Temporal variation in the effect of heat and the role of the Italian heat prevention plan.

OBJECTIVES: The aim of the article is to evaluate the temporal change in the effect of heat on mortality in Italy in the last 12 years after the introduction of the national heat plan. STUDY DESIGN: Time series analysis. METHODS: Distributed lag non-linear models were used to estimate the association between maximum apparent temperature and mortality in 23 Italian cities included in the national heat plan in four study periods (before the introduction of the heat plan and three periods after the plan was in place between 2005 and 2016). The effect (relative risks) and impact (attributable fraction [AF] and number of heat-related deaths) were estimated for mild summer temperatures (20th and 75th percentile maximum apparent temperature [Tappmax]) and extreme summer temperatures (75th and 99th percentile Tappmax) in each study period. A survey of the heat preventive measures adopted over time in the cities included in the Italian heat plan was carried out to better describe adaptation measures and response. RESULTS: Although heat still has an impact on mortality in Italian cities, a reduction in heat-related mortality is observed progressively over time. In terms of the impact, the heat AF related to extreme temperatures declined from 6.3% in the period 1999-2002 to 4.1% in 2013-2016. Considering the entire temperature range (20th vs 99th percentile), the total number of heat-related deaths spared over the entire study period was 1900. CONCLUSIONS: Considering future climate change and the health burden associated to heat waves, it is important to promote adaptation measures by showing the potential effectiveness of heat prevention plans.

Climate change, extreme weather events, air pollution and respiratory health in Europe.

Due to climate change and other factors, air pollution patterns are changing in several urbanised areas of the world, with a significant effect on respiratory health both independently and synergistically with weather conditions; climate scenarios show Europe as one of the most vulnerable regions. European studies on heatwave episodes have consistently shown a synergistic effect of air pollution and high temperatures, while the potential weather-air pollution interaction during wildfires and dust storms is unknown. Allergen patterns are also changing in response to climate change, and air pollution can modify the allergenic potential of pollens, especially in the presence of specific weather conditions. The underlying mechanisms of all these interactions are not well known; the health consequences vary from decreases in lung function to allergic diseases, new onset of diseases, exacerbation of chronic respiratory diseases, and premature death. These multidimensional climate-pollution-allergen effects need to be taken into account in estimating both climate and air pollution-related respiratory effects, in order to set up adequate policy and public health actions to face both the current and future climate and pollution challenges.

Traffic-related air pollution in relation to respiratory symptoms, allergic sensitisation and lung function in schoolchildren.

BACKGROUND: Urban air pollution can trigger asthma exacerbations, but the effects of long-term exposure to traffic-related air pollution on lung function or onset of airway disease and allergic sensitisation in children is less clear. METHODS: All 2107 children aged 9-14 years from 40 schools in Rome in 2000-1 were included in a cross-sectional survey. Respiratory symptoms were assessed on 1760 children by parental questionnaires (response rate 83.5%). Allergic sensitisation was measured by skin prick tests and lung function was measured by spirometry on 1359 children (77.2%). Three indicators of traffic-related air pollution exposure were assessed: self-reported heavy traffic outside the child's home; the measured distance between the child's home and busy roads; and the residential nitrogen dioxide (NO2) levels estimated by a land use regression model (R2 = 0.69). RESULTS: There was a strong association between estimated NO2 exposure per 10 microg/m3 and lung function, especially expiratory flows, in linear regression models adjusted for age, gender, height and weight: -0.62% (95% CI -1.05 to -0.19) for forced expiratory volume in 1 s as a percentage of forced vital capacity, -62 ml/s (95% CI -102 to -21) for forced expiratory flow between 25% and 75% of forced vital capacity and -85 ml/s (95% CI -135 to -35) for peak expiratory flow. The other two exposure indicators showed similar but weaker associations. The associations appeared stronger in girls, older children, in children of high socioeconomic status and in those exposed to parental smoking. Although lifetime asthma was not an effect modifier, there was a suggestion of a larger effect on lung function in subjects with a positive prick test. Multiple logistic regression models did not suggest a consistent association between traffic-related air pollution exposure and prevalence of respiratory symptoms or allergic sensitisation. CONCLUSION: The results of this study suggest that residential traffic-related air pollution exposure is associated with reduced expiratory flows in schoolchildren.

Prevalence of respiratory symptoms in migrant children to Italy: the results of SIDRIA-2 study.

BACKGROUND: Epidemiological studies have documented large international variations in the prevalence of asthma, and 'westernization' seems to play an important role in the development of the disease. The aims of this study were to compare the prevalence of respiratory symptoms in migrant and nonmigrant children resident in Italy, and to examine the effect of length of time living in Italy. METHODS: Data were collected in a large cross-sectional study (SIDRIA-2) performed in 12 Italian centres, using standardized parental questionnaires. For the 29 305 subjects included in the analysis (6-7 and 13-14 years old), information about place of birth and parental nationality was available. RESULTS: There were 1012 children (3%) born outside of Italy, mainly in East Europe. Lifetime asthma and current wheeze were generally significantly less common among children born abroad than among children born in Italy (lifetime asthma: 5.4% and 9.7% respectively, P < 0.001; current wheeze: 5.2% and 6.9%, respectively, P = 0.04). Lower risks for lifetime asthma (prevalence odds ratio, POR = 0.39; 95% CI: 0.23-0.66) and current wheeze (POR = 0.72; 95% CI: 0.47-1.10) were found for children who had lived in Italy <5 years, while migrant children who had lived in Italy for 5 years or more had risks very similar to Italian children. CONCLUSIONS: Migrant children have a lower prevalence of asthma symptoms than children born in Italy. Prevalence increased with the number of years of living in Italy, suggesting that exposure to environmental factors may play an important role in the development of asthma in childhood.

Time domain analysis of optical amplification in Er3+ doped SiO2-TiO2 planar waveguide.

A time domain analysis of light amplification in an erbium doped silica-titania planar waveguide is reported. The investigation is performed by means of a home-made computer code which exploits the auxiliary differential equation scheme combined with the finite difference time domain technique to solve Maxwell's equations and the rate equations. The simulation model takes into account the pump and input signal propagation, the secondary transitions pertaining to the ion-ion interactions and exploits the optical, spectroscopic and geometrical parameters measured on the fabricated waveguide.

Refinement of Er3+-doped hole-assisted optical fiber amplifier.

This paper deals with design and refinement criteria of erbium doped hole-assisted optical fiber amplifiers for applications in the third band of fiber optical communication. The amplifier performance is simulated via a model which takes into account the ion population rate equations and the optical power propagation. The electromagnetic field profile of the propagating modes is carried out by a finite element method solver. The effects of the number of cladding air holes on the amplifier performance are investigated. To this aim, four different erbium doped hole-assisted lightguide fiber amplifiers having a different number of cladding air holes are designed and compared. The simulated optimal gain, optimal length, and optimal noise fig. are discussed. The numerical results highlight that, by increasing the number of air holes, the gain can be improved, thus obtaining a shorter amplifier length. For the erbium concentration NEr=1.8x1024 ions/m3, the optimal gain G(Lopt) increases up to ~2dB by increasing the number of the air holes from M=4 to M=10.

Photonic band gap filter for wavelength division multiplexer.

An optical multiplexer-demultiplexer based on an index-confined photonic band gap waveguide is proposed. The dropping of electromagnetic waves having a given frequency or a certain frequency band is obtained via a phase-shifted grating obtained by breaking the uniform period sequence to include a defect layer. The selective filtering properties of the proposed structure are simulated by means of a computer code relying on a bi-directional beam propagation method based on the method of lines.

Effects of thermal annealing on the optical characteristics of k(+)-na(+) waveguides.

We present a systematic study of the changes induced in the refractive-index profile of different sets of K(+)-Na(+) ion-exchanged waveguides on soda-lime and BK7 substrates because of thermal annealing in the presence or absence of salt vapors. The concentration of potassium is recovered by secondary ion mass spectrometry, and the propagation losses are measured by means of the three-prism configuration.

Effects of thermal annealing on the optical characteristics of k -na + waveguides.

We present a systematic study of the changes induced in the refractive-index profile of different sets of K -Na + ion-exchanged waveguides on soda-lime and BK7 substrates because of thermal annealing in the presence or absence of salt vapors. The concentration of potassium is recovered by secondary ion mass spectrometry, and the propagation losses are measured by means of the three-prism configuration.