Concentrations of polychlorinated dibenzodioxins, polychlorodibenzofurans, and polychlorobiphenyls in women of reproductive age in Italy: A human biomonitoring study.

BACKGROUND: Polychlorinated dibenzodioxins (PCDDs), polychlorodibenzofurans (PCDFs), and polychlorobiphenyls (PCBs) are persistent organic pollutants that represent a major concern for women of reproductive age because of the neurodevelopmental effects associated to perinatal exposure. OBJECTIVES: This study was aimed at characterizing exposure of women of reproductive age to PCDDs, PCDFs, and PCBs as a function of residence in different Italian Regions, in areas at presumable different environmental contamination and human exposure to these pollutants. METHODS: Study participants were enrolled in 2011-2012 in 6 Italian Regions representative of Northern, Central and Southern Italy; in each region, areas at presumed different exposure (rural, urban and industrial) were selected for enrolment. Each participant provided a serum sample for the analysis of PCDDs, PCDFs and PCBs. RESULTS: Median concentrations of PCDDs+PCDFs, DL-PCBs, NDL6-PCBs and NDL9-PCBs in serum samples were respectively 6.0 and 3.5 pgWHO-TE05/g fat, and 75 and 93ng/g fat. Age was the variable that most affected median serum concentrations. Age adjusted concentrations were found significantly different between geographical zones: women from Northern Italy showed the highest values, followed by Central and Southern Italy. PCDDs+PCDFs concentrations were significantly higher in the group of women residing in industrial areas compared to the group residing in rural areas. A clear diminishing temporal trend was observed compared to levels reported in previous studies. CONCLUSIONS: This study produced the largest dataset on serum concentrations of PCDDs, PCDFs and PCBs in women of childbearing age in Italy. RESULTS: confirmed that environmental and lifestyle factors may influence exposure to these contaminants and thereby the body burden. The observed marked temporal decline in body burden during three decades is in agreement with the general trend observed worldwide.

Current exposure of Italian women of reproductive age to PFOS and PFOA: A human biomonitoring study.

Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) concentrations were determined in serum samples collected in 2011-2012 from 549 nulliparous Italian women of reproductive age who resided in six different Italian Regions. Assessment of exposure to perfluorinated compounds was part of a large human biomonitoring study (Project Life Plus "Womenbiopop") that aimed at examining the exposure of women of reproductive age to priority organic pollutants. The median concentrations of PFOS and PFOA were 2.43, and 1.55 ng g(-1), respectively. Significant differences in the concentrations of both compounds were observed among the six Regions. Women from central Italy had the highest levels of both compounds, followed by women from northern Italy, and southern Italy. No differences in the PFOS concentrations were found between women from urban/industrial areas and women from rural areas, whereas the levels of PFOA were significantly higher in women residing in urban/industrial areas than in women residing in rural areas. Taken together, the observed concentrations confirm that the overall exposure of the Italian population is among the lowest observed in industrialized countries. A downward temporal trend in exposure was observed for both compounds when comparing the results from the present study with those assessed in a study conducted in 2008.

[Study of possible urban environmental pollution by a steel plant through the biological monitoring of urine and hair in children]. / Studio del possibile inquinamento do metalli dell'ambiente generale di vita da parte di un' acciaieria elettrica condotto mediante il monitoraggio biologico di elementi metallici in urine e capelli e il dosaggio delle porfirine urinarie di bambini residenti nel comune di localizzazione dell'impianto.

The aim of this study was to evaluate the hypothesis of an increased exposure to metallic elements through the biological monitoring (urine and hair) in a group of children living near an electric steel plant and in a control group. The concentrations were also compared with the reference values of the literature. The study included the measure of porphyrins in urine (total and homologue), by some authors considered as effect indicators of xenobiotics such as heavy metals and some persistent organochlorine compounds (polychlorinated biphenyls, polychlorinated dibenzofurans, tetrachlorodibenzo-p-dioxin). The comparison between the groups and with the reference values shows that the metallic elements in the hair and urine and urinary porphyrins does not indicates significant differences thus excluding specific health risk. In both groups the values of some metallic elements exceeded the upper limit of reference values. Following a control carried out two months later values returned in reference range probable due to different food intake and individual behavior. As a whole our survey demonstrated that there is no exposure to metallic elements representing a significant risk for this particular groups of general population possibly exposed to environmental pollution.

Cancer incidence in people with AIDS in Italy.

People with HIV/AIDS (PWHA) have increased risk of some cancers. The introduction of highly active antiretroviral therapies (HAART) has improved their life expectancy, exposing them to the combined consequences of aging and of a prolonged exposure to cancer risk factors. The aim of this study was to estimate incidence rates (IR) in PWHA in Italy, before and after the introduction of HAART, after adjusting for sex and age through direct standardization. An anonymous record linkage between Italian AIDS Registry (21,951 cases) and Cancer Registries (17.3 million, 30% of Italian population) was performed. In PWHA, crude IR, sex- and age-standardized IR and age-specific IR were estimated. The standardized IR for Kaposi sarcoma and non-Hodgkin lymphoma greatly declined in the HAART period. Although the crude IR for all non-AIDS-defining cancers increased in the HAART period, standardized IR did not significantly differ in the 2 periods (352 and 379/100,000, respectively). Increases were seen only for cancer of the liver (IR ratio = 4.6, 95% CI: 1.3-17.0) and lung (IR ratio = 1.8, 95% CI: 1.0-3.2). Age-specific IRs for liver and lung cancers, however, largely overlapped in the 2 periods pointing to the strong influence of the shift in the age distribution of PWHA on the observed upward trends. In conclusion, standardized IRs for non-AIDS-defining cancers have not risen in the HAART period, even if crude IRs of these cancers increased. This scenario calls, however, for the intensification of cancer-prevention strategies, notably smoking cessation and screening programs, in middle-aged HIV-patients.

[End-of-life medical decisions: study of physician's opinions in four Italian centres]. / Decisioni mediche di fine vita: uno studio sulle opinioni dei medici in quattro aree italiane.

OBJECTIVE: Knowing the physicians' opinions on end-of-life decisions. DESIGN: In 2002, in the context of an European collaborative study (EURELD) a structured questionnaire has been sent to the physicians of the 9 specialties mostly involved in the assistance of terminal patients. The questionnaire asked to express an opinion on 13 statements on end-of-life decisions and to express his/her intention to behave about 4 hypothetical clinical cases. SETTING: four Italian centres: Florence-Prato, Venice, Trento and Bologna. PARTICIPANTS: 1508 questionnaires were studied, the response rate ranged between 34% (Firenze) to 50% (Trento). RESULTS: In the univariate analysis, there were no significant differences between centres for the 13 statements on end-of-life decisions. In all centres, about one third physicians accepted euthanasia; about one half supported advance directives whereas most physicians would have withheld treatment on the request of patient or intensified the alleviation of symptom and pain. The intended behaviours of withholding treatment, intensifying the alleviation of pain/symptoms, euthanasia, deep sedation until death were more frequently expressed in case of the request of patient than on the physicians own initiative or on request of the family CONCLUSION: The physicians' attitudes were homogeneous between the various centers and they may well be representative of the phenomenon which has been investigated, at least in Northern-Central Italy.