Air Pollution Impact on Pregnancy Outcomes in Como, Italy.

OBJECTIVE: This retrospective observational study investigates the association between maternal exposure to air pollutants and pregnancy adverse outcomes in low urbanization areas. METHODS: We used multivariate regression analysis to estimate, in the Como province (2005-2012), the effects of NO(x), NO2, SO2, O3, CO, and PM10 on low birth weight (LBW), babies small for gestational age (SGA), and preterm birth (PTB). RESULTS: PTB was inversely associated with high (5.5 µg/m³) exposure to SO2 (adjusted odds ratio [aOR] = 0.74, 95% confidence interval [95% CI] = 0.58-0.95) and to CO (1.8 mg/m³, aOR = 0.84, CI = 0.72-0.99). PTB risk increased with second trimester exposure to NO(x) (118.3 µg/m³, aOR = 1.53, CI = 1.25-1.87), while LBW risk increased with third trimester PM10 (56.1 µg/m³, aOR = 1.44, CI = 1.03-2.02). SGA was inversely associated with third trimester NO(x) (115.8 µg/m³, aOR = 0.89, CI = 0.79-0.99). CONCLUSIONS: Exposure to SO2 and CO seems to postpone delivery: a longer gestation could compensate for maternal hypoxemic-hypoxic damage.

Control of scabies outbreaks in an Italian hospital: an information-centered management strategy.

BACKGROUND: Scabies is a dermatologic infestation caused by Sarcoptes scabiei. In industrialized countries, hospitals and other health structures can sometimes be hit. The optimal management of scabies outbreaks still has to be established, mass prophylaxis being one possible option. METHODS: To identify the optimal approach to containing this re-emerging disease, a local health authority in Lombardy, Northern Italy, carried out an epidemiologic study into 2 scabies epidemics that took place from September to December 2012 in a 600-bed hospital with 26,000 admissions a year. RESULTS: Over a 3-month period, there were 12 cases of scabies on 4 wards; 43 contacts received prophylaxis. When the first cases were identified, an information campaign involving all hospital personnel was immediately set up. Regular staff meetings were organized, and information leaflets were distributed to patients. Family doctors of discharged patients were informed of the outbreak. CONCLUSION: A management model based on an information-centered strategy was used in place of mass prophylaxis to deal with scabies epidemics. The success of this approach was confirmed by the managers of the hospital involved (reduced expenditure for prophylactic drugs) and by hospital staff who did not have to deal with potential drug adverse effects.