Health, the environment, biodiversity and climate – the SINTESI project

SINTESI is a project funded by the National Plan for Complementary Investments (PNC) under Programme E.1 ‘Health, Environment, biodiversity and climate’, investment 1.2 ‘Development and implementation of two specific pilot operational programmes to define models for integrated health-environment-climate interventions at selected contaminated sites of national interest’. 

The project aims to establish a permanent environmental and health monitoring system at contaminated sites (SIN), where the available evidence – both environmental and epidemiological – enables the development of targeted interventions for the primary and secondary prevention of adverse health effects associated with contamination, with a view to tackling inequalities.

The project is structured around the following nine specific objectives:

1. Survey of available data on the socio-economic context and sources of environmental pressure, environmental contamination across different matrices, population exposure, health profiles, a description of healthcare provision and the uptake of healthcare services;
2. Design and consolidation of epidemiological surveillance tools and descriptive epidemiological data, with trend analysis (calendar and cohort effects), also taking into account data on socio-economic deprivation;
3. Design of analytical studies to assess and update the association between environmental exposures, socio-economic status and health outcomes in the general population and in vulnerable groups (residential population cohorts and birth cohorts); Case-control studies in selected Sites of Environmental Concern (SIN); investigation of exposure to environmental pollutants in schools;
4. Description of socio-economic disparities in exposure to environmental risk factors, associated health outcomes and access to healthcare services;
5. Development of a web portal for the Permanent Environment and Health Surveillance System to ensure the transparent and timely communication of environmental, epidemiological and contextual data;
6. Establishment of cross-sectoral round-table discussions involving the public to identify priority health needs and environmental remediation priorities;
7. Participatory design of local intervention and risk management plans to reduce exposure disparities, through area-based environmental and health impact assessments and the development of alternative decision-making scenarios, to support the strategic planning for the site’s sustainable development;
8. Design of an active health surveillance programme targeting the most exposed and vulnerable groups;
9. Design of studies to assess the programme’s effectiveness in terms of uptake/coverage and efficacy in relation to health objectives, including from the perspective of tackling social inequalities, and its transferability to other Sites of National Interest (SIN).

The project consortium, led by the Puglia Region through the Regional Agency for Health and Social Care (AReSS), brings together the regions of Piedmont, Lombardy, Friuli-Venezia Giulia, Veneto, Emilia-Romagna, Tuscany, Lazio, Marche, Basilicata, Calabria, Sicily, Sardinia and the Autonomous Province of Trento.

At the level of individual territories, numerous health authorities and environmental agencies are involved. The 22 Sites of National Interest (SIN) concerned are as follows:

• for Puglia: Taranto;
• for Piedmont: Casale Monferrato;
• for Lombardy: the Mantua Lakes and Chemical Cluster, Pioltello Rodano and Sesto San Giovanni;
• for Friuli-Venezia Giulia: Trieste;
• for Veneto: Venice – Porto Marghera;
• for Emilia-Romagna: Fidenza and the ETR Heavy Repair Workshops in Bologna;
• for Tuscany: Massa Carrara and Orbetello;
• for Lazio: the Sacco River basin;
• for the Marche region: Falconara Marittima;
• for Basilicata: Tito Industrial Estate and Val Basento Industrial Estate;
• for Calabria: Crotone–Cassano–Cerchiara;
• for Sicily: Gela, Augusta – Priolo and Milazzo;
• for Sardinia: Porto Torres and Sulcis Iglesiente;
• Autonomous Province of Trento: Trento Nord (including the former Carbochimica and former SLOI areas).

The implementation of the PNRR in Trentino forms an integral part of the provincial policy framework for sustainable development, in line with the policies set out in the Provincial Economic and Financial Document and the related Update Note.

Total PNC funding of €24,755,500, of which €893,064 is earmarked for the Autonomous Province of Trento. In Trentino, the Department of Health and Social Policy, the Provincial Agency for Environmental Protection and the Provincial Health Services Authority are involved.