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Tobacco smoking is the most important and well-established bladder cancer risk factor and a rich source of chemical carcinogens and reactive oxygen species that can induce damage to DNA in urothelial cells. Therefore, common variation in DNA repair genes might modify bladder cancer risk. In this study, we present results from meta-analyses and pooled analyses conducted as part of the International Consortium of Bladder Cancer. We included data on 10 single nucleotide polymorphisms corresponding to seven DNA repair genes from 13 studies. Pooled analyses and meta-analyses included 5,282 cases and 5,954 controls of non-Latino white origin. We found evidence for weak but consistent associations with ERCC2 D312N [rs1799793; per-allele odds ratio (OR), 1.10; 95% confidence interval (95% CI), 1.01–1.19; P = 0.021], NBN E185Q (rs1805794; per-allele OR, 1.09; 95% CI, 1.01–1.18; P = 0.028), and XPC A499V (rs2228000; per-allele OR, 1.10; 95% CI, 1.00–1.21; P = 0.044). The association with NBN E185Q was limited to ever smokers (interaction P = 0.002) and was strongest for the highest levels of smoking dose and smoking duration. Overall, our study provides the strongest evidence to date for a role of common variants in DNA repair genes in bladder carcinogenesis. [Cancer Res 2009;69(17):6857–64]

Supplementary Tables 1-8 from Polymorphisms in DNA Repair Genes, Smoking, and Bladder Cancer Risk: Findings from the International Consortium of Bladder Cancer

Supplementary Figure Legend from Polymorphisms in DNA Repair Genes, Smoking, and Bladder Cancer Risk: Findings from the International Consortium of Bladder Cancer

Supplementary Figure 1 from Polymorphisms in DNA Repair Genes, Smoking, and Bladder Cancer Risk: Findings from the International Consortium of Bladder Cancer

Social isolation strongly affects our emotions, behavior and interactions. Worldwide, individuals experienced prolonged periods of isolation during the first wave of the COVID-19 pandemic when authorities imposed restrictions to reduce the spread of the virus. In this study, we investigated the effects of social isolation on emotional and behavioral outcomes in young adults from Lombardy, Italy, a global hotspot of COVID-19. We leverage baseline (pre-social isolation) and follow-up (mid-or post isolation) data collected from young adults enrolled in the ongoing, longitudinal Public Health Impact of Metals Exposure (PHIME) study. At baseline, 167 participants completed the ASEBA questionnaires (ASR/YSR) by weblink or in person; 65 completed the ASR between 12-18 weeks after the onset of restrictions. Using the sign test and multiple linear regression models, we examined differences in ASR scores between baseline and follow-up adjusting for sex, age, pre-pandemic IQ (Kaufman Brief Intelligence Tests; K-BIT 2), and time with social restrictions (weeks). Further, we examined interactions between sex and time in social isolation. Participants completed the ASR after spending an average of 14 weeks in social isolation (range 12-18 weeks). Thought Problems increased between baseline and follow-up (median difference 1.0; 1st., 3rdquartile: -1.0, 4.0; p=0.049). Among males, a longer time with social isolation (≥ 14 weeks) was associated with increased rule-breaking behaviors of 2.8 points. These results suggest the social isolation related to COVID-19 adversely impacted mental health. In particular, males seem to externalize their condition. These findings might help future interventions and treatment to minimize the consequences of social isolation experience in young adults.

Introduzione. La tubercolosi (TB) rappresenta ancora oggi un problema di salute pubblica a livello globale. Sebbene l’incidenza mostri ampie differenze geografiche, la TB rappresenta una delle più importanti cause di morte e quella principale da singolo agente infettivo (3). Si stima che un terzo della popolazione mondiale risulti infettata in forma latente da ceppi di Mycobacterium tuberculosis. L’infezione tubercolare latente (ITBL) e la TB costituiscono ancora oggi, un rischio professionale per gli operatori sanitari e soggetti a questi equiparati, quali studenti che svolgono attività formativa professionalizzante in ambito assistenziale. La maggior parte dei casi di malattia attiva di origine occupazionale negli operatori sanitari si verifica quando il rischio di ITBL è sottostimato e i programmi di sorveglianza e controllo della TB risultano deficitari (1). Obiettivi. Il presente studio multicentrico italiano ha l’obiettivo di valutare la prevalenza dell’ITBL e identificare i fattori di rischio associati medici in formazione e in studenti di area sanitaria sottoposti a sorveglianza dell’ITBL presso diversi Ospedali universitari italiani. Metodi. Nel periodo gennaio 2016 - dicembre 2020, un campione di n=12.725 studenti è stato inserito in programmi di sorveglianza dell’ITBL nei Centri clinici di Bologna, Brescia, Genova, Napoli (L. Vanvitelli), Palermo e Sassari. Tali programmi prevedevano l’utilizzo del TST come esame di primo livello, come raccomandato dal Ministero della Salute e, in caso di positività, di un test di conferma basato sull’Interferon-gamma release assay (IGRA). Il TST basale è definito come positivo con un diametro d’indurimento cutaneo ≥10 mm (2). I soggetti positivi ai test diagnostici in assenza di segni e sintomi clinici di TB attiva sono stati considerati come soggetti con ITBL. I soggetti con ITBL sono stati sottoposti a radiografia del torace e a consulenza specialistica di II livello. Risultati e Conclusioni. La preliminare analisi dei dati, attualmente in progress, ha rilevato una prevalenza di cutipositività al TST del 1.8% nella popolazione dello studio, con una diagnosi di ITBL confermata con IGRA pari allo 0.4%. La popolazione arruolata era formata per la maggior parte da soggetti di sesso femminile (60.6%) con un’età media di 23 anni, mentre solo il 2.1% aveva effettuato la vaccinazione antitubercolare (BCG). I risultati dell’indagine dimostrano una bassa prevalenza dell’ITBL nella popolazione in studio e confermano quanto osservato in analoghi studi per quanto riguarda le condizioni e i fattori associati all’infezione. Programmi di sorveglianza e trattamento dei casi di ITBL in operatori sanitari e soggetti equiparati hanno lo scopo di minimizzare il rischio di trasmissione nosocomiale del micobatterio, rappresentando strumenti fondamentali per il controllo della TB particolarmente in Paesi a bassa incidenza, quali l'Italia

Environmental exposures to agrochemicals and nutritional factors may be associated with Parkinson’s Disease (PD). None of the studies to date has examined the combined effects of diet and agricultural chemical exposure together. To address these research gaps, we aimed to assess the association of nutritional factors and agrochemical exposure with the risk of PD. A hospital-based case-control study was conducted. Multivariable logistic regressions were used to estimate the association of nutritional and agrochemical exposures with PD, adjusting for gender, age, socio-economic status, head injury, family history, smoking, metals exposure, and α-synuclein gene polymorphism. Weighted Quantile Sum (WQS) regression was applied to examine the effect of dietary components as a mixture. We recruited 347 cases and 389 controls. Parent history of PD (OR = 4.15, 95%CI: 2.10, 8.20), metals exposure (OR = 2.50, 95%CI: 1.61–3.89), SNCA rs356219 polymorphism (OR = 1.39, 95%CI: 1.04–1.87 for TC vs. TT; OR = 2.17, 95%CI: 1.43–3.28 for CC vs. TT), agrochemical exposures (OR = 2.11, 95%CI: 1.41–3.16), and being born in the Brescia province (OR = 1.83, 95%CI: 1.17–2.90) were significantly associated with PD. Conversely, fish intake and coffee consumption had a protective effect. The study confirmed the role of environmental exposures in the genesis of PD. Fish intake and coffee consumption are protective factors even when agricultural chemical exposures exist. Genetic factors and metals exposure were confirmed as risk factors for PD.

During the first wave of COVID-19 pandemic, the most affected area in Italy was the southeast part of the Lombardy region. The University of Brescia is one of the largest in Northern Italy. The aim of this study is to investigate the psychological and somatic symptoms driven by lifestyle changes due to the lockdown among the students of the University of Brescia.15261 University students were enrolled through institutional email;14302 were Master's and Bachelor's Degreestudents,724 were Residents and 235 doctorates.3553 students (23.28% of total),aged on average 22 years, completed the survey. Physical health, dietary and sleep habits, physical activities, economic and social issues were investigated through an anonymous, online ad hoc form, available until July 2020 and approved by the local Ethic Committee. Five psychosomatic outcomes were assessed: digestive disorders, headache, panic-anxiety crises, depression-sadness, fear od COVID-19.Factor analysis was applied to reduce the number of variables while logistic and ordinal logistic regression models were used to test the association between the latent variables and each outcome. Female gender, medium-intensive use of telephone, worsening of sleep quality, mnemonic difficulties and performance reduction were associated with all the outcomes. Low physical activity, increased time spent watching television and the worsening of dietary habits represented a significant risk factor for at least three of the outcomes. Despite the relatively low compliance, the survey clearly identified few priorities of intervention to prevent psychological and somatic effects of pandemic in the next future: circadian rhythm, nutritional habits, physical activity, use of media, gender issues. The results of this study show the psychosomatic effects of social isolation and the pandemic on a population at risk of young adults and can promote interventions to minimize the occurrence of psychosomatic consequences on young adults. Key messages Analysis of the main risk and protection factors in a population of young adults in the development of psycho-physical symptoms during the period of isolation due to the covid-19 pandemic. Support the need to implement public health services also to reduce health costs with possible methods of intervention, in harmony with the findings.

Social isolation affects our emotions, behavior and interactions. Worldwide, individuals experienced prolonged periods of isolation during the first wave of the COVID-19 pandemic when authorities-imposed restrictions to reduce the spread of the virus. In this study, we investigated the effects of social isolation on emotional and behavioral outcomes in young adults from Lombardy, Italy, a global hotspot of COVID-19. We leveraged baseline (pre-social isolation) and follow-up (mid- or post-isolation) data collected from young adults enrolled in the ongoing, longitudinal Public Health Impact of Metals Exposure (PHIME) study. At baseline, 167 participants completed the ASEBA questionnaires (ASR/YSR) by web link or in person; 65 completed the ASR 12–18 weeks after the onset of restrictions. Using the sign test and multiple linear regression models, we examined differences in ASR scores between baseline and follow-up adjusting for sex, age, pre-pandemic IQ and time with social restrictions (weeks). Further, we examined interactions between sex and time in social isolation. Participants completed the ASR after spending an average of 14 weeks in social isolation (range 12–18 weeks). Thought problems increased between baseline and follow-up (median difference 1.0; 1st, 3rd quartile: −1.0, 4.0; p = 0.049). Among males, a longer time in social isolation (≥14 weeks) was associated with increased rule-breaking behaviors of 2.8 points. These results suggest the social isolation related to COVID-19 adversely impacted mental health. In particular, males seem to externalize their condition. These findings might help future interventions and treatment to minimize the consequences of social isolation experience in young adults.

BACKGROUND AND AIM: Exposure to neurotoxic metals occurs as a mixture, yet most studies consider single exposures, potentially missing the combined effects of environmental metals. Further, health ...

In this study, we investigated the symptoms of physical and mental health associated with lifestyle changes due to a lockdown among the students of a university in Northern Italy, one of the most affected areas in Europe during the first wave of COVID-19. We examined the psychopathological variations in relation to mental health problems in a young population. The goal was to develop interventions to resolve these new psychosocial problems. From June to July 2020, students participated in an anonymous survey asking about habits and symptoms that emerged during the lockdown and the COVID-19 pandemic. Five health outcomes were assessed: digestive disorders; headaches; fear of COVID-19; panic and anxiety crises; and depression/sadness. The conditions and duration of the social isolation, lifestyle, SARS-CoV-2 infection in the household, financial situation, and productivity were considered in the analysis. A total of 3533 students completed the survey. The participants experienced headaches, depression and sadness, digestive disorders, a fear of COVID-19, and anxiety/panic crises. The duration of isolation was associated with an increased risk of digestive disorders, headaches, and COVID-19 fear. The female gender, medium–intense telephone usage, sleep quality, memory difficulties, and performance reduction were associated with an increased risk of the health outcomes. Future interventions should focus on promoting and implementing different habits with the support of health and university organizations.

Introduction Understanding the neurodevelopmental effects of manganese (Mn) is complicated due to its essentiality for growth and development. While evidence exists for the harmful effects of excess Mn, pediatric epidemiologic studies have observed inconsistent associations between Mn and child cognition. Objective We sought to estimate prospective associations between Mn measured in three different early-life time windows with adolescent cognition using deciduous teeth biomarkers. Methods Deciduous teeth were collected from 195 participants (ages 10–14 years) of the Public Health Impact of Manganese Exposure (PHIME) study in Brescia, Italy. Measurements of tooth Mn represented prenatal (∼14 weeks gestation – birth), early postnatal (birth – 1.5 years) and childhood (∼1.5 – 6 years) time windows. Neuropsychologists administered the Wechsler Intelligence Scale for Children, 3rd edition (WISC-III), to obtain composite IQ and subtest scores. Associations between tooth Mn at each time window and adolescent WISC-III scores were estimated using multivariable linear regression. We tested differences in associations between Mn and outcomes across time windows using multiple informant models. Sex-specific associations were explored in stratified models. Results Adjusted associations between tooth Mn and composite IQ scores were positive in the prenatal period and negative in the childhood period. Associations were strongest for subtest scores that reflect working memory, problem solving, visuospatial ability and attention: prenatal Mn was positively associated with Digits backward [SD change in score per interquartile range increase in Mn: β = 0.20 (95 % CI: 0.02, 0.38)] and Block design [β = 0.21 (0.01, 0.41)] and early postnatal Mn was positively associated with Digits forward [β = 0.24 (0.09, 0.40)], while childhood Mn was negatively associated with Coding [β = -0.14 (-0.28, -0.001)]. Sex-stratified analyses suggested different Mn-cognition associations for boys and girls and was also dependent on the time window of exposure. Conclusion Our results suggest that exposure timing is critical when evaluating Mn associations between Mn and cognition. Higher prenatal Mn was beneficial for adolescent cognition; however, these beneficial associations shifted towards harmful effects in later time windows. Cognitive domains most sensitive to Mn across time windows included visuospatial ability, working memory, attention and problem-solving.

This paper highlights advantages and drawbacks due to the use of portable and low-cost devices for aerosol sampling, showing their performances during an aerosol monitoring campaign with the parallel use of the gravimetric sampling reference method and a cascade impactor. A specific monitoring campaign was held running all instruments in parallel in indoor, confined, and outdoor environments characterized by local emission sources or particulate matter background concentrations. PM2.5 concentrations were used to compare data emerging from the different instruments adopted. Significant underestimation of PM2.5 emerged when comparing data coming from optical sensors with those estimated by the cascade impactor, whose data resulted in being coherent with gravimetric determination, integrated over the same sampling time. A cause–effect relationship between PM2.5 concentrations and specific emission sources was found when observing the daily patterns of all the real-time sampling devices. It emerged that optical devices are useful for detecting concentration trends, the presence of peak values, or changes in the background value, even if with limited accuracy and precision. The comparison with particle size distributions obtained by the cascade impactor data allowed us to define which particle sizes are not detected by different optical devices, evidencing a low representativeness of optical low-cost sensors for health exposure measurements. The correlations among the specific particle size fractions detected by the cascade impactor and their specific emission sources were particularly high for car emissions in a semi-confined garage area.

Neurodevelopmental disorders are constantly increasing on a global scale. Some elements like heavy metals are known to be neurotoxic. In this cross-sectional study we assessed the neurobehavioral effect of the exposure to trace elements including lead, mercury, cadmium, manganese, arsenic and selenium and their interactions among 299 schoolchildren residing in the heavily polluted Taranto area in Italy. Whole blood, urine and hair were collected for metal analyses, while the Child Behavior Checklist and the Social Responsiveness Scale, administered to the main teacher and the mothers were considered to identify behavioral problems in children. Blood lead mainly influenced social problems, aggressive behavior, externalizing and total problems. Urinary arsenic showed an impact on anxiety and depression, somatic problems, attention problems and rule breaking behavior. A significant interaction between lead and arsenic was observed, with a synergistic effect of the two metals increasing the risk of attention problems, aggressive behavior, externalizing problems and total problems. Overall, we were able to test that higher blood lead, urinary arsenic concentrations and their interaction increase the risk of neurobehavioral problems. This is in line with the U.S. Environmental Protection Agency’s priority list of hazardous substances where arsenic and lead are ranked as first and second respectively.

Background/Aim: We developed multi-media biomarkers (MMBs) that integrate information across chemical exposure estimates when multiple biomarker media are used. Since each chemical has unique toxic...

The predisposition, severity, and progression of many diseases differ between males and females. Sex-related differences in susceptibility to neurotoxicant exposures may provide insight into the cause of the observed discrepancy. Early adolescence, a period of substantial structural and functional brain changes, may present a critical window of vulnerability to environmental exposures. This study aimed to examine sex-specific associations between co-exposure to multiple metals and visuospatial memory in early adolescence. Manganese (Mn), lead (Pb), chromium (Cr), and copper (Cu) were measured in blood, urine, hair, nails, and saliva of 188 participants (88 girls; 10–14 years of age). Visuospatial memory skills were assessed using a computerized maze task, the virtual radial arm maze (VRAM). Using generalized weighted quantile sum regression, we investigated sex-specific associations between the combined effect of exposure to the metal mixture and visuospatial working memory and determined the contribution of each component to the outcome. The results suggest that sex moderates the association between the metal mixture and visuospatial learning for all outcomes measured. In girls, exposure was associated with slower visuospatial learning and driven by Mn and Cu. In boys, exposure was associated with faster visuospatial learning, and driven by Cr. These results suggest that (a) the effect of metal co-exposure on learning differs in magnitude, and in the direction between sexes, and (b) early adolescence may be a sensitive developmental period for metal exposure.

Background: Research on the health effects of chemical mixtures has focused mainly on early life rather than adolescence, a potentially important developmental life stage. Objectives: We examined associations of a metal mixture with general cognition in a cross-sectional study of adolescents residing near ferromanganese industry, a source of airborne metals emissions. Methods: We measured manganese (Mn), lead (Pb), copper (Cu), and chromium (Cr) in hair, blood, urine, nails, and saliva from 635 Italian adolescents 10–14 years of age. Full-scale, verbal, and performance intelligence quotient (FSIQ, VIQ, PIQ) scores were assessed using the Wechsler Intelligence Scale for Children-III. Multivariable linear regression and Bayesian kernel machine regression (BKMR) were used to estimate associations of the metal mixture with IQ. In secondary analyses, we used BKMR’s hierarchical variable selection option to inform biomarker selection for Mn, Cu, and Cr. Results: Median metal concentrations were as follows: hair Mn, 0.08μg/g; hair Cu, 9.6μg/g; hair Cr, 0.05μg/g; and blood Pb, 1.3μg/dL. Adjusted models revealed an inverted U-shaped association between hair Cu and VIQ, consistent with Cu as an essential nutrient that is neurotoxic in excess. At low levels of hair Cu (10th percentile, 5.4μg/g), higher concentrations (90th percentiles) of the mixture of Mn, Pb, and Cr (0.3μg/g, 2.6μg/dL, and 0.1μg/g, respectively) were associated with a 2.9 (95% CI: −5.2, −0.5)–point decrease in VIQ score, compared with median concentrations of the mixture. There was suggestive evidence of interaction between Mn and Cu. In secondary analyses, saliva Mn, hair Cu, and saliva Cr were selected as the biomarkers most strongly associated with VIQ score. Discussion: Higher adolescent levels of Mn, Pb, and Cr were associated with lower IQ scores, especially at low Cu levels. Findings also support further investigation into Cu as both beneficial and toxic for neurobehavioral outcomes. https://doi.org/10.1289/EHP6803

Although family life stress adversely impacts child health, few tools measure its relationship to child outcomes in the setting of maternal variables. This study validates the Italian version of Crisis in Family Systems-Revised (CRISYS-R) and characterizes relationships between family life stress, maternal depression and child behavior in two Italian cities. This cross-sectional study was nested in current research on health impacts of neurotoxic environmental exposures in children. 101 mother-child pairs (child age=9.91±2.17yrs; 53% female) and children's teachers were enrolled in Taranto (south Italy) and Brescia (north Italy). Mothers performed the Italian CRISYS-R and PHQ9; teachers completed Child Behavior Checklist (CBCL/6-18). Spearman's rank correlation coefficients showed associations of family CRISYS-R, maternal PHQ9 and child CBCL/6-18. Wilcoxon Rank-Sum test compared groups of continuous variables. Mothers with depressive symptoms (PHQ9≥5) reported higher ongoing stress and proportion of negative stressors on CRISYS-R than non-depressed mothers (p This study describes links among maternal depression, family life stress, and child behavioral health. It is first to validate Italian CRISYS-R and to explore these factors conjointly in Italian contexts with known neurotoxic exposures. Findings support considering maternal depression and family life stress in child behavioral and environmental health research and policy. Key messages Family life stress, maternal depressive symptoms, and preadolescent behavioral health were highly interrelated in two industrialized Italian cities. The Italian version of CRISYS-R is a useful instrument for assessing and understanding family life stress, a crucial yet under-explored contributor to child behavioral health outcomes.

Elevated exposure to manganese (Mn) in environmental dusts and airborne particulates, particular from ferromanganese alloy steel production and metal working, is associated with a number of negative health outcomes, including Parkinsonism and other nervous system diseases. Manganese contamination and exposure from industrial sources is difficult to identify or quantify, as manganese is naturally abundant in the environment, and means to distinctly identify or fingerprint Mn arising from different industrial and environmental sources are limited. Here, the chemical and mineralogical properties of Mn in dusts from an active steel production facility in Taranto, Italy, were compared with those of indoor and outdoor deposited dust samples and surface soils collected in a series of schools in the nearby town. X-ray absorption spectroscopy revealed distinct chemical forms of Mn in industrial sources from those in typical background soils. Manganese ore from the facility contained abundant Mn(III, IV) oxides, while Mn-substituted magnetites were the most abundant mineral phase in dusts found in areas of the plant where metal was produced or combustion occurred. All school dusts were primarily composed of Mn-substituted magnetites, while most of the soils contained abundant manganese(IV) oxides. Source apportionment of Mn in regional dust and soil samples was estimated using linear combination fitting with representative industrial source materials. Manganese in dusts from the Taranto area community adjacent to the plant was derived primarily from industrially-sourced dusts produced during high temperature coke or steel production rather than re-suspended local soils or ore source material. Soils contained smaller proportion of industrially-derived Mn and are distinct from dusts, indicating that soil is a minor contributor of dust Mn in this area. Key messages Manganese speciation gives useful information in investigating Mn toxicology to humans in urban areas. Manganese-substituted magnetites may represent the target compound useful to distinguish toxic and non-toxic Mn-containing elements.

Evidence suggests that environmental exposures and socioeconomic factors may interact to produce metabolic changes in children. We assessed the influence of residential location and socioeconomic status (SES) on pediatric body mass index (BMI) Z-score and fasting blood glucose (FBG) concentration. Participants included 214 children aged 6&ndash, 11 years who live near a large industrial complex in Taranto, Italy. Participants were grouped into residential zones based on the distance between their home address and the complex periphery (Zone 1: 0.000&ndash, 4.999 km, Zone 2: 5.000&ndash, 9.999 km, Zone 3: 10.000&ndash, 15.000 km). BMI Z-scores were calculated via World Health Organization (WHO) pediatric reference curves. FBG was obtained via venous blood sampling. Closer residential location to the industrial complex on the order of 5.000 km was significantly associated with worsened metabolic outcomes, particularly in female children. Zone 1 participants had higher BMI-adjusted FBG than Zone 2 and 3 participants (p &lt, 0.05 versus Zone 2, p &lt, 0.01 versus Zone 3). SES did not significantly influence BMI-adjusted FBG. Moreover, BMI Z-scores indicated high rates of overweight (22.0%) and obesity (22.9%) in the cohort. BMI Z-score was not significantly associated with SES or residential zone but was negatively associated with maternal education level (p &lt, 0.05). These results offer new evidence that residing near industrial activity may predict adverse effects on child metabolic health.

Lombardy, the most populated and industrialized Italian region, was the epicentre of the first wave (March and April 2020) of COVID-19 in Italy and it is among the most air polluted areas of Europe. We carried out an ecological study to assess the association between long-term exposure to particulate matter (PM) and nitrogen dioxide (NO2) on COVID-19 incidence and all-cause mortality after accounting for demographic, socioeconomic and meteorological variables. The study was based on publicly available data. Multivariable negative binomial mixed regression models were fitted, and results were reported in terms of incidence rate ratios (IRRs) and standardized mortality ratios (SMR). The effect of winter temperature and humidity was modelled through restricted cubic spline. Data from 1439 municipalities out of 1507 (95%) were included in the analyses, leading to a total of 61,377 COVID-19 cases and 40,401 deaths from all-causes collected from February 20th to April 16th and from March 1st to April 30th, 2020, respectively. Several demographic and socioeconomic variables resulted significantly associated with COVID-19 incidence and all-cause mortality in a multivariable fashion. An increase in average winter temperature was associated with a nonlinear decrease in COVID-19 incidence and all-cause mortality, while an opposite trend emerged for the absolute humidity. An increase of 10 μg/m3 in the mean annual concentrations of PM2.5 and PM10 over the previous years was associated with a 58% and 34% increase in COVID-19 incidence rate, respectively. Similarly, a 10 μg/m3 increase of annual mean PM2.5 concentration was associated with a 23% increase in all-cause mortality. An inverse association was found between NO2 levels and COVID-19 incidence and all-cause mortality. Our ecological study showed that exposure to PM was significantly associated with the COVID-19 incidence and excess mortality during the first wave of the outbreak in Lombardy, Italy., Highlights • Lombardy is an industrialized region with one of the worst air quality in Europe. • Lombardy was the epicentre of the first wave of COVID-19 pandemic in Italy. • Long-term exposure to PM was associated with COVID-19 incidence and mortality. • Meteorological variables were associated with COVID-19 incidence and mortality. • Socioeconomic variables were associated with COVID-19 incidence and mortality.

This work reports on qualitative and semi-quantitative elemental analysis of particulate matter (PM) collected on PTFE membrane filters, for a source apportionment study conducted in Brescia (Italy). Sampling was undertaken in a residential area where an increase in Mn emissions has been highlighted by previous studies. Filters are measured by means of X-ray Fluorescence (XRF) based techniques such as micro-XRF and grazing incidence XRF using synchrotron radiation, Mo or W excitation sources, after applying an automatized sample preparation method. A heterogeneous distribution in PM shape, size and composition was observed, with features typical of anthropogenic sources. XRF measurements performed at various incidence angle, on large areas and different experimental setup were reproducible. The results demonstrate a successful comparison of the various XRF instrumentation, and the decrease in Mn content with the distance away from the identified emission source. This work highlights the potentialities of the presented approach to provide a full quantitative analysis, and ascertain its suitability for providing a direct, fast, simple and sensitive elemental analysis of filters in source apportionment studies and screening purposes.

Asbestos exposure is still relevant across the world and increases the risk of malignant mesothelioma through known and less known occupational exposure, as well as nonoccupational exposure. Cumulative exposure increases the risk of mesothelioma even at low doses of less than 0.1 (fiber/mL) years. Therefore, current legal standards are not protective for prolonged exposure and incremental exposure at any concentration can increase the risk of the disease. Individuals with previous exposure should not be further exposed even at “low” levels to avoid increased risk. Even after 40–50 years after the exposure, the risk of mesothelioma increases and it is not clear whether it may reduce afterwards.