Water and Soil Pollution: Ecological Environmental Study Methodologies Useful for Public Health Projects. A Literature Review.

Health risks at population level may be investigated with different types of environmental studies depending on access to data and funds. Options include ecological studies, case-control studies with individual interviews and human sample analysis, risk assessment or cohort studies. Most public health projects use data and methodologies already available due to the cost of ad-hoc data collection. The aim of the article is to perform a literature review of environmental exposure and health outcomes with main focus on methodologies for assessing an association between water and/or soil pollutants and cancer. A systematic literature search was performed in May 2019 using PubMed. Articles were assessed by four independent reviewers. Forty articles were identified and divided into four groups, according to the data and methods they used, i.e.: (1) regression models with data by geographical area; (2) regression models with data at individual level; (3) exposure intensity threshold values for evaluating health outcome trends; (4) analyses of distance between source of pollutant and health outcome clusters. The issue of exposure assessment has been investigated for over 40 years and the most important innovations regard technologies developed to measure pollutants, statistical methodologies to assess exposure, and software development. Thanks to these changes, it has been possible to develop and apply geo-coding and statistical methods to reduce the ecological bias when considering the relationship between humans, geographic areas, pollutants, and health outcomes. The results of the present review may contribute to optimize the use of public health resources.

The missing link between human ecology and public health: the case of cancer.

OBJECTIVES: The primary role played by the 'ecological context' in clarifying the causes and dynamics of human health and disease is the topic of this article. It emphasizes that the challenging incidence of cancer and other diseases can be charged primarily to the effects of the worldwide dominant economic model. METHODS: Human culture may act as a powerful force affecting the environment, biology and health of humans and other species. Human culture can be viewed as a special and extreme case of 'niche construction', where human-specific traits, technologies and beliefs act together. RESULTS: The feedback between human activities and the environment can promote different trends in public health. This should provide the opportunity to rethink the consequences that our economic model produces both on the environment and on physical, mental and social health of our species.

[Female breast cancer and occupational sectors: a preliminary study in the provinces of Lombardy, Italy]. / Cancro della mammella e settori occupazionali: studio esplorativo nelle province lombarde.

BACKGROUND: The role of occupational exposures in breast cancer development is still uncertain. A recent paper showed increased risks in some occupational sectors in Lombardy, Italy. We deepened this analysis at the level of single provinces of the same Italian region. METHODS: Based on administrative data, a case-control study was carried out recruiting all incident cases of female breast cancer in the period 2002-2009, aged between 35 and 69 years, residing in Lombardy, Italy. Controls were randomly sampled from all women residing in Lombardy as of December 31, 2005. Occupational histories, including blue collar status, were available from 1974 through record linkage with a social security pension database, and were obtained for 11188 cases and 25329 controls. Adjusted odds ratios (ORs) and corresponding 90% confidence intervals (CIs) were calculated using multiple unconditional logistic regression models. Analyses were performed also by single provinces of Lombardy, Italy. Multiple comparisons were accounted for according to the Benjamini-Hochberg method. RESULTS: The ORs for female breast cancer were modestly but significantly increased for employment in electrical manufacturing (OR 1.12, 90% CI 1.04-121), textile (OR 1.08, 90% CI 1.02-1.15), paper (OR 1.25, 90% CI 1.06-1.46) and rubber (OR 1.26, 90% CI 1.03-1.54) industries. Analysis by province showed significantly increased ORs for electrical manufacturing in the Milano province. After adjustment for multiple comparisons no estimates remained statistically significant, except OR for electrical manufacturing in the Milano province. CONCLUSIONS: Although with several limitations, our results point to a possible role of exposures in electrical manufacturing, textile, paper and rubber industries in the process leading to breast cancer. An in-dept study for the electrical manufacturing industry has been already planned in Milano province.

Occupational brain cancer risks in Umbria (Italy), with a particular focus on steel foundry workers.

OBJECTIVES: As a part of the Occupational Cancer Monitoring (OCCAM) project, a routine analysis based on Umbria region cancer registry (RTUP) database in 2002-2008 was performed. Among other results, the incidental finding of brain cancer increased risk in steel foundry workers in Terni province (Italy), lead us to deepen the analysis, focusing on this specific industrial sector. METHODS: A monitoring study, based on Umbria Regional Cancer Registry data, was recently carried out. Brain cancer cases and controls identified within this preliminary study were selected. Therefore, we considered all incident cases (in Umbria region 2002-2008) of brain cancer occurred among workers occupied for at least one year in private companies since 1974 and controls randomly sampled from the same population. Afterwards, taking in to account results from steel foundry in Terni province, we further deepened our analysis, focusing on this productive sector. Odds ratios (ORs) and corresponding 90% confidence intervals (CIs) were calculated using multiple logistic regression models, adjusted by age at diagnosis or sampling, sex and province of residence, when appropriate. RESULTS: Statistical analyses were carried out on 14913 subjects, 56 cases and 14857 controls. Significantly increased ORs were observed for garment, mechanical manufacturing and chemical industries. Moreover, the risk estimates were strongly correlated with exposures in iron and steel foundries and a cluster of 14 cases in the same foundry in Terni was observed (OR 9.59, 90% CI 2.76-33.34). CONCLUSIONS: Results of this explorative study showed increased ORs of brain cancer in some productive branches, involving possible exposures to chemical compounds and/or solvents. Moreover, our results pointed out a significantly increased risk in Terni foundry workers, determining an interesting brain cancer cluster (14 cases). Further studies on this industrial sector are needed with improved definitions of tasks and exposures.

[Multiple sclerosis and occupational exposures: results of an explorative study]. / Sclerosi multipla e esposizioni occupazionali: risultati di uno studio preliminare.

OBJECTIVES: The aim of the study is to explore possible relationships between occupational exposures and Multiple Sclerosis (MS), whose etiology is not well defined yet. To date, only few literature data are available on this subject. METHODS: We carried out a case-control study, where cases were MS patients included in the MS Register of the Province of Pavia, Northern Italy, and controls, 1:4 matched by sex and age (5 years classes), were randomly selected from the National Health Service population files. The occupational histories were obtained from Italian Institute for Social Security (INPS) archives by automatic linkage using Italian Occupational Cancer Monitoring (OCCAM) method that estimates the risk of specific occupational cancers, by geographic area and industrial sector. OR adjusted for sex and age and corresponding 90% confidence intervals were used to estimate the association between exposure and disease. RESULTS: We included in the study 227 MS patients (130 (57.3%) female, 97 (42.7%) male) and 907 controls (514 (56.7%) female, 393 (43.3%) male). Our results suggest an increased risk for men in mechanical manufacturing industry (OR 1.71, 90% CI 1.03-2.85) and agriculture (OR 2.47, 90% CI 1.03-5.91). Women show an increased risk in mechanical manufacturing industry (OR 2.05, 90% CI 1.22-3.45), agriculture (OR 2.57, 90% CI 1.09-6.09) and leather/shoe industry (OR 2.34, 90% CI 1.06-5.20). CONCLUSIONS: Our preliminary findings indicate that solvent exposures could be related to the risk of MS, as both shoe/leather workers and mechanical manufacturing industry workers are exposed to organic solvents. Interestingly, a major risk of MS was also found among workers engaged in agriculture, suggesting a role of pesticides, whose neurotoxic effect is well known.

Lung cancer risk in the electroplating industry in Lombardy, Italy, using the Italian occupational cancer monitoring (OCCAM) information system.

BACKGROUND: Occupational Cancer Monitoring (OCCAM) is an Italian organization that monitors occupational cancers, by area and industrial sector, by retrieving cases and employment history from official databases. OCCAM previously estimated a relative risk (RR) of lung cancer of about 1.32 among "metal treatment" workers in Lombardy, northern Italy, potentially exposed to chrome and nickel. In the present study, lung cancer risk was estimated among electroplating workers only. METHODS: Lombardy electroplating companies were identified from descriptions in Social Security files. Lung cancer risk was evaluated from 2001 to 2008 incident cases identified from hospital discharge records. RESULTS: The RR for lung cancer among electroplating workers was 2.03 (90% CI 1.33-3.10, 18 cases) for men; 3.00 (90% CI 1.38-9.03, 4 cases) for women. CONCLUSIONS: Electroplaters had higher risks than "metal treatment" workers. Although the risks were due to past exposure, case histories and recent acute effects indicate a present carcinogenic hazard in some Lombardy electroplating factories.

Retroviruses: a broad view of SARS-CoV-2 and its relatives, with a narrative essay on the current state of biomedical sciences.

The actual "pandemic" times, beside their burden of sorrow in terms of both victims, destruction of societal links and economic consequences, are an unprecedented occasion to give a closer look to the status of biomedical research. Beside the undoubted technological advances, the general impression is alarming: the fragmentation of science culture prevents any wise synthesis of the many aspects involved in a global phenomenon as SARS-CoV-2 epidemics. Here we try to acquire a "detached" view to some evolutionary and physiological aspects of the human-virus interaction highlighting the need to revitalize science by a strong departure from ultra-specialization toward a real integration of different fields of investigation.

What is Artificial about Life?

The announcement of "Artificial Life" by the Craig Venter group, and the media stir that arose from the news, provoked thoughts about the current technologies in contemporary science and the cultural tension of such projections on the media. The increasingly blurred boundaries between specialist and generalist media, while promising a wider appreciation of scientific discovery, potentially allow unrealistic, ideological claims to dictate scientific research. This is particularly evident in biology, where the pervading paradigm is still dominated by a physically naïve reductionism in which the only relevant causative layer is the molecular one. The reductionist hypothesis is that everything one observes is the result of an underlying molecular mechanism almost independent of the context in which it operates. Molecular mechanisms are often necessarily studied in isolation and therefore operate in unnatural conditions. The mechanistic view of biological regulation implies that we think of genes as intelligent agents. Here we try to critically analyze the motivations behind the spread of such unrealistic simplifications.

Childhood cancer and environmental integrity: a commentary and a proposal.

Improvements in the health standards of developed and developing societies depend primarily on the relationships between economy and environment. Recent long-term changes in the chemical composition of man-made environments may be linked to changes in the biology of human beings. Here we argue that children are at the greatest risk of being affected by the dangerous effects of these changes, with particular reference to cancer. The concept of cancer risk must be extended to new contexts. Considering the increasing rates of chemical pollution and its spreading in the environment, we illustrate a proposal aiming to protect the human health, in an intra- and intergenerational perspective. A surveillance system of occupational and residential exposures should be implemented to prevent cancer risk in embryos and children.

Occupational exposures and colorectal cancers: a quantitative overview of epidemiological evidence.

A traditional belief widespread across the biomedical community was that dietary habits and genetic predisposition were the basic factors causing colorectal cancer. In more recent times, however, a growing evidence has shown that other determinants can be very important in increasing (or reducing) incidence of this malignancy. The hypothesis that environmental and occupational risk factors are associated with colorectal cancer is gaining ground, and high risks of colorectal cancer have been reported among workers in some industrial branches. The aim of this study was to investigate the epidemiologic relationship between colorectal cancer and occupational exposures to several industrial activities, by means of a scientific literature review and meta-analysis. This work pointed out increased risks of colorectal cancer for labourers occupied in industries with a wide use of chemical compounds, such as leather (RR = 1.70, 95%CI: 1.24-2.34), basic metals (RR = 1.32, 95%CI: 1.07-1.65), plastic and rubber manufacturing (RR = 1.30, 95%CI: 0.98-1.71 and RR = 1.27, 95%CI: 0.92-1.76, respectively), besides workers in the sector of repair and installation of machinery exposed to asbestos (RR = 1.40, 95%CI: 1.07-1.84). Based on our results, the estimated crude excess risk fraction attributable to occupational exposure ranged from about 11% to about 15%. However, homogeneous pattern of association between colorectal cancer and industrial branches did not emerge from this review.

Female breast cancer and electrical manufacturing: results of a nested case-control study.

BACKGROUND: A previous explorative record-linkage study suggested a putative role of employment in electrical manufacturing in increasing female breast cancer risk in the Province of Milan (Italy). We deepened the understanding of this possible association in a single large electrical manufacturing plant located in Lombardy in the Province of Milan. METHODS: We carried out a nested case-control study within a cohort of women employed in a large electrical manufacturing plant. All incident cases during 2002 to 2009 of female breast cancer in individuals who worked at least a 1 year in the factory and resided in Lombardy, Italy, were selected. Controls were randomly sampled from all women who worked in the same plant and resided in Lombardy as of December 31, 2005. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated using multiple logistic regression models, taking into consideration only female workers as ever/never exposed to physical/chemical agents and their longest occupational period. ORs were adjusted for several potential confounders, namely, other known risk factors. RESULTS: The ORs for female breast cancer were significantly increased for exposure to chlorinated solvents (OR 1.65, 95% CI 1.04-2.62), and there was a twofold increase (OR 2.10, 95% CI 1.21-3.66) among women exposed for at least 10 years. We found no other significantly increased OR by exposure or job title. CONCLUSIONS: Our results suggest an increased risk of breast cancer after exposure to chlorinated solvents among women employed in the electrical manufacturing industry.

Childhood cancer and environmental integrity: a commentary and a proposal

ABSTRACT Improvements in the health standards of developed and developing societies depend primarily on the relationships between economy and environment. Recent long-term changes in the chemical composition of man-made environments may be linked to changes in the biology of human beings. Here we argue that children are at the greatest risk of being affected by the dangerous effects of these changes, with particular reference to cancer. The concept of cancer risk must be extended to new contexts. Considering the increasing rates of chemical pollution and its spreading in the environment, we illustrate a proposal aiming to protect the human health, in an intra- and intergenerational perspective. A surveillance system of occupational and residential exposures should be implemented to prevent cancer risk in embryos and children.

A contemporary pathology of science.

A contemporary pathology of science is outlined. This pathology suggests that "previous knowledge" drastically limits innovative thinking in science. In very raw "Bayesian" terms it is affirmed that a too rich and flexible a priori knowledge is detrimental to the appreciation of novelty coming from experimental results by both lowering the relative weight assigned to a posteriori contrasting evidence and adapting potentially revolutionary findings to an already existing frame.