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"Priority for the prevention and elimination of environmental risks". BMJ calls for a new medical vision

The Italian Association of Environmental Medicine: "Observations tell us that there is a true epidemiological transition that must be considered as a whole, starting with congenital malformations and neurodevelopmental disorders, paying particular attention to the increases recorded over the decades."

12 NOV – Famous pediatricians, epidemiologists, and scientists, on November 7, to doctors and scientists from around the world, the author of the international appeal published on the pages of the "British Medical Journal" to reverse the course of primary prevention: to count "patients" and to provide decision-makers with real-time evidence and useful indicators that will promptly carry out actions to protect collective health, even before disease develops.

"Starting from epidemiological observations, it is necessary to initiate a change of pace for a new drug vision," the first author of the article explains. Prisco PiscitelliHe is the medical epidemiologist of the European Mediterranean Biomedical Science Institute (ISBEM) and vice president of the Italian Association of Environmental Medicine (SIMA). Observations tell us that a real epidemiological transition that needs to be considered as a whole continues, starting from years of increases, congenital malformations and neurodevelopmental disorders such as autism, especially pediatric or young adult cancers, metabolic diseases – including pediatric diabetes -, thyroid and neurodegenerative, Alzheimer's , ALS and Parkinson's disease as once very rare ".

"If we look at the number of all these pathologies as a whole and look at the increases recorded for each of the last fifty years, minimizing the problem is a problem of difference or adjustment between observed and expected situations", continues Prisco Piscitelli. “In particular, according to ISTAT / EUROSTAT data, around 320 deaths per year (from 2000 to today, around 6,000) are unacceptable for societies where pediatric cancers have become the leading cause of death, from about 2000 to today. In Italy and many other European countries, the costs of hospitalization and treatment are estimated at 30 to 50 million euros per year only for our country (and incurable human costs). 11,000 new tumor cases estimated by ARTIUM in the 0-19 age range were not observed 50 years ago, but we had a larger pediatric population. As we wrote in the BMJ appeal, we need to change course, change the way we see it, and we need a drug that can change the world. ”As doctors, men or women of science, we should not be afraid to question established models if observations do not follow the proposed explanations. Science is not advancing by dogmas, just as epidemiology cannot be reduced to a vain accounting practice without having to show all possible solutions to decision-makers here and now ”.

The Professor has no doubt Alessandro Miani, SIMA President and co-author of the article: "Environmental exposure through epigenetic mechanisms is the lowest common denominator of all health problems that have reached rates of actual outbreaks since the postwar period. Continuous and general reference to lifestyles and smoking, as well as the accumulation of progressive mutations and life damage to DNA during the first year of life, for example, cannot explain why tumors in the first year of life are constantly increasing (with an increase of + 2% per year), focusing solely on individual risk factors, starting with what we breathe, eat, drink or drink, It is clear that it is an obstacle for us to find the right solutions for the collective health of health determinants. ”

November 12, 2019
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