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Benedetto Terracini

Publications and source records attributed to Benedetto Terracini.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

Meta-analysis of the Italian studies of short-term effects of air pollution (MISA), 1990-1999.

A meta-analysis of short-term effects of air pollution on health in eight Italian cities from 1990 to 1999 is presented. Death certificates and hospital admission data as well as daily concentrations of pollutants were collected. The same generalized linear model adjusted for age, day of the week, holidays, influenza epidemics, meteorological variables, and seasonality pattern was fitted to the city data. City-specific model selection was not done. In the meta-analysis, for each outcome, the city-specific estimates for each pollutant were combined using fixed and random-effects models. Hierarchical Bayesian models were use to investigate the effects of PM10 in detail. Each pollutant (SO2, NO2, CO, PM10, O3) was significantly associated with mortality for natural causes. The effect of PM10 on mortality was greater during the warm season and for elderly. A north-south gradient in risk was observed for total natural mortality. The excess risks on hospital admission were modified by deprivation score and by the NO2/PM10 ratio. Results add evidence for an association between air pollution and early mortality or morbidity and support the hypothesis of a synergism between meteorological variables and air pollution.

Adolescent↗
PubMedDate not supplied

Industrial activities in sites at high environmental risk and their impact on the health of the population.

A second mortality analysis of 15 areas of Italy identified in 1986 by the Italian Ministry of Environment as areas at high risk of environmental crisis has confirmed and extended the findings of the first. In regional comparisons, these areas, in which potentially hazardous industries are located, show excesses of deaths from almost all cancers and other diseases, particularly among men. Although more information is needed to identify corrective public health measures, the official recognition of areas in need of cleaning up, which appears to be unique to Italy and which fostered the study, is a promising beginning.

Data Collection↗
PubMedDate not supplied

FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe.

The Finnish Institute of Occupational Health (FIOH) has received support from the World Health Organization (WHO) and the International Labor Office (ILO) to publish the African Newsletter on Occupational Health and Safety. The African Newsletter on Occupational Health and Safety should not be a medium for industry propaganda, or the source of misinformation among the workers of Africa. Instead, FIOH should provide the same level of scientific information in Africa that it does in Finland and other developed countries.

Asbestos↗
PubMedDate not supplied

[Environment and health status of the population in areas with high risk of environmental crisis in Italy].

The Italian Ministry of Environment identified 15 areas throughout the country as at "high risk of environmental crisis". The areas host industrial activities that may entail noxious exposures, through occupation and the environment. An epidemiological descriptive study on the residents was carried out using routinely collected mortality data. Mortality data for the period 1981-1994 at the level of municipality were analysed, for around 30 causes of death for both sexes. Methods for small area analysis and disease mapping were used. Rates and SMRs (also adjusted for socio-economic factors) were tabulated for residents and restricted to people born locally. The geographical distribution within areas, time trends, and birth cohort effects were also investigated. Results for some specific areas indicate excesses that can be ascribed to known exposures. The mortality of the residents of areas taken together is substantially higher than expected; significant excesses are more than can be predicted by chance. Due to the heterogenous nature of the risk factors, no common patterns of mortality were observed, but for example 50% of the SMRs for total mortality calculated in the areas, for men and women separately, were significantly greater than unity, and so were 37% of the SMRs for all cancers and 30% for lung cancer. Relative risks were in general of small magnitude, but as populations are large (the areas include some 3.5 million people) and mortality is increased for common causes, absolute numbers of excess deaths were large. These results indicate the occurrence of important risk factors, some of which are related to the industrial activities, but more detailed data are needed for the identification of corrective public health actions.

Cause of Death↗
PubMedDate not supplied

[Hospital mortality at a cardiosurgical unit in Torino: international comparisons and time trend].

OBJECTIVE: To compare hospital mortality in a cardiac surgery unit with external data and to assess changes in time (patients undergoing surgery in two different periods). MATERIALS AND METHODS: Data on risk factors for hospital mortality were collected from clinical records (retrospectively for the first period and prospectively for the second) for all patients undergoing open heart surgery at the Heart Surgery Unit of the University of Turin (Italy) during 1991 and 1995 (n = 1794) and 1999 (n = 892). Comparisons of in-hospital mortality, expressed as Standardized Mortality Ratios (SMR), were adjusted for risk factors defined according to EuroSCORE (European System for Cardiac Operative Risk Evaluation). RESULTS: In the first and second period, complete information on all the 17 EuroSCORE items was available for 58.3% and 89.6% patients respectively. After exclusion of patients with one or more missing data, observed and expected numbers of death were found to be very similar, with SMRs ranging between 0.82 (isolated bypass in the second period) and 1.06 ("other" surgery in the first period). Mortality was higher among patients with missing data, but at least in 1999 the latter had a limited impact on the overall estimates. Compared to the first period, mortality was reduced during 1999 (from 5.9% to 5.4%), in particular for isolated bypass (from 4.4% to 3.4%). CONCLUSIONS: In the unit under investigation, hospital mortality following heart surgery was similar to that predicted from EuroSCORE and seemed to be lower in 1999 than in 1991-95, particularly for isolated bypass. Incompleteness of data on individual risk factors may have been a source of bias, especially when data were collected retrospectively.

Adolescent↗
PubMedDate not supplied

[Meta-analysis of the Italian studies on short-term effects of air pollution--MISA 1996-2002].

INTRODUCTION: the Italian Meta-analysis of short-term effects of air pollution for the period 1996-2002 (MISA-2) is a planned study on 15 Italian cities, among the larger country towns summing up 9 millions and one hundred thousand inhabitants at 2001 census. HEALTH OUTCOMES DATA: mortality for all natural causes (362254 deaths), for respiratory causes (22317) and cardiovascular causes (146830), and hospital admissions for acute conditions, respiratory (278028 admissions), cardiac (455540) and cerebrovascular (60960), have been considered. Mortality data came from Regional or Local Health Unit Registries, while hospital admissions data have been selected from Regional or Hospital Archives (exclusion percentages range for all admissions between 45% and 82%). For each participating city daily series averaged about 4.3 years, with a minimum of three consecutive years. AIR POLLUTANTS DATA: daily pollutants concentration series (SO2, NO2, CO, PM10, O3) came from air quality monitoring networks of Regional Environmental Protection Agencies, of Environmental Offices of Provinces or Municipalities. Monitors' selection has been done by a working group composed by representatives of monitoring network Agencies. The selection criteria are the representativeness of general population exposure for each specific pollutant, avoiding as possible monitors close to high traffic roads; and the number, quality and location of monitors, selecting around 3-4 monitors with continuous data flow in the period (at least 75% of valid hourly data). The final series has been created averaging over monitors and imputing missing values under proportionality assumptions. Median of Pearson correlation coefficients between pairs of monitors of the each city was 0.62, interquartile range 0.42-0.77. STATISTICAL METHODS: A generalized linear model on daily counts of health events has been fitted for each city. Linear pollutant effect has been specified and bi-pollutant models have been fitted for PM10+NO2 and PMO+O3. Temperature has been modelled parametrically using a change point at 21 degrees C and lagged effects. Humidity, day of the week, national holidays and influenza epidemics (using data from the National Surveillance Programs from 1999) are the other considered confounders. An age-specific natural cubic spline on season has been specified with 5 degree of freedom (on average) per year for mortality and 7 degree of freedom per year for hospital admission data. The base model is age-stratified (0-64, 65-74, 75+ years). Gender, age, season specific models have been fitted, too. Five sensitivity analyses have been done, varying the degree of freedom for the seasonality spline and specifying non parametric functions on temperature. Constrained distributed lag models have been fitted on mortality data to study potential harvesting effects. City-specific results have been meta-analyzed by random effects hierarchical Bayesian model. Four different models have been fitted in the sensitivity analyses, assuming different priors on heterogeneity variance and outlier-resistant prior on city-specific effects. Bayesian meta-regressions have been fitted on base model, bi-pollutant and season-specific city-specific results. Attributable deaths have been estimated by Monte Carlo methods using effect, pollutant, baseline rate distributions. Fourteen different scenarios have been considered for PM10 and ten for NO2 and CO, using meta-analitic and posterior city-specific effect estimates RESULTS: Pollutants effects are reported as percent increase on mortality or hospital admissions for an increase of 10 microg/m3 of SO2, NO2 and PM10, and 1 mg/m3 of CO. We found an increase on mortality for all natural causes associated to increase of air pollutants concentration (for NO2 0.6% 95%CrI 0.3,0.9; CO 1.2% 0.6,1.7; PM10 0.31% -0.2,0.7). Similar findings were found for cardiorespiratory mortality and hospital admissions for respiratory and cardiac diseases. We found no difference by gender. There was a weak evidence of greater effect size in extreme age groups (0-24 months and over 85 years where we found a percent increase in mortality for all natural causes for PM10 of 0.39% CrI95% 0.0,0.8). There was a strong evidence for each pollutant of greater effects in the warm season (1st May-30th September) on mortality and hospital admissions (we found a percent increase in mortality for all natural causes for PM10 in the warm season of 1.95% CrI95% 0.6,3.3). The associations between pollutants concentration and health events were present at different time lags, depending on outcome and exposure. For mortality, the excess risk peaked within few days from the exposure increase (two days for PM10, up to four days for NO2 and CO). Mortality displacement was minor and ended within two weeks. Cumulative effects at fifteen days showed higher risks for respiratory diseases (PM10 1.65% CI95% 0.3,3.0). The results of meta-regressions showed associations between PM10 effects on mortality and hospital admissions, and mortality for all causes (SMR) and PM10/NO2 ratio. The effect modification of temperature was very consistent, and also using bi-pollutant models. Such effect modification was greater during the cold season. We found and overall impact on mortality for all natural causes in the period 1996-2002 between 1.4% and 4.1% of all deaths for gaseous pollutants (NO2 and CO). The estimates were more imprecise for PM10, due to the variability among cities of the effect estimates (0.1%; 3.3%). The limits stated in the European Union directives for 2010 would have been saved about 900 deaths (1.4%) for PM10 or 1400 deaths for NO2 (1.7%) among all the MISA cities, applying posterior city-specific effect estimates.

Adolescent↗
PubMedDate not supplied

[Report on health status of residents in areas with industrial, mining or military sites in Sardinia, Italy].

The work described in the present report has been requested by the Secretary of Hygiene, Health and Social Welfare of the Sardinia Region (Italy). It has been carried out by the Regional Epidemiological Observatory within the domain of ESA (Epidemiology Development and Environment) and with the support of the European Union. Eighteen areas (for a total of 73 municipalities) were identified a priori as "potentially polluted", accounting for a population of 917,977 in 2001 census (56% of the total population of Sardinia). The areas have been named after the most important town, as listed below (in brackets rounded 2001 population), major activities in industrial areas are briefly described. INDUSTRIAL AREAS: Portoscuso (59,000). Processing of aluminium and other metals. Foundry. Power plants. Dismissed mines (mainly coal mining, lead, zinc). Plants for storing and treating special wastes. Italian Law 349/1986 classified this area as "at high risk of environmental crisis" and classified some plants as being "at high technological risk" (Norma Seveso Decree 334/1999). The area is part of the Sulcis National Restoration site. San Gavino (24,000). Industrial and commercial activities. Lead and zinc foundry. Dairy factories. Food industry. Sarroch (52,000). Petrochemical and refinery industry. Power plants. Mining. Incinerator. Plants for storing and treating special wastes. Gas and mineral oil deposits. Ottana (15,000). Chemical industry. Production of plastics and synthetic fibres. Denim production. Porto Torres (168,000). Chemical industry: production of basic chemicals (benzene, toluene, ethylene, propylene and others), polyethylene, elastomers and vinyl chloride. Textile industry. First and second category landfills. Some plants have been classified "at high technological risk" (Norma Seveso Decree 334/1999). The area is a National Restoration site. The town of Sassari is included. Tortolì (23,000). Construction of steel structures for offshore facilities of the oil and gas industry. Paper industry. Tempio Pausania (21,000). Cork production. Stone quarries. Macomer (17,000). Textile industry (velvet). First and second category landfills. Incinerator. MINING AREAS: Arbus (30,000). Extraction of zinc, lead and silver. Iglesias (39,000). Extraction of zinc, lead and silver. MILITARY SITES: Teulada (16,000). La Maddalena (11,000). Naval army shipyards. Salto di Quirra (31,000). Mining area. URBAN AREAS: Cagliari (299,000). Petrochemical plants, port, airport. Nuoro (37,000). Olbia (47,000). Port and airport. Oristano (31,000). Sassari (121,000). RESULTS: THE COMPARISON SARDINIA-ITALY: In 1997-2001, the age-standardized mortality rate (x1,000 person-years) among males was higher than in Italy (84.4 vs 80.8) while the reverse occurred in females (50.9 vs 52.0). Ill defined causes of death were 1.4% in males and 2.5% in females (vs corresponding estimates of 1.1% and 1.4% in Italy). Compared to Italian national data, regional age-standardized estimates were higher in Sardinia for infectious diseases (23% in males and 12% in females), respiratory diseases (22% and 14%: pneumoconiosis was more than 6 times more frequent in Sardinia than in Italy), diseases of the digestive system (26% and 9%: for liver cirrhosis, the excess was 33% in males and 9% in females; corresponding figures for liver cancer were 13% and 16%), breast cancer in females (5%). On the other hand, regional mortality rates were lower than the national rates for cardiovascular diseases (-1.3% and -7.4% in males and females respectively), all cancers considered as a whole (-9% and -7%) and lung cancer (-5% and -32%). Regional and national death rates for non Hodgkin lymphoma in both sexes and for leukaemia in females were almost identical, whereas the latter rate in males was slightly higher in Sardinia than in Italy (9.4 vs 8.4 x100,000 person-years). Particularly in men, the differences in mortality rates from all causes and from cardiovascular, respiratory diseases and lung cancer among the four traditional Provinces (Cagliari, Nuoro, Oristano and Sassari) were greater than the difference between Sardinia and Italy. Remarkably enough, also death rates from lymphohaemopoietic tumours were more heterogeneous within Sardinia. RESULTS IN THE INVESTIGATED AREAS: Rates of hospital discharges in Sardinia showed a high variability, which is partly attributable to differences in the availability of both hospital beds and alternative forms of care. This heterogeneity must be taken into account in the interpretation of rates of hospital discharge. These were relatively high in some areas (Cagliari, Iglesias, Portoscuso, Tortolì) and low in others (Olbia, Porto Torres, Sassari). All the reported observed/expected ratios were based on material deprivation adjusted figures. All the estimated statistics were reported with 90% Confidence Interval. INDUSTRIAL AREAS: In 1997-2001, deaths from respiratory diseases were significantly in excess in males in Portoscuso (obs/exp 205/124.77) and in San Gavino (69/46.77). Deaths from pneumoconiosis were recorded sporadically, with the exception of Portoscuso, where the excess was impressive (obs/exp 112/30.46). SMRs for lung cancer in males ranged between 0.62 in Ottana and 1.22 in San Gavino, with statistically significant departure from expected values in Portoscuso and Sarroch (both with SMR significantly in excess in males: 1.24). In Porto Torres mortality from all causes was in significant excess in both sexes (SMRs 1.04 in males and 1.09 in females), for respiratory diseases (1.08 and 1.28), for diseases of the digestive system (1.13 and 1.21), for all cancers (1.04 and 1.09). Liver cancer deaths were also in excess in both sexes (SMRs 1.18 and 1.21). The latter finding is confirmed by incidence rates from the local cancer registry. Among industrial areas, Porto Torres was also the one with a stronger evidence of an excess of deaths from lymphohaemopoietic cancer in males (obs/exp 99/83.60) and females (73/68.20). MINING AREAS: These areas are characterized by statistically significant excesses of mortality in males, largely caused by non neoplastic respiratory conditions (obs/exp 119/86.41 in Iglesias and 156/62.55 in Arbus). In recent years, deaths from pneumoconiosis averaged 20 per year in Arbus and 10 per year in Iglesias. Lung cancer in males was also significantly in excess in both areas (obs/exp 72/56.38 in Arbus and 108/72.14 in Iglesias). There is a time trend (1981-2001) towards a decrease of mortality from respiratory conditions, which nevertheless remains largely in excess over the regional average also in the most recent period. MILITARY AREAS: Statistically significant excesses of deaths and hospital discharges for non Hodgkin lymphoma were detected in La Maddalena (mortality, 1981-2001, in males 17 observed cases vs 6.13 expected, in females 8/5.64). In Salto di Quirra in 1997-2001 deaths from myeloma (in males 5/2.3) and leukaemias were increased in both sexes (total obs/exp 20/13.3, statistically non significant). URBAN AREAS: Urban areas in Sardinia are relatively well developed with high values of socioeconomic indicators. The health profile in Cagliari and Sassari is typical of towns of the Western world. In Cagliari there is a higher mortality for colorectal, breast, cervical and lung cancer. CONCLUSIONS: Environmental (non occupational) pollution might explain some of the observed excesses of disease in the investigated industrial areas of Sardinia, particularly in women, less likely to be exposed to hazards in the work environment, whereas in the mining areas studied the disease pattern suggests a major role of occupational exposures. On the other hand, the causal links between disease occurrence and exposures in the screened military areas remain uncertain. The disease patterns in the cities of Sardinia are likely to be associated with lifestyle and urban pollution. Historically, southern Italian Regions have been characterized by an advantage over the rest of the country in terms of health, but during the last decade such advantage tended to vanish. Sardinia confirms this secular trend. However in the most recent years studied, overall age-standardized mortality rate in Sardinian females still remains lower than Italian average, but this is not the case for males any more. Differences in the health profile between residents in different areas of Sardinia have been found to be far greater than the difference between Sardinia as a whole and Italy. A major contribution to intraregional differences is given by the 18 investigated areas where excesses were registered for: respiratory diseases (including cancer) in the industrial areas of Portoscuso, Sarroch and Porto Torres, and in the mining areas; diseases of the digestive tract, liver cancer and lymphohaemopoietic cancer in the area of Porto Torres; cancer of the lymphohaemopoietic system in some military areas; cancers of the colon and rectum, lung, breast and uterus in some of the major cities of the Region.

Catchment Area, Health↗