[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.

[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.

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.