Search

The aim of this study was to assess the relationship between preterm/early preterm delivery and active smoking as well as environmental tobacco smoke (ETS) exposure in a sample of pregnant Italian women. A case–control study was conducted in nine cities in Italy between October 1999 and September 2000. Cases of preterm birth were singleton babies born before the 37th gestational week; babies born before the 35th gestational week were considered early preterm births. Controls were babies with gestational ages ≥ 37th week. A total of 299 preterm cases (including 105 early preterm) and 855 controls were analysed. A self-administered questionnaire was used to assess active smoking and ETS exposure, as well as potential confounders. Multivariable logistic regression analysis showed a relationship between active smoking during pregnancy and preterm/early preterm delivery [adjusted ORs: 1.53; 95% CI 1.05, 2.21 and 2.00; 95% CI 1.16, 3.45, respectively]. A dose–response relationship was found for the number of cigarettes smoked daily. The adjusted ORs were 1.54 and 1.69 for preterm babies and 1.90 and 2.46 for early preterm babies for 1–10 and >10 cigarettes/day respectively. ETS exposure was associated with early preterm delivery [adjusted OR 1.56; 95% CI 0.99, 2.46] with a dose–response relationship with the number of smokers in the home. Smoking during pregnancy was strongly associated with preterm delivery with a dose–response effect. ETS exposure in non-smoking women was associated only with early preterm delivery. [ABSTRACT FROM AUTHOR]

Investigates the perchloroethylene (PCE) exposure of workers in dry-cleaning establishments and in their private homes. Investigation done in Modena, Italy; 8-h Permissible Exposure Limit (TWA-PEL) for PCE; Close correlation between alveolar PCE and ambient PCE values; Reliability of biological index of PCE.

Examines the presence of chloroform in the alveoli of individuals attending indoor swimming pools. Collection of samples from exposed subjects; Evaluation of chloroform levels in swimming pools; Composition of chloroform.

Evaluates the plasma chloroform (CHCl[sub 3]) concentrations in swimmers using indoor swimming pools in Modena, Italy. Correlation between CHCl[sub 3] and carcinogen; Impact of the intensity of the sport activity on plasma CHCl[sub 3]; Determination of CHCl[sub 3] in plasma and water.

Objective. The objective of this study was to assess the relationship between active smoking as well as environmental tobacco smoke (ETS) exposure and severe small for gestational age (SGA) at term in a sample of pregnant Italian women. Methods. A case-control study was conducted in nine cities in Italy between October 1999 and September 2000. Cases of severe SGA were singleton, live born, at term children with a birth weight ≤ 5th percentile for gestational age. Controls (10:1 to cases) were enrolled from among singleton at term births that occurred in the same hospitals one or two days after delivery of the case, with a birth weight > 10th percentile for gestational age. A total of 84 cases of severe SGA and 858 controls were analyzed. A self-administered questionnaire was used to assess active smoking and ETS exposure, as well as potential confounders. Results. Multivariate logistic regression analysis showed a relationship between active smoking during pregnancy and severe SGA (adjusted odds ratio (OR) 2.10, 95% confidence interval (CI) 1.13-3.68). ETS exposure was associated with severe SGA (adjusted OR 2.51, 95% CI 1.59-3.95) with a dose-response relationship to the number of smokers in the home. [ABSTRACT FROM AUTHOR]

Background: 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. Methods: 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–4pm; Sat: 8am–2pm). 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. Results: 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:0.80–0.89, 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:0.994–0.999, P<0.001) in the probability of a positive result. Discussion: 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. [ABSTRACT FROM AUTHOR]

Subjects attending indoor swimming pools are exposed to disinfection by-products (DBPs) by inhalation, dermal contact and/or ingestion, as a consequence of water disinfection treatments with chlorine and related compounds. The occurrence of trihalomethanes (THMs) in pool waters has been well documented, while information about other DBPs, including bromate, chlorite, chlorate and haloacetic acids (HAAs), is very limited even though some of these substances are potentially dangerous for human health. The aim of this study was to investigate the occurrence of bromate, chlorite, chlorate, HAAs and THMs both in pool and in source water of 24 public indoor swimming pools in Emilia Romagna Region, Northern Italy. THMs were evaluated with a standardized method involving the head-space gas-chromatographic technique, while HAAs, bromate, chlorite, and chlorate were detected by Ion Chromatography with Mass Spectrometry. THMs were measured in all the pool water samples (mean value: 36.9±28.2μg/l), while they were detectable in less than 50% of source waters and always at very low levels (mean value: 2.0±4.1μg/l), as a consequence of drinking water disinfection with chlorine dioxide, a widespread disinfection method in Italy. Bromate was always absent in source water samples, and it was detected in 3 samples of pool water only (range: 10–48μg/l). HAAs were scarcely detected in source waters (3 positive samples, maximum level observed: 21μg/l), while in pool water they were always present at detectable levels and showed high concentrations (range: 11–403μg/l, mean value of 164±108μg/l). Chlorite was present in 22 water supply samples (mean value: 149±122μg/l) but only in one pool water. Chlorate, on the contrary, resulted as the most prevalent DBP both in source (range: 2–499μg/l) and in pool waters, where it showed the highest levels, with a mean value of 3661μg/l and a maximum value of 19537μg/l. Such environmental levels could result in an important human exposure, mainly by ingestion and/or dermal contact, to non volatile DBPs different than THMs. Exposure to those DBPs, therefore, needs to be further investigated and strategies aimed at minimizing it should be identified and undertaken. Attention should be paid, above all, to chlorate: this substance appears really widespread in swimming pool water and, according to the most recent toxicological studies, its potential human health effects could be relevant. [ABSTRACT FROM AUTHOR]

The hypothesis that attendance at indoor chlorinated swimming pool is a risk factor for irritative ocular and respiratory symptoms and bronchial asthma is well known in literature, although epidemiological evidence is still inconclusive. The aim of this study was to evaluate the association between airborne trichloramine (NCl3) levels and irritative symptoms in swimming pool employees in order to obtain detailed data regarding dose-response relationships and to identify the airborne NCl3 exposure level, if any, without health effects. A total of 20 indoor swimming pools in the Emilia Romagna region of Italy were included in the study. Information about the health status of 128 employees was collected using a self-administered questionnaire. Exposure to airborne NCl3 was evaluated in indoor swimming pools by a modified DPD/KI method. The results of the study evidenced a mean value of airborne NCl3 of 0.65±0.20 mg/m3 (ranging from 0.20 to 1.02 mg/m3). Both ocular and upper respiratory symptoms, in particular red eyes, runny nose, voice loss and cold symptoms, were declared more frequently by lifeguards and trainers when compared with employees working in other areas of the facility (office, cafe, and so on). Pool attendants exposed to airborne NCl3 levels of >0.5 mg/m3 experienced higher risks for runny nose (OR: 2.91; 95% CI: 1.22-6.93) red eyes (OR: 3.16; 95% CI: 1.46-6.82), voice loss (OR: 3.56; 95% CI: 1.60-7.95) and itchy eyes (OR: 2.23; 95% CI: 1.04-4.78) than other employees. Moreover, red eyes, itchy eyes, runny nose and voice loss are related to airborne NCl3 levels, with strong dose-response relationships. In conclusion, this study shows that lifeguards and trainers experience ocular and respiratory irritative symptoms more frequently than employees not exposed. Irritative symptoms become significant starting from airborne NCl3 levels of >0.5 mg/m3, confirming that the WHO-recommended value can be considered protective in occupational exposure to airborne NCl3 in indoor swimming pools. [ABSTRACT FROM AUTHOR]

Background: Epidemiological evidence of an association between disinfection by-products (DBPs) exposure via drinking water and reproductive outcomes is still inconclusive. Objective: The aim of this study was to investigate the association between trihalomethanes (THMs), chlorite and chlorate exposure and congenital anomalies. Methods: A case-control study was carried out in Emilia-Romagna Region (Italy). Data on 1917 different congenital anomalies (neural tube, cardiac, diaphragm and abdominal wall, oesophagus, cleft lip and palate, respiratory, urinary tract and chromosomal anomalies) observed in the period 2002–2005 were extracted from the Regional Malformation Registry. Four controls (newborns without anomalies) were randomly selected form the Regional Birth Register and frequency matched to cases according to pregnancy period. The network supplying water during the first trimester of pregnancy was identified on the basis of mother's address: DBPs data, technical and structural information were linked to each subject. Results: Overall, THMs exposure was very low (mean: 3.8±3.6μg/l), and no risk excess was observed. Chlorite and chlorate values were fairly high (mean: 427±184μg/l and 283±79μg/l, respectively). Women exposed to chlorite level >700μg/l were at higher risk of newborns with renal defects (OR: 3.30; 95% IC: 1.35–8.09), abdominal wall defects (OR: 6.88; 95% IC: 1.67–28.33) and cleft palate (OR: 4.1; 95% IC: 0.98–16.8); women exposed to chlorate level >200μg/l were at higher risk of newborns with obstructive urinary defects (OR: 2.88; 95% IC: 1.09–7.63), cleft palate (OR: 9.60; 95% IC:1.04–88.9) and spina bifida (OR: 4.94; 95% IC:1.10–22). Conclusions: This was the first study showing an excess risk of different congenital anomalies related to chlorite and chlorate exposure via drinking water: further research is needed to confirm the observed relationships in large datasets, specifically for chlorate, an unregulated DBP. [Copyright &y& Elsevier]

There appears to be very good epidemiological evidence for a relationship between chlorination by-products, as measured by trihalomethanes (THMs), in drinking water and bladder cancer, but the evidence for other cancers, including colorectal cancer appears to be inconclusive and inconsistent. There appears to be some evidence for a relationship between chlorination by-products, as measured by THMs, and small for gestational age (SGA)/intrauterine growth retardation (IUGR) and preterm delivery, but evidence for other outcomes such as low birth weight (LBW), stillbirth, congenital anomalies and semen quality appears to be inconclusive and inconsistent. The overall aim of the HIWATE study is to investigate potential human health risks (e.g. bladder and colorectal cancer, premature births, SGA, semen quality, stillbirth, congenital anomalies) associated with long-term exposure to low levels of disinfectants (such as chlorine) and DBPs occurring in water for human consumption and use in the food industry. The study will comprise risk-benefit analyses including quantitative assessments of risk associated with microbial contamination of drinking water versus chemical risk and will compare alternative treatment options. The outcome will be improved risk assessment and better information for risk management. The work is divided into different topics (exposure assessment, epidemiology, risk assessment and management) and studies. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

A few epidemiologic studies have suggested that consumption of drinking water with high trihalomethane content increases the risk of cancer. We investigated the mortality of a cohort of 5144 residents in Guastalla, northern Italy, who were supplied tap water with high chloroform and trihalomethane content between 1965 and 1987. Using death rates of a nearby community as reference rates, the standardized mortality ratio from all cancers between 1987 and 1999 was slightly increased for both males (1.2, 95% confidence interval 1.1–1.4) and females (1.1, 95% confidence interval 1.0–1.3). This was mainly due to a higher mortality from stomach, liver, lung, prostate and bladder cancer in males and from stomach, pancreas, breast and ovarian cancer and lymphocytic leukemia in females. We also noted excess mortality from melanoma in both males and females. Overall, our findings were consistent with an association between trihalomethane exposure and increased cancer risk at some sites. However, the point estimates were statistically imprecise, due to the limited number of deaths for some site-specific cancers. In addition, we were unable to rule out the possibility of confounding due to smoking and other life-style factors with regard to some of the excess rates. [Copyright &y& Elsevier]

Studies the reliability of biologic indices for monitoring perchloroethylene exposure at low environmental solvent concentrations. Discussion of the epidemiological aspects of perchloroethylene pollution; Comparison between the merits and drawbacks of monitoring perchloroethylene exposure by measuring its concentration in alveolar air, blood or urine.

Looks at a study which explored the progression of color-vision loss and determined its reversibility in a group of workers at dry-cleaning establishments. How the study was conducted; Results and discussion.