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Analisi delle evidenze epidemiologiche sui fattori di rischio indoor per malattie respiratorie e allergiche nelle strutture scolastiche [Analysis of epidemiologic evidence on risk factors for respiratory and allergic diseases in school buildings]
No full textIl diritto a respirare aria sana nelle scuole è stato sancito già nell’anno 2001
in un documento dell’European Federation of Asthma and Allergy Associations
che ha evidenziato scarsa attenzione e assenza di direttive specifiche
dell’Unione Europea relativamente agli effetti sulla salute da inquinamento
dell’aria nelle scuole, ed è sostenuto dal numero enorme di bambini e ragazzi
che frequentano le aule scolastiche. Negli ultimi anni, a livello europeo si è
sviluppato un sempre crescente interesse nei confronti dell’effetto della qualità
dell’aria dell’indoor scolastico (IAQ) sulla salute dei ragazzi, e sono stati avviati
numerosi progetti di ricerca internazionali mirati, appunto, a determinare l’effetto
di una cattiva IAQ sulla salute. Il progetto THADE (Towards Healthy Air in
Dwellings in Europe), concluso nel 2006, ha prodotto raccomandazioni per un
programma europeo sulla qualità dell’aria negli ambienti confinati, tra le quali
il controllo della ventilazione e dell’umidità degli edifici per la prevenzione della
formazione di muffe. Lo studio HESE (Health Effects of School Environment)
ha raccolto per la prima volta nel 2004-2005 informazioni comparabili sulla
IAQ di aule in diversi Paesi europei (in Italia, 8 scuole a Siena ed 8 ad Udine)
e sulla salute respiratoria dei bambini (242 italiani), evidenziando una cattiva
IAQ nelle scuole italiane a causa dei livelli elevati di PM10 e CO2 essenzialmente
per l’assenza di un’adeguata ventilazione, e ne ha mostrato effetti sulla salute
respiratoria dei bambini. Lo studio HESEINT (Interventions on Health Effects
of School Environments), attualmente in corso, prosecuzione del precedente
HESE, intende contribuire alla tutela della salute dei bambini europei,
incrementando la consapevolezza delle autorità scolastiche per la IAQ con
interventi basati su prove scientifiche di efficacia. Lo studio EnVIE (European
Coordination Action for Indoor Air Quality and Health Effects), un’azione mirata
ad interfacciare scienza e politiche di intervento nel campo della IAQ, ha indicato
le principali patologie condizionate dall’esposizione a fattori di rischio indoor
proponendo strategie da adottare per ridurne l’impatto sulla salute. Lo studio
europeo SEARCH (School Environment And Respiratory health in CHildren),
che ha visto raccogliere, in Italia, misurazioni ambientali ed informazioni sulla
salute respiratoria in circa 1000 bambini di scuole in Lombardia, Piemonte,
LXVIII.1.2012 • 121
LA QUALITÀ DELL'ARIA INDOOR NELLE SCUOLE: RISCHI PER MALATTIE RESPIRATORIE E ALLERGICHE
QUADRO CONOSCITIVO DELLA SITUAZIONE ITALIANA E STRATEGIE DI PREVENZIONE
Igiene e Sanità Pubblica - Atti del Workshop
Lazio, Sardegna e Sicilia, ha ulteriormente confermato la scarsa qualità dell’aria
all’interno delle aule. La prevenzione ed il controllo delle patologie correlate
agli ambienti indoor sono obiettivi prioritari della Strategia per l’ambiente e
salute dell’Unione Europea: l’iniziativa “SCALE” (Science, Children, Awareness,
Legal instrument, Evaluation) identifica come prioritaria, per lo sviluppo umano
ed economico, la protezione della salute dei bambini dalle minacce
dell’ambiente, compresi gli ambienti indoor. Tale strategia è stata anche
sviluppata nella recente Fifth Ministerial Conference on Environment and Health
organizzata dall’OMS - Regione Europea (Parma, marzo 2010). Tutto ciò ha
contribuito alla produzione, da parte dell’OMS, di linee guida per la prevenzione
di umidità e muffe negli ambienti indoor (2009) e, più in generale, sulla IAQ
(2010). A livello Italiano, un programma di prevenzione per gli ambienti indoor
è previsto nelle “Linee Guida per la tutela e la promozione della salute negli
ambienti confinati” (Accordo tra Ministro della Salute, Regioni e Province
autonome - G.U. del 27 novembre 2001, n.276, SO n. 252), mentre, dopo una
lunga gestazione nell’ambito della Conferenza Stato-Regioni, sulla GURI n. 9
del 13 gennaio 2011 è stato pubblicato lo “Schema di linee di indirizzo per la
prevenzione nelle scuole dei fattori di rischio indoor per allergie e asma”.
Contestualmente, la componente italiana dell’Alleanza Globale contro le
Malattie Respiratorie croniche (GARD) ha istituito nel marzo 2010 un gruppo
di lavoro per definire un “Programma di prevenzione per le scuole dei rischi
indoor per malattie respiratorie e allergiche”. Sulla stesa linea si pone il
progetto paneuropeo “SINPHONIE” (Schools Indoor Pollution and Health:
Observatory Network in Europe), attualmente in corso, che dovrà produrre
linee guida sulle possibili misure di intervento per migliorare la qualità dell’IAQ
scolastica nei diversi contesti nazionali, diffondendole agli stakeholder locali.
Ancora, altro progetto sviluppato a livello internazionale nell’ambito del PO
Italia-Malta 2007-2013, è “RESPIRA” (Indoor and Outdoor Air Quality and
Respiratory Health in Malta and Sicily) mirato alla contemporanea valutazione
degli effetti dell’IAQ scolastica e domestica e della qualità dell’aria outdoor
su campioni di popolazione di Malta e della Provincia siciliana di Caltanissetta.
Tra le iniziative sviluppate a livello locale, vanno ricordati gli studi condotti
su un ampio campione di studenti di Scuola Secondaria di primo Grado tra
il 2005 e il 2009 a Palermo, che hanno fornito dati sull’effetto dell’indoor
domestico sulla salute respiratoria degli adolescenti.
Rimane però immutata la necessità di penetrare nelle dinamiche delle
politiche locali, al fine di far sì che, dalle dimostrazioni scientifiche degli
effetti nocivi sulla salute di una cattiva IAQ, si passi ai necessari interventi.
A tale riguardo, il progetto CCM 2010 “Indoor-School” (Esposizione ad
inquinanti indoor: linee guida per la valutazione dei fattori di rischio in ambiente
scolastico e definizione delle misure per la tutela della salute respiratoria
degli scolari e degli adolescenti), sviluppato in sette diverse Regioni italiane
è stato designare l’effetto sulla salute dei ragazzi e sull’IAQ delle scuole
dell’implementazione delle linee guida esistenti sull’indoor scolastic
Lifestyle influence on trace element contents in human scalp hair of young residents in different urban contexts. Preliminary results.
No full textA causal relationship between earth material and human health, although not always proven, is highly plausible because many chemical elements in rocks and soils are directly inhaled by respiration or transmitted, via air, water and vegetation, into food chain and then to human body. It is well known that metals and metalloids may result essential to biochemical and physiological functions, but it is also well known that health problems may derive from either dietary deficiencies or excesses. Among the techniques employed to assess the exposure of living organisms to metals and metalloids present in the environment, the human biomonitoring has attracted the attention of investigators over the past decades. More specifically, the human biomonitoring is a method for assessing human exposure to chemicals by measuring the searched chemicals or their metabolites in human tissues or specimens, such as blood, plasma, serum, breast milk, urine, teeth and also hairs. However, some of these specimens may not always be the best indicators of element intake because of the homeostatic system of control in the human body. Human hairs seem to be particularly appropriate as they offer several advantages. Hair are stable and their composition does not change over short time period. Furthermore, sampling procedure is very easy, requires no specific professional skills, is painless and non-invasive. The present study deals with the trace elements content of hair samples from the scalp of 136 young students, between 11 and 14 years of age, of female and male gender, resident in the metropolitan area of Palermo (80 samples) and in a small rural town, Altavilla (56 samples), 20 km far from Palermo. The concentrations of 18 elements (Al, As, Ba, Cd, Co, Cr, Cu, Li, Mn, Mo, Ni, Pb, Sb, Se, Sr, U, V, Zn) in hair were determined by ICP-MS. In order to eliminate external contamination, each hair sample was firstly properly washed. The obtained results were in line with the ranges of values published in other studies. The most abundant elements resulted Zn, Cu, Al, Sr, Ba, Pb in Palermo as well as in Altavilla, although with different abundance orders. All the remaining analyzed elements were below 1 ppm. Zn is known to be an essential element recognized in more than 300 enzymes depending on this element for catalytic, structural, and regulatory functions. Cu is considered an indispensable catalytic cofactor in redox chemistry for proteins. Al and Sr are typical geogenic elements; their different abundances in the Palermo and Altavilla samples are related to the different lithological site, carbonate rocks in Palermo and calcarenites-clays at Altavilla. Sr is also strictly related to calcium content in bones. The highest levels of most elements were found in Altavilla samples: this may indicate a possible different exposure due to different lifestyles, as evidenced by Al and Pb. In fact, children living at Altavilla spend more time outdoors than those living in Palermo. The higher Ba concentration in children from Altavilla may be also related to the Ba content of local drinkable water. Significant gender-related differences were found for certain elements. This was the case of Sr and Zn, more abundant in female subjects, and Cr, Li, Pb, Sb and U which were more abundant in males. When the elements are subdivided in essential and not essential, and their ratios with respect to aluminum are compared with those in air particulate matter and road dust, it appears evident that some elements typical of anthropogenic sources (Cd, Pb e Sb) are taken by PM10-2.5, PM2.5 and the finest fractions of road dust. Data concerning subjects exposed and not exposed to passive smoke are also reported. Further, it has been examined the relationship between exposure to passive smoke and concentration of nicotine (and its metabolite cotinine) in hairs. A first result of this work is that the reported data and concentration ranges can be used as guidelines for to evaluate environmental or occupational exposure to these elements
Respiratory Effects of Exposure to Traffic-Related Air Pollutants During Exercise
Full text linkTraffic-related air pollution (TRAP) is increasing worldwide. Habitual physical activity is known to prevent cardiorespiratory diseases and mortality, but whether exposure to TRAP during exercise affects respiratory health is still uncertain. Exercise causes inflammatory changes in the airways, and its interaction with the effects of TRAP or ozone might be detrimental, for both athletes exercising outdoor and urban active commuters. In this Mini-Review, we summarize the literature on the effects of exposure to TRAP and/or ozone during exercise on lung function, respiratory symptoms, performance, and biomarkers. Ozone negatively affected pulmonary function after exercise, especially after combined exposure to ozone and diesel exhaust (DE). Spirometric changes after exercise during exposure to particulate matter and ultrafine particles suggest a decrease in lung function, especially in patients with chronic obstructive pulmonary disease. Ozone frequently caused respiratory symptoms during exercise. Women showed decreased exercise performance and higher symptom prevalence than men during TRAP exposure. However, performance was analyzed in few studies. To date, research has not identified reliable biomarkers of TRAP-related lung damage useful for monitoring athletes' health, except in scarce studies on airway cells obtained by induced sputum or bronchoalveolar lavage. In conclusion, despite partly counteracted by the positive effects of habitual exercise, the negative effects of TRAP exposure to pollutants during exercise are hard to assess: outdoor exercise is a complex model, for multiple and variable exposures to air pollutants and pollutant concentrations. Further studies are needed to identify pollutant and/or time thresholds for performing safe outdoor exercise in cities
Determinants of Allergic Sensitization, Asthma and Lung Function: Results from a Cross-Sectional Study in Italian Schoolchildren
Full text linkPrenatal smoking exposure and early-life respiratory infections are major determinants of asthma during childhood. We investigate the factors influencing allergic sensitization (AS), asthma, and lung function in children and the balance between individual and environmental characteristics at different life stages. 1714 children aged 7-16 years and living in southern Italy were investigated using a parental questionnaire, skin prick tests, and spirometry. We found 41.0% AS prevalence: among children without parental history of asthma, male sex, maternal smoking during pregnancy (MatSmoke), and acute respiratory diseases in the first two years of life (ARD2Y) were significant risk factors for AS. MatSmoke was associated (OR = 1.79) with ARD2Y, and this association was influenced by sex. ARD2Y was, in turn, a significant risk factor (OR = 8.53) for childhood current asthma, along with AS (OR up to 3.03) and rhinoconjuctivitis (OR = 3.59). Forced mid-expiratory flow (FEF25-75%) was negatively affected by ARD2Y, with a sex-related effect. Thus, males exposed to MatSmoke had significantly lower FEF25-75% than unexposed males. Despite the difficulty of discriminating among the complex interactions underlying the development of allergic respiratory diseases, ARD2Y appears to strongly influence both asthma and lung function during childhood. In turn, ARD2Y is influenced by prenatal exposure to tobacco smoke with a sex-dependent effect
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Association of Blattella germanica sensitization with atopic diseases in pediatric allergic patients
Full text linkThe extent to which the sensitization to the German cockroach Blattella germanica (BG) affects onset/presence of rhinoconjunctivitis (RC) in children is unknown
Effect of age upon airway obstruction and reversibility in adult patients with asthma
No full textIn a cross-sectional study we evaluated the effect of aging (separately from that of duration of disease) on airway obstruction and reversibility by comparing two groups of non-smoker patients with asthma
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