Measuring the expected increase in cycling in the city of Milan and evaluating the positive effects on the population's health status: a Community-Based Urban Planning experience.

BACKGROUND: It's scientifically known that inactivity is one of the major risk factors for Non-Communicable Diseases. One of the elements affecting the choice of transport mode, regarding circulation in the city, is the cities' urban morphology, i.e. the infrastructural facilities for the slow mobility service. Cyclability, in fact, can help to increase daily physical activity level, therefore becoming a protective factor for individual health. METHODS: After a literature review about the state of the art regarding the correlation between built environment, active transport and quantification of the physical activity level, we have developed a specific questionnaire to collect information about current and forecast use of bicycle, in case of improvement and implementation of the cycling network. The questionnaire also investigated social and health aspects concerning the anamnesis of the interviewees (age, gender, health status, sport activity performed, etc) and users' opinions about existing infrastructure and planned interventions, designed to promote cycling mobility. Aim of the research was to quantify the increase of physical activity people would have realized in front of an improvement of the specific infrastructures, and the expected positive effects in terms of health. RESULTS: The collected data (343 interviewed in a district of Milan, named "Zona 7") demonstrate that through the implementation of the cycle network, there would be more cyclists to practice the 150 minutes weekly of physical activity recommended by WHO: time spent in cycling, indeed, would increases by 34.4% compared to the current level of cyclability, as detected by our survey. CONCLUSIONS: The investigation confirmed that urban interventions, especially those in small-scale, could play a key role in the promotion of healthy lifestyles, inducing therefore important positive effects on the population health. It was also carried out an application of the WHO "Health Economic Assessment Tool" to evaluate the benefits in terms of Non-Communicable Diseases' reduction, specifically a provisional quantification of deaths saved.

Measuring hygiene and health perfomance of buildings: a multidimensional approach.

This paper proposes an innovative and transparent methodology to support the "ASL Milano" (Local Health Agency) in the hygiene and health evaluation of construction projects, in order to highlight their positive and negative performance beyond the requirements imposed by the current laws and regulations regarding buildings' hygiene performance, which are too old and therefore unsuitable to ascertain the real quality of indoor environments. The compliance with laws or regulations, mostly out of date, and the assessment of performance involving only a part of the current emerging needs and problems, in fact, should be considered as a necessary, although not a sufficient step, to ensure high quality indoors. Consequently, it is necessary to identify and test an assessment tool which could provide an effective and flexible support for the development of hygiene and health statements regarding projects at building scale (new construction, conversion of the existing, rehabilitation, extension, change of use, etc). The assessment tool suggested by this paper is tailored for the metropolitan area of the city of Milan, but its evaluation framework could be developed and applied to other contexts.

Hygiene and emergency. Considerations and proposals for improving hygiene and health features of Advanced Medical Post.

BACKGROUND: In the last decades has been recorded, both nationally and internationally, a significant increase in disasters with a high number of deaths and injuries involved. The presence at the venue of the Advanced Medical Post (AMP) has improved the survival of the affected population. However, these temporary structures, not according to common standards relating to health hospital environments are devoid of design guidelines and technologies designed to hygiene and safety. METHODS: Starting from the inquiry into the functioning and the structure of an Advanced Medical Post through interviews, questionnaires and joint activities with Italian organizations and structures, a number of measures have been established for the improvement of health standards. RESULTS: Through the survey and questionnaires developed for this purpose it was possible to determine the most hygienically critical areas and then several solutions were processed and evaluated (in synergy with associations previously interviewed). The most important priorities to satisfy were the hygiene improvement to be achieved through the use of specific materials (fabrics antimicrobial ...), the study of the articulation inside the operating room and intensive care of AMP (insulation and Zoning filter ...) and the definition of more efficient technological systems-plant (ventilation, aeration, lighting...). Therefore the solution proposed involves the use of a new layer fabric for mounting inside of curtains already supplied to the main associations and a series of technological devices and installations for limiting the spread of virus-bacteria. CONCLUSIONS: The introduction of this new unit for AMP modules could give a significant contribution to achieving high standards of hygiene during health care assistance in critical situations (maxi-emergencies and disasters) which, unfortunately, are actually becoming more frequent.

[Healthy design for sustainable communities]. / Sistema multicriteriale di valutazione degli aspetti igienico- sanitari di piani di governo del territorio e piani attuativi.

Health, quality of life and sustainable development are strongly interconnected. The quality of living is a complex concept that includes different meanings. The quality of life issue has been studied for a long time, even if its measurement is a more recent matter. It's possible to distinguish two main approaches: the first one, depending on which the quality of life corresponds to the social wellbeing and it can be measured objectively; the second one, that emphasizes the perceptive dimension of quality of life, such as needs, feelings and aspirations. According to the WHO's wide definition of wellbeing, this paper suggests an approach focused on the effects that urban planning and designing can have on the health of citizens. Actually many of the problems of the cities like pollution, inequity, lack of services and accessibility depends on decisions about the development of land and buildings. To have more attractive cities in the future it is important that professionals involved in planning and local authorities focus on the major determinants of health: the physical and social environment in which people live and the nature of their lifestyles. The experience explained in this paper shows as local authorities can support professionals in designing process, producing quick and effective benchmark in order to improve the quality of urban spaces and architecture. More in deep the tool works by a set of performance indicators developed with the purpose to assess the degree of sustainability of building and urban space proposals at the planning stage (and at later stages), against a range of criteria. This evaluation procedure can be considered as a common platform from which different stakeholders can agree goals and work together contributing to increase the benefits of a well-designed built environment.