Sorveglianza delle malformazioni congenite in Italia: un approfondimento nella provincia di Siracusa

Objective: the study describes briefly the current situation of the surveillance of congenital anomalies in Italy and gives an insight into the province of Siracusa in order to better characterise health status of populations residing in an area at high environmental risk. Participants: the authors, who coordinate the Italian registries of congenital malformations, have collaborated with the Eastern Sicily Registry of congenital malformations (ISMAC) and the registry of diseases of the Siracusa province. Design and setting: data collected by the ISMAC Registry were used to calculate the prevalence of malformed newborns, resident in the municipalities of the province of Siracusa between 1991-2000. This prevalence was compared to that observed in rithe rest of the Siracusa province (RSP), in the whole area covered by the ISMAC Registry (ESR) and to the mean prevalence at birth of the North-East, Emilia Romagna, Toscana and Campania Registries (IR). Comparisons were made for all malformations and for groups of malformations (with the exclusion of groups with a 10 year frequence <10 cases in the province of Siracusa). In addition, heterogeneity among the municipalities of the province and temporal trends were statistically tested. Main outcome measures: total, groups and specific congenital malformations. Results: Results were statistically borderline considering all malformations when the Priolo-Augusta-Melilli area was compared to IR and ESR (standardized morbidity ratio SMRIR=1.1, SMRESR=1.2) and statistically significant when compared to RSP (prevalences ratio PRRSP=1.9). Significant excesses resulted in this area also for hypospadias (SMRIR= 1.9, SMRESR= 2.4,PRRSP= 2.5) and anomalies of the digestive system (SMRIR= 2.1,SMRESR= 1.9, PRRSP= 2.6). Conclusion: Following these results a case-control study on malformations observed in excess has been activated and a protocol for the surveillance of sensitive diseases in areas at environmentalrisk is being elaborated.Obiettivo: offrire una sintesi sullo stato della sorveglianza delle malformazioni congenite in Italia e un approfondimento nella provincia di Siracusa, con lo scopo di contribuire alla definizione di una metodologia per lo studio dello stato di salute di popolazioni residenti in aree ad alto rischio di crisi ambientale. Partecipanti: con gli autori, che svolgono funzione di coordinamento nazionale dei registri delle malformazioni congenite, hanno collaborato l\u27Indagine siciliana sulle malformazioni congenite (ISMAC) e il Registro territoriale di patologia della provincia di Siracusa. Disegno e setting: i dati rilevati dal registro ISMAC sono stati utilizzati per calcolare la prevalenza dei nati malformati del periodo 1991-2000, residenti nei comuni della provincia di Siracusa, e confrontati con i dati analoghi osservati nel resto della provincia di Siracusa (RSP), nella Sicilia Orientale (ESR) e con la prevalenza media osservata dai Registri del Nord-Est Italia, Emilia-Romagna, Toscana e Campania (IR). I confronti sono stati effettuati per il totale delle malformazioni rilevate e per gruppi di malformazioni (escludendo i gruppi con meno di 10 casi nella provincia nel decennio). Inoltre sono stati valutati statisticamente l\u27eterogeneit? fra comuni della provincia e i trend temporali. Outcome principale: malformazioni congenite, totali, in gruppi e selezionate. Risultati: per il totale delle malformazioni ? emerso un risultato al limite della significativit? nei comuni di Augusta-Priolo-Melilli rispetto agli standard IR ed ESR (rapporto standardizzato di morbosit? RSMIR = 1,1; RSMESR = 1,2) e statisticamente significativo rispetto a RSP (rapporto tra prevalenze RPRSP=1,9). La stessa area ? risultata in eccesso significativo per le ipospadie, sia nei confronti degli standard esterni che verso il resto della provincia (RSMIR = 1,9; RSMESR = 2,4; RPRSP = 2,5) e per le anomalie del sistema digerente (RSMIR = 2,1; RSMESR = 1,9; RPRSP = 2,6). Conclusione: sulla base dei risultati ottenuti ? stato attivato uno studio caso-controllo sulle patologie osservate in eccesso ed ? in corso di elaborazione un protocollo per la sorveglianza di patologie sensibili in aree riconosciute a rischio ambientale

Case-Control Study on Congenital Malformation Risk in the Petrochemical Area of Gela (Sicily-Italy)

Objective: A study on congenital malformations (CMs) prevalence in newborns residing in the Gela municipality over 1991 to 2002 showed statistically significant excesses of total CMs, spina bifida, microcephaly, heart defects, hypospadias, if compared with the Italian EUROCAT registries (Bianchi, 2006). Many environmental and occupational risk factors reported as potentially associated with CMs have been documented in Gela and other similar industrial areas. Among toxic substances documented in the Gela site several are known as teratogenic and mutagenic (heavy metals, chloro- and organophosphates solvents, PCBs, aromatic polycyclic hydrocarbons), some of which are documented or suspected to be endocrine disruptors. A case-control study was carried out to evaluate whether among malformed subjects there was risk excess due to environmental, occupational, or lifestyle exposures, particularly eating habits. Material and Methods: Among 91 cases with malformations found in excess, 77 were selected by specialty medical visits; 91 matched controls were included. The questionnaire included information on pregnancy, parents\u27 work (particularly in the industrial plants) before and during pregnancy, parents\u27 eating habits, purchase place (shop, street vendor, growing own food plants/fishing). Statistical analyses were performed for all CMs and for hypospadias only. Results: Significant risk associations resulted for consumers of fish, fruit, and vegetables if purchased at street vendors or for fishing and growing own food plants (OR from 6.0 to 51.3). Conclusions: Results on food consumption suggest a possible reproductive risk for fish, fruit, or vegetables purchased at street vendors or for fishing or growing own food plants potentially locally contaminated either by men (eg, pesticides) or by substances released in the environment. Notwithstanding the impossibility of making a distinction between effects of the 2 potential contamination sources and the possible bias and misclassification problems typical of retrospective studies, results obtained still represent major concern on food chain and on possible effects on reproductive health

Phase Change Material Evolution in Thermal Energy Storage Systems for the Building Sector, with a Focus on Ground-Coupled Heat Pumps

The building sector is responsible for a third of the global energy consumption and a quarter of greenhouse gas emissions. Phase change materials (PCMs) have shown high potential for latent thermal energy storage (LTES) through their integration in building materials, with the aim of enhancing the efficient use of energy. Although research on PCMs began decades ago, this technology is still far from being widespread. This work analyses the main contributions to the employment of PCMs in the building sector, to better understand the motivations behind the restricted employment of PCM-based LTES technologies. The main research and review studies are critically discussed, focusing on: strategies used to regulate indoor thermal conditions, the variation of mechanical properties in PCMs-based mortars and cements, and applications with ground-coupled heat pumps. The employment of materials obtained from wastes and natural sources was also taken in account as a possible key to developing composite materials with good performance and sustainability at the same time. As a result, the integration of PCMs in LTES is still in its early stages, but reveals high potential for employment in the building sector, thanks to the continuous design improvement and optimization driven by high-performance materials and a new way of coupling with tailored envelopes

Interpreting and technology

Unlike other professions, the impact of information and communication technology on interpreting has been moderate so far. However, recent advances in the areas of remote, computer-assisted, and, most recently, machine interpreting, are gaining the interest of both researchers and practitioners. This volume aims at exploring key issues, approaches and challenges to the interplay of interpreting and technology, an area that is still underrepresented in the field of Interpreting Studies. The contributions to this volume cover topics in the area of computer-assisted and remote interpreting, both in the conference as well as in the court setting, and report on experimental studies

Interpreting and technology

Unlike other professions, the impact of information and communication technology on interpreting has been moderate so far. However, recent advances in the areas of remote, computer-assisted, and, most recently, machine interpreting, are gaining the interest of both researchers and practitioners. This volume aims at exploring key issues, approaches and challenges to the interplay of interpreting and technology, an area that is still underrepresented in the field of Interpreting Studies. The contributions to this volume cover topics in the area of computer-assisted and remote interpreting, both in the conference as well as in the court setting, and report on experimental studies

Interpreting and technology

Unlike other professions, the impact of information and communication technology on interpreting has been moderate so far. However, recent advances in the areas of remote, computer-assisted, and, most recently, machine interpreting, are gaining the interest of both researchers and practitioners. This volume aims at exploring key issues, approaches and challenges to the interplay of interpreting and technology, an area that is still underrepresented in the field of Interpreting Studies. The contributions to this volume cover topics in the area of computer-assisted and remote interpreting, both in the conference as well as in the court setting, and report on experimental studies

Interpreting and technology

Unlike other professions, the impact of information and communication technology on interpreting has been moderate so far. However, recent advances in the areas of remote, computer-assisted, and, most recently, machine interpreting, are gaining the interest of both researchers and practitioners. This volume aims at exploring key issues, approaches and challenges to the interplay of interpreting and technology, an area that is still underrepresented in the field of Interpreting Studies. The contributions to this volume cover topics in the area of computer-assisted and remote interpreting, both in the conference as well as in the court setting, and report on experimental studies

Interpreting and technology

Unlike other professions, the impact of information and communication technology on interpreting has been moderate so far. However, recent advances in the areas of remote, computer-assisted, and, most recently, machine interpreting, are gaining the interest of both researchers and practitioners. This volume aims at exploring key issues, approaches and challenges to the interplay of interpreting and technology, an area that is still underrepresented in the field of Interpreting Studies. The contributions to this volume cover topics in the area of computer-assisted and remote interpreting, both in the conference as well as in the court setting, and report on experimental studies

Interpreting and technology

Unlike other professions, the impact of information and communication technology on interpreting has been moderate so far. However, recent advances in the areas of remote, computer-assisted, and, most recently, machine interpreting, are gaining the interest of both researchers and practitioners. This volume aims at exploring key issues, approaches and challenges to the interplay of interpreting and technology, an area that is still underrepresented in the field of Interpreting Studies. The contributions to this volume cover topics in the area of computer-assisted and remote interpreting, both in the conference as well as in the court setting, and report on experimental studies

Interpreting and technology

Unlike other professions, the impact of information and communication technology on interpreting has been moderate so far. However, recent advances in the areas of remote, computer-assisted, and, most recently, machine interpreting, are gaining the interest of both researchers and practitioners. This volume aims at exploring key issues, approaches and challenges to the interplay of interpreting and technology, an area that is still underrepresented in the field of Interpreting Studies. The contributions to this volume cover topics in the area of computer-assisted and remote interpreting, both in the conference as well as in the court setting, and report on experimental studies