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In the period 2015-2017 a Health Impact Assessment, HIA, was carried out in the Municipalities of Viggiano and Grumento Nova, in Val D'Agri, where since 2001 the oil first treatment plant, COVA, has been active. HIA envisaged the constant involvement of local communities and a multidisciplinary scientific group. Seven scientific articles have been published on: review of evidence on non-methane hydrocarbons; diffusion model of air pollutants emitted by the COVA; characteristics of the HIA process; investigation on volatile organic compounds, odorous substances and citizens' reports; sample study on respiratory function using spirometry and questionnaire; residential cohort study on mortality and hospitalization; analysis of media outputs in a critical period. The results showed environmental and health impacts related to the population's area of residence. In addition to environmental-health surveillance activities, the preventive HIA approach emerges as a preferential way for reducing communities' exposure to recognized pollutants and sustaining environmental justice options.

Objective: to describe transport policies adopted in recent years (2006-2010) by some Italian municipalities and their effectiveness., Design and Setting: survey data refer to fifteen cities participating in the EpiAir2 project: Torino, Milano, Venezia, Bologna, Firenze, Pisa, Roma, Taranto, Palermo, Cagliari, Trieste, Genova, Ancona, Napoli, and Bari., Results: this survey revealed strengths and weaknesses of the way in which these Italian cities address the promotion of sustainable mobility. As a general rule, the vehicle fleets have been renewed with a reduction of old-emission-standard vehicles. Italian cities reported a considerable delay in the development of underground and tram systems, and suburban rail networks, compared to other European urban areas. Regarding other aspects of urban mobility (supply/demand for public transport, low traffic and pedestrian zones, bike paths, car and bike sharing), this survey highlighted a great heterogeneity among Italian cities., Conclusion: differences between Italian cities are partly explained by structural and cultural features and also by local governance, specifically the political capability to design and adopt effective policies concerning urban transportation systems and their environmental impact. Various and fragmented initiatives are signs that Italy has not formulated a comprehensive and integrated strategy about sustainable mobility in urban areas yet.

In recent decades the quantity (in weight and volume) of solid waste is grown so rapidly to become a real problem especially in densely urbanized areas. The disposal of Municipal Solid Waste by incineration with energy recovery (WtE) is recognized as the most suitable system to process non-recyclable waste. However in several countries there are still concerns from experts and local communities about the environmental impact of incinerators. Epidemiological studies, developed since the 80s, are still the subject of controversial discussion because the results of research often refer to old incinerators--built a few decades ago--and therefore more impactful. In fact inadequate levels of gas cleaning and combustion process control in these facilities tended to risk the health of plant workers and local environment. This situation furthermore contributes to increase public risk perception and the spread of the NIMBY (not in my backyard) syndrome while siting this unwanted but necessary facilities. Actually, new strategies as advances in emission control designs and very stringent new governmental regulations, have resulted in large reductions in the amount of emissions. So the first aim of this work has been to understand if these high perception of risk have a reason to exist also in modern and new municipal waste incinerators. The second aim is to discover if the law, the new technologies and the mitigation strategies can really set a limit on the negative impacts on human health and on environment and if is it possible to improve or increase these strategies. Work has been divided into two parts. The first part focuses on analysis of waste environmental impact regulations, of plant operation systems and of epidemiological studies results. The second part involves the examination of the actual use of regulatory instruments, the most advanced technologies and the strategies for mitigation in the most effective new concept incinerators plants. For this verification has been analyzed in detail some different incineration plants recently created or rehabilitated in the last decade. The case-studies showed that the preliminary evaluation tools and the constant control of the waste incinerator are very effective. Moreover the comparison between the maximum emission limits, the BAT and the analysis of the actual emission of the cases study has shown the effectiveness of the depuration systems currently used. The emissions are in fact much lower than these limits. By the comparison we also identified the most efficient strategies and the best policies to inform and to involve people. Success in siting an unwanted but needed facility requires that authorities fully involve the public with openness and integrity in all aspects of the planning process. Starting from these result and in order to exploit what is already effective, some proposals where outlined and aim to be the basis for further approaches to design waste disposal plants.

Among the themes addressed in public health, environmental hygiene represents a good example of how certain questions can be resolved through the construction of strongly integrated operative networks. In particular when one speaks of air quality in urban centers there must be an awareness that there should be coordination of all actors involved. In this way the Department of Prevention can transform itself into the essential part of the hub thanks to its specific skills and expertise. In this discussion, some experiences of the Local Health Agency of Bologna where the Department of Prevention could become the hub of the system will be presented.

Objective: the present introductory paper illustrates the general framework of the Project EpiAir <>, of the Italian Centre for Disease Control and Prevention, Italian Ministry of Health. The project was designed to provide methods and criteria for epidemiological surveillance of the health effects of air pollution in large Italian cities., Method: we considered the relevant information available on the health effects of air pollution in Europe and in Italy, and the aspects critical to running a surveillance program., Results: the project made available a system of data and information to evaluate the health effects of air pollution. Health outcomes of interest are daily mortality (non accidental causes, cardiovascular, and respiratory causes) and cardiorespiratory hospital admissions. The project collected standardized data for the years 2001-2005 in ten Italian cities (Turin, Milan, Mestre, Bologna, Florence, Pisa, Rome, Taranto, Palermo, Cagliari). A network of public institutions in the field of environmental control and public health participated in the project. The surveillance system was set up for the period 2001- 2005 in order to evaluate future trends in the environmental and health circumstances (2006-2010) using reliable and standardized methods., Conclusion: we set up a long-term surveillance program of the health effects of air pollution.

Selecting the best emissions abatement strategy is very difficult due to the complexity of the processes that determine the impact of atmospheric pollutants and to the connection with climate change issues. Atmospheric pollution models can provide policy makers with a tool for assessing the effectiveness of abatement measures and their associated costs. The MINNI integrated model has been developed to link policy and atmospheric science and to assess the costs of the measures. The results have been carefully verified in order to identify uncertainties and the models are continuously updated to represent the state of the art in atmospheric science. The fine spatial and temporal resolution of the simulations provide a strong basis for assessing impacts on environment and health.

Objective: to provide an overview of the mobility policies implemented by local administrations participating in the EpiAir Project in recent years (2001-2007)., Design and Setting: data on the resident population, housing density, and composition and evolution of vehicular fleet were collected from Istat and ACI databases. A questionnaire on the general urban circumstances and on mobility policies that have direct and indirect effects on air quality was submitted to local administrations., Results: analyses on the ACI data show that, even if there is an environmental improvement in the emissions standards of vehicular fleet, number of cars per inhabitants is higher than the European mean and a general increase in the number of vehicles has been observed, mainly of diesel-fueled vehicles. All cities, with the exception of Cagliari and Milan, completed the questionnaire. Data varied greatly in quality and quantity due to collaboration differences of the various municipalities. For each of the policy categories, many "good practices" are reported: from vehicular transport restrictions to improvements in public transport; from the promotion of pedestrian and bicycle mobility to new forms of vehicles' use and/or ownership (car-sharing, car-pooling)., Conclusions: overall, transportation policies are not very favourable towards sustainable mobility, both due to the elevated number of vehicles per inhabitants and to different barriers encountered in policies' implementation, such as the lack of an integrated approach in addressing mobility issues, the inaccurate and confusing rules in interventions' application and primarily, the lack of efficient control measures. As a result, the beneficial effects of local transportation regulations on urban air quality may be still very limited.

Objectives: Estimate of the possible benefits, in Trieste, of a reduction of PM10 to values not over 60, 50, 40, 30, 20, 10 microg/mc, utilizing data of PM10 of the year 2002 as cause specific deaths and admissions., Design: Cause specific deaths and admissions attributable to short term effects of PM10 calculated by software AirQ, utilizing Relative Risk from MISA 1 study (as published in 2002)., Setting: Trieste (Italy)., Main Outcomes Measures: Cause specific deaths and admissions., Results: Using air pollution data for 2002, 1.8% (CI 95% 0.6%; 2.9%) of natural deaths, 2.2% (CI 95% 0.6%; 3.7%) of cardiovascular deaths and 2.5% (CI 95% 0; 7.3%) of respiratory deaths, 1.5% (CI 95% 0.6; 2.4%) of cardiovascular admissions and 1.6% (CI 95% 0; 3.3%) of respiratory admissions were attributable to PM10 concentrations over 20 microg/mc., Conclusions: AirQ software proved to be a valid and reliable tool to estimate the potential short term effects of air pollution. Special attention is required to choose the relative risks to be utilized.

The authors have investigated the issue of air pollution and its impact on people's health. The study touches such topics as the origins and types of pollutants, airspread contaminants, pollutants' biological effect and consequences on human health. Although pollution levels have recently shown to be lower, they still reflect a major concern for public health. Automobile traffic is the main responsible for air pollution and thin dusts are virtually the most dangerous particles in the atmosphere. Prevention will only be possible if governing bodies adopt effective strategies and public health agents develop adequate prevention plans.

This paper is an up-to-date review of the scientific evidence on mechanisms of pollutant generation and health effects for a number of urban air pollutants. The review focuses on main sources and health effect of ozone and photochemical smog, benzene, polycyclic aromatic hydrocarbons, and particulate matter. These agents are "priority pollutants", generated by vehicle traffic, and their regulation is currently being examined by the European Council and the European Commission. The aim is to reach, by the year 2010, values lower than 180 micrograms/m3 for ozone as maximum hourly concentration, 2.5 micrograms/m3 for benzene as an annual average, 93 micrograms/m3 for nitrogen dioxide as 98 degrees percentile of hourly concentrations, 50 micrograms/m3 for particulate as a daily average. The goal can be achieved only by means of immediate interventions on emissions.

Thirty to 40% of European citizens are exposed to air pollution levels above EU standards. Recent epidemiological studies, both in Italy and elsewhere, have shown that excess mortality and morbidity may occur in relation to air pollutant concentrations below current standards. EU is trying to work out a strategy of interventions for the reduction of air pollution. Italian policies in the field of air quality have been fragmentary. However, the Italian National Health Plan (NHP) 1998-2000 aims at: 1) contrasting the current division between health and environmental policies; 2) giving priority to a renewed focus on prevention; 3) improving a strict cooperation to solve the problem. A specific aim of the NHP consists in the reduction of private vehicular traffic. In conclusion, an integrated strategy of international, national and local policies is needed, based on a wide information exchange among risk evaluators and decision-makers. Likewise, strong efforts in communicating scientific evidences and public health policies to the large public are needed, in order to elicit an active participation to environmental control interventions.

In this work we take under examination the aromatic polycyclic hydrocarbons (APHs) as a class of organic micropolluting agents which have a considerable impact in the life and in the working environment of man. The authors decided to expressly start this study by proposing the changes pattern cause by APHs according to their chemical-physical reactivity characteristics, in order to realise a qualitative and quantitative evaluation of their toxicologic impact. Therefore, the specific aspects of chemism (reactions of substitution, aromatic electrophilia and addition) of these organic micropolluting agents are studied with particular reference to their chemical structure and to the properties which are the main important cause of every effect of diffusion both in productive environments and of toxicity in the human body. In this way, come toxicologic risk sources, responsible, within some technological cycles for the APHs emission in the working areas, are identified, shown and evaluated; carrying factors, not much investigated till now, which represent a synergic effect to the introduction and absorption of the APHs by the human body. For the necessity of a useful environmental monitoring which could be applied to different matrices, the techniques and the methods useful for carrying out sampling and analytical evaluation in a correct way, are introduced as well. Lastly, the Authors stress on the engagement and discuss the measures of prevention and protection, technically performable on the basis of the chemico-physical-granulometric properties of APHs, with the goal of safeguarding at best health of people occupationally exposed.

There is a high density of industries for the production of ceramic tiles in the District of Scandiano (province of Reggio Emilia, Emilia Romagna region). In this area, since the beginning of 1970s, the time trend of Pb exposure in ceramic tile plants has been evaluated by means of biological monitoring (BM) data collected at the Service of Prevention and Safety in the Work Environment and its associated Toxicology Laboratory. From these data, a clear decreasing time trend of exposure levels is documented, the reduction being more evident during the seventies and in 1985-88. During the seventies BM was introduced systematically in all ceramic tile plants with the determination of delta-aminolevulinic acid in urine (ALA-U). As a consequence of the BM programme, hygienic measures for the abatement of pollution inside the plants were implemented, and a reduction, from 20.6% to 2%, of ALA-U values exceeding 10 mg/l, was observed. In 1985, the determination of lead in blood (PbB) replaced that of ALA-U in the BM programmes and highlighted the persistence of high level of exposure to Pb, which could not be outlined by means of ALA-U because of its lower sensitivity. PbB levels were 36.1 micrograms/100 ml and 25.7 micrograms/100 ml in male and female workers, respectively. These results required the implementation, within the plants, of additional hygienic measures and a significant reduction of PbB was obtained in the following three years. In 1988 PbB levels were 26.0 +/- 10.7 and 21.6 +/- 10.3 micrograms/100 ml in male and female workers, respectively. In 1993-95 Pb levels were obtained from 1328 male and 771 female workers of 56 plants, accounting for about 40% of the total number of workers in the ceramic industry, in the zones of Sassuolo and Scandiano. Exposure levels are not different from those observed in the preceding years, with PbB levels of 25.3 +/- 11.1 and 19.1 +/- 9.2 micrograms/100 ml in male and female workers, respectively.

The present national and international trends about waste management favour recycling and recovery of waste either as materials or as energy. Therefore, it can be supposed that recycling activities of materials as for example the composting of urban waste organic fraction will be more and more encouraged in the future. Nevertheless, if we intend really to develop a market of recycling and recovery of waste, the quality of products obtained must be especially considered. As regards the compost, these problems have taken a great importance in the last years, since only high quality compost finds utilization in agriculture. In this paper, we investigate the procedure to carry out in order to obtain a compost of high quality either from a chemical, microbiological or technological point of view, by examining particularly the effects on compost quality, in consequence of separation of some specific waste streams at source.

The risk communication processes concerning atmospheric pollution and health effects in Modena, Reggio Emilia and Bologna, are described from the public health service point of view. The description includes the chronological developments, the principal events which influenced, or have been influenced by these risk communication processes, their most significant and critical aspects. Finally the air quality evaluation and its impact on risk communication is discussed.

The authors discuss problems associated with indoor atmospheric pollution including a large number of pollutants coming partly from outdoors and produced partly by internal sources. Passive tobacco smoke, radon decay products, carbon monoxide, nitrogen dioxide, formaldehyde, asbestos fibers, microorganisms and allergens are the most important contaminants. Health risks associated with indoor air pollution require an overall strategy to control sources, dilute indoor contaminants and promulgate specific regulations.

The strategy involves an initial phase during which environment characteristics, substances used, apparatus involved and working procedures are investigated. Such information is used to define areas to be monitored, periods of sampling and number of measurements to be performed. The adopted procedure takes into account the results obtained on an interaction basis. The scheme makes use of a decisional criterion based on the one sided tolerance limit (OTL) test in order to estimate risk evaluation trends. Each decision is based on a simultaneous control action on ambient and on men. The procedure minimizes the number of measurements, makes effective use of technical and human resources, reduces decisional errors in establishing engineering techniques and can be readily applied to different situations.

The area around Rho and Pero in the north west of the province of Milan is densely populated and highly industrialised. It is also characterised by high levels of sulphur dioxide pollution. During the 1980s it was decided to check the sources of production of the pollutant and its distribution in the area. The main area for improvement was the refinery at Rho where it was aimed to disperse gases at a higher level by raising the chimneys and to use fuel gas in those burners which were connected to lower chimneys. For domestic systems it was decided to diffuse the use of methane as much as possible and limit oil-fired central heating, by statute from the Mayor. In order to rationalise the programme of action the pollution was to be determined for each single area by subdivision of the territory into a grid. By means of a census of all the production sources of sulphur dioxide appropriate data were collected to estimate each area's contribution to pollution. The theoretical hourly quantity of sulphur dioxide was calculated on the basis of the combustion equation. The data were then analysed, in total and divided into component parts, i.e. the type of fuel used, the season of the year and industrial or domestic usage. With Gifford and Hanna's ATDL mathematical model the data thus obtained, together with meteorological variables, were used to simulate the expected effect on the distribution of pollution after carrying out the programmed actions. The simulations foresee a reduction of up to 80% of sulphur dioxide concentrations in the areas of greatest use of liquid fuels. In the territory in question the monitoring of the pollutant was assured by the presence of five fixed positions of continuous survey. These turned out to be useful above all for analysis of the phenomenon over a period of time. In order to study spatial distribution better 374 findings were gathered in the winter of 1985-6 from various points of the territory by means of a mobile instantaneous detector. From these data the average aerial concentration was calculated on a grid, with sides of 500 metres, first for all the observations and then separately for the direction of the wind. Taking into account meteorological factors and the actual hour (during daytime) when the concentration of the pollutant was recorded, it was possible to estimate concentrations by means of linear models in which meteorological parameters were taken as independent variables.(ABSTRACT TRUNCATED AT 400 WORDS)

A modified Ayre T system for the elimination of anaesthetic gas and vapour pollution from operating theatres is described.

Following a rapid review of equipment available for the depolluting of operating theatres, new equipment which does not interfere with anaesthesia circuit pressures is presented; experimental data obtained during use of this equipment are also reported and compared with standard data.

The biometeorological factors underlying atmospheric pollution are discussed, together with its biological effects and its direct and indirect damage to human health. Damage is particularly likely when particularly adverse ambient and climatological conditions result in a massive and persistent concentration of contaminants in the ambient air. In this case, since the highly biologically interesting phenomenon of physicochemical reaction between pollutants and atmospheric components prevails over that of the dilution and dispersion of such contaminants, nature's major processes of removal and self-purification may be rendered nugatory and insufficiently prompt. The effects of atmospheric pollution, primarily with respect to urban background pollution, on human health make their appearance in the respiratory system, where there is a continuous relation between man and his environment throughout his life, in the form of immediate or short, medium and long-term damage. The desirability of preparing a meteorological map showing the distribution of the risk of atmospheric pollution is discussed. For this purpose, use could be made of meteorological data, and the hi-tech observations now made possible, inter alia, by the employment of satellites and aerospace data. A map of this kind would give more precise information concerning the part played by the weather in distributing the risk of respiratory damage caused by environmental pollution. It would also provide the knowledge required for the purpose of prediction and prevention in an organised struggle against such pollution. This would be of great social significance and value. Its practical applications could be enormous consequence to humanity.

Indoor atmospheric pollution includes a lot of pollutants coming partly from outdoors and produced partly by internal sources. Concerns about potential public health problems are based on evidence that urban residents typically spend more than 90 percent of their time indoors and concentrations of some contaminants are higher indoors than outdoors. Adverse effects of indoor air pollution are obviously dependent on the type of pollutant; among the more important indoor contaminants are passive tobacco smoke, radon decay products, carbon monoxide, nitrogen dioxide, formaldehyde, asbestos fibers, microorganisms and allergens. Efforts to assess health risks associated with indoor air pollution are limited by insufficient information about the number of people exposed, the pattern and severity of exposures and the health consequences of exposures. An overall strategy should be developed to control sources, dilute indoor contaminants and promulgate specific regulations.

Several surveys of ethrane pollution were made by the authors in operating rooms, either equipped or not with general ventilation systems, during operations where non-rebreathing anaesthesia devices were used. In operating rooms without general ventilation systems, but with simple air conditioning systems, ethrane pollution was found to be rather high and to attain 30-40 ppm at the fourth hour of operation. No statistically significant differences were elicited among levels found at the anaesthetist, surgeon and assistance personnel sites. The authors analyze the kinetics of ethrane pollution as a function of its consumption and of time and discuss the most suitable means for decreasig and preventing such pollution.

Post-operative infection is one of the main risks attached to surgery, especially when synthetic materials or artificial prostheses are employed. The fundamental principles of laminar flow apparatuses are described, with particular reference to one employing a horizontal flow and fluid bulkheads. During the first two years of its use, this particular apparatus has reduced cases of infection from prostheses in vascular surgery from 5.5 to 1.8%.

Mathematical calculations were employed in an assessment of the resistances associated with a passive outward conveyance system for the removal of anesthetic gases and fumes from operating theatres. It was found that the magnitude of such resistances was not enough to interfere with the patient's respiratory dynamics.