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Introduction Polychlorinated biphenyls (PCBs) are persistent pollutants classified among endocrine disruptors and human carcinogens. In an urban area in Northern Italy (Brescia), a chemical factory producing PCBs from 1938 to 1984 caused soil and food pollution. Since the discovering of the environmental pollution in the area in 2001, various public health interventions have been implemented to avoid human contamination. Methods Two independent surveys were carried out in 2003 and 2013 using the same study design and methods. A random sample of the adult general population living in four areas of the town with different soil contamination level was enrolled in both surveys. Investigation included serum levels of 24 PCB congeners and of other common clinical-chemical parameters and questions about residential and occupational history as well as current and past diet and consumption of locally produced food. 537 subjects were tested in the 2003 and 488 in the 2013 survey. Results Total PCB serum levels showed a strong correlation with age (Spearman r = 0.71 in 2003 and r = 0.80 in 2013), but not with gender. Consumers of food produced in the most polluted area had higher total PCB serum levels (median 15.6 and 4.7 ng/ml in 2003 and 2013, respectively) than non-consumers (4.1 and 2.3 ng/ml) and consumers of food produced in non-polluted areas (6.5 and 1.9 ng/ml), with increasing trend of PCB serum levels with cumulative local food intake. PCB serum levels from 2003 to 2013 survey declined by around half in all age groups, especially among the youngest people. The total PCB reduction was found to be due to a combination of a birth cohort effect (− 41% every 10 years) and survey period effect (− 18% in 2013 versus 2003), with medium chlorinated CB congeners showing the most relevant reduction (− 30%) between the two surveys. High chlorinated CBs were more strongly associated with birth cohort (− 46% every 10 years): in the 2013 survey they represented 58% of total PCBs in 60–79 years old while they were 37% among the under 40s with a median value 20 times higher in the oldest than in the youngest (3.1 versus 0.16 ng/ml). Conclusions PCBs serum levels declined from the 2003 to 2013 survey though they are still high in the elderly mainly because of past intake of locally produced contaminated food. Present findings suggest that PCBs food chain contamination and human absorption have been interrupted successfully in the area since discovery of the pollution in 2001. [ABSTRACT FROM AUTHOR]

Abstract: It is rarely possible to identify reverse faults that bring portions of substratum solid rock to lie above decomposed rock. Only where the differences between the fresh rock and weathered rock are very clear is it possible to recognise such faults. A “reverse profile” is defined as a slope profile in which fresh rock (granitoids) overlaps rocks which have been greatly altered by mature weathering (saprolite of granitoids). Such a profile occurs along the slopes of Molini Valley to the south of the village of Fabrizia (Calabria, southern Italy) and we interpret the morphological, mechanical and structural evidence as typical of a reverse fault. The mineral-petrographic analysis of the grus on the bed of the fault and of the cover of relatively fresh rock (Schmidt hammer 18–35) confirms that the granular framework can be attributed to subaerial alteration and not to mechanical deformation. The study area is located at the centre of the largest kinematic body of southern Calabria (the Serre massif-exclusively granitoids) until now considered to be only affected by extensional tectonics, creating high angle normal faults. In this area the tectonic processes, the thickness and spread of granitoid weathering mantles and the depth of the valleys, give rise to several landslides. These are generally translational slides with ample cut surfaces between the weathered body and the underlying fresh rock; as a consequence, very large deposits in the valleys can be found, mostly produced by debris flow processes. At the foot of the slopes around Fabrizia, coarse debris avalanches (with cobbles having a volume of over 0.3–0.4 m3) are occasionally observed, unless there is widespread development of a “reverse weathering profile” on the slopes above. [Copyright &y& Elsevier]

Abstract: High levels of PCBs were recently found in soil, food and some farmers living close to a chemical factory which until the 1980s had produced polychlorinated biphenyls (PCBs) in Brescia, North Italy. We performed a survey on a random sample of subjects aged 20–79 years living in various areas of the town with different levels of soil pollution to investigate factors associated with increased levels of PCB in serum (24 congeners were tested). Total PCB values were closely related to age (Spearman r =0.68; p <0.0001). The 166 consumers of locally produced food had higher PCB levels than non-consumers (median=1143 versus 719; 95th centile=9301 versus 2635ng/g lipid) with the highest levels among consumers of food produced in the most contaminated area close to the factory (median=2551; 95th centile=33464ng/g lipid). A dose-effect relationship between consumption of food produced in this area and PCB blood levels was observed (Spearman r =0.52, p =0.0014). Consumers of only plant food produced in this area had higher levels of PCB than non-consumers (median=1100; 95th centile=10800ng/g lipid). Three subjects who had worked at the factory in the past showed high PCB levels. Distribution of PCB congeners did not differ between consumers of locally produced food and non-consumers, apart from PCB 209 which was found at high levels in former factory workers and was more common among consumers of food produced in the polluted area. In conclusion, we found high serum PCB levels in humans living in a highly polluted area in an industrialized town in Italy, due mainly to consumption of food produced in polluted areas. [Copyright &y& Elsevier]

Introduction: A chemical factory located in Brescia, an industrialized town in North Italy, produced polychlorinated biphenyls (PCBs) since the 1930s to the 1980s, determining a relevant pollution of soil, food and people. Since 2001, following a survey carried out in the general population living in the town, the individuals with PCB serum levels higher than the reference entered a follow-up study.Methods: We performed a prospective cohort study including subjects with at least three PCB measures during the period 2003-2015. We evaluated the temporal trends of total PCB serum levels, the most common PCB congeners (PCB 138,153, 170, 180, 194 and 209), and toxic equivalency of dioxin-like PCBs using univariate and multivariate mixed models with and without a cubic-spline term for time.Results: A total of 128 subjects were enrolled (46.1% males, mean age at enrolment 57.7 years). The geometric mean of PCBs decreased from 35.4ng/ml at 0-3 years to 29.3ng/ml at 4-8 years and to 23.0ng/ml at 9-12 years. A 3.8% reduction of total PCB serum levels per year was estimated using both univariate and multivariate mixed models adjusted for age; a similar reduction was found for the most common PCB congeners and for toxic equivalency. Total PCB serum levels decreased over time for each age group: -3.9%, -4.0% and -3.4% for subjects aged ≤55 years, 56-65 and ≥66 years, respectively.Conclusion: A significant decrease of serum concentrations of PCBs was observed in subjects with high serum levels of these chemicals at enrolment over a twelve year period. The decrease was evident for each PCB congener and age group. [ABSTRACT FROM AUTHOR]

Abstract: Brescia (North Italy) is located in a highly industrialized area with diffuse environmental pollution by polychlorinated biphenyls (PCBs) and with a high incidence of hepatocellular carcinoma (HCC). We aimed to investigate the concentration of PCBs congeners in serum, liver and adipose tissue of patients with HCC living in this area. We enrolled prospectively 101 HCC incident cases. Lipid-adjusted PCBs concentration of single congeners and total PCBs concentration, computed as the sum of 24 PCBs congeners, were measured in the serum of all subjects and in the liver and abdominal fat of 59 HCC cases undergoing surgery. A high correlation was found between PCBs serum and liver (Spearman r =0.79), serum and fat (r =0.91), and liver and fat (r =0.75) concentrations. Serum PCBs concentration in HCC patients did not vary according to demographical, clinical or epidemiological variables, apart from age, as PCBs concentration increased linearly with the subject’s age. This study confirms that serum lipid-adjusted PCBs concentration is a valid measure of PCBs body storage and is highly correlated with PCBs concentration detected in other biological samples. [Copyright &y& Elsevier]

Abstract: Background: Hepatitis C virus (HCV) infection is a global health problem. In Western countries, illicit drug users (IDUs) constitute the largest proportion of HCV patients. International guidelines no longer regard ongoing illicit drug use as a contraindication to antiviral therapy for chronic hepatitis C (CHC). Nonetheless, in clinical practice, few IDUs have access to HCV treatment, likely because many physicians believe these patients will have poor adherence or a lack of treatment efficacy. Objective: The aim of this study was to assess effectiveness and tolerability of combination treatment with ribavirin plus recombinant or pegylated interferon-α in the treatment of CHC in IDUs. Methods: MEDLINE, EMBASE, and the Cochrane Library were searched for relevant studies published in English between 2000 and December 2008. The following terms were searched: chronic hepatitis C, interferons, antiviral agents, methadone, and substance-related disorders. Full-text articles and abstracts were searched using predefined criteria. A manual search of abstracts from 8 international meetings of hepatologists was also conducted. Only prospective studies with a sample size >15 and a homogeneous treatment schedule were included. Articles were extracted independently by 2 of the authors using an electronic standardized form including study quality indicators. Results: Sixteen prospective studies were included, and data from a cohort of 953 IDUs were analyzed. The estimated overall sustained virologic response (SVR) and dropout (DO) rates in IDUs were 52% (95% CI, 44%–60%) and 26% (18%–35%, 95% CI), respectively. The rate of psychiatric severe adverse events (SAEs) that led to treatment discontinuation was 2% (95% CI, 1%–3%). These prevalences were not significantly different from those reported in registration trials of treatment of CHC that excluded IDUs from the study population (SVR, 50% [95% CI, 39%–61%]; DO, 26% [95% CI, 12%–41%]; and psychiatric SAEs, 2% [95% CI, 0%–6%]). By subgroup analysis, active ongoing drug use negatively affected the rate of treatment success (39% [95% CI, 30%–49%] vs 55% [95% CI, 45%–64%]; P = 0.02). Conclusion: Based on data from 16 prospective clinical studies of CHC treatment in IDUs published in the past 10 years, findings on effectiveness and tolerability are comparable to those in the general population. [Copyright &y& Elsevier]

Food Frequency Questionnaires (FFQs) are valuable research tools in nutritional epidemiology. This study aimed to develop and validate a new semi-quantitative FFQ, specifically designed for the Italian population and best fitted for self-administration. During the development process, we adapted to Italian needs the validated FFQ proposed by the Fred Hutchinson Cancer Research Center, revising food items, food frequency scale, portion sizes, and time frame. To assess the validity of the proposed FFQ, we compared the estimated daily intake using FFQ with the mean of 3-day food diaries and one 24-hour recall (considered as reference method). The validation process was conducted among a cohort of 51 healthy subjects enrolled in a clinical trial. Four statistical tests were applied on 23 estimated nutrient intakes. Spearman's coefficients ranged from 0.223 (sodium) to 0.748 (alcohol) and were good (≥0.50) and acceptable (0.20-0.49) for 7 and 16 nutrients, respectively. Cross classification showed a good agreement (≥50% in the same tertile or ≤10% in the opposite tertile) for 7 nutrients. The weighted Cohen's kappa values indicated an acceptable outcome (0.20-0.60) for 13 nutrients. Bland Altman plots did not show heteroscedasticity in the error terms, despite the presence of a bias. Our study provided a new Italian semi-quantitative FFQ for self-administration with an acceptable validation level. Its definitive release requires additional refinements and efforts. [ABSTRACT FROM AUTHOR]

Background: Recent data support the hypothesis that genetic damage occurring early in life during childhood can play an important role in the development of chronic diseases in adulthood, including cancer.Objectives: The objective of this paper, part of the MAPEC_LIFE project, is to describe the frequency of micronuclei and meta-nuclear alterations in exfoliated buccal cells of 6-8year-old Italian children recruited in five Italian towns (i.e., Brescia, Torino, Pisa, Perugia and Lecce) with different air pollution levels.Methods: About 200 children per town were recruited from primary schools. Biological samples were collected twice from the same children, in two different seasons (winter 2014-15 and late spring 2015). Cytogenetic damage was evaluated by the buccal micronucleus cytome assay.Results: Overall,n = 1046 children represent the final cohort of the MAPEC_LIFE study. On the whole, the results showed a higher mean MN frequency in winter (0.42 ± 0.54‰) than late-spring (0.22 ± 0.34‰). MN frequency observed among the five Italian towns showed a trend that follows broadly the levels of air pollution in Italy: the highest MN frequency was observed in Brescia during both seasons, the lowest in Lecce (winter) and Perugia (late-spring).Conclusions: To the best of our knowledge, the number of recruited children included in the analysis (n = 1046) is the highest compared to previous studies evaluating the frequency of MN in exfoliated buccal cells so far. MN frequency was associated with winter season and living in towns at various levels of air pollution, suggesting an important role of this exposure in determining early cytogenetic effects. [ABSTRACT FROM AUTHOR]

Abstract: A chemical factory which produced polychlorinated biphenyls (PCBs) operated in Brescia, North Italy, (about 200000 inhabitants) from the 1930s to the 1980s. High levels of PCBs were recently found in soil, food and people living in an area close to the factory. We performed a survey among the general population living in non-polluted areas of the town in order to define the reference values (RVs) of the non-exposed population. A random sample of subjects aged 20–79 years (50% males) was selected. Participants underwent PCB determination and were interviewed on their residential and occupational history and current diet. For RV determination, subjects who had resided in the polluted area or consumed any food produced in the area in their lifetime were excluded. Eight hundred and ninety-two subjects were contacted, 579 (65%) of whom agreed to participate; 311 of them were considered for RV determination (53% male, mean age=48.7 years). Total PCB serum levels, computed as the sum of the 24 congeners determined, were: mean=5.15ng/ml (SD=8.83), median=4.11ng/ml, range=0.4–34.12ng/ml, 95th centile=14.38ng/ml. Lipid-adjusted mean and median were 897 and 705ng/g lipid, respectively. PCB values showed positive correlations with age (Spearman’s r =0.76) and with serum concentration of total cholesterol (r =0.40) and triglycerides (r =0.36). No association was found with gender, cigarette smoking, alcohol or diet. Seven PCB congeners, (PCB 180, 153, 138, 170, 194, 118, and 156), including those at higher chlorination, were present in more than 30% of the subjects and contributed 99% of the total PCB levels, with a modest role of dioxin-like congeners. [Copyright &y& Elsevier]

Background/Aims: The role of coffee in the development of hepatocellular carcinoma (HCC) is debated. The aim of this study was to investigate the role of coffee in HCC, taking the main risk factors into account. Methods: A hospital-based case-control study was conducted in an area of northern Italy. We recruited 250 HCC cases and 500 controls hospitalized for any reasons other than neoplasms, and liver and alcohol-related diseases. Subjects were interviewed on their lifetime history of coffee consumption using a standardized questionnaire. Results: Coffee consumption in the decade before the interview was associated with a decreasing risk of HCC with a clear dose-effect relation. With respect to non-drinking subjects, the odds ratios (ORs) were: 0.8, (95% CI 0.4–1.3) for 1–2 cups/day, 0.4 (95% CI 0.2–0.8) for 3–4 cups/day and 0.3 (95% CI 0.1–0.7) for 5 or more cups/day. The ORs for HCC decreased for drinking >2, compared to 0–2 cups/day of coffee, for an alcohol intake >80g/day (OR from 5.7 to 3.3), for presence of hepatitis B virus infection (OR from 16.4 to 7.3) or hepatitis C virus infection (OR from 38.2 to 9.0). Conclusions: Coffee drinking was inversely associated with HCC regardless of its aetiology. [Copyright &y& Elsevier]