Pesticide exposure assessed through agricultural crop proximity and risk of amyotrophic lateral sclerosis.

BACKGROUND: Epidemiologic studies have raised the possibility that some pesticide compounds induce the neurodegenerative disease amyotrophic lateral sclerosis (ALS), though the available evidence is not entirely consistent. METHODS: We conducted a population-based case-control study in two Italian populations to assess the extent to which residence in the vicinity of agricultural crops associated with the application of neurotoxic pesticides is a risk factor for ALS, using crop acreage in proximity to the residence as an index of exposure. RESULTS: Based on 703 cases and 2737 controls, we computed an ALS odds ratio of 0.92 (95% confidence interval 0.78-1.09) for those in proximity to agricultural land. Results were not substantially different when using alternative exposure categories or when analyzing specific crop types, with the exception of a higher risk related to exposure to citrus orchards and olive groves in Southern Italy, though based on few exposed subjects (N = 89 and 8, respectively). There was little evidence of any dose-response relation between crop proximity and ALS risk, and using long-term residence instead of current residence did not substantially change our estimates. CONCLUSIONS: Though our index of exposure is indirect and subject to considerable misclassification, our results offer little support for the hypothesis that neurotoxic pesticide exposure increases ALS risk.

[Knowledge, attitudes, and training needs of residents in Preventive Medicine and Hygiene in Italy, in the context of Primary Health Care]. / Ricognizione dei bisogni formativi dei medici specializzandi di Igiene e Medicina Preventiva nell'ambito dell'Assistenza Primaria: risultati di una survey online.

In June 2015, the working group "Primary Health Care" of the Italian Society of Hygiene Representatives of Hygiene and Preventive Medicine Residents, performed an online questionnaire survey among residents of this specialty in Italy, to analyze their training needs regarding primary health care. In total, 730 residents in 32 schools were invited to participate by email, of whom 40.7% (297/730) completed the questionnaire. Most of the respondents were female (66.7%) and 40.1% were enrolled in a school in northern Italy. Almost half of participating residents were enrolled in the second or third year of the five-year program. Over 65% reported interest in deepening their knowledge in each of the proposed thematic areas of primary healthcare. For each area, less than one quarter of respondents (range 5-22%) considered satisfactory the skillsets acquired in that area. Eighty-seven percent reported that the option to do electives in primary health care during the residency was available to them.

Medical school fails to improve Mediterranean diet adherence among medical students.

BACKGROUND: The Mediterranean Diet (MeDi) is associated with a reduced risk of several non-communicable chronic diseases. High levels of nutrition knowledge are associated with greater MeDi adherence irrespective of education and other socio-economic factors. The present study investigates whether attending medical school changes students' adherence to the MeDi. METHODS: A cross-sectional study was conducted in November-December 2014 using the 16-item KIDMED questionnaire, which inquiries into eating habits. Each respondent's KIDMED index (range 0-12), whose scores reflect 'poor', 'average' or 'good' MeDi adherence, was calculated. Scores were analyzed for gender, age and early/late medical school year. The Mann-Whitney U-test and the chi-square test were used for group comparisons. Ordinal logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for changes in MeDi adherence from early to late medical school after adjustment for potential confounders. RESULTS: Participants were 1038 medical students (573 females) aged 18-34 years (mean 21.9 ± 2.4). There were 20.8% 'poor', 56.5% 'average' and 22.7% 'good' scores. Gender significantly affected scores (P < 0.01). In the ordinal logistic regression model the odds for greater MeDi adherence increased for the female gender (P < 0.05); females were 48% more likely to have a 'good' KIDMED score than their male peers, whereas early/late medical school year did not affect results [adjusted odds ratio (OR) = 0.95; P = 0.15]. CONCLUSIONS: More than 70% of our medical students know very little about healthy eating and the MeDi. However, this knowledge is essential in their future profession both to support therapeutic decision-making and effective preventive actions.

The importance of indicators in monitoring water quality according to European directives.

Directive 2000/60/EC and subsequent legislation provide a list of priority substances to be measured and monitored in EU water bodies and require the adoption of analytical methods that ensure comparability of the data collected in all Member States. These regulations and standards have gradually improved water quality in the EU. However, new drugs, whose effects on ecosystems and health are still to be determined, are detected with growing frequency. The Member States are now called upon to characterize and monitor these pollutants in view of their possible inclusion in the priority substance list.

[Brominated flame retardants: environmental contamination, exposure sources and potential negative health effects]. / Ritardanti di fiamma bromurati: contaminazione ambientale, fonti di esposizione e potenziali effetti sulla salute.

This article summarizes recent evidence regarding brominated flame retardants. These represent the most common type of flame retardants used and recent studies have highlighted their presence in various concentrations in different environmental matrices, including areas distant from production areas, and in human biological samples. Many doubts persist regarding exposure sources, toxicity, metabolism and transformation processes once these products are released into the environment.

[Allergic rhinitis and asthma in children and indoor pollution]. / Rinite allergica e asma in età pediatrica e inquinamento dell'ambiente Indoor.

A literature review was conducted in order to give an update on data regarding the various factors involved in the pathogenesis of allergic rhinitis and asthma. Preventive strategies are also discussed.

Magnetic fields exposure from high-voltage power lines and risk of amyotrophic lateral sclerosis in two Italian populations.

The aetiology of amyotrophic lateral sclerosis (ALS), a rare and extremely severe neurodegenerative disease, has been associated with magnetic fields exposure. However, evidence for such a relation in the general population is weak, although the previous null results might also be due to exposure misclassification, or a relationship might exist only for selected subgroups. To test such a hypothesis we carried out a population-based case-control study in two Northern and Southern Italy regions, including 703 ALS cases newly diagnosed from 1998 to 2011 and 2737 controls randomly selected from the residents in the study provinces. Overall, we found that a residence near high-voltage power lines, within the corridors yielding a magnetic fields of ≥0.1 µT, was not associated with an excess disease risk, nor did we identify a dose-response relationship after splitting the exposed corridor according to the 0.1, 0.2 and 0.4 µT cut-points of exposure. These results were confirmed taking into account age at onset, period of diagnosis, sex, geographical area, and length of exposure. Overall, despite the residual possibility of unmeasured confounding or small susceptible subgroups not identified in our study, these results appear to confirm that the exposure to magnetic fields from power lines occurring in the general population is not associated with increased ALS risk.