Risk of Congenital Anomalies Around a Municipal Solid Waste Incinerator - Recent Advances and Issues in Environmental Science - page 109

roughly superimposed to C area for dioxins, and these exposure boundaries were not
further used in the analysis.
Figure 1. Map of exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) in the
city of Reggio Emilia, northern Italy, around the municipal solid waste incinerator (MSWI).
Study Population
We attempted to identify all cases of congenital anomalies in the offspring or in aborted
foetuses of women residing in the Reggio Emilia municipality since January 1, 1998
until December 31, 2006. To do this, we used data from the population-based registry
of congenital malformations of the Emilia-Romagna Region, named IMER and part
of the Eurocat EU program [14], recording since 1979 all cases of abnormalities in
live- and stillbirths and since 1996 the induced abortions associated with diagnoses
of congenital anomaly observed in the regional hospitals. We also used as additional
source of data the Hospital Discharge Directory of Emilia-Romagna residents, avail-
able at the Emilia-Romagna Region Health Authority since 1996, and in particular the
discharges by Italian hospitals to regional residents reporting an ICD9-CM diagnostic
codes from 740.0 to 759.9. These diagnoses were further reviewed by a clinical ge-
neticist (F.R.), and all cases of minor malformations, as defined in accordance to the
Eurocat guidelines, were removed from the analysis.
We retrieved control births with their corresponding mothers through random se-
lection within the regional Hospital Discharge Directory. Specifi cally, to each case we
associated a control birth randomly selected among the live births without diagnosis of
malformations during the same year to women residing in the Reggio Emilia munici-
pality, referred to the same hospital and born in the same year of the matched “case”
mother.