Annali dell'Istituto Superiore di Sanità
Not a member yet
755 research outputs found
Sort by
Exploring available options in characterising the health impact of industrially contaminated sites
Get PDFIndustrially contaminated sites (ICS) are of high concern from an environmental public health perspective, since industrial plants may produce a widespread contamination that can result in several health impacts on the populations living in their neighbourhood. The objective of this contribution is to briefly explore available options in studying the health impact of ICS, mainly referring to information provided by documents and activities developed by the WHO and the WHO Collaborating Center for Environmental Health in Contaminated Sites. In current practice the health impact of ICS is evaluated using studies and assessments falling in two broad types of strategies: one based on epidemiology and the other on risk assessment methods. In recent years, traditional approaches to assess relationships between environmental risks and health has been evolved considering the intricate nature between them and other factors. New developments should be explored in the context of ICS to find common strategies and tools to assess their impacts and to guide public health interventions
Illicit drugs in Emergency Department patients injured in road traffic accidents
Get PDFUrine and blood samples from 1730 drivers involved in road accidents (July 2012- December 2015) were analyzed for the evaluation of driving under influence of drug of abuse according to the Lombardia Region guideline. The 22.5 % of urine screenings tested positive for at least one class of drugs. 10.6% of the 1730 drivers were under the influence of drug, being blood concentration above the cut-off limit for at least one active substance; the prevalence of illicit drugs in blood was cocaine (5.7 %), cannabinoids (3.7 %), opiates (1.4 %), methadone (1.4 %), amphetamines (0.2 %). Trend in prevalence showed similar percentage (about 5 %) of cocaine and cannabinoids consumption in the last two years. Poly-drug of abuse consumption emerged in the 10.4 % of the positive blood and alcohol was above the legal limit in 47 % of the subjects driving under the influence of drugs
A harmonized and efficient clinical research environment would benefit patients and enhance European competitiveness
Get PDFBackground. Implementation of the EU Regulation No. 536/2014 through national guidelines is a great opportunity to make sponsors reconsider Europe as a prime location for clinical trials. Methods. In November 2014, a Panel of clinical researchers and representatives of the pharmaceutical industry, patient organisations and Italian regulatory agency discussed potential advances fostering Italian competitiveness in terms of clinical research. As a case study, this analysis of the Italian situation can be representative of the average European situation. Results. Features characterising Italian clinical research patterns were analysed. Considerable engagement and cooperation by all stakeholders is required in addition to a well-structured interaction between National Authorities and ethical committees to comply with the strict timeframes mandated by the new Regulation. Conclusions. In the Panel’s view, harmonisation of the approval process and strengthening of clinical site performance are mandatory to provide a good return on investment in Europe for the pharmaceutical industry, access for patients to innovative treatments and new resources for clinical sites.
Local health rules and building regulations: a survey on local hygiene and building regulations in Italian municipalities
Get PDFAbstractIntroduction: WHO highlighted the need to strengthen the relationship between health and built environment; in particular, environmental factors and inadequate housing conditions are the most harmful risk factors for NCDs. Local Health Rules (LHRs) and Building Codes (BCs) are useful tools to provide safety and hygiene in building construction. The paper presents a survey on the adoption and updating of LHRs and BCs in Italian municipalities. Methodology: The survey analyses the state-of-the-art of LHRs, BCs and Municipal Development Plans (MDPs) on a sample of 553 cities, with different demographic and geographic characteristics from each other. Results: the survey highlights the serious shortage of updated LHRs, especially in small and medium municipalities. Instead, BCs and MDPs are much more current and updated, but only 30% of them are previously validated by Local Health Authorities. Conclusion: According to the analysis, it is necessary to introduce ever more performance guidelines, instead of prescriptive rules. The Government is taking steps to give rise to a National Building Code guidelines and this initiative could also be expanded to invest LHRs’ issues
Poliomyelitis: residual hurdles to global eradication
Get PDFThe global eradication of polio is close to achieving success. However, transmission of wild poliovirus persists in countries where the disease is endemic, and outbreaks may also occur in previously polio-free countries where population immunity is not maintained. To achieve polio eradication, several key actions are required: (1) to detect any poliovirus transmission, (2) to strengthen immunization systems and withdraw all oral polio vaccines from use, (3) to contain polioviruses and certify interruption of transmission, and (4) to sustain ongoing public health programs. In this context, residual hurdles to global polio eradication have been identified, from unstable political situation in affected countries to population movements from and to endemic areas, and opposition to immunization strategies. Global efforts are needed in order to promote routine immunization campaigns and large-scale vaccination rounds, which may provide direct protection of individuals and minimize virus circulation
Environmental nickel exposure from oil refinery emissions: a case study in Ecuador
Get PDFIntroduction. Nickel is a strong skin and respiratory sensitizer and a recognized carcinogen. Oil refineries are important sources of atmospheric emissions of toxic pollutants, including nickel. Populations residing close to oil refineries are at potential risk. The aim of this study was to evaluate the exposure to nickel in a population living close to the largest oil refinery in Ecuador, located in the city of Esmeraldas. Methodology. We recruited 47 workers from the oil refinery as well as 195 students from 4 different schools close to the plant and 94 students from another school 25 km far from the industry. Urinary nickel concentrations were used to assess the exposure to nickel. Results. Students from the school next to the oil refinery showed the highest urinary nickel concentrations while workers from the refinery showed the lowest concentrations. Median nickel concentrations were > 2μg/L in all study groups. Conclusions. The populations living close to the oil refineries are potentially exposed to nickel from atmospheric emissions. Further studies investigating nickel-relate
The relevance of the food roduction chain with regard to the population exposure to chemical substances and its role in contaminated sites
Get PDFFood may be contaminated with many chemical substances at any level along the production chain. Chemicals that may be found in food items can simultaneously be present in other matrices, as air, water, soil and dust; therefore, human exposure to chemicals via food has to be summed to the exposure through all the other possible routes. The role played by the food production chain with regard to the population exposure to chemicals assumes amplified proportions when considering contaminated sites. Indeed the link between environment and food production is undeniable and consequently, when population chemical exposure is considered, an integrated approach assessing the contribution of the different routes of exposure, including dietary exposure, is needed. Such integrated approach allows a realistic and comprehensive risk assessment of chemical substances in order to identify and deploy effective prevention and intervention measures to protect human health
Animal assisted intervention (AAI) for children in either research, practice or policy from a One Health perspective
Get PDFHealth Software: a new CEI Guide for software management in medical environment
Get PDFThe increasing spread of software components in the healthcare context renders explanatory guides relevant and mandatory to interpret laws and standards, and to support safe management of software products in healthcare.In 2012 a working group has been settled for the above purposes at CEI (Italian Electrotechnical Committee), made of experts from ISS (Italian National Institute of Health), representatives of industry, and representatives of the healthcare organizations.As a first outcome of the group activity, Guide CEI 62-237 was published in February 2015. The Guide incorporates an innovative approach based on the proper contextualization of software products, either medical devices or not, to the specific healthcare scenario, and addresses the risk management of IT systems.The Guide provides operators and manufacturers with an interpretative support with many detailed examples to facilitate the proper contextualization and management of health software, in compliance with related European and International regulations and standards