Impact of COVID-19 restrictive measures during lockdown period on eating disorders: An umbrella review.

The COVID-19 pandemic has sparked or amplified many mental health problems. The aim of this study was to compile evidence from existing systematic reviews to provide an overall assessment of the impact of social restrictions during the COVID-19 pandemic on people affected by eating disorders (EDs). PubMed and Scopus were searched up to August 16, 2023. Systematic reviews and meta-analyses were selected using the PRISMA 2020 statement. The quality assessment of the included studies was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Eleven studies were included in this umbrella review. Six main categories emerged from the studies described in the review: dietary changes and psychopathological effects showed an overall worsening of symptomatology; in studies concerning the impact of isolation and restrictive measures, it was found that social distancing was associated with feelings of loneliness, anxiety, and depression; limited access to direct care was found and therapeutic changes were made; the influence of mass media negatively impacted people with ED; several studies reported positive findings regarding symptomatology; finally, studies regarding 'impact on vulnerable populations showed that vulnerable people are more at risk of reporting body image distortion and eating disorders. The COVID-19 pandemic has negatively impacted most of the population with ED leading to a worsening of specific symptomatology. In addition, this worsening of the condition may be caused by limited access to care and treatment, changes in routine, or to the negative influence of the media.

Pollutant exposure and myocardial injury: Protocol and progress report for a toxicological systematic mapping review.

An increasing body of evidence identifies pollutant exposure as a risk factor for cardiovascular disease (CVD), while CVD incidence rises steadily with the aging population. Although numerous experimental studies are now available, the mechanisms through which lifetime exposure to environmental pollutants can result in CVD are not fully understood. To comprehensively describe and understand the pathways through which pollutant exposure leads to cardiotoxicity, a systematic mapping review of the available toxicological evidence is needed. This protocol outlines a step-by-step framework for conducting this review. Using the National Toxicology Program (NTP) Health Assessment and Translation (HAT) approach for conducting toxicological systematic reviews, we selected 362 out of 8111 in vitro (17%), in vivo (67%), and combined (16%) studies for 129 potential cardiotoxic environmental pollutants, including heavy metals (29%), air pollutants (16%), pesticides (27%), and other chemicals (28%). The internal validity of included studies is being assessed with HAT and SYRCLE Risk of Bias tools. Tabular templates are being used to extract key study elements regarding study setup, methodology, techniques, and (qualitative and quantitative) outcomes. Subsequent synthesis will consist of an explorative meta-analysis of possible pollutant-related cardiotoxicity. Evidence maps and interactive knowledge graphs will illustrate evidence streams, cardiotoxic effects and associated quality of evidence, helping researchers and regulators to efficiently identify pollutants of interest. The evidence will be integrated in novel Adverse Outcome Pathways to facilitate regulatory acceptance of non-animal methods for cardiotoxicity testing. The current article describes the progress of the steps made in the systematic mapping review process.

Heart disease is a leading global cause of death. Recent research indicates that certain environmental chemicals can worsen heart problems. We're conducting a rigorous review of scientific studies to understand how these chemicals affect the heart. This will inform policymakers and promote non-animal testing methods for cardiotoxicity by providing a clear overview of the toxicological evidence. We have reviewed over 8,000 articles and focused on 362 studies about 129 chemicals, including heavy metals, air pollutants and pesticides, and their effects on the heart. The current manuscript describes the used methods and steps made in this process. The outcome of our systematic review of these 362 articles will be a comprehensive database that will aid the development of alternative testing methods for cardiotoxicity.

Occupational Exposure during Pregnancy and Effects on Newborns: A Nested Case-Control Study.

BACKGROUND: The protection of pregnant workers should be based on evidence regarding the risks to reproductive health from exposure to specific work environments and conditions. The objective of this study was to identify the effects on mothers and newborns resulting from environmental exposure to various occupational risks. METHODS: The study cohort was composed of 399 women admitted to the Obstetrics/Postpartum ward at Hospital La Fe in Valencia, Spain. Face-to-face interviews were conducted to establish associations between workplace exposure during pregnancy and its effects on maternal and newborn health. Sex, anthropometric characteristics, and blood gas analysis in arterial and venous umbilical cord blood at delivery were collected. RESULTS: A total of 138 women were exposed to biological and/or chemical risks, 122 to physical risks, and 139 at no risk of exposure. In the group with chemical and/or biological risks, the frequency of women who resorted to in vitro fertilization to achieve the studied pregnancy is less than half of the group exposed to physical risks, with statistically significant differences (p = 0.047). The mean values for the arterial analysis in both exposure groups were within average values, with similar pH values between them, but the mean values of PCO2 and PO2 were lower in the group of neonates of mothers exposed to physical risks, with a significant difference for arterial PO2 (p = 0.027). CONCLUSION: Our analysis contributes evidence for planning and prioritizing preventive actions to protect women's reproductive health. The results suggest the continuation of a future project that would consider more factors and potentially increase the sample size.

A systematic review on the association between exposure to air particulate matter during pregnancy and the development of hypertensive disorders of pregnancy and gestational diabetes mellitus.

Particulate matter (PM) is considered an intrauterine toxin that can cross the blood-placental barrier and circulate in fetal blood, affecting fetal development, and implicating placental and intrauterine inflammation, and oxidative damage. However, the relationship between PM exposure and adverse pregnancy outcomes is still unclear and our aim was to systematically review toxicological evidence on the link between PM exposure during pregnancy and the development of gestational diabetes mellitus or hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia. PubMed and Science Direct were searched until January 2022. Of the 204 studies identified, 168 were excluded. The remaining articles were assessed in full-text, and after evaluation, 27 were included in the review. Most of the studies showed an association between PM exposure and gestational hypertension, systolic and diastolic blood pressure, pre-eclampsia, and gestational diabetes mellitus. These results should be interpreted with caution due to the heterogeneity of baseline concentrations, which ranged from 3.3 µg/m3 to 85.9 µg/m3 and from 21.8 µg/m3 to 92.2 µg/m3, respectively for PM2.5 and PM10. Moreover, critical exposure periods were not consistent among studies, with five out of ten observational studies reporting the second trimester as the critical period for hypertensive disorders of pregnancy, and ten out of twelve observational studies reporting the first or second trimester as the critical period for gestational diabetes mellitus. Overall, the findings support an association between PM exposure during pregnancy and adverse pregnancy outcomes, highlighting the need for further research to identify the critical exposure periods and underlying mechanisms.

Relationship between parental exposure to radiofrequency electromagnetic fields and primarily hematopoietic neoplasms (lymphoma, leukemia) and tumors in the central nervous system in children: a systematic review.

Low-frequency electromagnetic fields have grown exponentially in recent years due to technological development and modernization. The World Health Organization (WHO)/International Agency for Research on Cancer (IARC) has classified radiofrequency electromagnetic fields (RF-EMFs) as possibly carcinogenic to humans (Group 2B), and recent studies have investigated the association between exposure to electromagnetic fields in parents and possible health effects in children, especially the development of tumours of the central nervous system (CNS). The objective of this systematic review was to collate all evidence on the relationship between parental occupational exposure to electromagnetic fields and the development of CNS cancer in children and to evaluate this association. This review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched from January 1990 to April 2021. The search was conducted using the following search string: "occupational" AND "child" AND "electromagnetic" AND "cancer". Seventeen articles met our inclusion criteria: 13 case-control studies, two cohort studies, and 2 meta-analyses. Most of the studies showed several methodological weaknesses that limited their results. Due to a lack of consistency regarding the outcome as well as the heterogeneity in the reviewed studies, the body of evidence for the effects of parental exposure to electromagnetic fields is not clear. Methodological heterogeneity in the way that studies were conducted could be responsible for the lack of consistency in the findings. Overall, the body of evidence allows no conclusion on the relationship between parental exposure to electromagnetic fields and the occurrence of CNS tumours in children.

Risk Associations between Vehicular Traffic Noise Exposure and Cardiovascular Diseases: A Residential Retrospective Cohort Study.

Environmental noise can induce detrimental health effects such as cardiovascular disease (CVD). The relationship between vehicular traffic noise pollution and CVD was investigated through a retrospective residential cohort study in the city of Pisa. Four exposure classes were defined for noise pollution, using noise propagation maps. The association between noise exposures and cause-specific mortality or hospitalization of the subjects of the cohort was calculated using the hazard ratio (HR) for night and day through a multiple time-dependent and sex-specific Cox regression adjusting for age, the socio-economic deprivation index, and traffic air pollution. Mortality excess for CVD and risk trends for a 1 decibel noise increment were observed among the most exposed women (mortality: HRnightclass4 1.15 (1.03-1.28); Trendnight 1.007 (1.002-1.012); HRdayclass4 1.14 (1.02-1.27); Trendday 1.008 (1.003-1.013)), particularly for ischaemic disease (mortality: Trendnight 1.008 (0.999-1.017); Trendday 1.009 (0.999-1.018)) and cerebrovascular disease (mortality: HRnightclass3 1.23 (1.02-1.48), HRdayclass3 1.24 (1.03-1.49)). Hospitalization analyses confirm mortality results. A decreased risk for hospitalization was also observed among the most exposed men (HRdayclass4 0.94 (0.88-1.01), particularly for ischaemic disease (HRnightclass4 0.90 (0.80-1.02); HRdayclass4 0.86 (0.77-0.97)) and cerebrovascular disease (HRnightclass4 0.89 (0.78-1.01)). Authors recommend the adoption of prevention measures aimed at mitigating noise and the activation of a monitoring of the risk profile in the Pisa population updating both the residential cohort and health data.

Longitudinal Nitric Oxide Levels and Infections by Ultrastructure and Genotype in Primary Ciliary Dyskinesia.

BACKGROUND: We hypothesized that differences in nasal nitric oxide (nNO) and fractional exhaled nitric oxide (Feno) relate to prognosis in primary ciliary dyskinesia (PCD). RESEARCH QUESTION: What is the relationship between baseline values and longitudinal evolution of nNO and Feno and ultrastructure, genotype, and respiratory infections in PCD? STUDY DESIGN AND METHODS: Prospective, longitudinal, single-center study in adults and children evaluated biannually for up to 10 years. We compared cross-sectional and longitudinal values of nNO and Feno in ultrastructural (inner dynein arm [IDA] and microtubular disorganization [MTD]) and genetic (CCDC39 and CCDC40) groups known to have worse pulmonary function with patients within the ultrastructural and genetic groups with a better prognosis. Linear mixed-effects models were used to evaluate longitudinal associations. RESULTS: One hundred forty-one patients with PCD underwent 1,014 visits. At enrollment, no differences were found in children in nNO or Feno between the IDA and MTD group and the other ultrastructural groups. In adults, nNO (P = .038) and Feno (P = .032) were significantly lower in the IDA and MTD group than in all other combined ultrastructural groups. Feno values were significantly lower in the CCDC39 and CCDC40 group than in the DNAH5 and DNAH11 combined genotype group (P = .033) and in all other genotypes (P = .032). The IDA and MTD group showed a significant decline in nNO with age (P < .01) compared with other ultrastructural groups who showed stable levels. The CCDC39 and CCDC40 group showed the steepest decline in nNO over time (P < .01) compared with all other genotypes. A higher nNO was associated with lower likelihood of any positive bacterial isolate from the lower respiratory tract (P = .008). Changes in Feno over time did not differ between structural groups or genotypes. INTERPRETATION: Lower nNO in patients with PCD with genetic and ultrastructural changes associated with greater lung function decline may be related to worse prognosis, but whether a low nNO is causal needs further study. If lower nNO directly results in a poorer prognosis, strategies augmenting upper airway nitric oxide production may be worth evaluating.

Protocol for a Systematic Review and Meta-Analysis of Observational Studies on the Association of Exposure to Toxic Environmental Pollutants and Left Ventricular Dysfunction.

The association between environmental exposure to toxic substances and cardiovascular diseases (CVDs) in humans is widely recognized. However, the analysis of underlying pathophysiological mechanisms is essential to target meaningful endpoints of cardiotoxicity and allow a close-to-real life understanding of the role of chronic and acute exposure to multiple toxicants. The aim of this study is to outline the process for a systematic review of the literature that investigates the relationship between environmental pollution and left ventricular dysfunction. This systematic review and meta-analysis protocol will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) statement. PubMed, Embase, and Web of Science databases will be searched without applying search filters. Two independent reviewers will screen all titles and abstracts and identify the articles to be included in the synthesis. The risk of bias (RoB) will be assessed using an instrument developed for non-randomized (i.e., observational) studies (NRS) of environmental exposures. The results of cohort, case-control, cross-sectional, time-series, and case-crossover studies will be extracted and presented in tables considering different population subgroups and length of exposure. This protocol will be expected to provide a sound basis for selecting toxic chemicals and pollutants to contribute with the epidemiological evidence to the in vitro testing protocol within the EU-funded ALTERNATIVE Project.

Anorexia Nervosa, Body Image Perception and Virtual Reality Therapeutic Applications: State of the Art and Operational Proposal.

Anorexia Nervosa (AN) patients exhibit distorted body representation. The purpose of this study was to explore studies that analyze virtual reality (VR) applications, related to body image issues, to propose a new tool in this field. We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Scopus, and Web of Science databases were explored; the review included 25 studies. Research has increased over the last five years. The selected studies, clinical observational studies (n = 16), mostly concerning patients' population with AN (n = 14) or eating disorders (EDs) diagnosis, presented multiple designs, populations involved, and procedures. Some of these studies included healthy control groups (n = 7). Studies on community sample populations were also selected if oriented toward clinical applications (n = 9). The VR technologies in the examined period (about 20 years) have evolved significantly, going from very complex and bulky systems, requiring very powerful computers, to agile systems. The advent of low-cost VR devices has given a big boost to research works. Moreover, the operational proposal that emerges from this work supports the use of biofeedback techniques aimed at evaluating the results of therapeutic interventions in the treatment of adolescent patients diagnosed with AN.

Role of meteorological factors on SARS-CoV-2 infection incidence in Italy and Spain before the vaccination campaign. A multi-city time series study.

Numerous studies have been conducted worldwide to investigate if an association exists between meteorological factors and the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection incidence. Although research studies provide conflicting results, which can be partially explained by different methods used, some clear trends emerge on the role of weather conditions and SARS-CoV-2 infection, especially for temperature and humidity. This study sheds more light on the relationship between meteorological factors and SARS-CoV-2 infection incidence in 23 Italian and 52 Spanish cities. For the purposes of this study, daily air temperature, absolute and relative humidity, wind speed, ultraviolet radiation, and rainfall are considered exposure variables. We conducted a two-stage meta-regression. In the first stage, we estimated the exposure-response association through time series regression analysis at the municipal level. In the second stage, we pooled the association parameters using a meta-analytic model. The study demonstrates an association between meteorological factors and SARS-CoV-2 infection incidence. Specifically, low levels of ambient temperatures and absolute humidity were associated with an increased relative risk. On the other hand, low and high levels of relative humidity and ultraviolet radiation were associated with a decreased relative risk. Concerning wind speed and rainfall, higher values contributed to the reduction of the risk of infection. Overall, our results contribute to a better understanding of how the meteorological factors influence the spread of the SARS-CoV-2 and should be considered in a wider context of existing robust literature that highlight the importance of measures such as social distancing, improved hygiene, face masks and vaccination campaign.

Relations between Air Quality and Covid-19 Lockdown Measures in Valencia, Spain.

The set of measures to contain the diffusion of COVID-19 instituted by the European governments gave an unparalleled opportunity to improve our understanding of the transport and industrial sectors' contribution to urban air pollution. The purpose of this study was to assess the impacts of the lockdown measures on air quality and pollutant emissions in Valencia, Spain. For this reason, we determined if there was a significant difference in the concentration levels of different particulate matter (PM) sizes, PM10, PM2.5, and NOx, NO2, NO, and O3, between the period of restrictions in 2020 and the same period in 2019. Our findings indicated that PM pollutant levels during the lockdown period were significantly different from the same period of the previous year, even if there is variability in the different local areas. The highest variations reduction in the PM10 and PM2.5 levels were observed for the València Centre, València Avd Francia, and València Pista de Silla (all of the urban traffic type) in which there was a reduction of 58%-42%, 56%-53%, and 60%-41% respectively. Moreover, consistent with recent studies, we observed a significant reduction in nitric oxide levels in all the air monitoring stations. In all seven monitoring stations, it was observed, in 2020, NOx, NO2, and NO concentrations decreased by 48.5%-49.8%-46.2%, 62.1%-67.4%-45.7%, 37.4%-35.7%-35.3%, 60.7%-67.7%-47.1%, 65.5%-65.8%-63.5%, 60.0%-64.5%-41.3%, and 60.4%-61.6%-52.5%, respectively. Lastly, overall O3 levels decreased during the lockdown period, although this phenomenon was more closely related to weather conditions. Overall, no significant differences were observed between the meteorological conditions in 2019 and 2020. Our findings suggest that further studies on the effect of human activities on air quality are needed and encourage the adoption of a holistic approach to improve urban air quality.

Invasive Pneumococcal Disease in Tuscany Region, Italy, 2016-2017: Integrating Multiple Data Sources to Investigate Underreporting.

Invasive pneumococcal disease (IPD) is a vaccine-preventable disease characterized by the presence of Streptococcus pneumoniae in normally sterile sites. Since 2007, Italy has implemented an IPD national surveillance system (IPD-NSS). This system suffers from high rates of underreporting. To estimate the level of underreporting of IPD in 2016-2017 in Tuscany (Italy), we integrated data from IPD-NSS and two other regional data sources, i.e., Tuscany regional microbiological surveillance (Microbiological Surveillance and Antibiotic Resistance in Tuscany, SMART) and hospitalization discharge records (HDRs). We collected (1) notifications to IPD-NSS, (2) SMART records positive for S. pneumoniae from normally sterile sites, and (3) hospitalization records with IPD-related International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9) codes in discharge diagnoses. We performed data linkage of the three sources to obtain a combined surveillance system (CSS). Using the CSS, we calculated the completeness of the three sources and performed a three-source log-linear capture-recapture analysis to estimate total IPD underreporting. In total, 127 IPD cases were identified from IPD-NSS, 320 were identified from SMART, and 658 were identified from HDRs. After data linkage, a total of 904 unique cases were detected. The average yearly CSS notification rate was 12.1/100,000 inhabitants. Completeness was 14.0% for IPD-NSS, 35.4% for SMART, and 72.8% for HDRs. The capture-recapture analysis suggested a total estimate of 3419 cases of IPD (95% confidence interval (CI): 1364-5474), corresponding to an underreporting rate of 73.7% (95% CI: 34.0-83.6) for CSS. This study shows substantial underreporting in the Tuscany IPD surveillance system. Integration of available data sources may be a useful approach to complement notification-based surveillance and provide decision-makers with better information to plan effective control strategies against IPD.

Risk Perception of Air Pollution: A Systematic Review Focused on Particulate Matter Exposure.

The adverse health effects of exposure to air pollutants, notably to particulate matter (PM), are well-known, as well as the association with measured or estimated concentration levels. The role of perception can be relevant in exploring effects and pollution control actions. The purpose of this study was to explore studies that analyse people's perception, together with the measurement of air pollution, in order to elucidate the relationship between them. We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In March 2020, PubMed, EMBASE, and Scopus databases were explored in an attempt to search for studies published from 2000 to 2020. The review included 38 studies, most of which were conducted in China (n = 13) and the United States (n = 11) and published over the last four years (n = 26). Three studies were multicenter investigations, while five articles were based on a national-level survey. The air quality (AQ) was assessed by monitoring stations (n = 24) or dispersion models (n = 7). Many studies were population questionnaire-based, air monitoring and time-series studies, and web-based investigations. A direct association between exposure and perception emerged in 20 studies. This systematic review has shown that most of the studies establish a relationship between risk perception measurement. A broad spectrum of concepts and notions related to perception also emerged, which is undoubtedly an indicator of the wealth of available knowledge and is promising for future research.

Particulate Matter Exposure and Attention-Deficit/Hyperactivity Disorder in Children: A Systematic Review of Epidemiological Studies.

Attention-deficit/hyperactivity disorder (ADHD) is the most common cognitive and behavioural disorder affecting children, with a worldwide-pooled prevalence of around 5%. Exposure to particulate matter (PM) air pollution is suspected to be associated with autism spectrum disorders and recent studies have investigated the relationship between PM exposure and ADHD. In the absence of any synthesis of the relevant literature on this topic, this systematic review of epidemiological studies aimed to investigate the relationship between the exposure of children to PM and ADHD and identify gaps in our current knowledge. In December 2018, we searched the PubMed and EMBASE databases. We only included epidemiological studies carried out on children without any age limit, measuring PM exposure and health outcomes related to ADHD. We assessed the quality of the articles and the risk of bias for each included article using the Newcastle-Ottawa Scale and the Office of Health Assessment and Translation (OHAT) approach, respectively. The keyword search yielded 774 results. Twelve studies with a total number of 181,144 children met our inclusion criteria, of which 10 were prospective cohort studies and 2 were cross-sectional studies. We subsequently classified the selected articles as high or good quality studies. A total of 9 out of the 12 studies reported a positive association between PM exposure to outdoor air pollution and behavioral problems related to attention. Despite these results, we found a significant degree of heterogeneity among the study designs. Furthermore, 11 studies were judged to be at a probably high risk of bias in the exposure assessment. In conclusion, we opine that further high quality studies are still needed in order to clarify the association between PM exposure and ADHD diagnosis.

The application of quantitative microbial risk assessment to natural recreational waters: A review.

This review examines the aims of and approaches to the Quantitative Microbial Risk Assessment (QMRA) of untreated recreational waters. The literature search was conducted on four databases and yielded 54 papers, which were analyzed on a quantitative (time-trend, geographical distribution, water type) and qualitative (aims, source of microbial data, pathogens and their measurement or estimation, ways to address variability and uncertainty, sensitivity analysis) basis. In addition, the parameters, implications, and limitations were discussed for each QMRA step. Since 2003, the number of papers has greatly increased, highlighting the importance of QMRA for the risk management of recreational waters. Nevertheless, QMRA still exhibits critical issues, above all regarding contamination data and dose-response relationships. To our knowledge, this is the first review to give a wide panoramic view on QMRA in relation to recreational exposure to untreated waters. This could be useful in identifying the current knowledge gaps and research needs.

The Association between Lead and Attention-Deficit/Hyperactivity Disorder: A Systematic Review.

The etiology of Attention-Deficit/Hyperactivity Disorder (ADHD) is complex and multifactorial. Although the development of ADHD symptoms remains to be elucidated, in recent years, epigenetic processes have emerged as candidate mechanisms. Lead is one of the most dangerous environmental pollutants, and it is suspected to be associated with ADHD. The aim of the present study was to review the epidemiological literature currently available on the relation between lead exposure and the diagnosis of ADHD. The PubMed and EMBASE databases were searched from 1 July 2018 up to 31 July 2018. The authors included observational studies (cohort, case⁻control and cross-sectional studies) published in English carried out on children within the last 5 years, measuring lead exposure and health outcomes related to ADHD. Seventeen studies met the inclusion criteria: 5 of these studies found no association between lead exposure and ADHD whereas the remaining 12 studies showed positive associations, even though not all of them were homogeneous in terms of exposure periods considered or ADHD diagnosis. To conclude, the evidence from the studies allowed us to establish that there is an association between lead and ADHD and that even low levels of lead raise the risk. However, there is still a lack of longitudinal studies about the relationship between lead exposure and the development of ADHD. Given the potential importance for public health, further research that includes the entire potential risk factors for ADHD in children must be encouraged.

Human adenoviruses as waterborne index pathogens and their use for Quantitative Microbial Risk Assessment.

The current microbial water quality standards are based on the monitoring of fecal indicator organisms, which are mainly bacterial indicators (i.e., Escherichia coli, intestinal enterococci), however epidemiological data indicate that viruses are important etiological agents of waterborne illnesses. Among waterborne viruses, human adenovirus can be considered as an index pathogen, owing to its abundance in sewage and persistence in the environment, as well as its potential infectivity. In this study, data on human adenoviruses from different water matrices (the entrance and exit of a water treatment plant, rivers and seawaters) were analyzed, in parallel with traditional fecal bacterial indicators and somatic coliphages. The results showed a 64% frequency of positive adenovirus samples, decreasing from the sewage system (100% at the entrance and 94% at the exit) to rivers (92% and 72% for different rivers) and seawater (21%). Adenovirus concentrations showed a significant correlation with somatic coliphages in one river and seawater, thus supporting the recent inclusion of coliphages as viral indicators in water safety guidelines. The data collected were used to estimate adenovirus to indicator ratios, which could be used as input in Quantitative Microbial Risk Assessment (QMRA) studies.

Quantitative Microbial Risk Assessment for Workers Exposed to Bioaerosol in Wastewater Treatment Plants Aimed at the Choice and Setup of Safety Measures.

Biological risk assessment in occupational settings currently is based on either qualitative or semiquantitative analysis. In this study, a quantitative microbial risk assessment (QMRA) has been applied to estimate the human adenovirus (HAdV) health risk due to bioaerosol exposure in a wastewater treatment plant (WWTP). A stochastic QMRA model was developed considering HAdV as the index pathogen, using its concentrations in different areas and published dose⁻response relationship for inhalation. A sensitivity analysis was employed to examine the impact of input parameters on health risk. The QMRA estimated a higher average risk in sewage influent and biological oxidation tanks (15.64% and 12.73% for an exposure of 3 min). Sensitivity analysis indicated HAdV concentration as a predominant factor in the estimated risk. QMRA results were used to calculate the exposure limits considering four different risk levels (one illness case per 100, 1.000, 10.000, and 100.000 workers): for 3 min exposures, we obtained 565, 170, 54, and 6 GC/m³ of HAdV. We also calculated the maximum time of exposure for each level for different areas. Our findings can be useful to better define the effectiveness of control measures, which would thus reduce the virus concentration or the exposure time.

[A network of LIFE projects to promote the transfer and exchange of knowledge on environment and health]. / Un network di progetti LIFE per promuovere il trasferimento e lo scambio di conoscenze su ambiente e salute.

Eleven projects within the LIFE programme (through which the Directorate-General for Environment of the European Commission provides funding for projects aim at protecting environment and nature) addressing environmental-health-related issues have been involved in a collaborative network called KTE LIFE EnvHealth Network. The shared issues tackled by that projects are knowledge transfer and exchange (KTE). The objective of the LIFE programme is to support the implementation of the environmental legislation in the European Union, to provide new tools and knowledge that will help to better protect both the territory and the communities. Transferring knowledge to decision makers, at the appropriate and effective level, is therefore a central function of the projects. The Network promotes national and international networking, which intends to involve other projects, to provide methodological support, to make information and successful practices circulate, with the aim of multiplying the energies of each project involved.