OBSERVATIONS ON FLUORINE POLLUTION DUE TO EMISSIONS FROM AN ALUMINUM PLANT IN TRENTINO

by M. Colombini, C. Mauri, R. Olivo, and G. Vivoli
Modena, Italy

From the Medical Office of Health, Trento; The Chair of Department of Occupational Medicine and The Hygiene Institute of The University of Modena

This paper presents observations on the harmful effects of fumes emanating from an aluninum plant on the surrounding population. The factory was built in 1927. It is situated in the Lagarina valley on the west bank of the Adige about 2500 meters south-west of the village of Mori and 3000 meters north of the village of Chizzola in the commune of Ala.

From April to September the prevailing winds in the area blow from North to South between the hours of 8 p. m. and 12 noon and from South to North between 12 noon and 8 p. m. From October to March they blow from North to South. Rising air-currents are rare and short-lived.

The valley is surrounded by mountains (Fig. 1). It narrows into a neck where the factory is situated and then opens up toward the South at the right of the Adige to beyond the village of Chizzola. Thus the village lies in a pocket of an unusual anemology. Chizzola and its surroundings form a part of an orographic system that can concentrate a large portion of the air-borne waste products of the factory and deposit them on the area.

In 1929, shortly after production started at the factory, certain changes were noted in the vegetation of the area. Characteristic lesions occurred in the leaves of mulberry trees, grape vines and fruit trees. In subsequent years, as production in the factory increased, the phenomenon became more pronounced and widespread until it involved an area about 7 km long. The lesions were found to be due to the action of fluorine fumes emanating from the factory (1).

Another serious abnormality not previously encountered was noted in 1929. It concerned decline of silk-worms bred in the area. The situation grew worse in subsequent years until silk-worm culture had to be abandoned in a large area. Pigorini, Catoni and Marchi (2) studied the phonomenon in detail. They were able to reproduce the pathological picture of the disease experimentally by allowing silk-worms to feed on mulberry leaves gathered from the stricken area and on mulberry leaves artificially contaminated by fluorine salts.

Towards mid-1931 the farmers of the region reported that cattle and goats were afflicted with an unusual disease. The clinical and anatomical histopathological aspects of the phenomena were thoroughly described by Bardelli and Menzani in their valuable monograph (3). It was shown definitely that the disease was due to contamination of food by chemical agents contained in the waste gases from the factory. Bardelli and Menzani furnished conclusive evidence that the skeletal changes observed were consistent with industrial fluorine poisoning. They reproduced experimentally the essential clinical and anatomical-histopathological features by administering fluoride compounds to the animals.

At the same time, various disturbances were reported among the inhabitants of Chizzola. Children and later women experienced pains localized principally in the lower limbs. They exhibited unusual skin lesions, somewhat suggestive of bruises.

In order to remedy the situation the factory suspended operations temporarily and installed special equipment to purify the waste gases. Following institution of these measures, the damage to vegetation, to livestock and to the population decreased and finally ceased altogether.

A long period ensued during which the factory gave no further cause for complaints. In 1964 it was again established that damage to vegetation was due to contamination by fluorine compounds. Local farmers complained coincidentally with considerably increased production at the plant.

In 1965 some inhabitants of the area were found to be suffering from a skin condition exactly the same as the one observed between 1933 and 1937. It was described in detail by Cristofoline and Largaiolli (4).

The lesions consist of roundmarks of varying size (Fig. 2), mainly in the extremities, dark-blue or brown in color. They resemble bruises except that they gradually become paler and disappear without changing color. The appearance of the lesion is sometimes preceded by pronounced headache, sudden episodes of sharp pain and aching of the bones and joints at or near the point where the lesions appear. Each mark lasts for about five to six days and then disappears. If the patient remains in the contaminated zone the symptoms recur in other areas of the skin. On palpation the larger marks appear like a sponge.

When the lesions were first observed they cleared up within five to six days after the patient was removed from the contaminated zone. Lately, however, (Spring 1967), it has taken up to 20 days for the symptoms to disappear. As in 1933 to 1937, the condition mainly affects women and children. During the acute phase, the histological examination of the biopsied skin revealed an edematous-fibrinous leucocytic exudate in the interstice of the adipose lobules (5). It is most pronounced at the dividing line between dermis and hypodermis. It is associated with degeneration of the adipose cells, partial reabsorption of the fat and formation of frothy, basophilic cells. The regressive phase of the lesions is characterized by mild perivascular infiltration. These histological changes resemble those of erythema nodosum but cannot be identified as such.

The lesions do not appear to have been observed in populations living close to similar establishments nor do they correspond with the typical symptoms of chronic fluorosis, at least not so far as we know.

After the first cases were reported in July and August, 1965, an epidemiological survey was carried out in September of the same year. Of 830 inhabitants of Chizzola, the disease occurred in 110 namely, 15 males and 95 females. The lesions regressed during the winter months and reappeared in May and June 1966.

Another acute outbreak occurred toward the end of 1966. It provoked angry protests by the afflicted population. A special medical service was set up to study the general health of the people from the epidemiological point of view. The lesions were observed in 257 inhabitants of Chizzola, in 142 out of 460 inhabitants of the nearby village of Serravalle and 106 out of 625 inhabitants of Pilcante. They were distinctly more prevalent in children up to 12 years and in women.

A thorough investigation was carried out concerning the incidence of the phenomenon among pupils of the elementary schools of Chizzola. Pupils of a village outside of the factory emission area with the same geographic and socio-economic characteristics served as a control. Even though conclusive data about this study are not yet available, it is nevertheless clear that the incidence of the skin lesions is considerably higher among the Chizzola pupils than among those of the control group. Upon repeated re-examination, and upon evaluation of the symptomatology and differential diagnosis, it appears that the incidence of the typical skin lesions in Chizzola pupils is of the order of 17 to 61 percent, whereas in the pupils of the control group it is practically zero.

To ascertain the level of pollution of the area affected by the waste-products from the factory, three permanent stations were set up in April 1966 to take samples of the volatile F compounds. In February 1967 five deposit gauges were placed to collect deposited particulate material. The gauges were placed at increasing distances of 600 to 3250 m (1/3 to 2 miles), from the source of the waste gases in a line running from North to South, as shown on the map. Samples of volatile F compounds were taken by means of impingers at intervals varying from I to 10 days. Rain-water samples were collected in the deposit gauges once in a fortnight.

The concentrations of fluorine in the impingers showed considerable fluctuation. At times not even a trace of the pollutant agent could be found. Other samples gave readings higher than 10 ug/-3 as shown in Table I.

The topographical distribution of the pollution level also seems to follow an irregular pattern, which most probably depends on the particular anemological situation of the area. In some samplings the highest readings were obtained at the station closest to the source of pollution (2 miles); high readings were also obtained at stations in the village of Chizzola, about 3 km from the factory.

The level of air pollution is less than that found in the same area between 1935 and 1938 by Marotta, Vita and Anselmi (5).

As our data indicate, air pollution seemed to show a tendency to decrease with the passage of time. This decrease may by connected with the installation of modern purification equipment designed to eliminate airborne waste particles.

In fact, Fig. 3 shows that the F concentrations in rain-water were considerably lower in all stations after the installation of an electrostatic filter. At the first station (Table 2) it dropped from an average of 3504 ug/m3 to an average of 1228 in the months following the installation of the new purification device. For stations 2, 3, 4 and 5, readings dropped from 2023 to 491, 1089 to 450, 1025 to 367 and H17 to 356 ug F/m3, respectively.

The highest concentration of fluorine occurs usually during periods of heavy precipitation.

As for the topographical distribution, the pollution is highest nearest the source. Readings decrease the farther away from the factory they are taken.

The measures adopted by the factory to reduce the level of air-pollution appear to be effective. The diminution of the harmful effects on agriculture distinctly parallels the improvement in the health of the population. During recent months skin lesions tended to appear less frequently simultaneously with the reduction of fumes emanating from the factory. However, at the present stage of our research, the lesions cannot be definitely attributed to incipient chronic fluorosis, since the level of air pollution in the area is lower than that in the vicinity of other similar industrial establishments.

Other factors, so far not yet identified, may play a part in the pathogenesis of the phenomenon and intensify the toxic action of fluorine.

It seemed to us to be worth commenting on this phenomenon even though we are not yet in possession of conclusive evidence. We wish to alert others living near similar factories to the lesions. The same condition has been recognized near an aluminum plant in Bolzano.

SUMMARY

For many years, women and children have complained of skin lesions similar to suffusions in an area of Trentino, near an aluminum plant. These lesions first were observed in the same place about 30 years ago. The symptomatology is related to damage to the vegetation due to emission of fluorine compounds. Since March 1966 three permanent stations were installed in the area in order to collect volatile compounds of fluorine. Since February 1967, five deposit gauges were established at progressively increasing distances from the source.

Fluorine air pollution has reached values close to and sometimes above 10 ug of fluorine per cubic meter of air.

Rain-water collected for two weeks in the deposit gauges showed decreasing concentrations of fluorine the greater the distance from the source. The highest value of 7.13 mg of fluorine per liter was found in the deposit gauge closest to the factory. In the inhabited area, the fluorine content ranged between 0. 14 and 2. 55 mg/liter.

Since May 1967, the degree of fluorine pollution has decreased following installation of modern purification equipment at the plant.

Editor's Note: Having been alerted to these lesions, the editor has observed them in patients afflicted with fluorosis near a foundry in Michigan, near fertilizer factories in Iowa and in two individuals intolerant to fluoridated water.

REFERENCES

1. Martinelli, E. : L vapori fluoridrici degli stabilimenti per la estrazione del Alluminio e i danni cagionati alla vegetazione. Ed. A. Verrocchio, Pescara, 1935.
2. Pigorini, L., Catoni, G., and Marchi, C.: Relazione. Ed. Arti Grafiche Saturnia. Trento, 1932.

3. Bardelli, P. and Menzani, C.: La Fluorosi, Atti del Reale Istituto Veneto Di Scienze, Lettere ed Arti 97, 1938.

4. Cristofolini, M. and Largaiolli, D.: Su di una probabile tossidermia da fluoro. Rivista Medica Trentina 4, 1966.

5. Marotta D., Vita, D. and Anselmi, S.: Indagini su le emenazioni di una fabbrica di allurninio in rapporto all ambierte. Rend. Ist. Sup. Sanita 1:735, 1938.

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