and international level a COST (European Cooperation in Science and Technology) has been used as as application for funding.  This proposal project is named “Industrially contaminated sites and health ICSHnet”.

Forastiere (Epidemioloy Dpt, ASL RM, Lazio) proposed the definition of guidelines to harmonize and to enhance the implementation of the Regional Prevention Plans according to the PNP.

It was agreed that some notes would be presented to the President of Italian Association of Epidemiology (AIE) in order to draw up a document addressed to the Ministry of Health and to  the  National/Regional Conference, offering the contribution of AIE in the field of Environment and Health and Environmental Health Surveillance.