Poor weight control, alcoholic beverage consumption and sudden sleep onset at the wheel among Italian truck drivers: A preliminary pilot study.

Objectives: The aim of this study was to investigate the prevalence of obesity, alcoholic beverage consumption, unhealthy alcohol use and sudden sleep onset at the wheel among Italian truck drivers. In addition to prevalence rates, this study also aimed at investigating potential predictors for sudden-onset sleepiness and obesity. Material and Methods: A sample of truck drivers was extracted from the database of the High Risk Professional Driver Study. Data concerning demographics, anthropometry, medical information and working conditions were collected using anonymous questionnaires. Logistic regression analyses were performed to assess the association of the reported body mass index (BMI), alcohol consumption and sudden sleep onset with working conditions and general lifestyle factors. Results: Three hundred and thirty-five questionnaires were collected. According to their BMI, 45% of the participants were overweight and 21.4% of them were obese. Twenty-four point two percent declared they drank alcoholic beverages during working hours or work breaks and 21.3% of the drivers had an Alcohol Use Disorders Identyfication Test Consumption (AUDIT C) score ≥ 5 (the threshold value for unhealthy alcohol use). Forty-one point six percent of the interviewees experienced one episode of sudden sleep onset at the wheel per month (5.5% per week and 0.9% daily). Predictive factors for obesity were: length of service (odds ratio (OR) = 1.09, confidence interval (95% CI): 1.04–1.15, p 55 years old (OR = 5.22, 95% CI: 1.29–21.1, p = 0.020), driving more than 50 000 km per year (OR = 2.89, 95% CI: 1.37–6.11, p = 0.006) and the Chalder Fatigue Questionnaire (CFQ) score > 11 (adjusted OR = 2.97, 95% CI: 1.22–7.21, p = 0.016). Conclusions: This study strongly emphasizes the need for intervention in order to reduce and prevent important risk factors for the sake of road safety and truck drivers' health

Health impact of the emissions from a refinery: case-control study on the adult population living in two municipalities in Lomellina, Italy

Background: In the municipalities of Sannazzaro de’ Burgondi and Ferrer Erbognone (District of Lomellina, Pavia, Lombardy, Italy), an oil refinery is operating since 1963. In 2008, the company running the plant (eni S.p.A.) asked the competent bodies the permission for building a new facility (“EST”). The present work is aimed at evaluating the ante-operam health impacts of the existing facility refinery. Methods: A case-control study design was implemented. Cases were subjects admitted to hospital in 2002-2014 due to acute respiratory, cardiovascular or gastrointestinal conditions. Controls were selected among those who had not been hospitalised in that timespan. Cases and controls had to be alive at enrolment, aged 20-64 years, and were frequency-matched by age, gender and municipality. Data were extracted from the health insurance registry and from Hospital Discharge Records (ATS Pavia). Enrolled subjects were asked to complete a mailed survey. Environmental exposure was the fallout of refinery emissions (PM10) at participants’ homes, as predicted by an AERMOD model. Results: 541 respondents (125 cases, 416 controls) were included in the analyses. Response bias was excluded. Individual PM10 exposure was not significantly different between cases and controls, while it was significantly associated with municipality (being higher in Sannazzaro). The crude effect estimate of PM10 over case/control status indicated a not-significant excess of hospitalisation with the increase in PM10 exposure. Multivariate analyses confirmed those results. Conclusion: Findings indicate a possible excess of hospitalisation risk in most exposed people, but the effect is not statistically significant and may be affected by bias

Estrés percibido y estrategias de afrontamiento durante el confinamiento por COVID-19 en cinco países

Several studies have shown how mental health could be affected during the COVID-19 pandemic, which led us to wonder about the psychological impact that the initial period of lockdown could have. We conducted a multicentric study that sought to describe, compare, and analyze the association between perceived stress, coping strategies and sociodemographic characteristics in a snowball-style convenience sample of 1169 participants from Colombia, Brazil, Mexico, Italy, and Spain who responded to an online survey. There were differences in perceived stress and coping strategies between countries and depending on sociodemographic characteristics. The variables positively associated with perceived stress were the coping strategies alcohol-drug use, focus on emotions and venting, being a woman, and living in Brazil, Italy, and Spain. The variables negatively associated with perceived stress were planning and active coping, positive reinterpretation, being over 45 years old, and being a worker. These results contribute to understanding the stress responses to lockdown and help identify vulnerability factors in order to design prevention and intervention programs.  Varios estudios han demostrado cómo la salud mental pudo verse afectada durante la pandemia de COVID-19, lo que nos llevó a preguntarnos sobre el impacto psicológico que podría tener el período inicial de confinamiento. Llevamos a cabo un estudio multicéntrico que buscó describir, comparar y analizar la asociación entre el estrés percibido, las estrategias de afrontamiento y las características sociodemográficas en una muestra de conveniencia tipo bola de nieve de 1169 participantes de Colombia, Brasil, México, Italia y España que respondieron un cuestionario en línea. Se encontraron diferencias en el estrés percibido y las estrategias de afrontamiento entre países y según características sociodemográficas. Las variables asociadas positivamente con el estrés percibido fueron las estrategias de afrontamiento consumo de alcohol y drogas, centrarse en las emociones y desahogo, ser mujer y vivir en Brasil, Italia y España. Las variables asociadas negativamente con el estrés percibido fueron planificación y afrontamiento activo, reinterpretación positiva, ser mayor de 45 años y ser trabajador. Estos resultados contribuyen a comprender las respuestas de estrés al confinamiento y ayudan a identificar factores de vulnerabilidad para diseñar programas de prevención e intervención.

Sudden Unexpected Deaths and Vaccinations during the First Two Years of Life in Italy: A Case Series Study

Background The signal of an association between vaccination in the second year of life with a hexavalent vaccine and sudden unexpected deaths (SUD) in the two days following vaccination was reported in Germany in 2003. A study to establish whether the immunisation with hexavalent vaccines increased the short term risk of SUD in infants was conducted in Italy. Methodology/Principal Findings The reference population comprises around 3 million infants vaccinated in Italy in the study period 1999–2004 (1.5 million received hexavalent vaccines). Events of SUD in infants aged 1–23 months were identified through the death certificates. Vaccination history was retrieved from immunisation registries. Association between immunisation and death was assessed adopting a case series design focusing on the risk periods 0–1, 0–7, and 0–14 days after immunisation. Among the 604 infants who died of SUD, 244 (40%) had received at least one vaccination. Four deaths occurred within two days from vaccination with the hexavalent vaccines (RR = 1.5; 95% CI 0.6 to 4.2). The RRs for the risk periods 0–7 and 0–14 were 2.0 (95% CI 1.2 to 3.5) and 1.5 (95% CI 0.9 to 2.4). The increased risk was limited to the first dose (RR = 2.2; 95% CI 1.1 to 4.4), whereas no increase was observed for the second and third doses combined. Conclusions The RRs of SUD for any vaccines and any risk periods, even when greater than 1, were almost an order of magnitude lower than the estimates in Germany. The limited increase in RRs found in Italy appears confined to the first dose and may be partly explained by a residual uncontrolled confounding effect of age

Association between Protective and Deleterious HLA Alleles with Multiple Sclerosis in Central East Sardinia

The human leukocyte antigen (HLA) complex on chromosome 6p21 has been unambiguously associated with multiple sclerosis (MS). The complex features of the HLA region, especially its high genic content, extreme polymorphism, and extensive linkage disequilibrium, has prevented to resolve the nature of HLA association in MS. We performed a family based association study on the isolated population of the Nuoro province (Sardinia) to clarify the role of HLA genes in MS. The main stage of our study involved an analysis of the ancestral haplotypes A2Cw7B58DR2DQ1 and A30Cw5B18DR3DQ2. On the basis of a multiplicative model, the effect of the first haplotype is protective with an odds ratio (OR) = 0.27 (95% confidence interval CI 0.13–0.57), while that of the second is deleterious, OR 1.78 (95% CI 1.26–2.50). We found both class I (A, Cw, B) and class II (DR, DQ) loci to have an effect on MS susceptibility, but we saw that they act independently from each other. We also performed an exploratory analysis on a set of 796 SNPs in the same HLA region. Our study supports the claim that Class I and Class II loci act independently on MS susceptibility and this has a biological explanation. Also, the analysis of SNPs suggests that there are other HLA genes involved in MS, but replication is needed. This opens up new perspective on the study of MS

Un approccio bayesiano all'analisi di studi ecologici

Tesi di dottorato in sanita' pubblica e medicina di comunita'. 7. cicloConsiglio Nazionale delle Ricerche - Biblioteca Centrale - P.le Aldo Moro, 7, Rome; Biblioteca Nazionale Centrale - Piazza Cavalleggeri, 1, Florence / CNR - Consiglio Nazionale delle RichercheSIGLEITItal