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Background This study is part of a national plan of epidemiological surveillance of malignant mesothelioma (MM) mortality in Italy. The paper shows the results of malignant peritoneal mesothelioma (MPeM) mortality study in Italian Regions and municipalities. Methods National Bureau of Statistics data for MPeM municipal mortality (ICD-10, Code C45.1) were analyzed in the time-window 2003–2014: mortality standardized rates (reference Italian population, census 2011), temporal trends of the annual national rates, Standardized Mortality Ratios and a municipal clustering analysis were performed. Results 747 deaths for MPeM were recorded (0.10/100,000): 464 in men (0.14/100,000) and in 283 women (0.07/100,000). No significant MPeM mortality temporal trend was found. Seventeen municipalities showed excesses of mortality for MPeM in at least one gender and/or overall population. Four clusters in male population, and one in women were identified. Conclusions The study identifies some areas where remediation activities and/or health care actions may be warranted.

Purpose Both health interview surveys (HISs) and health examination surveys (HESs) are used to describe the health status of populations. In Italy, to determine the feasibility of conducting a national-level HES, a pilot HES was conducted in the city of Florence among participants of a previous national-level HIS. The aim of the present analysis was to compare the results of the two surveys. Methods The study population consisted of the 343 Florence residents 35 to 74 years of age who participated in both surveys (sample drawn with probabilistic criteria). We compared the self-reported HIS data to the HES health measurements for diabetes, hypertension, osteoporosis, smoking, height, weight, and body mass index. For categorical variables, contingency tables were used, calculating symmetric and asymmetric indices. For the continuous variables, Student's t test for matched samples was used. Results The prevalence of the most important pathologic conditions and risk factors determined with HES measurements was significantly higher than that based on self-reported HIS data. Conclusions The results stress that individuals have poor knowledge of their own health; therefore health measurements need to be taken.

Introduction: It is widely recognized that extreme climatic conditions during summer months may constitute a major public health threat. Owing to what is called the “urban heat island effect,” as well as to the consequences of heat waves on health, individuals living in cities have an elevated risk of death when temperature and humidity are high compared to those living in suburban and rural areas. Studies on heat wave-related mortality have further demonstrated that the greatest increases in mortality occur in the elderly. Following the unusually hot summer of 2003 and the dramatic news from neighboring countries such as France, the Italian Minister of Health requested the Istituto Superiore di Sanita-Bureau of Statistics to undertake an epidemiologic study of mortality in Italy during Summer 2003 to investigate whether there had been an excess of deaths, with a particular focus on the elderly population. Materials and methods: Communal offices, which maintain vital statistics, were asked for the individual records of death of residents registered daily during the period 1 June–31 August 2003 and during the same period of 2002 for each of the 21 capitals of the Italian regions. As it was necessary to obtain mortality data quickly from many municipalities and to make the analysis as soon as possible, the method adopted was comparison of mortality counts during the heat wave with figures observed during the same period of the previous year. Results: Compared with 2002, between 1 June and 31 August 2003, there was an overall increase in mortality of 3134 (from 20,564 to 23,698). The greatest increase was among the elderly; 2876 deaths (92%) occurred among people aged 75 years and older, a more than one-fifth increase (21.3%, from 13.517 to 16.393%). The highest increases were observed in the northwestern cities, which are generally characterized by cold weather, and in individuals 75 years and older: Turin (44.9%), Trento (35.2%), Milan (30.6%), and Genoa (22.2%). Of note are also the increases observed in two southern cities, L’Aquila (24.7%) and Potenza (25.4%), which are located, respectively, at 700 and 800 m above see level. For Bari and Campobasso, both in the South, with a typically hot summer climate, the increase during the last 15 days of August was 186.2 and 450%, respectively. Conclusions: The relationship between mortality and discomfort due to climatic conditions as well as the short lag time give a clear public health message: preventive, social, and health care actions must be administered to the elderly and the frail to avoid excess deaths during heat waves.

PURPOSE: To analyze the relationship between an aspect of drinking pattern (i.e., drinking with or without meals) and risk of all-cause and specific-cause mortality. METHODS: The Risk Factors and Life Expectancy Study, is a pooling of a series of epidemiological studies conducted in Italy. Eight-thousand six-hundred and forty-seven men and 6521 women, age 30–59 at baseline, and free of cardiovascular disease, were followed for mortality from all causes, cardiovascular and noncardiovascular, during an average follow-up of 7 years. RESULTS: Drinkers of wine outside meals exhibited higher death rates from all causes, noncardiovascular diseases, and cancer, as compared to drinkers of wine with meals. This association was independent from the cardiovascular disease (CVD) risk factors measured at baseline and the amount of alcohol consumed and seemed to be stronger in women as compared to men. CONCLUSIONS: The present results indicate that drinking patterns may have important health implications, and attention should be given to this aspect of alcohol use and its relationship to health outcomes. The relationship between alcohol consumption and disease has been the focus of intensive scientific investigation 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 . Most studies to date, however, have limitations. A major drawback is that limited information has been collected regarding the complex issue of alcohol consumption. In many studies, ascertainment of alcohol consumption frequently focused only on quantity of alcohol consumed without considering the many different components of alcohol consumption, particularly drinking pattern 10 , 11 , 12 . It has been hypothesized, and preliminary data support the notion, that drinking pattern could have important influences on determining the health effects of alcohol 13 , 14 . The present study examines the relationship between one aspect of drinking pattern (drinking wine outside meals) and mortality in a large cohort of men and women.

Among 11, 579 men ages 40–59 without evidence of cardiovascular disease, 2,289 died in 15 years, 618 from coronary heart disease. The 15 cohorts in seven countries (four regions) differed in all-causes death rate, mainly reflecting great differences in coronary mortality. Among characteristics of entry, only mean blood pressure helped to explain cohort differences in all-causes death rate. Three-quarters of the variance in coronary death rate was accounted for by differences in mean serum cholesterol and blood pressure of the cohorts. The mortality risk for individuals was examined in each of the regions. For coronary death, age, serum cholesterol, blood pressure, and smoking were highly significant in all regions except Japan, where coronary deaths were too few for evaluation. Relative weight was not significant anywhere. Physical activity was significant only in southern Europe, where differences are associated with socioeconomic status. For all-causes death, age and blood pressure were highly significant risk factors in all regions as was smoking habit, except in Japan. Relative body weight tended to be a negative risk factor everywhere, significantly so in southern Europe. Expectations for coronary death from the experience in the United States and northern Europe greatly exceeded observed deaths in southern Europe for men of their age, serum cholesterol, blood pressure, smoking habits, physical activity, and relative weight. The reverse, prediction of coronary deaths in America and in northern Europe from the southern European experience, greatly underestimated the deaths observed. Similar cross-predictions between the United States and northern Europe were good for all causes deaths, excellent for coronary deaths. Analysis of time trends in relationships of mortality to entry characteristics showed continued importance of age, blood pressure, and smoking and a tendency for the importance of cholesterol to fall in the last 5 years of follow-up.

Risk factors for definite hypertension were examined using data from two Italian rural cohorts from the Seven Countries Study, originally composed of 1,712 men ages 40-59 at entry. Two approaches were used: cross-sectional examination of baseline exposure/outcome measurements; and prospective examination of data, correlating baseline measurements with subsequent definite hypertension, diagnosed at the 10-year follow-up exam. Hypertension was defined as diastolic blood pressure greater than or equal to 95 mm Hg or systolic blood pressure greater than or equal to 160 mm Hg. Included in the cross-sectional analysis were 1,437 subjects free from other cardiovascular diseases at baseline. Of these, 590 were included in the prospective analysis. Using a multiple logistic function that did not include baseline (normal) blood pressure, age, pulse rate, and weight were confirmed as risk factors for hypertension both cross-sectionally and prospectively, thus suggesting that bias cannot explain the relationship of hypertension to these factors. Although proteinuria and vital capacity were associated with hypertension in the cross-sectional analysis, no such relationships were detected prospectively, thus implying that these factors are effects, rather than determinants, of definite hypertension. Smoking had a negative prospective (but not cross-sectional) association with hypertension, which can probably be explained by survival bias at 10 years after ascertainment of smoking habits. When mean baseline blood pressure was added to the prospective multiple logistic function, it became the only factor significantly associated with hypertension (P less than 0.001), again confirming the importance of "tracking" in the determination of hypertension.

A 20-year follow-up study for all causes of death has been conducted on two groups of men aged 40-59 at entry in two rural communities of northern and central Italy on a total of 1,712 subjects representing 98.9% of defined demographic samples. Personal characteristics or risk factors usually studied for coronary heart disease (CHD), as measured at entry, have been related to the risk of dying in 20 years (600 cases). By means of multivariate analysis, 11 out of 33 considered characteristics were shown to be significant predictors of any cause of death. These were mean blood pressure, age, arm circumference (protective), early death of parents, cigarette smoking, forced expiratory volume (protective), CHD, arcus senilis, vital capacity (protective), xanthelasma, and serum cholesterol. Discrimination between cases and noncases was satisfactory with about 40% of deaths in the upper quintile of the estimated distribution of risk and less than 7% in the lowest quintile (relative risk = 6.20).