• Andrea Ranzi1

  1. ARPA, Modena

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Ricerca bibliografica periodo dal 16 agosto 2012 al 31 ottobre 2012

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Stringa: (pollution[Title/Abstract] OR pollutant[Title/Abstract] OR pollutants[Title/Abstract] OR climate change[Title/Abstract] ) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2012/08/16"[PDAT] : "2012/10/31"[PDAT])
1. Santus P, Russo A, Madonini E, Allegra L, Blasi F, Centanni S, Miadonna A, Schiraldi G, Amaducci S. How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan. Respir Res. 2012 Oct 18;13(1):95. [Epub ahead of print]
BACKGROUND: Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. METHODS: We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0--2 and lag 3--5 in both single and multi-pollutant models, adjusted for daily weather variables. RESULTS: An increase in ozone (O3) levels at lag 3--5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0--2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO2), CO, nitrate dioxide (NO2), and particulate matter (PM10 and PM2.5). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0--2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association. CONCLUSIONS: Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.

Breve commento a cura di Andrea Ranzi
Interessante articolo, legato allo studio Milanese POEMI, sugli effetti a breve termine dell’inquinamento, sulle malattie respiratorie, indagati attraverso un approccio case-crossover sugli accessi al pronto soccorso in 5 ospedali di Milano. Si conferma l’utilità della banca dati di Pronto Soccorso nello studio degli effetti acuti dell’inquinamento in ambito urbano, con un interessante risultato riguardante la rappresentatività del CO nella miscela dell’inquinamento atmosferico di natura prevalentemente legata al traffico veicolare.

2. Schifano P, Leone M, De Sario M, de'Donato F, Bargagli AM, D'Ippoliti D, Marino C, Michelozzi P. Changes in the effects of heat on mortality among the elderly from 1998-2010: results from a multicenter time series study in Italy. Environ Health. 2012 Sep 3;11:58.
Department of Epidemiology, Lazio Regional Health Service, Via di Santa Costanza, Roma 53, 00198, Italy.

BACKGROUND: This multicenter study is aimed at estimating changes in the effect of high temperatures on elderly mortality before and after the 2003 heat waves and following the introduction of heat prevention activities. METHODS: A total of sixteen cities were included in the study. City-specific relationships between maximum apparent temperature (MAT) and elderly daily mortality before (1998-2002) and after (2006-2010) intervention were modelled through non-linear distributed lag models and estimates were combined using a random effect meta-analysis. We estimated the percentage change in daily mortality for 3°C variations in MAT above the 25th percentile of the June city-specific 1998-2002 distribution. A time-varying analysis was carried out to describe intra-seasonal variations in the two periods. RESULTS: We observed a reduction in high temperatures' effect post intervention; the greatest reduction was for increases in temperature from 9°C to 12°C above the 25th percentile, with a decrease from +36.7% to +13.3%. A weak effect was observed for temperatures up to 3°C above the 25th percentile only after. Changes were month-specific with a reduction in August and an increase in May, June and September in 2006-2010. CONCLUSIONS: A change in the temperature-mortality relationship was observed, attributable to variations in temperature distributions during summer and to the introduction of adaptation measures. The reduction in the effect of high temperature suggests that prevention programs can mitigate the impact. An effect of lower temperature remains, indicating a relevant impact of temperature at the beginning of summer when the population has not yet adapted and intervention activities are not fully operational.

Breve commento a cura di Andrea Ranzi
L’articolo porta i risultati degli effetti delle ondate di calore sulla salute prima e dopo i noti episodi dell’estate 2003, successivamente ai quali sono stati attuati dei sistemi di allerta precoce in molte città italiane. Lo studio, condotto su 16 città, focalizza l’attenzione sulle modifiche nella mortalità della popolazione anziana. La analisi effettuata, sicuramente rilevante dal punto di vista della numerosità della popolazione indagata, ha notevole importanza nella valutazione dell'impatto delle alte temperature sulla salute, nonché nella valutazione dell’efficacia dei sistemi di allarme precoce e aiuta ad individuare possibili aree di miglioramento da apportare ai sistemi di allerta.

3. Andreoli R, Protano C, Manini P, De Palma G, Goldoni M, Petyx M, Rondinone BM, Vitali M, Mutti A. Association between environmental exposure to benzene and oxidative damage to nucleic acids in children. Med Lav. 2012 Sep-Oct;103(5):324-37.
Laboratory of Industrial Toxicology, Department of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy.

OBJECTIVES: To evaluate the association between environmental exposure to benzene and oxidative damage to nucleic acids in children, also considering the role of Environmental Tobacco Smoke (ETS). METHODS: 396 children living in central Italy were recruited in districts with different urbanization and air pollution. All biomarkers were determined in spot urine samples by mass spectrometric techniques to assess exposure [benzene (U-Benz), and its metabolites (t,t-muconic and S-phenylmercapturic acids, t,t-MA and S-PMA, respectively), cotinine] and nucleic acid oxidation [8-oxo-7, 8-dibydro-2'-deoxyguanosine (8-oxodGuo), 8-oxo-7, 8-dihydroguanosine (8-oxoGuo), and 8-oxo-7, 8-dihydroguanine (8-oxoGua)]. RESULTS: Biomarkers of exposure and nucleic acid oxidation increased with urbanization and were correlated with each other (r > 0.18, p < 0.005). In a multiple linear regression model, benzene exposure, assessed by S-PMA and t,t-MA, was associated (p < 0.0001) with both 8-oxodGuo (R2 = 0.392) and 8-oxoGuo (R2 = 0.193) in all areas of residence, with similar slopes. CONCLUSIONS: (i) Biomarkers of exposure to benzene increased as a function of environmental air pollution and urbanization level; (ii) U-Benz clearly distinguished both exposure to ETS and areas of residence, whereas benzene metabolites were associated only with the latter; (iii) the variance of 8-oxodGuo and 8-oxoGuo was accounted for by environmental benzene exposure, thus suggesting that benzene is a good tracer of other components of complex mixtures of pollutants causing oxidative damage to nucleic acids.

4.Franchini M, Guida A, Tufano A, Coppola A. Air pollution, vascular disease and thrombosis: linking clinical data and pathogenic mechanisms. J Thromb Haemost. 2012 Sep 25.
Immunohematology and Transfusion Medicine, Carlo Poma Hospital, Mantova Regional Reference Center for Coagulation Disorders, Federico II University Hospital, Naples; Italy.

The public health burden of air pollution has been increasingly recognized over the last decades. Following the first assessed adverse effects on respiratory diseases and lung cancer, a large body of epidemiologic and clinical studies definitely documented an even stronger association of air pollution exposure with cardiovascular mortality and morbidity, particularly related to atherothrombotic (coronary and cerebrovascular) disease. Particulate matter (PM), mainly that with lower aerodynamic diameter (fine and ultrafine PM), are responsible for the most severe effects, due to its capacity to vehicle toxic substances deep in the lower airways. These effects have been shown to occur not only after short-term exposure to elevated concentrations of pollutants, but even on long-term, relatively low levels of exposure. Vulnerable subjects (elderly persons and those with preexisting cardiopulmonary diseases) show the highest impact. Fewer and conflicting data also suggest an association with venous thromboembolism. Although not completely elucidated, a series of mechanisms have been hypothesized and tested in experimental settings. These phenomena, including vasomotor and cardiac autonomic dysfunction, hemostatic unbalance, oxidative stress and inflammatory response, have been shown to change over time and differently contribute to the short-term and long-term adverse effects of pollution exposure. Beyond environmental health policies, crucial for improving air quality and reducing the impact of such an elusive threat to public health, the recognition and assessment of the individual risk, together with specific advice, should be routinely implemented in the strategies of primary and secondary cardiovascular prevention.

5. Buonanno G, Marini S, Morawska L, Fuoco FC. Individual dose and exposure of Italian children to ultrafine particles. Sci Total Environ. 2012 Nov 1;438:271-7.
Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, via Di Biasio 43, 03043 Cassino, Italy; International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, Australia. Electronic address:

Time-activity patterns and the airborne pollutant concentrations encountered by children each day are an important determinant of individual exposure to airborne particles. This is demonstrated in this work by using hand-held devices to measure the real-time individual exposure of more than 100 children aged 8-11years to particle number concentrations and average particle diameter, as well as alveolar and tracheobronchial deposited surface area concentration. A GPS-logger and activity diaries were also used to give explanation to the measurement results. Children were divided in three sample groups: two groups comprised of urban schools (school time from 8:30am to 1:30pm) with lunch and dinner at home, and the third group of a rural school with only dinner at home. The mean individual exposure to particle number concentration was found to differ between the three groups, ranging from 6.2×10(4) for children attending one urban school to 1.6×10(4) for the rural school. The corresponding daily alveolar deposited surface area dose varied from about 1.7×10(3)mm(2) for urban schools to 6.0×10(2)mm(2) for the rural school. For all of the children monitored, the lowest particle number concentrations are found during sleeping time and the highest were found during eating time. With regard to alveolar deposited surface area dose, a child's home was the major contributor (about 70%), with school contributing about 17% for urban schools and 27% for the rural school. An important contribution arises from the cooking/eating time spent at home, which accounted for approximately 20% of overall exposure, corresponding to more than 200mm(2). These activities represent the highest dose received per time unit, with very high values also encountered by children with a fireplace at home, as well as those that spend considerable time stuck in traffic jams.

6. Fabrini R, Bocedi A, Del Grosso E, Morici L, Federici G, Palleschi A, Ricci G. Erythrocyte glutathione transferase: A novel biomarker to check environmental pollution hazardous for humans. Biochem Biophys Res Commun. 2012 Sep 14;426(1):71-5.
Department of Chemical Sciences and Technologies, University of Rome "Tor Vergata", 00133 Rome, Italy.

Glutathione transferase (GST) is an enzyme capable of protecting the body from a lot of toxic compounds. Previous studies demonstrated that the erythrocyte GST (e-GST) expression increases as the level of circulating toxins increases. Aim of the present study is to verify if e-GST may represent a biomarker able to signalize an environmental pollution hazardous for humans. The study involved about 500 healthy volunteers living in eight distinct areas at or near the Sacco river valley, a region of the Frosinone district (Lazio-Italy) well known for its environmental pollution. Subjects of six areas displayed increased levels of e-GST ranging from 18% to 44% compared to 400 volunteers living in the Rome hinterland. Higher levels of GSTs are present in the areas where the risk of pollution is higher (areas 7 and 8). Interestingly, women living in the Sacco valley display much higher expression of e-GST than men, possibly due to a greater time exposition to the environmental contamination. Possible oxidative alteration of GST activity has not been observed. In conclusion, e-GST may represent an early and sensitive bio-signal of dangerous pollution for humans.

7. Lonati G, Zanoni F. Probabilistic health risk assessment of carcinogenic emissions from a MSW gasification plant. Environ Int. 2012 Sep;44:80-91.
Dipartimento di Ingegneria Idraulica, Ambientale, Infrastrutture viarie, Rilevamento, Politecnico di Milano, Piazza L. da Vinci 32, Milan, Italy.

Health risk assessment due to the atmospheric emissions of carcinogenic pollutants (PCDD/Fs and Cd) from a waste gasification plant is performed by means of a probabilistic approach based on probability density functions for the description of the input data of the model parameters involved in the assessment. These functions incorporate both the epistemic and stochastic uncertainty of the input data (namely, the emission rate of the pollutants) and of all the parameters used for individual exposure assessment through the pathways of inhalation, soil ingestion and dermal contact, and diet. The uncertainty is propagated throughout the evaluation by Monte Carlo technique, resulting in the probability distribution of the individual risk. The median risk levels nearby the plant are in the 10(-8)-10(-10) range, ten-fold lower than the deterministic estimate based on precautionary values for the input data; however, the very upper percentiles (>95th) of the risk distribution can exceed the conventional 10(-6) reference value. The estimated risk is almost entirely determined by the Cd exposure through the diet; the pathways arising from PCDD/Fs exposure are without any practical significance, suggesting that the emission control should focus on Cd in order to reduce the carcinogenic risk. Risk variance decomposition shows the prevailing influence on the estimated risk of the Cd concentration at the emission stack: thus, for a more accurate risk assessment the efforts should focus primarily on the definition of its probability density function.

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