Door-to-door waste collection: A framework for the socio - Economic evaluation and ergonomics optimisation.

Waste collection is the first step of waste management, and its characteristics impact workers' health and safety. Arising out of the challenge for waste collection operators to design sustainable systems of work, the authors review the literature on ergonomics and socio-economic sustainability and design a theoretical framework for assessing the sustainability of waste collection. The framework quantitatively assess the impact of the door-to-door collection system on the health and safety of the workers to provide indications to waste collection operators on how the load carried by workers can be minimised and the economic and social sustainability can be improved. As a case study, this paper investigates the musculoskeletal disorders derived from the manual material handling of waste containers affecting the workers in charge of door-to-door sorted collection of paper waste with the goal of optimizing the workers well-being and overall waste collection system performance The research study was conducted in collaboration with a company which operates in solid waste collection for Italian municipalities. For this purpose, the ergo-quality level of two paper waste collection systems is evaluated. For each system, ten scenarios of door-to-door paper waste collection are considered. The analysis is complemented by an economic analysis, which estimates the costs associated with the collection system under consideration, and a social life-cycle assessment. Results suggest that using 120-litres capacity bins would effectively improve ergonomics and optimise the costs of the investigated activity. More specifically, due to mechanised collection, the more limited number of lifting and carrying operations would expose the workers to lower ergonomic risk.

Municipal solid waste collection systems: An indicator to assess the reusability of products.

GRAPHICAL ABSTRACT: [Formula: see text].

A framework for sustainability assessment and prioritisation of urban waste prevention measures.

Waste prevention (WP) can play a significant role in pursuing both sustainable development and decarbonization. Nevertheless, a general method to monitor and evaluate WP does not exist yet. This study proposes a framework for the sustainability assessment and prioritisation of waste prevention measures (WPMs), at consumption level. Firstly, some WPMs are selected, based on relevant criteria. Secondly, their impacts are assessed, in terms of environmental, economic, and social sustainability, in a life-cycle perspective. Then, a set of significant effectiveness and efficiency indicators are chosen and calculated. Finally, an algorithm for the prioritisation is proposed. This methodological approach might be useful to guide the financing choices of the public decision-makers, to assess and promote WPMs, and to develop WP strategies. Moreover, the results can be used in waste management planning and to motivate local actors through benchmarking. The designed framework has been applied to 17 projects implemented by Municipalities in the Emilia-Romagna Region (Italy), as case study. The projects, whose aim is the reduction of waste from plastic disposable goods, can be grouped in three different categories: i) drinking water dispensers in towns/cities, ii) drinking water dispensers in schools and iii) replacement of disposable goods in school canteens. The project category of drinking water dispensers in towns proved to be the most sustainable one, achieving a score of 0,4265, while the other categories scored around 0,28. The study confirms that WP should be promoted, despite being very difficult to monitor. The political institutions should invest in implementing a specific monitoring system, also able to reveal potential integration of WP strategies with other policy areas. Finally, an improved institutional framework might help the Municipalities in overcoming barriers to the identification and implementation of WPMs, by allowing for coordination and networking of individual projects and by encouraging the spread of good practices.

HPV infection and pre-neoplastic cervical lesions among 321 HIV+ women in Florence, Italy, 2006-2016: prevalence and associated factors.

Women living with HIV (WLWH) are at higher risk for HPV-related malignancies. To estimate the factors associated to HPV infection and to pre-neoplastic cervical lesions, we observed 321 WLWH in an HIV care-centre in Florence, Italy. In 2006-2016, WLWH followed at S. Maria Annunziata Hospital underwent to gynaecological examination including HPV-test, Pap-smear, colposcopy and, if needed, cervical biopsy. Demographical and clinical information were collected and linear logistic regression was performed. Among 321 WLWH, 161 (50.2%) resulted HPV+. Multiple genotypes were identified in 35%, and cancer high-risk genotypes in 61%. Younger age, not-caucasic origin, increasing number of partners, and shorter duration of HIV are associated with HPV infection. A colposcopy was performed in 154 HIV+/HPV+ women: histological lesions were present in 47 (30%). Among these, CIN1, CIN2 and CIN3 were present in 16, 4, and 1 patients, respectively. Being caucasic, smoking 1-20 cigarettes/day, having 2 partners in the last year, and being an injective-drug-user are associated with cervical lesions. The use of bi-valent, 4-valent and 9-valent HPV vaccines would potentially prevent lesions in 19%, 33%, and 48%. Among WLWH efficaciously in care for HIV, demographic and behavioral factors mainly contribute to acquisition of HPV and to development of cervical lesions.

Reasons for switching ART: Comparison of data collected in 2012-2013 and 2014-2015 in Florence, Italy.

Persons living with HIV should remain on antiretroviral therapy (ART) indefinitely; however, a switch in the drug regimen is often necessary. In order to investigate if reasons for switching ART changed over time, we retrospectively analyzed reasons for switching and characteristics of switches among patients at Santa Maria Annunziata Hospital (OSMA), Florence area, Tuscany, Italy, over two periods (November 2012-October 2013 and November 2014-October 2015). The reasons for switching were classified as: simplification; virologic failure; occurrence of co-morbidities; and drug tolerability/toxicity issues. In period 1 (2012-2013), 18% patients changed their regimen vs. 13.5% in period 2 (2014-2015) (p = 0.019). Among reasons for switching, switches for simplification significantly increased from 41% in period 1 to 53% in period 2 (p = 0.004), with an increasing use of single tablet regimens (p = 0.002); no other statistically significant differences were found in other reasons for switching in periods 1 and 2. Characteristics of patients and of switches were analyzed and described. According to our data, the main reason for switching is now simplification, reflecting the recent changes in recommendations aimed to enhance adherence and quality of life, and to minimize, at the same time, drug toxicity and side effects.

Spoligotyping and Mycobacterium tuberculosis.

We evaluated the clinical usefulness of spoligotyping, a polymerase chain reaction-based method for simultaneous detection and typing of Mycobacterium tuberculosis strains, with acid-fast bacilli-positive slides from clinical specimens or mycobacterial cultures. Overall sensitivity and specificity were 97% and 95% for the detection of M. tuberculosis and 98% and 96% when used with clinical specimens. Laboratory turnaround time of spoligotyping was less than that for culture identification by a median of 20 days. In comparison with IS6110-based restriction fragment length polymorphism typing, spoligotyping overestimated the number of isolates with identical DNA fingerprints by approximately 50%, but showed a 100% negative predictive value. Spoligotyping resulted in the modification of ongoing antimycobacterial treatment in 40 cases and appropriate therapy in the absence of cultures in 11 cases. The rapidity of this method in detection and typing could make it useful in the management of tuberculosis in a clinical setting.