Monitoring air pollution effects on children for supporting public health policy: the protocol of the prospective cohort MAPEC study.

INTRODUCTION: Genotoxic biomarkers have been studied largely in adult population, but few studies so far have investigated them in children exposed to air pollution. Children are a high-risk group as regards the health effects of air pollution and some studies suggest that early exposure during childhood can play an important role in the development of chronic diseases in adulthood. The objective of the project is to evaluate the associations between the concentration of urban air pollutants and biomarkers of early biological effect in children, and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. METHODS AND ANALYSIS: Two biomarkers of early biological effects, DNA damage by the comet assay and the micronuclei (MN) test, will be investigated in oral mucosa cells of 6-8-year-old children. Concurrently, some toxic airborne pollutants (polycyclic aromatic hydrocarbon (PAH) and nitro-PAH) and in vitro air mutagenicity and toxicity in ultra-fine air particulates (PM0.5) will be evaluated. Furthermore, demographic and socioeconomic variables, other sources of exposures to air pollutants and lifestyle variables will be assessed by a structured questionnaire. The associations between sociodemographic, environmental and other exposure variables and biomarkers of early biological effect using univariate and multivariate models will be analysed. A tentative model for calculating the global absolute risk of having early biological effects caused by air pollution and other variables will be proposed. ETHICS AND DISSEMINATION: The project has been approved by the Ethics Committees of the local Health Authorities. The results will be communicated to local Public Health Agencies, for supporting educational programmes and health policy strategies. LIFE+2012 Environment Policy and Governance. LIFE12 ENV/IT/000614.

[Alcohol consumption among high school students in Brescia, Italy]. / Indagine sui consumi, atteggiamenti e conoscenze nei confronti delle bevande alcoliche tra gli studenti delle scuole secondarie di secondo grado di Brescia.

A random sample of 1,495 high school student of 9th and 13th grade in Brescia, North Italy, were interviewed about their alcohol consumption, knowledge and attitudes using an anonymous self-administered questionnaire. The percentages of students who usually consumed alcoholic beverage, were 39.7% and 30.3% in males and females, respectively, in 9th grade students and were 51.4% and 23.8% in males and females, respectively, in 13th grade students. The frequency of drunkenness during the month previous the interview was, among 9th graders: 6.9% males and 8.7% females; among 13th graders: 20.7% males and 13.3% females. The following variables were positively associated with alcohol consumption: 1) regular smoking; 2) peer alcohol drinking (best friend and partner); 3) parents' alcohol consumption. When comparing the present survey with a previously carried out in 1989, similar results were found as regards alcohol consumption; on the contrary higher prevalence of drunkenness was found in the 2008 survey, that in the 1989 one.

[Assessment of the genotoxic effects of gaseous emissions and percolates from three municipal landfills using plant bioassays]. / Valutazione dei rischi genotossici derivanti dalla produzione di biogas e percolati in tre discariche controllate mediante test su vegetali.

The biomonitoring of genotoxic effects in environmental complex mixtures using higher plants is very useful for hazard evaluation. In this study we evaluated the potential application of plant genotoxicity tests in monitoring mutagens in landfill environment. The clastogenic effects of gaseous emissions (biogas)from three municipal landfills were evaluated by in situ monitoring using the Tradescantia micronucleus assay. The cytotoxicity and genotoxicity of leachates were studied using the Allium cepa test. We found no significant differences in micronuclei frequency in pollen cells of Tradescantia. Leachate samples showed elevated toxicity that inhibited root tip development in Allium cepa. Genotoxicity of the leachates was evaluated in diluted samples only. We found a significant increase in chromosomal metaphase aberrations only in one of the samples analyzed. In conclusion, biogas was not shown to be a real hazard, whereas leachates were found to display elevated toxicity. It would be advisable to treat leachates before releasing them into the environment as they can cause ecological damages. Since plant bioassays are very useful for the in situ monitoring of environmental genotoxins they are important for the prevention of environmental pollution resulting from the disposal of solid waste.

Pattern of cancer risk in persons with AIDS in Italy in the HAART era.

A record-linkage study was carried out between the Italian AIDS Registry and 24 Italian cancer registries to compare cancer excess among persons with HIV/AIDS (PWHA) before and after the introduction of highly active antiretroviral therapy (HAART) in 1996. Standardised incidence ratios (SIR) were computed in 21951 AIDS cases aged 16-69 years reported between 1986 and 2005. Of 101 669 person-years available, 45 026 were after 1996. SIR for Kaposi sarcoma (KS) and non-Hodgkin lymphoma greatly decreased in 1997-2004 compared with 1986-1996, but high SIRs for KS persisted in the increasingly large fraction of PWHA who had an interval of <1 year between first HIV-positive test and AIDS diagnosis. A significant excess of liver cancer (SIR=6.4) emerged in 1997-2004, whereas the SIRs for cancer of the cervix (41.5), anus (44.0), lung (4.1), brain (3.2), skin (non-melanoma, 1.8), Hodgkin lymphoma (20.7), myeloma (3.9), and non-AIDS-defining cancers (2.2) were similarly elevated in the two periods. The excess of some potentially preventable cancers in PWHA suggests that HAART use must be accompanied by cancer-prevention strategies, notably antismoking and cervical cancer screening programmes. Improvements in the timely identification of HIV-positive individuals are also a priority in Italy to avoid the adverse consequences of delayed HAART use.

Southern Europe as an example of interaction between various environmental factors: a systematic review of the epidemiologic evidence.

Hepatitis B virus (HBV), hepatitis C virus (HCV) and alcohol consumption are major causes of hepatocellular carcinoma (HCC) worldwide. We performed a systematic review of epidemiologic studies carried out on HCC aetiology in Southern Europe, an area with an intermediate-high prevalence of these agents as well as of putative risk factors such as tobacco smoking, diabetes and obesity. To retrieve the articles, we performed a Medline search for titles and abstracts of articles. After the Medline search, we reviewed the papers and reference lists to identify additional articles. A synergism between HCV infection and HBV infection, overt (hepatitis B virus antigen (HbsAg) positivity) or occult (HBsAg negativity with presence of HBV DNA in liver or serum), is suggested by the results of some studies. The pattern of the risk for HCC due to alcohol intake shows a continuous dose-effect curve without a definite threshold, although most studies found that HCC risk increased only for alcohol consumption above 40-60 g of ethanol per day. Some evidence supports a positive interaction of alcohol intake probably with HCV infection and possibly with HBV infection. A few studies found that coffee has a protective effect on HCC risk due to various risk factors. Some data also support a role of tobacco smoking, diabetes and obesity as single agents or preferably co-factors in causing HCC. In countries with a relatively high alcohol consumption and intermediate levels of HCV and HBV infections (1-3% of population infected by each virus), such as Mediterranean countries, the three main risk factors together account for about 85% of the total HCC cases, leaving little space to other known risk factors, such as haemochromatosis, and to new, still unrecognised, factors as independent causes of HCC.

[Cancer incidence and mortality in some health districts in Brescia area 1993--1995]. / Incidenza e mortalità per tumore maligno in alcuni distretti socio-sanitari dell'ASL di Brescia nel triennio 1993--1995.

Cancer Registries are an essential part of any rational programme of cancer control, for assessing the impact of cancer in the community, for health care planning and monitoring screening programmes, according to local enviromental problems. The Brescia Cancer Registry started in 1994 producing prevalence, incidence and mortality data using only manual procedures of colletting and processing data from clinical and pathological sources in Brescia in 1993--1995. Data quality indicators such as the percentages of istologically or cytologically verified cases and that of cases registered on the basis of Death Certificate Only (DCO) are similar to those from the other Northern Italian Registries. Incidence rates for all causes and for various common sites are higher in Brescia than in other areas covered by Cancer Registries in North of Italy.

[Environmental risk factors and epidemiologic study]. / Fattori di rischio ambientale e contesto epidemiologico.

The problems regarding communication of risks in the environmental sector and the analysis of certain causes of pollution, together with their effects on human health are the subjects of this article. In an illustrative and concise manner results of the most important epidemiological studies concerning the effects of non-ionizing radiations, of radon and of air pollution have been analyzed. Throughout this analysis emphasis has been placed on the difficulty of obtaining clear and scientifically based results. Such results are needed in order to provide the population with satisfying information and thus meet the increasing demand for unambiguous answers. Among the risk factors for human health are the high frequency electromagnetic fields used for mobile phones (radiofrequency--RF) nd extremely low frequency electromagnetic fields (ELF-EMFs) of power-lines. Even though these risk factors may be minimal the high number of persons exposed could make them an important impact on public health. Regarding the topic of air pollution, effects on particular segments of the population (children, elderly people and subjects with chronic diseases) have been found in various studies; for example, for an increase of PM(10) of 10 microg/m(3) an increase in daily mortality of 0.69% (CI 0.40-0.98) due to cardiovascular and respiratory causes has been estimated as well as an increase in general daily mortality of 0.54% (CI 0.33-0.76). Due to the populations' low risk perception (caused by unawareness of the problem) radon is undoubtedly the environmental pollutant which has the most impact on public health. This is true even in Italy where 4,000 cases of lung cancer attributable to radon (about 11% of total lung cancer) have been estimated per year; this risk is heightened by the combined effect with smoking. When dealing with health risks the tools of communication must be simple and correct; the mass-media are the most important mediators between the scientific community and the public. It is therefore vital for the public health operators to maintain a continuous relationship with the mass media which should be based on reciprocal trust and full collaboration.