A Case-Control Study on Leisure Time Physical Activity (LTPA) during the Last Three Months of Pregnancy and Foetal Outcomes in Italy

The association between Leisure Time Physical Activity (LTPA) during pregnancy and foetal outcomes has been extensively investigated. However, epidemiological studies specifically referred to LPTA in the last months of pregnancy are scarce. We evaluated the association between LPTA and the risk of both preterm delivery and small for gestational age (SGA) during the last three months of pregnancy in Italy. A nationwide case-control study was performed in nine Italian cities. A total of 299 preterm delivery, 364 SGA and 855 controls were enrolled in the study. A self-administered questionnaire was used to assess socio-demographic variables, medical and reproductive history, life-style habits and LTPA referred to the last three months of pregnancy. Univariate and multivariate regression analyses were performed in order to estimate Odds ratios and 95% CI. LTPA during the last three months of pregnancy decreases the risk of preterm delivery (adjusted OR = 0.56; 95% CI 0.39 - 0.79). Among the different types of physical activity, walking, the most frequently referred activity, appears significantly protective against preterm delivery (adjusted OR = 0.53; 95% CI 0.36 - 0.81). Moreover, a small protective effect of walking was evidenced against SGA (adjusted OR = 0.72; 95% CI 0.51 - 1.00). In conclusion, a mild physical activity such as walking in the last three months of pregnancy seems to reduce the risk of preterm delivery and, at a lesser extent, of SGA, confirming the beneficial effects of physical activity along the whole pregnancy

Prevalence of Ocular, Respiratory and Cutaneous Symptoms in Indoor Swimming Pool Workers and Exposure to Disinfection By-Products (DBPs)

The objective of this cross-sectional study was to investigate the prevalence of self-reported respiratory, ocular and cutaneous symptoms in subjects working at indoor swimming pools and to assess the relationship between frequency of declared symptoms and occupational exposure to disinfection by-products (DBPs). Twenty indoor swimming pools in the Emilia Romagna region of Italy were included in the study. Information about the health status of 133 employees was collected using a self-administered questionnaire. Subjects working at swimming pools claimed to frequently experience the following symptoms: cold (65.4%), sneezing (52.6%), red eyes (48.9%) and itchy eyes (44.4%). Only 7.5% claimed to suffer from asthma. Red eyes, runny nose, voice loss and cold symptoms were declared more frequently by pool attendants (lifeguards and trainers) when compared with employees working in other areas of the facility (office, cafe, etc.). Pool attendants experienced generally more verrucas, mycosis, eczema and rash than others workers; however, only the difference in the frequency of self-declared mycosis was statistically significant (p = 0.010). Exposure to DBPs was evaluated using both environmental and biological monitoring. Trihalomethanes (THMs), the main DBPs, were evaluated in alveolar air samples collected from subjects. Swimming pool workers experienced different THM exposure levels: lifeguards and trainers showed the highest mean values of THMs in alveolar air samples (28.5 ± 20.2 μg/m3), while subjects working in cafe areas (17.6 ± 12.1 μg/m3), offices (14.4 ± 12.0 μg/m3) and engine rooms (13.6 ± 4.4 μg/m3) showed lower exposure levels. Employees with THM alveolar air values higher than 21 μg/m3 (median value) experienced higher risks for red eyes (OR 6.2; 95% CI 2.6–14.9), itchy eyes (OR 3.5; 95% CI 1.5–8.0), dyspnea/asthma (OR 5.1; 95% CI 1.0–27.2) and blocked nose (OR 2.2; 95% CI 1.0–4.7) than subjects with less exposure. This study confirms that lifeguards and trainers are more at risk for respiratory and ocular irritative symptoms and cutaneous diseases than subjects with other occupations at swimming pool facilities

Impact of Pre-Analytical Time on the Recovery of Pathogens from Blood Cultures: Results from a Large Retrospective Survey

Prompt identification of bloodstream pathogens is essential for optimal management of patients. Significant changes in analytical methods have improved the turnaround time for laboratory diagnosis. Less attention has been paid to the time elapsing from blood collection to incubation and to its potential effect on recovery of pathogens. We evaluated the performance of blood cultures collected under typical hospital conditions in relation to the length of their pre-analytical time. We carried out a large retrospective study including 50,955 blood cultures collected, over a 30-month period, from 7,035 adult septic patients. Cultures were accepted by the laboratory only during opening time (Mon-Fri: 8am\ub14pm; Sat: 8am\ub12pm). Samples collected outside laboratory hours were stored at room temperature at clinical wards. All cultures were processed by automated culture systems. Day and time of blood collection and of culture incubation were known for all samples. A maximum pre-analytical interval of 2 hours is recommended by guidelines. When the laboratory was open, 57% of cultures were processed within 2 h. When the laboratory was closed, 4.9% of cultures were processed within 2 h (P<0.001). Samples collected when the laboratory was closed showed pre-analytical times significantly longer than those collected when laboratory was open (median time: 13 h and 1 h, respectively, P<0.001). The prevalence of positive cultures was significantly lower for samples collected when the laboratory was closed compared to open (11% vs 13%, P<0.001). The probability of a positive result decreased of 16% when the laboratory was closed (OR:0.84; 95%CI:0.80\ub10.89, P<0.001). Further, each hour elapsed from blood collection to incubation resulted associated with a decrease of 0.3% (OR:0.997; 95%CI:0.994\ub10.999, P<0.001) in the probability of a positive result. Delayed insertions of cultures into automated systems was associated with lower detection rates, with potentially important consequences for patients. In each hospital setting the logistic factors able to shorten pre-analytical time should be carefully investigated and specifically targeted

Work-related injuries in young workers: an Italian multicentric epidemiological survey.

Emergency departments records from 33 hospitals were reviewed to disclose work-related injuries occurred in teen-subjects living in 14 Italian cities. During January-June 2000, 317 work-related injuries were reported. Male subjects, 17 year old, working in the industrial field, resulted the most affected,probably due to the fact that among young workers this sex and age class is the most represented one. Cluster analysis identified two groups of work-related injuries: one includes mainly transportation injuries causing lower extremities or multiple body sites traumas. The other is more strictly related to specific working tasks and includes mostly traumas and cut wounds in hand/wrist and head, together with eye lesions. A more intensive supervision on the use of protective equipment, a more appropriate training in hazard recognition and safe work practices, including operation of vehicles in the work site, must be implemented to reduce work-related injuries

Childhood Asthma and Environmental Exposures at Swimming Pools: State of the Science and Research Recommendations

OBJECTIVES: Recent studies have explored the potential for swimming pool disinfection by-products (DBPs), which are respiratory irritants, to cause asthma in young children. Here we describe the state of the science on methods for understanding children's exposure to DBPs and biologics at swimming pools and associations with new-onset childhood asthma and recommend a research agenda to improve our understanding of this issue. DATA SOURCES: A workshop was held in Leuven, Belgium, 21-23 August 2007, to evaluate the literature and to develop a research agenda to better understand children's exposures in the swimming pool environment and their potential associations with new-onset asthma. Participants, including clinicians, epidemiologists, exposure scientists, pool operations experts, and chemists, reviewed the literature, prepared background summaries, and held extensive discussions on the relevant published studies, knowledge of asthma characterization and exposures at swimming pools, and epidemiologic study designs. SYNTHESIS: Childhood swimming and new-onset childhood asthma have clear implications for public health. If attendance at indoor pools increases risk of childhood asthma, then concerns are warranted and action is necessary. If there is no such relationship, these concerns could unnecessarily deter children from indoor swimming and/or compromise water disinfection. CONCLUSIONS: Current evidence of an association between childhood swimming and new-onset asthma is suggestive but not conclusive. Important data gaps need to be filled, particularly in exposure assessment and characterization of asthma in the very young. Participants recommended that additional evaluations using a multidisciplinary approach are needed to determine whether a clear association exists

La formazione alla prevenzione nei corsi di laurea in Medicina e Chirurgia

In questo capitolo viene presa in esame la formazione per la prevenzione nel Corso di Laurea Magistrale in Medicina e Chirurgia.Questo tema viene affrontato in più ambiti entro il core curriculum deglistudi medici e più specificatamente in alcuni corsi integrati quale quellodi Igiene e sanità Pubblica, Medicina del lavoro e, nell'esperienza delcorso di laurea della Facoltà di Medicina e Chirugia dell'Università diModena e Reggio Emilia, nel corso integrato di medicina generale e Cureprimarie.Si può comunque affermare che in generale l’attuale configurazione delCorso di Laurea Magistrale in Medicina e Chirurgia nelle diverse sediaccademiche italiane assicura, entro diversi corsi integrati che siarticolano lungo i sei anni, la massima attenzione alla formazione deiprossimi medici in tema di prevenzione