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OBJECTIVES: to compare three injuries indicators to establish which are less affected by underreporting and therefore best suited for the monitoring of the occupational injuries time trend during economic crisis. DESIGN: open cohort. SETTING AND PARTICIPANTS: a national sample of employees in the private sector, blue collars, males aged 15-64 years, extracted from the Work History Italian Panel-Healt archive, which combines data about firms and employee from the National Social Security Institute (Inps) and occupational injuries data from the Italian National Institute for Insurance against Accidents at Work (Inail). MAIN OUTCOME MEASURES: annual injuries rates for the period 2001-2012 classified according to three severity definitions: ⢠serious injuries according to the prognosis (IGP); ⢠serious Injuries according to the type of lesion (IGL); ⢠minor injuries. Time trends and their changes during the economic crisis (2008-2013) were analysed through negative binomial regression models, stratified by country of origin, macroarea of work, firm size, and economic activity. RESULTS: IGP rates decreased more than IGL and minor injuries rates during the economic crisis, highlighting their greater association with the economic cycle. Negatives and significant trend changes were observed in some subgroups: in manufacturing, among workers from high developed countries and Moroccans, in the Northern and Central macroareas of Italy, and in larger firms. CONCLUSIONS: variations in injuries rates were not so much influenced by the underreporting of injuries as by the changes in the working conditions following the economic crisis. To accurately monitor the injuries time trends, it is recommended to report at the same time at least one indicator based on minor injuries and one based on serious injuries.
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Traumatismos Ocupacionales , Academias e Institutos , Accidentes de Trabajo , Humanos , Italia/epidemiología , Masculino , Traumatismos Ocupacionales/epidemiologíaRESUMEN
BACKGROUND: 'Scuola sicura' (SS) programme aims to monitor the rate of COVID-19 and to contain its spread within the school population through early case isolation. OBJECTIVES: to describe the initial process and outcome evaluation results. DESIGN: descriptive study of an experimental screening testing programme in children in Piedmont Region (Northern Italy) in the period January-March 2021. The data used came from the COVID-19 platform and the Local Health Units, the archives of birth certificates (CedAP), and hospital discharge files (SDO). SETTING AND PARTICIPANTS: the screening programme targeted second and third grade students in first level secondary schools. Participants were subdivided into four groups; one group each week underwent screening, yielding one test per student per month. MAIN OUTCOME MEASURES: it was calculated: 1. number of positive cases detected vs total number of students tested in the SS programme; 2. number of positive cases detected outside the SS program vs. total number of students in the target population. The number of quarantines due to SS and no-SS case identification were detected. To investigate the spread of COVID-19 in households, the mother-child pairs were identified through record linkage between the CedAP and SDO archives, and positive mothers were identified. RESULTS: sixty-nine percent of schools and 19.5% of the students participated in the programme. SS detected 114 positives cases for SARS-CoV-2. On 08.03.2021, the target classes started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. Only for 61 out of 69 of those students (88%) was possible to identify the mother; 46 mothers had performed a swab test after the positivity of their child with a positive result in 11 cases. Asymptomatic cases identified at screening during in-class learning period accounted for 26.5% of the total number of cases occurred in the participating classes. CONCLUSIONS: this is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for SARS-CoV-2 in a real-world situation. The findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programmes.
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COVID-19 , Humanos , Italia/epidemiología , SARS-CoV-2 , Instituciones Académicas , EstudiantesRESUMEN
Exposure to polycyclic aromatic hydrocarbons (PAHs) was assessed in a cohort of 394 subjects, 198 residing in three small municipalities near a new waste-to-energy (WTE) incinerator located in the Turin area, and 196 residing in neighbouring control areas in the town (of Turin). The assessment of exposure to PAHs was part of a human biomonitoring study aimed at assessing potential incremental exposure to pollutants related to incineration activities through the analysis of such pollutants before the plant start-up, and after one and three years of operation. The exposure assessment described in this study was carried out before the start-up of the WTE incinerator. Ten monohydroxy-PAHs (OH-PAHs) were analyzed in urine samples, consisting in the principal metabolites of naphthalene (NAP), fluorene (FLU), phenanthrene (PHE), and pyrene (PYR). Concentrations of the sum of OH-PAHs (Σ10OH-PAHs) were in the range of 525-85200â¯ng/g creatinine, with P50 equal to 6770â¯ng/g creatinine. Metabolites of naphthalene were found at the highest concentrations (P50 values of 892 and 4300â¯ng/g creatinine for 1- and 2-OH-NAP, respectively) followed by the three OH-FLUs (P50 values of individual compounds in the range of 58.2-491â¯ng/g creatinine), the four OH-PHEs (P50 values in the range of 30.5-145â¯ng/g creatinine), and 1-OH-PYR (P50 value of 82.8â¯ng/g creatinine). Concentrations of 1-OH-NAP, 9-OH-FLU, 1-, 2-, 3, 4-OH-PHE, and 1-OH-PYR were significantly lower in subjects living near the WTE plant compared to those living in the town of Turin, with differences between the two groups in the range 14-31%. Smoking habits markedly influence the urinary concentrations OH-PAHs. Median concentrations of the single metabolites in smokers were from 1.4 fold (for 4-OH-PHE) to 14 fold higher (for 3-OH-FLU) than those observed in non-smokers. The heating system used also resulted to be a major contributor to PAH exposure. Concentrations of OH-PAHs were generally comparable with those observed in other industrialized countries. The profile pattern was consistent with those reported in the literature. Concentrations of OH-PAHs assessed in this study may be considered indicative of the background exposure to PAHs for adult population living in an urban and industrialized area.
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Monitoreo del Ambiente , Incineración , Hidrocarburos Policíclicos Aromáticos , Adulto , Monitoreo Biológico , Biomarcadores , Ciudades , HumanosRESUMEN
BACKGROUND: The start-up of the Turin municipal solid waste incineration plant (2013) was accompanied by surveillance of health effects, which included a human biomonitoring campaign. Here we present the results of the risk perception survey of local residents before the plant went into operation. METHODS: The survey sample was 394 local residents: 198 residing near the plant (exposed group) and 196 residing in an area distant from the plant site (unexposed group). The survey questionnaire investigated awareness of environmental and health issues, including a section on the perception of environmental health risks. Multivariate Poisson regressions were performed to determine the differences in risk perception between the two groups (exposed vs. unexposed). RESULTS: The exposed group was more concerned about natural hazards (prevalence ratio [PR] 1.61; 95% confidence interval [CI] 0.99-2.61), anthropogenic hazards (PR 1.35; 95% CI 1.03-1.77), and waste management (PR 1.19; 95% CI 0.94-1.50). There were no significant differences in opinions about environmental pollution-related diseases between the two groups, though the exposed considered themselves to be at risk for developing these diseases. The survey population placed its trust more in health care providers than in any other category. CONCLUSIONS: The risk perception survey questionnaire yielded data that enabled a better understanding and interpretation of the social context: residents living near the incineration plant were more concerned than those living distant from it, especially about anthropogenic hazards. This information was subsequently incorporated into the design the communication tools.
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Exposición a Riesgos Ambientales/efectos adversos , Contaminación Ambiental/prevención & control , Incineración , Eliminación de Residuos/métodos , Residuos Sólidos/efectos adversos , Instalaciones de Eliminación de Residuos , Monitoreo del Ambiente/métodos , Humanos , Italia , Medición de Riesgo , Encuestas y Cuestionarios , Administración de Residuos/métodosRESUMEN
BACKGROUND: It is known that occupational injury rates are higher for immigrant than for native workers, however the effects of the economic cycles on these differences has not been assessed to date. The aim of the paper is to test if the crisis has the same mechanism of selection in the two groups by comparing injury rates in 2005 (before the crisis) and in 2010 (after the crisis). METHODS: The Work History Italian Panel-Salute integrated database was interrogated to identify employment contracts in the metalworking and construction industries for the years 2005 and 2010 and the occupational injuries. A definition based on the type of injury, less likely to be biased by underreporting, was used to select serious events. Immigrants and natives were matched using the propensity score method and injury rates were calculated in the two years. Analyses were stratified by industry. RESULTS: In the metalworking industry injury rates slightly increased over time for both groups, and were higher among immigrant than native workers in both 2005 and 2010. In the construction industry the 2005 injury rate was the same in the two groups, and there was a negative trend over time in both groups. However the decline in the 2010 injury rate for Italian workers was much larger, which led to a considerable increase of the incidence rate ratio of immigrants with respect to native (IRR 3.83, 95% CI 2.52-5.75). CONCLUSIONS: The economic recession had an impact on the risk of workplace injury. Though the main observed factors (18 variables) usually reported in literature to explain the higher injury rates of the immigrant workers were controlled through the matching, there were still differences between immigrants and natives. The main reason is that immigrants continue to be assigned to the more dangerous jobs and the more dangerous tasks within these job. Furthermore, also differences in the perception of workplace injury risks, linguistic barriers, and cultural factors may have a role in explaining this gap.
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Industria de la Construcción , Emigrantes e Inmigrantes/estadística & datos numéricos , Metalurgia , Traumatismos Ocupacionales/epidemiología , Adolescente , Adulto , Bases de Datos Factuales , Recesión Económica , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Medición de Riesgo , Adulto JovenRESUMEN
BACKGROUND: The method "Learning by mistakes" was developed in Italy to conduct occupational injury investigations and to collect information on the genesis of injuries. The aim is to analyze data classified with this method in order to identify patterns among the factors contributing to injury dynamics. METHODS: Data regarding 673 factors, corresponding to 354 occupational fatalities that occurred in the Piedmont region (north-west of Italy) during 2005-2014 were considered. Latent Class Analysis (LCA) was applied to find patterns among these factors. RESULTS: The eight-class model was selected. Most of the factors fell in the class "Fall from height or vehicle rollover due to incorrect practice" (40.56%) while the remaining factors where heterogeneously distributed in the other classes. CONCLUSIONS: All the classes found allow for a logical interpretation. Systematic use of LCA could aid in uncovering new, unexpected patterns of factors not otherwise detectable by analysis of the single fatal accident.
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Accidentes de Trabajo/mortalidad , Análisis de Clases Latentes , Accidentes de Trabajo/estadística & datos numéricos , Conjuntos de Datos como Asunto , Humanos , Italia/epidemiología , Modelos TeóricosRESUMEN
PURPOSE: To evaluate the in vitro efficacy of surface coating sealer (SCS) in reducing the amount of water absorption and stain formation in resin composites. METHODS: To evaluate the amount of water sorption, 40 stainless steel round molds (n=10 per composite) were filled with Filtek Supreme XTE; Venus Diamond; Clearfil Majesty ES-2; Gradia Direct Anterior. Groups were further divided into two subgroups (n=5) according to the presence/absence of SCS (Easy Glaze). Their masses were measured at baseline and reweighed at 1, 4, 12, and 20 weeks. For staining evaluation, 48 resin composite discs, 2 mm-thick, were obtained with the same composites and SCS was applied on a single surface of each sample. After baseline color assessment, samples were immersed in vials containing 5 mL of six different staining solutions. Color evaluation was performed again after 1, 4, 12, and 20 weeks. Three-way ANOVA was performed to evaluate differences in weight gain and color changes (P< 0.05). RESULTS: A significant protective action of SCS (P< 0.001), but not of the composites (P= 0.366) was found. Differences in weight and color change were not influenced by the resin composite, but only by the presence of the coating on the surface of the samples. SCS are well-established materials for polishing and protecting composite restorations from water sorption and color changes. Different staining solutions can still produce different effects on resin composite. CLINICAL SIGNIFICANCE: Surface coating sealers are able to reduce water uptake and discoloration from resin composites, thus leading to less degradation of composite restorations over time.
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Resinas Compuestas , Agua , Color , Ensayo de Materiales , Propiedades de SuperficieRESUMEN
BACKGROUND: Controversial results have shown a significant association with either low or high total testosterone (tT) levels and high risk prostate cancer (PCa). We tested the relationship between circulating tT and grade group 5 (G5) PCa at radical prostatectomy (RP) in patients with preoperative low- to intermediate-risk disease. METHODS: Serum sex hormones were assessed the day before RP in a cohort of 846 patients with low- to intermediate-risk PCa. Patients were segregated using the new 5-tiered Gleason grade groups. Restricted cubic spline functions and logistic regression analyses tested the association between sex hormones and G5 PCa. Differences in potential predictive accuracy (PA) were assessed for tT and prostate-specific antigen (PSA) levels. RESULTS: Overall, 27 men (3.2%) had G5 PCa at RP, and this group had higher PSA values than patients with G1-G4 PCa (P = 0.02). The groups did not differ in terms of preoperative mean hormonal values. Both low and high circulating tT values depicted a nonlinear U-shaped correlation with G5 PCa at RP. The lowest and highest (10th and 90th percentiles) tT values and biopsy PCa grade emerged as multivariable independent predictors of G5 PCa at RP (all P < 0.05). PA for G5 PCa did not differ between tT (area under the curve [AUC] 0.631) and PSA (AUC 0.636). CONCLUSIONS: Circulating tT was a significant predictor of G5 PCa at RP in patients with preoperative low- to intermediate-risk disease. Preoperative tT and PSA values showed similar PA for the most aggressive disease, confirming a potential role for circulating androgens in preoperative risk assessment of PCa patients. Prostate 77:234-241, 2017. © 2016 Wiley Periodicals, Inc.
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Biomarcadores de Tumor/sangre , Medicina de Precisión/tendencias , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/patología , Testosterona/sangre , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor/métodos , Clasificación del Tumor/tendencias , Medicina de Precisión/métodos , Prostatectomía/tendencias , Neoplasias de la Próstata/cirugíaRESUMEN
OBJECTIVES: to describe a pilot study to evaluate the impact on injury rates of Occupational health and safety (OHS) inspections conducted in the construction sites of the Novara Health Unit territory during 2005-2007. DESIGN: study design is "treated/non treated" where: "treated" are construction companies inspected during 2005-2007 and not inspected in the periods before and after; "non treated" are construction companies never inspected during 2002-2010. SETTING AND PARTICIPANTS: two information sources have been used: Italian Workers' Compensation Authority databases and Novara Health Unit inspection database. The period of analysis is 2002-2010 divided into sub-periods: pre-inspection (2002-2004); inspection (2005-2007); post-inspection (2008-2010). MAIN OUTCOME MEASURES: two injury rates, total and serious, have been calculated and the difference-in-differences (DID) method was used to assess the effectiveness. RESULTS: passing from pre-inspection to post-inspection period, the rate of total injuries in the companies inspected decreased more than the rate of the companies not inspected (DID: -1,95; 95%CI -15,30; 11,39). No effect was shown on severe injuries (DID: -0,27; 95%CI -7,84;7,31). CONCLUSION: the inspections conducted during 2005-2007 on the construction sites operating in the Novara Health Unit territory seem to have had a slight positive impact on reducing the injury rates. The procedures developed in this pilot study can be used in other Italian Health Units. Further research is needed to confirm the results and to clarify the mechanism by which the inspections were effective.
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Accidentes de Trabajo/estadística & datos numéricos , Industria de la Construcción , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/prevención & control , Salud Laboral , Indemnización para Trabajadores/estadística & datos numéricos , Lugar de Trabajo , Industria de la Construcción/estadística & datos numéricos , Bases de Datos Factuales/estadística & datos numéricos , Humanos , Italia/epidemiología , Proyectos Piloto , Estudios RetrospectivosRESUMEN
BACKGROUND: An increased frequency of psychotic disorders in amyotrophic lateral sclerosis (ALS) families compared to controls has been reported. Aim of our study was to assess the relationship between nervous system drugs prescriptions and subsequent onset of ALS in a large Italian population. METHODS: The study population consisted of all subjects over 15 years at the 2001 Italian census, resident in Turin since 1996 (n = 687,324), followed up for ALS occurrence from 2002 to 2014. Exposure to nervous system drugs was measured until 2012, or until 1 year before ALS onset. The association was estimated for ever and cumulative exposure, through Cox proportional Hazards models adjusted for sex, age, education, marital status and drug co-exposure. RESULTS: In the analysis for ever exposure, opioids were significantly inversely associated with ALS risk (hazard ratio (HR) 0.59; 95% CI 0.35-0.97), while antiepileptics (HR 1.35; 95% CI 0.92-2.00) showed a marginally significantly positive association. Examining cumulative exposure, the protective role of opioids associated with more than 4 prescriptions and the risk effect of antiepileptics for over 6 prescriptions was confirmed. CONCLUSIONS: The present study revealed associations of ALS onset with previous exposure to opioids, maybe through the activation of δ receptor and σ receptors and antiepileptics, which are novel findings to our knowledge.
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Esclerosis Amiotrófica Lateral/epidemiología , Fármacos del Sistema Nervioso Central/efectos adversos , Fármacos del Sistema Nervioso Periférico/efectos adversos , Medicamentos bajo Prescripción/efectos adversos , Adolescente , Adulto , Edad de Inicio , Anciano , Esclerosis Amiotrófica Lateral/inducido químicamente , Analgésicos Opioides/efectos adversos , Analgésicos Opioides/uso terapéutico , Anticonvulsivantes/efectos adversos , Anticonvulsivantes/uso terapéutico , Fármacos del Sistema Nervioso Central/uso terapéutico , Femenino , Humanos , Incidencia , Italia , Masculino , Persona de Mediana Edad , Fármacos del Sistema Nervioso Periférico/uso terapéutico , Medicamentos bajo Prescripción/uso terapéutico , Factores de Riesgo , Adulto JovenRESUMEN
INTRODUCTION: Several definitions of erectile function (EF) recovery after bilateral nerve-sparing radical prostatectomy (BNSRP) have been proposed based on the results of the International Index of EF (IIEF). AIM: We aimed at evaluating overall satisfaction (OS) after BNSRP according to the ability to achieve the pretreatment EF. METHODS: We evaluated data of 652 patients treated with BNSRP for clinically localized prostate cancer (PCa). Erectile dysfunction (ED) was classified according to the IIEF-EF domain score. Return to baseline EF was defined as patients who reached the same preoperative ED category during the 3-year follow-up. Cox regression analyses were fitted to predict return to baseline IIEF-EF and to predict OS defined according to the IIEF-OS in the overall population. Logistic regression analyses were performed to analyze OS in men who reached the back to baseline status. MAIN OUTCOME MEASURES: The outcome of the study was to evaluate back to baseline EF status and to correlate it with postoperative OS. RESULTS: Preoperative satisfaction was reported by 218 (33.4%) patients. Postoperative satisfaction was achieved by 103 patients. Overall, 383 patients were able to achieve the preoperative IIEF-EF score. However, only 26.9% reported being satisfied. Age and preoperative IIEF-EF score were significantly associated with baseline IIEF-EF recovery (all P ≤ .02). Patients who were able to return to baseline IIEF-EF were more likely to be satisfied (P < .001). Time elapsed between surgery and achievement of baseline IIEF-EF was significantly associated with OS (P < .001). Among patients who were able to achieve the baseline IIEF-EF score, a preoperative IIEF-EF of 22-25 and 26-30 was significantly associated with postoperative satisfaction (all P < .001). CONCLUSION: After BNSRP, reaching the baseline IIEF-EF score is not always sufficient to obtain patient satisfaction. Only patients with a preoperative IIEF-EF ≥22 who reached the baseline score after surgery considered themselves satisfied. This should be taken into account in preoperative patient counseling.
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Disfunción Eréctil/prevención & control , Erección Peniana , Pene/fisiopatología , Próstata/cirugía , Prostatectomía , Neoplasias de la Próstata/cirugía , Anciano , Disfunción Eréctil/etiología , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Erección Peniana/fisiología , Pene/inervación , Periodo Posoperatorio , Cuidados Preoperatorios , Próstata/inervación , Prostatectomía/efectos adversos , Prostatectomía/métodos , Neoplasias de la Próstata/fisiopatología , Recuperación de la Función , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The human biomonitoring (HBM) of metals is a part of the ongoing project SPoTT for the longitudinal health surveillance of the population living near a waste-to-energy (WTE) incinerator (Turin, Italy). The HBM of metals in the SPoTT population aimed to evaluate: i) reference values (RVs) before the WTE incinerator started operation; ii) differences in exposure by variables; iii) variations respect to other HBM studies; iv) exposure that exceeds the available health-based benchmarks as the Biomonitoring Equivalents (BEs) for urine Cd and Human Biomonitoring (HBM-I and HBM-II) values for urine Hg, Tl, and blood Pb; v) risk assessment by generating hazard quotients (HQs) for the single metal and hazard index (HI) for the co-occurrence of metals. Eighteen metals in urine and Pb in blood were determined by sector field inductively coupled plasma mass spectrometry. Metal concentrations were comparable with RVs reported in other countries, except for slightly higher As, Be, Ir, Pd, Pt, Rh, and Tl levels. Smoking was associated with Cd; age with Pb; drinking bottled water with As and Cd; consumption of fish with As and Hg; amalgams with Hg and Sn; dental restorations with Pd and Pt; use of jewelry with Co and Rh, and piercing with Ni. While HQs for urine Cd, Hg, Tl and blood Pb suggested that adverse effects were unlikely, the HQ value raised the question of whether additive interactions of these metals could produce health concern. The obtained HBM data can be an early warning for accumulations of metals and identification of subgroups at risk.
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Contaminantes Ambientales/sangre , Contaminantes Ambientales/orina , Incineración , Metales/sangre , Metales/orina , Adulto , Anciano , Conservación de los Recursos Energéticos , Monitoreo del Ambiente , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Valores de Referencia , Medición de Riesgo , Fumar/sangre , Fumar/orinaRESUMEN
The aim of this in vitro study was evaluate the effect of application of synthetic hydroxyapatite on fiber post bond strength to radicular dentine. Forty, single-root teeth were endodontically treated and an 8 mm post space was prepared. Specimens were randomly placed in four groups (n = 10 in each) and treated using the following fiber post luting procedures: group 1, 17% EDTA + Panavia SA; group 2, 17% EDTA + Teethmate Desensitizer + Panavia SA; group 3, All-Bond Universal + Duo-Link Universal; and group 4, All-Bond Universal + Teethmate Desensitizer + Duo-Link Universal. Fiber posts were luted in the post space and light-cured for 120 s using a light-emitting diode (LED) lamp. After 7 d of storage at 37°C, the teeth were cut into 1-mm-thick slices, which were subjected to a push-out test until failure using a universal testing machine. Two specimens per group were prepared for scanning electron microscopy analysis. An energy-dispersive X-ray spectroscopy detector was used for elemental analysis of the specimen surface. The results were statistically analyzed using one-way anova. The fiber post bond strength was statistically significantly increased after the application of Teethmate Desensitizer to post space walls, either with a 10-MDP-containing self-adhesive cement or with a universal adhesive. Scanning electron microscopy and EDAX analysis showed that Teethmate Desensitizer created a calcium phosphate precipitate over post space dentinal tubules, which significantly improved the bond strength of the fiber post luted with 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP)-containing adhesive systems.
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Recubrimiento Dental Adhesivo , Recubrimientos Dentinarios , Metacrilatos , Técnica de Perno Muñón , Dentina , Durapatita , Vidrio , Humanos , Ensayo de Materiales , Cementos de ResinaRESUMEN
BACKGROUND: Numerous safety promotion interventions in schools exist but these are rarely subject to impact evaluation. Few available studies are focused on intermediate outcomes. Our objective is to evaluate the impact of prevention interventions on school injuries in a number of schools in Italy. METHODS: A pre-post-study with a control group was used. One hundred and three intervention units were selected; control units were selected randomly from those which did not implement safety projects. The general objective was to promote a safety culture by increasing expertise and knowledge, and by enabling the adoption of appropriate behavior. All projects combined various elements: training and educational, information and communication, as well as organizational. The projects evaluated in this article were specifically aimed at safety in indoor premises; they were implemented in 2009-10. Injury rates standardized by gender were calculated for 5 school years (from 2007/2008 to 2011/2012) stratified by type of school and place of occurrence. To assess the effectiveness the difference-in-differences method was used. RESULTS: Overall, 207 012 student-years and 2918 school injuries were considered. In all types of schools, the injury rates in indoor areas show a decreasing trend in the intervention units and an increasing trend in the control units. In high schools, there were no changes in the trend of injuries occurring in the gym and/or related to sports activities. CONCLUSIONS: The results suggest a positive short-term effect of the programs on injuries occurring in indoor premises. The quasi-experimental design has never been previously used to evaluate the effectiveness of a prevention program in schools.
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Evaluación de Programas y Proyectos de Salud/métodos , Administración de la Seguridad/métodos , Instituciones Académicas , Estudiantes , Heridas y Lesiones/prevención & control , Adolescente , Niño , Femenino , Humanos , Italia , MasculinoRESUMEN
BACKGROUND: This study investigated mortality in a cohort of 1,988 male workers at a chemical manufacturing plant (1981-2011) and evaluated the quality of the results obtained using administrative databases. METHODS: Information about the workers was obtained from the archives of the Italian National Institute for Social Insurance. Vital status and causes of death were ascertained through record linkage with electronic archives and follow-up mailing. Regional reference rates were used to calculate standardized mortality ratios (SMRs) and 90% confidence intervals (CI). RESULTS: The analysis showed increased SMR for selected cancers of a priori interest: respiratory system (SMR: 126.8; 90%CI: 105-152), pleura (330.5; 90%CI 164-596), and non-Hodgkin lymphoma (196.1; 90%CI 102-342). CONCLUSIONS: The results indicate an effect of hazardous exposures among workers in this chemical manufacturing plant. Using administrative databases to construct historical cohorts is an efficient method in time and resources, for estimating the risk of mortality and generating hypotheses. Am. J. Ind. Med. 59:866-876, 2016. © 2016 Wiley Periodicals, Inc.
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Enfermedad Crónica/mortalidad , Sustancias Peligrosas/efectos adversos , Enfermedades Profesionales/mortalidad , Exposición Profesional/efectos adversos , Adulto , Anciano , Causas de Muerte , Industria Química , Estudios de Cohortes , Bases de Datos Factuales , Humanos , Italia/epidemiología , Masculino , Instalaciones Industriales y de Fabricación , Persona de Mediana Edad , Neoplasias/mortalidad , Enfermedades Profesionales/etiología , Sistema de Registros , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Literature suggests that more research is needed to clarify the effect of workplace inspections by governmental officers on injury rates. This paper aims to compare comprehensive and partial inspections in Italian manufacturing companies. METHODS: Survival analysis was applied to the period free from injuries following inspection by means of the Kaplan-Meier method and of Cox models. RESULTS: Kaplan-Meier curves show that, compared to companies with a partial inspection, companies which had a comprehensive inspection had a higher survival through the entire period. Adjusting for confounders, the Cox model confirms a significant preventive effect of comprehensive inspection for companies with 10-30 employees, but not for those with >30 employees. CONCLUSIONS: The results suggest that the effect on injuries is greater if all aspects of safety are addressed during the inspection instead of focusing on a single aspect. These findings are interesting because they can help in planning effective prevention activities.
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Industria Manufacturera/estadística & datos numéricos , Salud Laboral/estadística & datos numéricos , Traumatismos Ocupacionales/epidemiología , Administración de la Seguridad/métodos , Humanos , Italia/epidemiología , Estimación de Kaplan-Meier , Industria Manufacturera/legislación & jurisprudencia , Industria Manufacturera/organización & administración , Salud Laboral/legislación & jurisprudencia , Traumatismos Ocupacionales/prevención & control , Modelos de Riesgos ProporcionalesRESUMEN
Only few studies on the health effect of waste incinerators were focused on human biomonitoring (HBM). Our aim is to describe a protocol for assessing early variation of selected items in a population group living close to a waste incinerator in Turin, Italy. A cohort of 394 subjects was randomly selected, among residents near the incinerator and residents far from it. To achieve this sample size, 765 subjects were contacted. The cohort was monitored before the start-up of the plant and will be followed up 1 and 3 years after, with measurements of respiratory function, selected blood and urine parameters including 19 metals, 17 congeners of PCDDs/Fs, 12 congeners of DL-PCBs, 30 congeners of NDL-PCBs, 11 OH-PAHs, specific hormones (T3, T4, TSH, cortisol and ACTH) and common health parameters. The same protocol is applied for plant workers and breeders living near the plant. Individual exposure to urban pollution and waste incinerator fallout were assessed through the use of mathematical models. Information on individual habits was assessed using a specific questionnaire. SPoTT is the first Italian study that adopts a longitudinal design of appropriate statistical power to assess health impacts of waste incinerator plants' emission. The initial results comparing the baseline to the first follow-up are due at the end of 2016.
Asunto(s)
Exposición a Riesgos Ambientales , Monitoreo del Ambiente/métodos , Metales/análisis , Bifenilos Policlorados/análisis , Dibenzodioxinas Policloradas/análisis , Hidrocarburos Policíclicos Aromáticos/análisis , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Incineración , Italia , Masculino , Metales/sangre , Metales/orina , Persona de Mediana Edad , Bifenilos Policlorados/sangre , Bifenilos Policlorados/orina , Dibenzodioxinas Policloradas/sangre , Dibenzodioxinas Policloradas/orinaRESUMEN
Si intende qui descrivere il sistema di sorveglianza sugli effetti sulla salute (SpoTT) dell'inquinamento ambientale nelle aree circostanti l'inceneritore di Torino. SPoTT ha 3 linee di attività: 1. monitoraggio epidemiologico degli effetti a breve termine attraverso analisi temporali e misura della correlazione tra livelli giornalieri di emissioni dell'impianto e andamento degli eventi individuati dagli archivi dei dimessi (SDO), di pronto soccorso e di mortalità; sono coinvolti coloro che nel 2013-2018 risiedevano nell'area di ricaduta delle emissioni; 2. sorveglianza epidemiologica degli effetti a lungo termine, stimando tassi standardizzati di mortalità e morbosità; a ogni soggetto è attribuito il valore stimato di esposizione cumulato nel tempo caratteristico della residenza anagrafica; le informazioni sulla salute sono reperite dagli archivi SDO, di mortalità e dai certificati di assistenza al parto; sono studiati due decenni pre-post l'avvio dell'impianto: 2003-2012 e 2013-2022; 3. monitoraggio biologico con misurazione pre-post di metalli, PCDD/F, PCB, OH-IPA; sono coinvolti 196 residenti esposti e 196 di controllo di 35-69 anni, campionati a caso dalle anagrafi comunali; sono effettuate misure di funzionalità endocrina e respiratoria, pressione arteriosa, rischio cardiovascolare; l'esposizione cumulativa sarà stimata per ciascuna persona campionata integrando l'indirizzo di residenza, il tempo di permanenza in ciascun indirizzo e i dati ricavati dai modelli di ricaduta; sarà costituita una biobanca per future indagini di laboratorio; sono coinvolti anche 20 allevatori e i lavoratori dell'impianto. Una quarta linea di attività, non descritta in questo articolo, riguarda il monitoraggio della salute dei lavoratori addetti all'impianto. SPoTT è il primo studio in Italia su inceneritori e salute che adotta un disegno di studio longitudinale di adeguata potenza sia per i residenti sia per i lavoratori. I primi risultati sono attesi nel corso del 2016.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Incineración , Plomo/análisis , Metales Pesados/análisis , Material Particulado/análisis , Enfermedades Respiratorias/epidemiología , Residuos Sólidos/efectos adversos , Adulto , Anciano , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Italia/epidemiología , Plomo/toxicidad , Estudios Longitudinales , Masculino , Metales Pesados/toxicidad , Persona de Mediana Edad , Material Particulado/toxicidad , Salud Poblacional/estadística & datos numéricos , Vigilancia de la Población , Centrales Eléctricas , Enfermedades Respiratorias/etiología , Enfermedades Respiratorias/mortalidad , Administración de Residuos/métodosRESUMEN
OBJECTIVES: At the end of the 1990s, as required by European Directive 92/57/EEC, two laws were enacted in Italy which laid down safety and health requirements for construction sites: Decree 494/96 and Decree 528/99. The aim is to evaluate the impact on injury rates due to actions performed by a group of eight regions that planned formalised programmes to enforce the laws around the year 2000. METHODS: Using the Work History Italian Panel-Salute integrated database, which extends from 1994 to 2005, total and serious injury rates were calculated for the construction sector. An interrupted time series analysis was applied to serious injury rates. RESULTS: During the 12 years under observation, at the national level the total and serious injury rates decreased while the number of employees increased. The results of the regression models indicate that in the period after the intervention the injury rates (×10 000 weeks worked) decreased by 0.21 per year more than in the period before the intervention (CI -0.41 to -0.01). The difference in pre-post trends is even larger after adjusting for external factors. CONCLUSIONS: The intervention plans developed to enforce the two Italian decrees had an effect on the reduction in injury rates. The results showed that there was a decrease in injury rates that could not be explained by external factors. These findings highlight the importance of concrete initiatives to have employers and workers comply with regulatory safety standards.