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It is uncertain the Forced Expiratory Time (FET) acceptable during spirometry of young people (16-20 years old) because they are not children nor adults. We studied 235 boys and 187 girls of this age and, comparing spirometries with FET > 3 s and > 6 s, we found no significative difference (t test) between Vext, DtPEF, FVC and FEV1 repeatibility, while for wheight in males (p =0.0022) and plateau time (p < 0.00001) in males and females. We conclude that blows with FET < 6s but > 3s can be acceptable in young people when other criteria are respected.

Objective: development of an algorithm to estimate the prevalence of obstructive lung diseases (OLD) through record linkage of administrative health data sources in three Italian areas., Setting: AULSS 12 Veneziana, city of Torino, ASL10 Firenze., Participants: all residents in the three areas in the period 2002-2004 (N = 1,944,471 on 30th June 2003)., Main Outcome: crude prevalence, standardized prevalence with 95% confidence intervals., Methods: the following data sources were used to identify OLD cases: hospital discharges (HD), health-tax exemptions (HTE), death causes (DC) and drug prescriptions (DP). All patients diagnosed with (from HD) or dead because of chronic bronchitis, emphysema and asthma have been included in the analysis. We defined as a prevalent case a subject found in each year in at least one of the four data sources. We reported the absolute and relative contribution of each information system by area, age, gender and year of interest. We performed a sensitivity analysis using more restrictive criteria to identify prevalent cases (two or more DPs per year)., Results: DP was the most relevantsource in identifying cases (from 86 to 88%). The relative contribution ofHD ranged from 3 to 5%. In 2003, standardized prevalence of OLD ranged from 5.35% in Firenze to 6.02% in Venezia. Venezia showed a higher prevalence in children aged 0-14years and a lower prevalence in older age groups (> 64 years) compared to other centers. Overall, the prevalence was higher among males. The use of more restrictive criteria in case identification substantially reduces the estimated prevalence, particularly in younger age-groups and to a lesser extent, in older age-groups., Conclusions: the algorithm provides estimates with differences between centres. The validity of this algorithm (in terms of sensitivity and positive predictive value) needs to be evaluated through further ad hoc studies.

Objectives: tuberculosis is a global heath priority and the surveillance systems are essential tools to control the spread of the disease. The objectives are to estimate: the incidence tuberculosis in Piedmont for the period 2001-03, using multiple sources of information; the sensitivity of the regional system for the surveillance of tuberculosis; the impact ofimmigration from areas with high prevalence of tuberculosis., Design: deterministic linkage between electronic databases and estimate of non-observed cases of microbiologically confirmed tuberculosis, using the 'capture-recapture method'., Methods: the Piedmonti population was the study base. Tuberculosis cases were identified from the integrated Regional Tuberculosis Surveillance System (SSR- TB), the Tuberculosis Laboratory Registry (RL-TB), and the Regional Registry of Inpatient Records (SDO)., Results: 1790 cases of tuberculosis were recorded, in 28.6% (512) of the cases the disease was observed among individuals from countries with high prevalence of tuberculosis. Microbiologically confirmed cases of tuberculosis were 1254 (70%), while pulmonary cases were 1233 (69%). The annual crude incidence of tuberculosis (per 100,000 inhabitants) was 14.1 cases, 31.5% of whom were attributable to immigration from countries with high prevalence of tuberculosis. The incidence among immigrants was 122.4 cases, while that of microbiologically confirmed cases was 9.8 cases. The overall estimated sensitivity, for the microbiologically confirmed cases, was 97%, while the sensitivity of SSR-TB was 90%., Conclusions: Our estimate of tuberculosis incidence in Piedmont is about two times as great as that given by the WHO for Italy (8 cases per 100,000 inhabitants). The fraction of incident cases attributable to immigration from countries with high prevalence of tuberculosis is also consistent with that estimated in other industrialized countries undergoing high immigration flows. The integration of surveillance systems is essential to obtain accurate and timely estimates of the tuberculosis epidemiology.

Several epidemiological studies have provided evidence that exposure to auto vehicular traffic increases the prevalence of bronchitis, cough and deficits in lung function and may exacerbate pre-existing asthma, especially in children. The aim of this study was to investigate the role of road traffic pollution on respiratory health in a large sample of Italian school children. Eighteen percent of the SIDRIA-2 sample reported high traffic density in the zone of residence; 60% and 20% of subjects reported a very frequent transit of cars and lorries, respectively on the street of residence. High frequency of lorry traffic in the street of residence was associated with significantly increased risks for chronic cough or phlegm and sinusitis symptoms. These results, confirming previous findings (SIDRIA, 1994-95), show that children living near streets with intense traffic of heavy vehicles are at higher risk for adverse respiratory effects, especially for productive cough.

Prevalence of asthma and allergies in children shows large variations among different populations, but there is limited evidence about these conditions in immigrants from developing countries. The aim of this study was to evaluate the prevalence of asthma symptoms and allergies in immigrant children and adolescents living in Italy and to investigate the possible role of genetic and environmental factors in the development of such diseases. There were 1340 (4.0%) immigrants in Italy, mainly from East Europe (31.7%); 532 were born in Italy to foreign parents and 808 were born abroad. Asthma and other atopic diseases were on the whole significantly less common among immigrant children than among Italians, while some infectious diseases in the first two years of life resulted more present in immigrant children than in Italians.

The present study investigated the prevalences of asthma, allergic rhinitis (both to pollen and to other causes) and eczema in Italian children (6-7 yr old) and adolescents (13-14 yr old) in the second phase of SIDRIA (2002), aiming also to highlight geographical differences in the prevalence of the studied diseases. Prevalence of lifetime asthma is 9.3% in children and 10.3% in adolescents; lifetime prevalences of allergic rhinitis and eczema are 12.3% and 15.9% in children, 20.9% and 11.9% in adolescents. In both age groups, prevalence of lifetime asthma and lifetime and past 12 months wheezing was greater in central than in northern and southern areas. A similar situation was also seen for allergic rhinitis but not for eczema whose prevalence decreased between North to South of Italy. An excess in prevalence of lifetime asthma and rhinitis was found in metropolitan areas compared to other areas; prevalence of eczema did not show any difference by urbanization level. Prevalence of asthma and, only in children, prevalence of rhinitis symptoms was greater in males than in females. On the contrary, prevalence of eczema and, only in adolescents, prevalence of rhinitis symptoms was greater in females. Prevalence of childhood asthma, allergic rhinitis and eczema in Italy ranks intermediate with respect to other countries participating in ISAAC phase three.

We described a case of a male worker, 62 years old, with a combined exposure to low noise levels (80-85 dB Leq,A) and organic solvents mixture for more than 30 years in the automobile industry as a painter. His ear canal has a diameter of more than 1.3 cm. and determine a peculiar pattern of hearing loss, similar to the noise induced one, but chiefly in the speech frequencies. According to experimental and human studies we speculate that in this patient the peculiar morphology of the audiogram, with the low or mean frequencies maximally affected, may been explained by a synergistic effect of solvents mixture in conjunction with noise exposure and a high ear canal volume.

This article presents the AIPO-TB proposal for protection of health care workers from risks related to exposure to airborne biological agents and especially TB, according to law 626/94. The risk of contagion among health care workers arises mainly from contact with contagious patients (not diagnosed or not isolated after diagnosis). The proposal puts forward classification criteria for health structures and services according to risk level. It also suggests procedures for risk limitation (respiratory isolation and individual protection) and epidemiological and health surveillance. Guidelines for a tuberculin survey, vaccination and special risk situations are also provided.

The results of the sweat tests performed in Turin CF Centre in the last four years were reviewed. The opportunity of changing the range of doubt, commonly situated between 40 and 70 mEq/l Cl-, has been considered. The sweat test appears worth to be repeated only for values > 60, unless clinical signs and symptoms persist.

The EC Respiratory Health Survey (ECRHS) design is presented: the survey aim is to estimate asthma prevalence and risk factors distribution in the various European countries population. In Italy three centres are involved: Pavia, Turin and Verona. EC Health Respiratory Survey is an international two stages cross-sectional survey on probability samples of general population aimed to asses asthma prevalence in different countries. In the first stage a random sample was sent a Screening Questionnaire by post; in the second stage a subsample was invited to clinical centres in order to undergo lung function tests, allergy tests and a standardised clinical interview. The analysis of the response pattern in Italy shows that both in stage 1 and in stage 2 a selection bias overestimating real prevalence is present. Some methodological issues concerning the design of cross sectional surveys are addressed.

Immigration in Italy from developing countries is a recent problem and the possible consequences on public health must be taken into account. The present study reports the results of Tuberculosis control activities performed by the Dispensario di Igiene Sociale of Turin, related to this population. Up to now the available data suggest that the immigrant population (mainly from North Africa and Senegal), in spite of representing a small part of residents (approximately 33,000/1,000,000) contributes to one third of Tuberculosis cases. The consequences on Tuberculosis epidemiology in Italy and our operational experience on Tuberculosis control and prevention are discussed.

An examination was made of the series of 439 lung tumours diagnosed ambulatorially at the Turin Social Health Dispensary to assess the diagnostic return from several techniques (cytology of the sputum, bronchial aspirate and brushing; histology on a biopsy specimen) used singly or in combination. It was also sought to determine the increase in sensitivity obtained by adding technique to each one other, and to establish the overall sensitivity of the protocol. It was found that biopsy was the most sensitive technique (91% in tumours visible by fibrobronchoscopy). The single cytological techniques displayed a lower sensitivity than in the literature, and there was no significant difference among them. The most sensitive combination was brushing + sputum (89.2%), while the sensitivity of the protocol as a whole was much the same as that reported in the literature. In the case of fibrobronchoscopically visible lesions, multiple biopsies (preferably 3) may be sufficient, whereas combination of the three cytological techniques is necessary to ensure acceptable sensitivity with regard to invisible lesions.