In May 2012 SACBO signed an agreement with ASL (Local Health Authority) of Bergamo for the award of a management assignment, definition of protocols, procedures and activities necessary to conduct an epidemiological study on the health status of residents in the towns neighbouring the grounds of Milano Bergamo Airport, with the primary aim of understanding if and how the presence of the airport, with the same existing boundary conditions could affect the health status of the population.
The study was carried out by addressing the following types of issues:
- Evaluation of specific literature
- Development of health data
- Preparation and distribution of questionnaires to a percentage of the population and processing of data
- Reading of the information and evaluation of results
The main objective of this study is to understand the relationship between exposure to noise and air pollution and the health status of residents living in the vicinity of Milano Bergamo Airport. The population involved in the epidemiological study - based on hospital admissions data, the mortality rate and the consumption of medicines - is the entire resident population in the following towns: Azzano San Paolo, Bagnatica, Brusaporto, Grassobbio, Lallio, Orio al Serio, Seriate, Stezzano, Treviolo, to which are added the residents in the areas of Colognola and Campagnola of the city of Bergamo. The reference population is represented by the residents of the entire Province of Bergamo in the same observation period.
For this purpose, three types of analysis were carried out: a study of the incidence and mortality of the main disease groups (with particular focus on the causes of cancer), a study aimed at evaluating the consumption of certain categories of medicines, and finally a study to actively evaluate, through the distribution of a questionnaire and measurement of blood pressure (BP), parameters such as frequency of hypertension, intolerance to noise ("annoyance") and sleep disorders among the population residing close to the airport.
Below are the results and the preliminary conclusions released by ASL of Bergamo
1. Conclusions from the preliminary epidemiological study on the health status of the residents of the municipalities affected by the routes of Milano Bergamo Airport: mortality and incidence of major diseases
For the period analysed and for the diseases looked at, the descriptive epidemiological analysis did not reveal, at present, differences in incidence and mortality when comparing the towns being studied and the province of Bergamo as the area of reference. Even if the results of the epidemiological evaluation are reassuring ASL of Bergamo will continue the epidemiological monitoring of the territory by updating data and analyses (every two years).
2. Conclusions from the study on the consumption of medicines
The analyses carried out through the Prevalence of Use indicator (PU) showed the presence of an excess consumption of class A02 drugs (stomach disturbances)* in the exposed area with respect to the expected results, both for women and for men, in all age groups considered. This excess varies between 9 and 12% in women and between 4 and 8% in men. It also indicated a moderate consumption excess, ranging between 10 and 13%, of class N drugs (sedatives, anxiolytics, hypnotics, antidepressants)* in the exposed area with respect to that expected both for women and men in all the age groups considered. The statistical significance of such excesses is not always present, even when considering the overall quantitative dimension of the exposed population, often numerically small, especially for men.
3. Conclusions from the cross-sectional study on noise and health of residents: results of the cross-sectional survey on blood pressure, noise annoyance, sleep disorders
The participation rate in the study was 57.6% (N. 400/695), perfectly in line, if not even higher, with respect to studies carried out in other Italian airports. The sample studied consisted of 400 persons, of whom 166 were residents in the areas in which the estimated LVA was less than 60 dB, 164 were residents in the airport noise range of between 60 and 65 dB and 70 were residents in the 65 dB range. The study revealed a clear relationship between noise exposure, reported nuisance (annoyance) and sleep disorders. The study however showed no significant differences in BP (Blood pressure) among the resident population nor a difference in the percentage of hypertension in the 3 noise ranges (LVA) identified by the noise contours. In conclusion, at present no damage was found to health as a result of the environmental impact of the activities of Milano Bergamo Airport and particularly no impact was found on the blood pressure of residents in the vicinity of the airport, as reported in scientific literature and as evidenced for some European and Italian airports (SERA and HYENA Study). This result may be linked to the "youth" of the airport from the point of view of the effects of environmental impact on health: health impacts due to noise exposure (hypertension as extra-auditory effect from chronic exposure to noise) in the most exposed population may arise, albeit hypothetically and based on what is known from similar studies, after a latency period of several years, if you do not adopt measures for mitigating and reducing exposure, especially with regard to the nighttime exposure. Some results highlighted (consumption of sedatives and medicine for stomach disorders), sleep disorders, and annoyance, are however indicators of an initial and reversible response by the human body.
* Drugs Note - Using the ATC international classification, pharmaceutical prescriptions were selected containing the codes for the following classes of drugs: - for anti-hypertensive therapy: consumption of alpha blockers (CO2), diuretics (CO3), beta blockers (C07), calcium antagonists (CO8) and substances that act on the renin-angiotensin system without restrictions (C09) - for respiratory diseases: all the drug group for obstructive syndromes of the airways (R03) - for sedatives: anxiolytic benzodiazepine derivatives (N05BA), hypnotics and sedatives (N05C), antidepressants (N06A) - for stomach problems: drugs for disorders related to acid secretion (A02)
Data monitoring and related analysis are carried out periodically by the Bergamo Regional Health Agency with the close cooperation of SACBO.
Lastly, the epidemiological study was also updated in 2018 and its summary conclusions are shown below:
1. Conclusions of the monitoring activity on the health status of the population surrounding Orio al Serio Airport: hospitalisation, incidence and mortality related to the main pathologies taken into consideration.
For the period analysed and for the pathologies considered, the descriptive epidemiological analysis resulting from the monitoring activity carried out did not highlight any differences in incidence and mortality in the area under study when compared to the province of Bergamo. The current monitoring activity has confirmed the previous findings of the epidemiological study for the period 2006-2011.
With regards to hospitalisations due to specific causes, an additional section to the previous epidemiological study, the present monitoring activity shows no difference between the area under study and the province of Bergamo.
2. Conclusions of the monitoring activity on the health status of the population surrounding Orio al Serio Airport: prescription of pharmaceuticals.
The analyses of drug prescription monitoring carried out by means of the Prevalence Rate, differ from what emerged in the previous epidemiological study with regard to group A drugs, i.e., drugs prescribed for disorders related to gastric acidity. In the previous epidemiological study, an excess of prescriptions for group A drugs was found in the study area when compared with the province of Bergamo; the excess varied between 9.0 and 11.7% in women and between 5.0 and 7.5% in men during the 2006-2011 period. The present monitoring activity does not show the aforementioned excess. There are no differences between the study area and the province of Bergamo in terms of prescriptions of group A drugs in the period 2012-2017.
For the first two years of observation and exclusively with regards to women, the moderate excess of prescriptions of group N drugs, i.e., drugs prescribed as anxiolytics, hypnotics, sedatives and antidepressants in the study area compared with the province of Bergamo was confirmed. The over-prescribing seen in the previous epidemiological study ranged from 10.0 to 12.9% in women and 6.0 to 12.8% in men during the 2006-2011 period. With the present monitoring, there is a variation of between 5 and 8% in 2012 and 2013 among women. Later years do not indicate any differences in the prescription of group N drugs between the study area and the province of Bergamo.
The results of the epidemiological assessment and the latest updates are reassuring and do not reveal any particular critical situations.