DETERMINANTS OF METHADONE TREATMENT ASSIGNMENT AMONG HEROIN ADDICT ON FIRST ADMISSION TO PUBLIC TREATMENT CENTRES IN ITALY.

Aims: To identify factors associated with entering any methadone treatment at first admission at an NHS treatment centre in Italy and to investigate determinants of receiving detoxification or maintenance methadone treatments. Methods: Data were analysed from 565 heroin addicts who entered for the first time one of 90 NHS treatment centres in 12 Italian regions between September 1998 and March 2001. Subjects were interviewed at admission by the centre's staff and followed-up for 18 months. Details on treatments provided were recorded using a standardised form. Random effects logistic regression analysis was applied. Results: Factors positively associated with any methadone treatment assignment were: being younger than 25 years and using heroin more than twice a day, having been recently incarcerated, and living with a partner. Independent predictors of admission to methadone maintenance were injecting heroin, having sex without a condom in the previous six months, being HIV positive and having been enrolled at a NHS TC where a psychiatrist was present. Using heroin once a day or more and using cocaine were factors associated with enrolment into detoxification treatment. A significant heterogeneity between centres was observed. Conclusions: Results from this study give an insight into different patient profiles who are enrolled in methadone treatments. The observed heterogeneity between centres indicates the need to develop and implement common guidelines for the access of heroin addicts to substitution treatment. © 2005 Elsevier Ireland Ltd. All rights reserved

Wastewater workers and hepatitis A virus infection.

The main occupational hazard of wastewater workers (WWs) is the direct exposure to the variety of infectious agents present in sewage material, with hepatitis A virus (HAV) being the most frequent one. Most epidemiological studies have shown a higher risk of hepatitis A among WWs, although some studies have produced conflicting evidence. To evaluate the hypothesis of increased risk of HAV infection in WWs. The prevalence of antibodies toHAV in 869WWswas compared to 311 other subjects and analysed to detect the main potentially confounding variables. Univariate analysis demonstrated that occupational exposure to sewage was not significantly associated with the prevalence of anti-HAV(1). The anti-HAV(1) prevalence was strongly associated with age and shellfish consumption (P,0.05) when the subcategories of workers were examined separately (WWs and control group) and jointly. In the logistic regression model, a significant association between anti-HAV(1) prevalence and duration of employment (P,0.05) was found. The interaction term(age3duration of employment) was significant (P,0.001) when included in the logistic model. This study shows that working in a wastewater treatment plant does not seem to be related to a greater prevalence of antibodies to hepatitis A. Moreover, the relative risk of HAV infection among WWs seems to be correlated with low anti-HAV(1) prevalence in the general population

The consumption of genetically modified foods in Italian high school students

Genetically modified organisms (GMOs) can be defined as organisms in which the DNA has been altered in a way that does not occur naturally. Such methods are used to create GM plants – which are then used to grow (GM) food crops. GM foods have the potential to solve many of the world’s hunger and malnutrition problems, and to help protect and preserve the environment by increasing yield and reducing reliance upon chemical pesticides and herbicides. Nevertheless, the consumption of GM foods provokes doubts and hesitations among consumers, especially in Italy. This paper has two aims, the first is to investigate genetically modified (GM) foods consumption in Italian high school students through a large sample size survey on 2122 students randomly selected in 39 schools of a metropolitan area (Naples, South-Italy). The second, by examining the behavioural process that drives individual’s perceptions of GM food taking advantage of an empirical choice methodology that corrects for endogeneity in decision making relationships, namely structural equation model (SEM). The results show that a very large percentage of students never or rarely eat GM food and a lot of them do not suggest the consumption of GM food. The proposed SEM is a full formative measurement model and shows that GM foods consumption in Italian students depends on the knowledge of GMO and on the impact of the GMO on the men’s health and on the environment. Therefore, in order to orient population it could be realized a standardized evaluation systems relative to human health and environment consequences produced by GM organisms and GM foods

Polycyclic aromatic hydrocarbons loads into the Mediterranean Sea: Estimate of Sarno River inputs

The polycyclic aromatic hydrocarbons (PAHs) pollution in the Sarno River and its environmental impact on the Gulf of Naples (Tyrrhenian Sea, Central Mediterranean Sea) were estimated. The 16 PAHs identified by the USEPA as priority pollutants and perylene were determined in the water dissolved phase (DP), suspended particulate matter (SPM) and sediments. Total PAHs concentrations ranged from 23.1 to 2670.4 ng L(-1) in water (sum of DP and SPM) and from 5.3 to 678.6 ng g(-1) in sediment samples. Source analysis revealed that PAHs mainly came from combustion process. Contaminant discharges of PAHs into the sea were calculated in about 8530 gd(-1) showing that this river should account as one of the main contribution sources of PAHs to the Tyrrhenian Sea

Polychlorinated biphenyls and organochlorine pesticides in Tiber River and Estuary: Occurrence, distribution and ecological risk

The polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) pollution in the Tiber River and its environmental impact on the Tyrrhenian Sea (Central Mediterranean Sea) were estimated. 32 PCBs and 17 OCPs (aldrin, α-BHC, β-BHC, δ-BHC, lindane, p,p'-DDD, p,p'-DDE, p,p'-DDT, dieldrin, endosulfan I, endosulfan II, endosulfan sulfate, endrin, endrin aldehyde, heptachlor, heptachlor epoxide, methoxychlor) were determined in the water dissolved phase (DP), suspended particulate matter (SPM) and sediment samples. Total concentrations of PCBs ranged from 0.54 to 74.75ngL-1 in water (sum of DP and SPM) and from 3.73 to 79.30ngg-1 dry weigh in sediment samples; while the concentrations of total OCPs collected in water (sum of DP and SPM) ranged from 0.07 to 7.04ngL-1 and from 0.66 to 10.02ngg-1 dry weigh in sediment samples. Contaminant discharges into the sea were calculated in about 227.08kgyear-1 for PCBs and 24.91kgyear-1 for OCPs, showing that this river should account as one of the main contribution sources of PCBs and OCPs to the Tyrrhenian Sea. The ∑TEQPCB from the sediment samples ranged from 0.0006 to 0.37ngg-1 with an average level of 0.13ngg-1. Based on Sediments Quality Guidelines, biological adverse effects on aquatic ecosystem were rare to occasional for PCB and OCP levels in Tiber water syste

Evaluation of immunization practices in Naples, Italy.

This paper reports the results of a survey on vaccination coverage among children born in January 1995 and residing at the beginning of the study (March 1998) in the city of Naples, Italy. The percentages vaccinated, at various times from birth, with oral polio vaccine (OPV), have been compared with those found in a similar survey conducted at the end of 1985 regarding the cohort of children born in June 1983. By the fourth month of life 67% of the 1995 cohort were vaccinated with the first doses of OPV, an increase of about 26% on that found in the 1983 cohort. Similar results were found with the second doses. Among the 1995 cohort 49% were vaccinated with the third dose of OPV within the thirteenth month of life; the corresponding value for the 1983 cohort was 33%. Within the twenty-fourth month of life, in the 1995 cohort, 86% completed the primary cycle of vaccination with OPV; the corresponding figure for the 1983 cohort was 65%. At the end of the third year of life 80% of the 1995 cohort received the fourth dose of OPV. A significant association has been found between socioeconomic status and coverage level

Respiratory function in power plant workers exposed to nitrogen dioxide.

BACKGROUND: Power plant workers are potentially exposed to nitrogen dioxide (NO2) and may therefore be at higher risk of pulmonary diseases than the general population. AIMS: To assess the association of NO2 exposure with spirometric abnormalities in power plant workers. METHODS: Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and forced expiratory ratio (FER = FEV1/FVC) were correlated with demographic characteristics, smoking history and environmental exposure to NO2 in power plant workers exposed to environmental NO2 at work and in a control group of administrative employees. Twenty-four hour environmental NO2 concentrations were measured at each workplace. RESULTS: The concentrations of environmental NO2 ranged from 1.21 to 7.82mg m(-3) with a mean value of 3.91 + 1.51mg m(-3). The results showed that FEV1 and FVC were significantly lower in 347 power plant workers than in the 349 controls (P < 0.001). The FER was significantly correlated with age, environmental NO2 concentration, smoking and height. CONCLUSIONS: Occupational exposure to NO2 emissions in power plants is significantly associated with lung function abnormalities as assessed by spirometry. Spirometric measurements in power plant workers exposed to NO2 emissions may be an effective means of detecting early signs of impaired respiratory health in this group of workers

Spatial distribution and partitioning of organophosphates pesticide in water and sediment from Sarno River and Estuary, Southern Italy

The organophosphates pesticide (OPP) pollution in the Sarno River and its environmental impact on the Gulf of Naples (Tyrrhenian Sea, Central Mediterranean Sea) were estimated. Nine selected OPPs (diazinon, dimethoate, malathion, chlorpyrifos, dichlorvos, fenitrothion, methidathion, tolclofos-methyl, azinphos-methyl) were determined in the water dissolved phase (DP), suspended particulate matter (SPM) and sediment samples. Total OPP concentrations ranged from 5.58 to 39.25 ng L−1 in water (as the sum of the DP and SPM) and from 0.19 to 3.98 ng g−1 in sediment samples. Contaminant discharges of OPPs into the sea were calculated in about 48,064.08 g year−1, showing that this river should account as one of the main contribution sources of OPPs to the Tyrrhenian Sea

Environmental quality of the operating theaters in Campania Region: long lasting monitoring results

BACKGROUND: The health risk level in the operating theaters is directly correlated to the safety level offered by the healthcare facilities. This is the reason why the national Authorities released several regulations in order to monitor better environmental conditions of the operating theaters, to prevent occupational injuries and disease and to optimize working conditions. For the monitoring of environmental quality of the operating theaters following parameters are considered: quantity of supplied gases, anesthetics concentration, operating theatres volume measurement, air change rate, air conditioning system and air filtration. The objective is to minimize the risks in the operating theaters and to provide the optimal environmental working conditions. This paper reports the environmental conditions of operating rooms performed for several years in the public hospitals of the Campania Region. METHODS: Investigation of environmental conditions of 162 operating theaters in Campania Region from January 2012 till July 2014 was conducted. Monitoring and analysis of physical and chemical parameters was done. The analysis of the results has been made considering specific standards suggested by national and international regulations. RESULTS: The study showed that 75% of the operating theaters presented normal values for microclimatic monitoring, while the 25% of the operating theaters had at least one parameter outside the limits. The monitoring of the anesthetics gases showed that in 9% of measurements of nitrous oxides and 4% of measurements of halogenated was not within the normal values

[A cohort study on mortality and morbidity in the area of Taranto, Southern Italy].

Introduction: the area of Taranto has been investigated in several environmental and epidemiological studies due to the presence of many industrial plants and shipyards. Results from many studies showed excesses of mortality and cancer incidence for the entire city of Taranto, but there are no studies for different geographical areas of the city that take into account the important confounding effect of socioeconomic position. Objective: to assess mortality and hospitalization rates of residents in Taranto, Statte and Massafra through a cohort study, with a particular focus on residents in the districts closest to the industrial complex, taking into account the socioeconomic position. Methods: a cohort of residents during the period 1998-2010 was enrolled. Individual follow-up for assessment of vital status at 31.01.2010 was performed using municipality data. The census-tract socioeconomic position level and the district of residence were assigned to each participant, on the basis of the geocoded addresses at the beginning of the follow-up. Standardized cause specific mortality/morbidity rates, adjusted for age, were calculated by gender and districts of residence. Mortality and morbidity Hazard Ratios (HR, CI95%) were calculated by districts and socioeconomic position using Cox models. All models were adjusted for age and calendar period, and were done separately for men and women. Results: 321.356 people were enrolled in the cohort (48.9% males). Mortality/morbidity risks for natural cause, cancers, cardiovascular and respiratory diseases were found to be higher in low socioeconomic position groups compared to high ones. The analyses by districts have shown several excess mortality/morbidity risks for residents in Tamburi (Tamburi, Isola, Porta Napoli and Lido Azzurro), Borgo, Paolo VI and the municipality of Statte. Conclusions: The results of this study showed a significant relationship between socioeconomic position and health status of people resident in Taranto. People living in the districts closest to the industrial zone have higher mortality/morbidity levels compared to the rest of the area also taking into account the socioeconomic position