The Italy of fires, pollution and new pathologies

The "Land of Fires" includes a territory of 1076 km², with 57 municipalities and a total of approximately 2 and a half million residents. This term, coined at the beginning of the 2000s to define an area in Campania, has for some years indicated a national emergency.

Our country is burning from Campania to the rest of Italy. Dumping of illegal waste, which is then set on fire, has generated and continues to generate extreme damage to the ecosystem over the years: significant reduction in air quality, contamination of water and soil, with consequences on agricultural products, high levels of toxic metals in the blood, massive doses of pollutants in the human body and increase in oncological pathologies.

Although the trend of waste fires is decreasing, the illicit disposal sites from North to South are (according to one of the latest Ispra reports) more than 20 thousand, and the damage to human and environmental health caused in previous years will also have repercussions in the future.

“It is now a fact that health and development of serious pathologies is closely related to the health of the environment. I believe that identifying areas at risk, maximum doses of pollutants tolerated by the body, specific biomarkers, improving the healthcare system, implementing prevention, preserving the environment and residents for whom healthcare can be guaranteed be a One Health approach. It is necessary to study not only human beings, but also air, soil, water, the food chain: ecological healthcare", Professor Antonio Giordano, oncologist and teacher, director and founder, explained in the interview with One Health of the Sbarro Health Research Organization.

You have always been involved with Terra dei Fuochi. Almost 10 years have passed since your book "Monnezza di Stato", which assesses the incalculable environmental and health damage caused by the spillage of toxic waste in the area.

Has something changed? What is the situation in your Campania today?

I coordinated a study on the Campania population in order to propose solutions to a ten-year problem. In this study, blood levels of carcinogenic heavy metals and persistent organic pollutants (POPs) were measured on a cohort of 95 cancer patients residing in Campania. High levels of blood concentrations of heavy metals have been observed in municipalities like Pianura, Giugliano, Qualiano and Castel Volturno.

Despite some limitations of this exploratory study (small sample size for some Municipalities), our preliminary observations confirm some previous studies: the level of toxic metals in the blood of cancer patients in some Municipalities of Terra dei Fuochi is completely above the norm. After this study, a report was drawn up by the Public Prosecutor's Office of Naples North and the Istituto Superiore di Sanità which confirms that there is a link between illicit waste disposal and the incidence of various pathologies, including cancer. We are starting to face reality even if there is still a lot to do.

As we focus on Naples, the latest data from Legambiente on air quality are alarming as in fact the regional capital and the province are experiencing a significant environmental and health emergency.

The constant exceeding of the legal limits allowed for environmental pollutants that I have been denouncing for years is an alarming fact. We must act. Solutions must be implemented quickly, it is necessary to clean up, block illegal spills, organize an efficient waste and population surveillance program. Thus, it is necessary to raise awareness among the population and encourage public health by increasing prevention and screening activities.

“Speaking of Puglia as a new land of fires is a fact as the damage is very considerable. The traffic of waste is enormous and is causing considerable damage to Puglia.” This was stated by Bari prosecutor, Roberto Rossi.  “Land of Fires”  is therefore not only in Campania.

Is there a risk of an Italy of Fires?

Unfortunately, it is no longer possible to limit the "Land of Fires" to Campania alone. In Italy there are many "Lands of Fires". Environmental pollution is a global problem and the health emergency caused by Covid is the result of an altered relationship between man and environment. We must respect the environment to protect the health of the world population.

You are an internationally renowned oncologist in the USA. What are the health risks?

The risks in the USA are the same for all nations but perhaps in the United States an incorrect eating style can have a greater impact. Today, chronic diseases, including cancer, are defined as "environmental genetic pathologies" because, in addition to age, there are other factors such as exposure to environmental insults and lifestyle to which the disease can be ascribed (e.g. smoking, lack of physical exercise, obesity, diet). Consequently, if on one hand we have diagnostic improvements, increase diffusion of screening programs, increase in life expectancy, on the other hand there is a concomitant progressive increase in oncological pathologies.

Whose responsibilities are? How could we try to tackle this problem?

Identifying “the cause” is not a simple task. The characterization of multifactorial pathologies, the development of which could also be related to environmental factors, is very complex. There are many confounding factors that make this mission difficult. On top of this, there are political and economic problems that make the situation even more difficult to deal with. For example, lack of mechanisms of control and unrealized remedies represent a problem.

Citizens and environmental committees are calling for analysis and screening to demonstrate the connection between pollution and onset of certain diseases.

What are the institutions doing? Can PNRR money help on this?

The One Health approach we described above could be implemented on PNRR funds, as the committees request.

“De Luca must have respect for citizens: if the healthcare system in Campania doesn't work, he must take responsibility for it”. Thus, Minister Schillaci is in full controversy with Governor De Luca.

In your opinion, what is the state of healthcare in your region?

I'm not a politician, I'm a scientist. I can only say that the Campania Healthcare system boasts excellent colleagues of international standing.

The recent Italy - USA study, conducted by your team in collaboration with the National Cancer Institute Pascale Foundation of Naples, was in the news a few days ago.

What is it about? Why is it important piece in the fight against cancer?

The result obtained are important data: the study demonstrated how the lack of a Cdk9 protein negatively impacts DNA repair processes. Alterations in this process are therefore responsible for the development of various tumour pathologies for which the discovery opens up new scenarios for the identification of precision drugs.

Professor Antonio Giordano, M.D., Ph.D., is the creator and head of the Sbarro Health Research Organization, located at Temple University's College of Science and Technology in Philadelphia. Stay connected with him through his various social media platforms, including Facebook, LinkedIn, Twitter, and Instagram, to receive the latest updates.