Evaluation of different molecular systems for detection and quantification of SARS-CoV-2 RNA from wastewater samples.

Wastewater-based epidemiology has proved to be a suitable approach for tracking the spread of epidemic agents including SARS-CoV-2 RNA. Different protocols have been developed for quantitative detection of SARS-CoV-2 RNA from wastewater samples, but little is known on their performance. In this study we compared three protocols based on Reverse Transcription Real Time-PCR (RT-PCR) and one based on Droplet Digital PCR (ddPCR) for SARS-CoV-2 RNA detection from 35 wastewater samples. Overall, SARS-CoV-2 RNA was detected by at least one method in 85.7 % of samples, while 51.4 %, 22.8 % and 8.6 % resulted positive with two, three or all four methods, respectively. Protocols based on commercial RT-PCR assays and on Droplet Digital PCR showed an overall higher sensitivity vs. an in-house assay. The use of more than one system, targeting different genes, could be helpful to increase detection sensitivity.

Calibration of Methods for SARS-CoV-2 Environmental Surveillance: A Case Study from Northwest Tuscany.

The current pandemic has provided an opportunity to test wastewater-based epidemiology (WBE) as a complementary method to SARS-CoV-2 monitoring in the community. However, WBE infection estimates can be affected by uncertainty factors, such as heterogeneity in analytical procedure, wastewater volume, and population size. In this paper, raw sewage SARS-CoV-2 samples were collected from four wastewater treatment plants (WWTPs) in Tuscany (Northwest Italy) between February and December 2021. During the surveillance period, viral concentration was based on polyethylene glycol (PEG), but its precipitation method was modified from biphasic separation to centrifugation. Therefore, in parallel, the recovery efficiency of each method was evaluated at lab-scale, using two spiking viruses (human coronavirus 229E and mengovirus vMC0). SARS-CoV-2 genome was found in 80 (46.5%) of the 172 examined samples. Lab-scale experiments revealed that PEG precipitation using centrifugation had the best recovery efficiency (up to 30%). Viral SARS-CoV-2 load obtained from sewage data, adjusted by analytical method and normalized by population of each WWTP, showed a good association with the clinical data in the study area. This study highlights that environmental surveillance data need to be carefully analyzed before their use in the WBE, also considering the sensibility of the analytical methods.

[The Tuscan experience on the asbestos discharge process 28 years after the ban: critical issues and future perspectives]. / L'esperienza toscana sul processo di dismissione dell'amianto a 28 anni dal bando: criticità e prospettive future.

OBJECTIVES: to examine the progress of the remediation and disposal of asbestos containing materials (ACMs) in Tuscany Region (Central Italy), the relative workforce employed, and how these activities are framed and reflected in the Italian panorama. DESIGN: descriptive study on the asbestos removal process in Tuscany. SETTING AND PARTICIPANTS: Reports drawn up according to article No. 9 of Law No. 257/92 received by the Tuscany Region from 1993 to 2019. The on-line submission of the reports has been available since 2011. MAIN OUTCOME MEASURES: quantities and characteristics of used or removed ACMs by compact and friable matrix, the ones transferred to temporary storage and/or landfill plants during 1995-2019; number of employees engaged in activities with asbestos presence, by type and duration of activity during 2015-2019. RESULTS: from 1993 to 2019, the Tuscany Region received a total of 5,284 reports. From 1995 to 2019, a total of 423,487 tons of ACMs were removed in Tuscany, 402,897 in a compact matrix and 20,590 in a friable matrix. Over the past five years, the workers employed in these activities were on average 1,500, with around 182,000 hours per year in contact with ACMs. CONCLUSIONS: Reports article No. 9 are an essential tool to monitor and evaluate the impact of political choices to incentivize the process of ACM removal, which is still proceeding too slowly: still 3/4 of installed ACMs remain in place 28 years after the ban. Furthermore, Reports article No. 9 are a source to identify workers who are potentially exposed to lower doses than in the past; they can be included in epidemiological cohort studies as well as in health surveillance programmes of past asbestos workers, an essential assistance level of collective prevention.

Lifestyle and resulting body composition in young athletes.

BACKGROUND: Key aspects in a lifestyle analysis are physical activity level and eating habits. An unhealthy lifestyle results in fat mass increase and in a predisposition to non-communicable chronic diseases even in young age. The purpose of this study was to investigate the lifestyle and body composition in young athletes. METHODS: The subjects underwent to an assessment of body composition and they completed two questionnaires, one concerning the level of physical activity and the other regarding eating habits. RESULTS: One hundred fifty-two young athletes (63 females and 89 males) aged 8 to 18 years (13.4±2.5 years, height 159±14 cm) were enrolled in this study. 80.3% of subjects were normal weight (13.4±2.6 years) and 19.7% subjects (13.5±2.5 years) were overweight or obese. Greater sedentary behaviors were found in the overweight or obese participants compared to normal weight (618±125 vs. 523±89 min; P<0.001) and a lower consumption of milk and yoghurt (5.0±3.2 vs. 6.9±4.1 times/week; P=0.031). CONCLUSIONS: Although competitive sports often increase physical activity levels in young people, this activity does not seem to reach the daily recommended amount of physical activity during youth. Therefore, it is necessary to have a comprehensive approach to create a primary prevention strategy from even a young age.

Integrated total body composition versus Body Mass Index in young athletes.

BACKGROUND: The aim of this study was to assess if the evaluation of Body Mass Index is sufficient to define an overweight index in young athletes, or if a more effective evaluation is preferable in order to examine body fat mass, free-fat mass and hydration status in young athletes. METHODS: Two hundred ninety-nine young athletes between the ages of 8 to 18 have been analyzed in this study. Data from evaluation in body composition of young athletes were studied and subdivided by age, sex and method used. In order to measure body composition in young people, the participants who attend our Department for sport eligibility examination, were evaluated through anthropometric measurements as far as, fat mass, fat-free mass and hydration status are concerned. RESULTS: The statistical differences showed with Body Mass Index and body fat assessment reflect that more accurate evaluation is preferable: the normal-weight with Body Mass Index are 78.0%, overweight 18.7% and obese 3.3% respect to a 75.0%, 14.0% and 11.0% detected with a body fat evaluation (P<0.000); statistical differences have been found also subdividing the group per sex, higher in males (P=0.046) than to females (P<0.000). Bio-impedance data shown a statistical differences in young obese athletes. CONCLUSIONS: The results obtained show clearly that the analysis of the Body Mass Index is not sufficient in young athletes. Therefore, for young athletes a full assessment of body composition would be appropriate to reduce classific-tion errors.

Growth Charts for Height, Weight, and BMI (6-18 y) for the Tuscany Youth Sports Population.

Overweight during youth is a large-scale public health issue. Engaging in regular physical activity generally reduces weight status. The hypothesis of the study is that organized sport plays an active role in maintaining a correct body weight during youth. The purpose of this study is to trace growth charts by height, weight, and body mass index (BMI) to be applied to the youth sports population. A retrospective study was conducted on 14,700 young athletes (10,469 males and 4231 females) aged between 6 and 18 years from surveillance carried out during the pre-participation screening of sports eligibility. The calculation of the prevalence of overweight and obesity was also performed. The new percentiles for the youth sports population show BMI values at 18 years 21.9 kg/m2 for males and 20.7 kg/m2 for females at the 50th percentile. The male sample shows 12.3% of the subjects were overweight and 1.5% were obese, while the female sample shows 9.8% are overweight and 1.1% obese. The higher prevalence of excess weight is evident up to 12 years old in both sexes and then gradually decreases. The development of the new specific growth charts for the youth sports population could reduce the risk of error in identifying the correct weight status of young athletes.

Overweight in Young Athletes: New Predictive Model of Overfat Condition.

The aim of the study is to establish a simple and low-cost method that, associated with Body Mass Index (BMI), differentiates overweight conditions due to a prevalence of lean mass compared to an excess of fat mass during the evaluation of young athletes. 1046 young athletes (620 male, 426 female) aged between eight and 18 were enrolled. Body composition assessments were performed with anthropometry, circumferences, skinfold, and bioimpedance. Overweight was established with BMI, while overfat was established with the percentage of fat mass: 3.5% were underweight, 72.8% were normal weight, 20.1% were overweight, and 3.5% were obese according to BMI; according to the fat mass, 9.5% were under fat, 63.6% were normal fat, 16.2% were overfat, and 10.8% were obese. Differences in overfat prediction were found using BMI alone or with the addition of the triceps fold (area under the receiver operating characteristics curve (AUC) for BMI = 0.867 vs. AUC for BMI + TRICEPS = 0.955, p < 0.001). These results allowed the creation of a model factoring in age, sex, BMI, and triceps fold that could provide the probability that a young overweight athlete is also in an overfat condition. The calculated probability could reduce the risk of error in establishing the correct weight status of young athletes.

[Health surveillance programme for workers with past asbestos exposure in Tuscany Region (Central Italy)]. / Il percorso di sorveglianza sanitaria degli ex-esposti ad amianto in Toscana.

Asbestos-related diseases are characterized by a long latency time since exposure. This accounts for a health surveillance programme addressed to asbestos workers to be performed for decades after the cessation of occupational exposure. We describe the health surveillance programme for former asbestos-exposed workers in Tuscany Region (Central Italy), with particular attention to organization and related critical issues. The Deliberation of the Regional Administration of Tuscany (No. 396/2016) supports the programme, defined by a regional group of experts, and defines the public health services where the programme has to be implemented. The programme activities are classified in two levels: a first level for a basic health evaluation and a second level for in-depth analyses. The former asbestos workers, aged less than 80 years and with cessation of occupational asbestos exposure in the last 30 years, that might be included free of charge in the programme are about 5.600. The funds assigned to develop the programme from 2016 to 2024 were 2,044,808 euros. The Regional Administration of Tuscany decided to offer and guarantee a homogeneous programme in the whole region. The identification of a specific public health programme and the cooperation of social stakeholders, defined with specific regional agreements, might facilitate to overcome the problems which are still open, such as a broaden invitation to adhere to the programme, an extended knowledge on the service, and the application of a similar health programme for still-working former asbestos workers.

Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region.

Asbestos-related diseases usually have a long latency since first exposure and this legitimates a health surveillance programme addressed to asbestos workers after the cessation of their occupational exposure. After a brief history of health surveillance initiatives performed in Italy as well as in other countries, we describe a regional programme for former asbestos-exposed workers, focusing on organizational features. A regional group of experts defined its operational and economical aspects. The Regional Council supported the whole programme, making it free of charge for all subjects who fulfil the predefined enrolment criteria (being resident in the region, being younger than 80 years old with cessation of occupational asbestos exposure within the last 30 years). The programme activities are classified in two levels: a first level for a basic health evaluation and a second level for in-depth analyses. In order to guarantee an homogeneous delivery in the whole region, the programme has to be performed by public health services with a quality control of activities. The involvement of specific public health services and the cooperation of social stakeholders are expected to play a major role in overcoming still open critical issues, such as the lack of programme existence awareness and adhesion, the correct stratification of subjects for the follow-up, and the real homogeneous delivery of the health surveillance in whole region.

[Phisycal activity and primary prevention: lifestyle analysis in young people]. / Attività fisica e prevenzione primaria: valutazione dello stile di vita nei giovani.

OBJECTIVES: to assess physical activity and overweight in a young population as factors associated with well-being. DESIGN: cross-sectional study. SETTING AND PARTICIPANTS: data collection was performed in primary and secondary schools of a district located in Florence (Tuscany Region, Central Italy) by a validated questionnaire; 1,776 subjects were enrolled. MAIN OUTCOME MEASURES: physical activity levels and overweight. RESULTS: an overweight or obese condition in 14,4% of the study population was observed. Vigorous physical activity prevailed in normal weight children, while the time spent in a sitting position was higher in overweight subjects. CONCLUSIONS: physical activity levels do not follow the guidelines for youth people. Educational programmes, also at schools, are recommended in order to prevent the risk of developing chronic diseases in adulthood.

Evaluation of physical activity and dietary behaviors in young athletes: a pilot study.

BACKGROUND: The aim of this study was to evaluate the lifestyle based on the physical activity and eating habits of young athletes. METHODS: In order to measure physical activity and eating habits in young people, 922 young athletes between the ages of 8 to 18 have been analyzed in this study. The participants were all patients come to our Department for sport eligibility evaluation; we have asked them to complete an accurate questionnaire in order to assess their personal physical activity levels and their regular eating habits. Parents were invited to sign a letter explaining the aims of the study and were asked for permission on behalf of their child to take part on the study. RESULTS: The eating habits and the physical activity levels of the young athletes observed, resulted improper. We have noticed that the 13.7% of the participants were overweight and obese, despite their practiced sport activity. Physical activity, without sport activity, resulted inadequate in 38.6% of participants: they did not practice regular physical activity. CONCLUSIONS: The results of the study clearly indicate that higher education is therefore necessary in order to promote a healthy lifestyle in terms of both eating habits and physical activity not only in young people, but also in parents and coaches of teams.

Lifestyle interventions in preventing new type 2 diabetes in Asian populations.

The aim of this study was to review current evidence on interventional studies aimed at the prevention of type 2 diabetes in Asian population with lifestyle interventions. Prevalence of type 2 diabetes sharply increased in most Asian countries during the last decades. This issue has now also relevant implication for Europe where different surveys are also consistently revealing an higher prevalence of type 2 diabetes and other and major CVD risk factors among subjects originating from Asian Countries than in the native population. Nutrition and lifestyle transition seem to play a role in disclosing the predisposition for the development of type 2 diabetes and great interest is now shown toward the possibility to intervene with lifestyle intervention on at risk populations. A meta-analysis of Randomized Controlled Trials showed that lifestyle interventions are highly effective also in the Asian population. All studies were, however, conducted with an individual approach based on the identification of high-risk individuals. When ethnic minority groups have to be addressed, an approach directed to the community rather than to the individual might, however, be more effective. This review reinforces the importance for policy-makers to consider the involvement of the whole community of minority immigrant groups with lifestyle intervention programs.

Pesticides and their metabolites in selected Italian groundwater and surface water used for drinking.

The control of groundwater and surface water quality in relation to the presence of pesticides and their metabolites is a rather complicated task. National and local authorities with the responsibility to guarantee an adequate quality of water cannot rely on international guidelines for monitoring activities. In a national project, forty-three pesticides and pesticide metabolites were selected on the basis of sale, monitoring and physical-chemical data, and investigated from some of the main Italian agricultural areas, susceptible to pesticide contamination. Twelve compounds were found in the tested water samples at levels exceeding the 0.1 µg/L European Union (EU) limit for drinking water (European Directive 98/83/EC). Maximum levels up to 0.62 were determined. Several water samples were characterized by the simultaneous occurrence of pesticides and their metabolites (up to ten). In some samples, the total concentration of pesticides and their metabolites was higher than the EU limit of 0.5 µg/L. Total triazine concentrations up to 1.02 µg/L were found. In all the cases the highest concentrations were well below the respective guideline values defined by the World Health Organization (WHO) for drinking water quality.