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NAPLES, Italy — A five-year review of children born to U.S. military personnel who had lived in Naples concluded that the birth defect rate is lower than the overall Navy rate, but higher than the rate in other Navy overseas locations.

Naples’ birth defect rate was 3.13 per 100 births. That’s higher than the rate of 2.35 per 100 births for other Navy overseas sites, yet lower than the Navy’s overall rate of 3.6 per 100 births, according to the records review conducted by the Naval Health Research Center in San Diego.

"Overall, these analyses do not suggest a statistically significant increase in the birth defect rate of infants who gestate in the first trimester of their development in the Naples area compared to infants who gestate in the first trimester of their development in other overseas Navy areas," reads a portion of the four-page report. "Although reassuring, additional surveillance in the region should continue in order to further evaluate the effect of specific exposures potentially influenced by the trash situation such as air and water."

For decades, the Campania region has experienced numerous environmental crises spurred by inadequate trash collection, burning of trash in the streets and reports of illegal hazardous waste disposal. Health concerns prompted the Navy to launch a multimillion-dollar health assessment one year ago to determine if living in Naples poses a health hazard. Those concerns have been amplified by "recent studies conducted by the Italian government [that] appear to suggest an increased risk of cancer and birth defects among their citizens in this area of Italy," states the Navy’s birth defect review that was released Friday.

The review did not seek to determine whether living in Naples caused children to be born with birth defects. Instead, the study was designed to answer one question: "Was the risk of a birth defect in children who were conceived while the mothers were enrolled in Naples significantly different from children born to mothers who were enrolled in other overseas facilities," Dr. (Cmdr.) Timothy Halenkamp, occupational and environmental medicine specialist in Naples, wrote in the executive summary.

The study included infants born from January 2000 through December 2005 to mothers who either were military or spouses of military personnel, enrolled in a military treatment facility, and in Naples for one month before conception and during the first trimester. The study did not analyze children born to civilians.

Of the 894 Naples births reviewed, 28 children were born with birth defects, and 35 children were born pre-term.

Navy officials were unable to reach health experts by deadline Friday to answer questions such as what types of birth defects the children were born with, whether those defects are consistent with birth defects found in the other study groups, whether experts considered miscarriage rates, or why the study excluded years beyond 2005.

Though Navy officials acknowledged that health concerns stemming from environmental crises peaked in 2007, the birth defects study encompassed a record review only for that five-year period ending in 2005.

Several studies and reports by both the Italian health system and the World Health Organization point to potentially larger health concerns, namely cancers, malformations and birth defects in "clusters" of the Campania region, with a predominate concentration of rates in the provinces of Caserta and Naples — where most U.S. and NATO personnel assigned to Naples live and work, and sites of uncontrolled or illegal toxic waste dumps.

The Navy’s birth review is one of three epidemiology studies by the Navy and Marine Corps Public Health Center, tasked by the Navy to conduct the unprecedented, expansive health review in Naples.

In October, a 20-month asthma study ended with inconclusive results as officials tried to determine if living in Naples increased the number of asthma sufferers, or increased the severity of the illness. Center experts analyzed records of 581 patients who sought asthma-related treatment at the Navy’s hospital and clinics between Oct. 1, 2006, through June 30, 2008.

Experts analyzed patients suffering only from asthma, and did not include those treated for eye irritations, runny noses, sore throats, coughs or colds, for example, since there are too many variables beyond exposure to smoke or pollution that can trigger problems.

"This study was unable to identify any significant trends that might associate increased exposure to smoke from burning trash with either an increase in average asthma severity or number of medical visits diagnosed as asthma," the study’s conclusion read.

The third epidemiological study will seek to determine if there are changes in cancer rates for Navy personnel and families living in Naples compared to cancer rates for the Navy in general.

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