The impact of COVID-19 pandemic on gambling: A systematic review.

BACKGROUND AND AIMS: Since the COVID-19 outbreak, people's habits changed radically. In fact, to limit the spread of SARS-CoV-2, governments implemented restrictive measures that influenced the lives of individuals. The aim of this systematic review is to analyze the impact of COVID-19 on gambling by examining three different outcomes: frequency, expenditure, and transition among possible types of gambling. METHODS: All studies assessing the impact of restrictive measures implemented to limit the spread of SARS-CoV-2 on gambling were included. For the search, two different databases were used: Pubmed and CINAHL. Moreover, two different populations were analyzed: the general population, and subjects who used to gamble before SARS-CoV-2 pandemic. All qualitative studies, reports not based on peer-review, and papers in which the statistical unit was not the subject but the gambling or wagering operators were excluded. RESULTS: From the search, 408 reports were identified. Of these, 28 were included in the systematic review. From the studies, a strong reduction in the frequency and expenditure of land-based gambling emerged, while the results about online gambling were different among the studies. However, a reduction was observed assessing sports betting, and an increase emerged considering online casino and skill games. Finally, a significant migration from land-based gambling to online platforms was identified. The main reasons for these findings were the physical closures of land-based gambling venues and the more time spent at home, the suspension or cancelation of sporting events on which subjects used to bet, and more mental health issues during this challenging period. CONCLUSIONS: The COVID-19 pandemic greatly affected subjects' habits, including gambling, by reducing land-based gambling and sports betting, and increasing gambling on online platforms. This shift poses significant challenges, requiring a comprehensive approach to monitor and mitigate the negative consequences of this increase in online gambling caused by the pandemic.

[Storytelling in prevention: the case-study of accidents at work. How the narrative method can enhance the prevention of occupational injuries.] / Narrare per prevenire: il caso degli infortuni sul lavoro.Come il metodo narrativo può valorizzare la prevenzione degli infortuni lavorativi.

OBJECTIVE: This article aims to analyze the elements of the narrative which, applied to investigations of accidents at work, transform them into stories, making the dynamics of accidents clearer, more complete and emotionally engaging and also capable of being transferred to a non-experts audience. METHOD: The theoretical reference identified for the analysis of the accident histories is the work of the Lithuanian semiologist Algirdas Julien Greimas. The title, the dimensions of space and time, the characters (according to the actantial model), the point of view, the structure of the story (following the canonical narrative scheme), and the moral of the tale are the elements of the narration analyzed in this article. RESULTS: This article illustrates how the dynamics of accidents can lend themselves to being told according to the typical categories of narration and textual organization, resulting in them being enriched with important elements for the communication of prevention and the learning of safe behaviour. The accident investigation that becomes history takes on important characteristics also in terms of communication: the contents become clearer, more accessible and more engaging. Unlike traditional surveys, injury stories, through the elements of the narrative and in particular with the addition of indications for prevention, become an efficient learning and sharing tool valid in training contexts, and the contents effectively usable in practice of prevention workers. CONCLUSIONS: The narration applied to accidents at work, allowing for greater attention to the elements of the context, relationships and the emotional sphere of the various actors involved, is able to bring out more clearly the important and various factors that can contribute to causing an accident, becoming thus an effective tool for the transfer of indications for prevention.

[School-based screening strategies to prevent the spread of COVID-19 in school: a systematic review of the literature]. / Strategie di screening per contenere la diffusione del COVID-19 nella scuola: una revisione sistematica della letteratura.

OBJECTIVES: to describe studies that evaluated the screening programmes implemented in the school during the COVID-19 pandemic. DESIGN: a systematic literature review was conducted according to the PRISMA 2020 Guidelines. Studies published until December 2021 were included. The methodological quality of the studies was assessed with validated scales. Study selection, data extraction, and quality assessment were carried out by two authors independently. SETTING AND PARTICIPANTS: teachers and students belonging to schools of all levels, including universities. MAIN OUTCOMES MEASURES: a. transmission-related outcomes (such as the number or proportion of cases, cumulative frequency, incidence); b. feasibility/acceptability of the screening strategies; c. socioeconomic outcomes (such as testing cost, number of days spent in school, quarantine). RESULTS: after having removed duplicate articles, 2,822 records were retrieved. Thirty-six studies were included (15 used an observational design and 21 modelling study). Regarding the former, the methodological quality has been rated as high in 2 studies, intermediate in 6 and low in 2; in the remaining ones, it was not evaluated because only descriptive. Screenings were quite different in terms of school study population, types of tests used, methods of submission and analysis, and level of incidence in the community at the time of implementation. Outcome indicators were also varied, a heterogeneity that, on the one hand, did not allow for meta-analysis of results and, on the other, allowed for testing the performance of the screenings in very different settings. All of the field studies claim that the screenings reduced SARS-CoV-2 exposure and infection among children, adolescents, and college students, curbing at-school transmission and helping to reduce the number of closing school days. Studies that evaluated the cost of the intervention emphasized its cost-effectiveness, while those that focused on the acceptability of the instrument showed a preference among children, adolescents, and parents for minimally invasive, self-administered tests with high sensitivity and lower frequency of repetition. Simulation-based studies are mostly based on compartmental and agent-based models. Their quality is quite high methodologically, although uncertainty quantification and external validation, aimed at verifying the model ability to reproduce observed data, are lacking in many cases. The contexts to which the simulations refer are all school-based, although 7 studies consider residential situations, which are poorly suited to the Italian context. All simulation-based models indicate the importance of planning repeated testing on asymptomatic individuals to limit contagion. However, the costs of these procedures can be high unless assessments are spaced out or pool testing procedures are used. Obtaining high student adherence to the screening programme is extremely important to maximize results. CONCLUSIONS: school-based screenings, especially when combined with other preventive measures, have been important public health tools to contain infections during COVID-19 waves and to ensure children's and adolescents' right to education and to prevent the fallout in physical and mental health (with strong equity consequences) associated with school closures.

Short-term effect of colorectal cancer on income: analysis of an Italian cohort.

INTRODUCTION: The ability to return to work after a cancer diagnosis is a key aspect of cancer survivorship and quality of life. Studies have reported a significant risk of income loss for cancer survivors; however, there is limited evidence of the Italian context. METHODS: The Work Histories Italian Panel (WHIP)-Salute database was used to select a cohort of incident cases of colorectal cancer (CRC) among workers in the private sector, based on hospital discharges. A propensity score matching was used to find a balanced control group for several confounders. Ordinary least square and logistic regressions were used to estimate the effect of a CRC diagnosis on annual income and the probability of switching from a full-time contract to a part-time one considering 3 years after the diagnosis. RESULTS: Overall, we identified 925 CRC incident cases from 2006 until 2012. Our results confirm a statistically significant reduction in survivors' income compared with controls. This reduction was greater in the first year and then tend to decrease, with an average income loss over 3 years of about €12 000. Stratified analyses by sex and position confirmed the overall trend while indicating a strong effect modification. Regarding the switching from full-time to part-time employment, the results were never significant. CONCLUSION: Income loss does not seem to be related to an increase in part-time contracts, but rather to survivors' reduced work capacity following the invasive treatments. Further research is needed to investigate the complex dynamics behind this association.

School closures and mental health, wellbeing and health behaviours among children and adolescents during the second COVID-19 wave: a systematic review of the literature.

OBJECTIVES: to evaluate the impact of school closures, as a measure to contain the transmission of SARS-CoV-2 infection, on the psychological well-being of students of all levels starting from the 2020-2021 school year. DESIGN: a systematic literature review was conducted according to the PRISMA 2020 Guidelines. The literature search was conducted on 4 different databases: MedLine, Embase, PsycINFO, and L.OVE Platform. Quantitative observational studies published until 10.01.2022 were included. Studies conducted during the first pandemic wave, i.e., during the 2019-2020 school year and/or during the mandatory lockdown or confinement period, were excluded. The methodological quality of the studies was assessed with validated scales. Study selection, data extraction, and quality assessment were carried out independently by two authors. SETTING AND PARTICIPANTS: children, adolescents, and young people attending all levels of education (including universities) and, for reasons related to COVID-19, having a suspension of "in presence" school or attending classes remotely. MAIN OUTCOME MEASURES: a. outcomes directly related to mental health: suicides, emergency department visits, and hospitalizations for psychiatric problems; anxiety and depression, emotional difficulties, feelings of loneliness and isolation; b. well-being outcomes: sleep quality, perceived well-being (by child/adolescent/youth or referred by parents); c. health-related behaviours: tobacco smoking, alcohol, drug use. Outcomes related to school/academic performance, physical health, and those related to parents were not considered. RESULTS: after having removed duplicate articles, 2,830 records were retrieved with the bibliographic search. Twelve studies (2 uncontrolled before-after studies and 10 cross sectional surveys) were included, involving a total of 27,787 participants. Three studies involved university students, 2 involved high school students, and the remaining involved a mixed population of students attending primary and middle schools. The studies were conducted between September 2020 and April 2021. The methodological quality was rated as high in five studies and intermediate in the remaining studies. Due to the high heterogeneity of outcome measures and statistical analyses performed among the included studies, it was not possible to conduct a meta-analysis of the results of the considered publications. Nevertheless, the present review showed a clear signal of increase in mental health problems in relation to school closure or virtual instruction. In particular, results suggest evidence of association between school closure and risk of suicidal attempts or thoughts, mental health symptoms such as anxiety, depression, emotional disorders, psychological stress. Sleeping problems, drug and alcohol addiction were poorly studied. CONCLUSIONS: despite the limitations of the included studies and possible residual confounding and contamination due to restrictive measures and social isolation implemented during the pandemic, the available evidence confirms the negative impact on students' mental health associated with school closures and distance learning. Given the availability of vaccination also for young children, a long period of school closure should be avoided also in the case of the emergence of new pandemic waves.

[Monitoring the trend of occupational injuries: comparison between different indicators]. / Monitorare il trend degli infortuni sul lavoro: confronto tra diversi indicatori.

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.

'Scuola sicura': a school screening testing programme to prevent the spread of COVID-19 in students in Piedmont.

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.

The Community of Practice: A Method for Cooperative Learning of Occupational Health and Safety Inspectors.

BACKGROUND: Workplace injuries in Italy still occur despite laws and safety norms. We need to understand the causes rooted in the context and social conditions, and need to improve the practice of Occupational Safety and Health (OSH) inspectors of the Workplace Safety and Prevention Services (WSPS) of the Italian regional health boards. The aims of this study were to describe the setting up of a Community of Practice (CoP) for the production of best practices for injury prevention and to evaluate the motivation of OSH inspectors for participating in the CoP and the effects of CoP participation on their professional practice. METHODS: Two workplace injury stories underwent peer review during each CoP meeting. We evaluated the CoP using a focus group and a questionnaire. RESULT: Between 2014 and 2021, the CoP met in 18 workshops. Over the 8-year period, the CoP grew from 20 to 150 participants. Overall, 30 stories underwent peer review and were published on the institutional website. The focus group participants stated that the reasons why they participated in the CoP were the need to share experience and to tackle new challenges. CONCLUSION: The CoP was found to be useful for improving professional practice by strengthening professional identity and contributing to the production of new knowledge.

Perceived Risk in the Population Living near the Turin Incinerator: Comparison between before and at Three Years of Operation.

When the Turin incinerator went into operation in 2013, it was accompanied by surveillance of health effects that included a human biomonitoring survey of 394 residents. They responded to items investigating their awareness of environmental and health issues and perception of environmental health risks. In this study, we compared the questionnaire responses before plant startup and at 3 years of operation. To accomplish this, we investigated changes in perceived risk and evaluated the efficacy of communication strategies. A total of 344 participants equally distributed in an exposed and an unexposed group responded to the follow-up questionnaire. Survey items investigated the perception of a relationship between illness and exposure to environmental pollution, feeling at risk of developing an illness, and concern about natural and anthropogenic hazards. The proportion of 'certain' and 'very probable' responses was compared to the total using the difference-in-differences method. Analyses showed an overall decrease in the differences between the two groups, which suggests that the communication actions undertaken for the exposed group were effective. Future communication plans should also include initiatives targeting the unexposed group.

Human biomonitoring of metals in workers at the waste-to-energy incinerator of Turin: An Italian longitudinal study.

Evidence of negative health effects of solid waste management is uncertain. Available reviews suggests the use of biomarkers in human biomonitoring (HBM) to detect low exposure levels. In September 2013, a waste-to-energy plant located in the Turin (Italy) went into operation. The SPoTT (acronym for Population health Surveillance in the Turin incinerator's area) monitoring program was set up to assess the potential health impact caused by the plant. The paper illustrates the results of HBM of metals in the workers before the plant went into operation and then at 1 year and 3 years. This study is one of the few focusing on workers with a longitudinal design (the first in Italy). Eighteen metals in urine and lead in blood were determined by sector field inductively coupled plasma mass spectrometry. Information on participant habits and other characteristics that could potentially affect metals concentrations were collected via a structured questionnaire. Subjects were classified according to their work role at the facility: administrative staff workers (AW); plant workers (PW). Nonparametric methods were used to evaluate the changes in metals concentration over time. Comparison of the metals concentration in the samples taken at baseline and at the following two-time points shows a general decrease in levels: urinary concentration of beryllium (Be), cobalt (Co), mercury (Hg), Ir, nickel (Ni), tin (Sn), thallium (Tl), and blood level of lead (Pb) among the PW and Ir and Pd among the AW were significantly lower at T2 versus baseline. A decrease was also recorded in arsenic (As) among the PW and in cadmium (Cd), chromium (Cr), palladium (Pd), rhodium (Rh), and zinc (Zn) for both groups, whereas the levels of copper (Cu) and vanadium (V) remained unchanged over time. The downward trend remained also after taking confounding factors into account. The only exceptions were Mn, Pt, Sb among the PW: increase levels between T0 and T2 were recorded, which cannot be specifically attributable to the plant activity. The median urinary and blood concentrations of the metals were lower than those reported in the literature and were below the occupational reference values at all three-time points. Our results are consistent with those reported for the cohort of local residents and with the ambient air measurements.

Biomonitoring of the adult population in the area of turin waste incinerator: Baseline levels of polycyclic aromatic hydrocarbon metabolites.

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 525-85200 ng/g creatinine, with P50 equal to 6770 ng/g creatinine. Metabolites of naphthalene were found at the highest concentrations (P50 values of 892 and 4300 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 58.2-491 ng/g creatinine), the four OH-PHEs (P50 values in the range of 30.5-145 ng/g creatinine), and 1-OH-PYR (P50 value of 82.8 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.

[Thromboembolic vein disease (TVD): antithrombotic therapy choice in ASL TO3.] / Malattia tromboembolica venosa: scelta della terapia antitrombotica nei pazienti della ASL TO3.

BACKGROUND: Thromboembolic vein disease (TVD) comprises of deep vein thrombosis (DVT) and pulmonary embolism (PE). Standard therapy consists of the administration of low molecular weight heparin (LMWH) imbricated with antivitamin K agonists (AVK). Recently a new series of oral anticoagulants known as the direct oral anticoagulants (DOACs) has been introduced. CHEST 2016 guidelines recommend the use of DOACs rather then AVKs for the treatment of TVD. AIM: The aim of this study was to analise the choice of antithrombotic treatment and to see if CHEST 2016 guidelines were used in the ASL TO3 district for TVD therapy. METHODS: Data obtained from the SISR archives was used to perform a cohort retrospective study. Patients who had been recovered for TEVD were selected 6 months after dismissal. Based on Chest guidelines, the period that ranged from 01/01/2014 to 30/06/2017 was divided into two parts. The cohort was classified according to antithrombotic therapy administered to these patients. RESULTS: 475 patients that had been dismissed after recovery for TVD were identified and enrolled into this study. 1st period: from 275 patients, 247 had a prescription: 132 TAO, 73 DOACs, 42 eparine, 0 ASA. 2nd period: from 200 patients, 185 had a prescription: 55 TAO, 95 DOACs, 34 eparine, 1 ASA. DISCUSSION AND CONCLUSIONS: Our analysis shows a significant difference between the choice of antithrombotic therapy during both periods, this difference is greater among males. We can conclude that antithrombotic prescriptions carried out in the ASL TO3 area have been adherent to Chest guidelines.

Differences in work injury risk between immigrants and natives: changes since the economic recession in Italy.

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.

Risk perception in the population living near the Turin municipal solid waste incineration plant: survey results before start-up and communication strategies.

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.

Human biomonitoring health surveillance for metals near a waste-to-energy incinerator: The 1-year post-operam study.

This human biomonitoring (HBM) follow-up survey, within the SPoTT project, assessed the temporal and spatial trends of exposure to 18 metals in a cohort living around the waste-to-energy (WTE) incinerator of Turin (Italy) before (T0, 2013) and after 1-year of plant activity (T1, 2014). Urine of 380 adult individuals (186 exposed and 194 unexposed subjects, classified on fallout maps) were analyzed by sector field inductively coupled mass spectrometry. A decrease trend of the majority of metals in all subjects indicates that the overall air quality of the studied sites was not significantly compromised, also in proximity of the WTE plant, as corroborated also by air monitoring data of the regional agency. The only relevant exception was the higher Cr levels found at T1 than T0 in exposed subjects, suggesting a possible contribution from the WTE plant. Chromium, Mn and Pt urine levels were also higher in the site far from the WTE, in relation to other sources as vehicular traffic, industrial and civil activities. Whilst, As and Cd were influenced by fish intake and tobacco smoke. A very small number of individuals at T1, equally distributed in both areas, exceeded the health-based guidance values and so, at current knowledge, living near the Turin incineration did not significantly influence the exposure status of the population.

Finding causation in occupational fatalities: A latent class analysis.

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.

[The health of foreign workers: an Italian and international priority.] / La salute dei lavoratori stranieri: una priorità italiana e internazionale.

About 5 million migrants are resident in Italy. Migrant workers are mainly employed in manual, unqualified jobs that Italians tend not to perform anymore. Compared to Italians, they tend to be more hired by precarious contracts. Migrants present a higher risk of work injuries and occupational illnesses than natives. This excess risk is linked to the concentration of migrants in the most dangerous jobs, greater risk tolerance, language and cultural barriers that reduce the effectiveness of any training actions. With the economic crisis, there has been a further worsening of the conditions of workers. Despite the decline in work injury rates, which follow the trend of the economic cycle, the distance between Italians and migrants has remained largely unaltered. The worst health conditions of migrants are not related to individual intrinsic factors, but to the way the economy exploits the social weakness of the migrant to gain profits. Better surveillance data is needed to improve the description and understanding the mechanisms by which migrants are systematically in worse health and safety conditions and to provide direction to effective public health interventions.