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Carducci AL, Agodi A, Ancona C, Angelini P, Bagordo F, Barbone F, Birbaum L, Carreri V, Casuccio A, Conti A, Conversano M, De Donno A, De Giglio O, Desiante F, Di Pietro A, Dogliotti E, Donato F, Fara GM, Fiore M, Forastiere F, Giammanco G, Izzotti A, Montagna MT, Oliveri Conti G, Petronio MG, Sciacca S, Signorelli C, Testai E, Verani M, Vinceti M, Vitale F, Ferrante M, Adani G, Berghella L, Calia C, Calzolari R, Canale A, Castiglione D, Conti A, Copat C, Cristaldi A, Cuffari G, Coronel Vargas G, De Vita E, De Nard F, Federigi I, Filippini T, Grasso A, Leonardi N, Letzgus M, Lo Bianco G, Mazzucco W, Nicolosi I, Orlandi P, Paladino G, Pizzo S, Pousis C, Raffo M, Rivolta S, Scarpitta F, Trani G, Triggiano F, Tumbarello A, Vecchio V, Zuccarello P, Vassallo M. Impact of the environment on the health: From theory to practice. Environ Res 2021; 194:110517. [PMID: 33271142 DOI: 10.1016/j.envres.2020.110517] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
The Erice 56 Charter titled "Impact of the environment on the health: from theory to practice" was unanimously approved at the end of the 56th course of the "International School of Epidemiology and Preventive Medicine G. D'Alessandro" held from 3rd to November 7, 2019 in Erice - Sicily (Italy) and promoted by the Study Group of "Environment and Health" of the Italian Society of Hygiene, Preventive Medicine and Public Health. The course, that included lectures, open discussions and guided working groups, was aimed to provide a general training on epidemiological and toxicological aspects of the environmental health impact, to be used by public health professionals for risk assessment, without forgetting the risk communications. At the end of the course 12 key points were agreed among teachers and students: they underlined the need of specific training and research, in the perspective of "One Health" and "Global Health", also facing emerging scientific and methodological issues and focusing on communication towards stakeholders. This Discussion highlight the need to improve knowledge of Health and Environment topic in all sectors of health and environmental prevention and management.
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Affiliation(s)
- A L Carducci
- Department of Biology, University of Pisa, Italy
| | - A Agodi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - C Ancona
- Department of Epidemiology of the Regional Health Service, Lazio Region, Rome, Italy
| | - P Angelini
- Public Health Service, Emilia-Romagna Region, Italy
| | - F Bagordo
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Italy
| | - F Barbone
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy
| | - L Birbaum
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - V Carreri
- Past-President of Italian Society of Hygiene (SItI), Italy
| | - A Casuccio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - A Conti
- Regional Agency for Environmental Protection of Sicily, Italy
| | - M Conversano
- Department of Public Health, ASL, Taranto, Italy
| | - A De Donno
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Italy
| | - O De Giglio
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - F Desiante
- Department of Prevention, Local Health Authority of Taranto, Taranto, Italy
| | - A Di Pietro
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - E Dogliotti
- Department of Environmental and Health. Istituto Superiore di Sanità. Rome, Italy
| | - F Donato
- Department of Medical and Surgical Specialties, Radiological Sciences, And Public Health, University of Brescia, Italy
| | - G M Fara
- International School of Epidemiology and Preventive Medicine «Giuseppe D'Alessandro», Erice, Trapani, Italy
| | - M Fiore
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - F Forastiere
- Department of Epidemiology of the Regional Health Service, Lazio Region, Rome, Italy
| | - G Giammanco
- International School of Epidemiology and Preventive Medicine «Giuseppe D'Alessandro», Erice, Trapani, Italy
| | - A Izzotti
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - M T Montagna
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - G Oliveri Conti
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - M G Petronio
- Health and Environment-Department of Prevention, Local Health Authority-Empoli, Florence, Italy
| | - S Sciacca
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - C Signorelli
- University Vita-Salute San Raffaele, Milan, Italy
| | - E Testai
- Istituto Superiore di Sanità, Environment & Health Dept., Rome, Italy
| | - M Verani
- Department of Biology, University of Pisa, Italy
| | - M Vinceti
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Vitale
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - M Ferrante
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy.
| | - G Adani
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - L Berghella
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - C Calia
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - R Calzolari
- Regional Agency for Environmental Protection of Sicily, Italy
| | - A Canale
- Department of Biology, University of Pisa, Italy
| | - D Castiglione
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - A Conti
- Regional Agency for Environmental Protection of Sicily, Italy
| | - C Copat
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - A Cristaldi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - G Cuffari
- Regional Agency for Environmental Protection of Sicily, Italy
| | - G Coronel Vargas
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - E De Vita
- Department of Biology, University of Pisa, Italy
| | | | - I Federigi
- Department of Biology, University of Pisa, Italy
| | - T Filippini
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - A Grasso
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - N Leonardi
- University Center for the Protection and Management of Natural Environments and Agrosystems (CUTGANA), University of Catania, Italy
| | | | | | - W Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - I Nicolosi
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - P Orlandi
- Local Health Authority of Rome, Italy
| | - G Paladino
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - S Pizzo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - C Pousis
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | - M Raffo
- Local Health Authority of Rome, Italy
| | | | - F Scarpitta
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, "G. D'Alessandro", University of Palermo, Italy
| | - G Trani
- Central Health Department of the Friuli Venezia Giulia Region, Trieste, Italy
| | - F Triggiano
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Italy
| | | | - V Vecchio
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - P Zuccarello
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - M Vassallo
- Department of Medical Science, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
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Berselli N, Adani G, Filippini T, Vinceti M. Lifestyle risk Factors for early versus late onset dementia: A systematic review and meta-analysis. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Dementia is a widely prevalent and growing condition, affecting nearly 10% of people aged 60 years and older. It is a leading cause of disability entailing important economic and social costs for the population, so much so that it has been defined as a “global public health priority' from WHO in 2016. Dementia can be divided into two forms according to age of onset of the first symptoms: Early Onset Dementia (EOD - < 65 years) and Late Onset Dementia (LOD, ≥ 65 years). The differences between the two forms, and if they could be considered as separate diseases, are still not well understood. The aim of this meta-analysis was to determine if environmental-lifestyle risk factors of dementia may differ between EOD and LOD.
Methods
Literature databases were searched to June 2020, to retrieve studies assessing the impact of modifiable factors in patients who had developed the first symptoms of dementia before (for EOD) or after (for LOD) 65 years. Data were then meta-analysed in order to understand the overall impact of the single factors on EOD and LOD separately.
Results
The results show different effects for some risk factors as alcohol consumption (OR 2.8, 95%CI: 2.2-3.4 for EOD and OR 1.2, 95%CI: 0.9-1.5 for LOD) and brain injuries (OR 1.4, 95%CI: 1.2-1.6 for EOD, and OR 1, 95%CI: 0.6-1.4 for LOD), which appear to have more impact on EOD compared with LOD. No association with smoking for both forms of dementia emerged. The other factors considered, such as low educational attainment, socio-economic status, closeness of magnetic field, appear to have similar impact on the two forms of dementia.
Conclusions
These results suggest that there may be a difference, in terms of modifiable risk factors, between the two forms of dementia, even if more research is needed on this issue.
Key messages
There may be different risk factors determining EOD versus LOD onset. By modifying some environmental and lifestyle factors we could delay or prevent the onset of dementia.
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Affiliation(s)
- N Berselli
- CREAGEN, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Adani
- CREAGEN, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - T Filippini
- CREAGEN, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - M Vinceti
- CREAGEN, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
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Adani G, Filippini T, Garuti C, Malavolti M, Vinceti G, Zamboni G, Tondelli M, Vinceti M, Chiari A. Life-style and occupational risk factors for early onset dementia in an Italian community. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Early onset dementia (EOD) is defined as dementia with symptoms onset before 65 years, deeply impacting on patients' employment and income, as well as on their families. Little is known about role of occupational and life-style risk factors, we aimed at assessing their role in disease etiology.
Methods
Using a case-control study design, we recruited all EOD cases resident in Modena province from October, 2016 to October, 2019, and a referent population drawn from patients' care-givers. We investigated residential, life-style history, and occupational and environmental exposures to toxics through a self-administered questionnaire. We used a multivariate unconditional logistic regression model adjusted for sex, age, and education to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of EOD risk for exposed vs. non-exposed subjects.
Results
Overall, fifty-eight EOD cases and fifty-four controls agreed to participate. Possible life-style risk factors are to be widowed (10.3% of cases vs. 2% of controls), and to have a lower educational attainment. Also smoking (OR 1.3, 95% CI 0.6-2.9), playing football (OR 2.2, 95% CI 0.5-9.3) or cycling (OR 2.3, 95% CI 0.4-13.4) were associated with higher EOD risk, although overall sport practice appeared to be a powerful protective factor (OR 0.4, 95% CI 0.2-0.9), particularly swimming (OR 0.2, 95% CI 0.0-0.8). Among occupational factors, disease risk was associated with exposure to aluminum (OR 2.6, 95% CI 0.4-15.7), pesticides (OR 2.3, 95% CI 0.7-7.8), and dyes, paints or thinners (OR 1.7, 95% CI 0.6-5.0). Finally, disease risk was not associate to overall history of any trauma, while head trauma and especially upper arm trauma showed positive association.
Conclusions
Despite the study limitations, our results appear to support a role of modifiable risk factors in EOD etiology, particularly of some chemical exposures and professional sports, while overall sports practice may have a beneficial effect.
Key messages
Some modifiable environmental, occupational and life-style risk factors seem associated with EOD onset. Awareness of EOD environmental and occupational risk factors, as well as life-style ones, is advisable on a public health perspective.
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Affiliation(s)
- G Adani
- Environmental, Genetic and Nutritional Epidemiology Research, University of Modena and Reggio Emilia, Modena, Italy
| | - T Filippini
- Environmental, Genetic and Nutritional Epidemiology Research, University of Modena and Reggio Emilia, Modena, Italy
| | - C Garuti
- Environmental, Genetic and Nutritional Epidemiology Research, University of Modena and Reggio Emilia, Modena, Italy
| | - M Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research, University of Modena and Reggio Emilia, Modena, Italy
| | - G Vinceti
- Center for Neurosciences and Neurotechnology, Department of, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
| | - G Zamboni
- Center for Neurosciences and Neurotechnology, Department of, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - M Tondelli
- Neurology Unit, Modena Policlinico-University Hospital, Modena, Italy
- Primary care Department, Modena Local Health Authority, Modena, Italy
| | - M Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research, University of Modena and Reggio Emilia, Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - A Chiari
- Center for Neurosciences and Neurotechnology, Department of, University of Modena and Reggio Emilia, Modena, Italy
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Pravisani R, Baccarani U, Adani G, Lorenzin D, Vit A, Cherchi V, Calandra S, Rispoli I, Toniutto P, Sponza M, Risaliti A. Splenic Artery Syndrome as a Possible Cause of Late Onset Refractory Ascites After Liver Transplantation: Management With Proximal Splenic Artery Embolization. Transplant Proc 2016; 48:377-9. [PMID: 27109959 DOI: 10.1016/j.transproceed.2016.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/03/2016] [Accepted: 01/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Portal hyperperfusion (PHP) is a hemodynamic condition which may develop after liver transplantation and cause refractory ascites (RA). The diagnosis is established by exclusion of other causes of increased sinusoidal pressure/resistance such as cellular rejection or toxicity and outflow obstruction. PHP as part of the pathogenesis of the splenic artery syndrome (SAS) can be treated with splenic artery embolization (SAE). METHODS This is a retrospective study on a cohort of first-time whole-size liver transplant recipients diagnosed with RA due to PHP and treated by proximal SAE (pSAE) at the Liver Transplant Unit of the University Hospital of Udine between 2004 and 2014. RESULTS For this study, 23 patients were identified (prevalence 8%) and treated. Preliminary clinical workup to diagnose SAS was based on exclusion of other possible causes of RA with graft biopsy, cavogram with hepatic venous pressure measurement, computed tomography scan, and angiography. The pSAE was performed 110 ± 61 days after transplantation, and no procedure-related complications occurred. pSAE resulted in a significant decrease of portal vein velocity (P = .01) and wedge hepatic venous pressure (P = .03). The diameter of the spleen showed a slightly significant reduction (P = .047); no modification of hepatic artery resistive index were encountered (P = .34). Moreover, pSAE determined the resolution of RA in all cases. CONCLUSIONS pSAE is a safe and effective procedure to modulate the hepatic inflow and thus to treat RA secondary to SAS, with a low incidence of complications and a high rate of clinical response.
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Affiliation(s)
- R Pravisani
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - U Baccarani
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy.
| | - G Adani
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - D Lorenzin
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - A Vit
- Division of Interventional Radiology, University Hospital of Udine, Udine, Italy
| | - V Cherchi
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - S Calandra
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - I Rispoli
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - P Toniutto
- Department of Medicine and Pathology Clinical and Experimental, Medical Liver Transplantation Unit, Internal Medicine, University of Udine, Udine, Italy
| | - M Sponza
- Division of Interventional Radiology, University Hospital of Udine, Udine, Italy
| | - A Risaliti
- General Surgery and Transplantation Unit, Department of Medical and Biological Sciences, University of Udine, Udine, Italy
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