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Today a large part of the European population is exposed to levels of air pollution exceeding the standards recommended by the World Health Organization. Moreover, air pollution and the seasonal emission of allergenic pollen are progressively affecting human health and can cause severe allergic reactions, particularly when air pollution combines with pollen allergen peaks. Unlike atmospheric pollutants of anthropogenic origin, pollen sources have a pulsating trend that leads to high values in the flowering period and values close to, or equal to, zero in the rest of the year. This aspect makes essential the definition of data coverage standards for the main allergenic taxa. For air quality assessment detailed classification criteria for monitoring stations are defined by international standards, not the same from the European Standards for the Sampling and analysis of airborne pollen grains and fungal spores. This paper describes the status and the air concentration trends of the main allergenic pollen and the Alternaria spore measured in Rome from 2003 to 2019 by the Aerobiological Monitoring Center of Tor Vergata (Rome) and calculated by the Seasonal Kendall test with the open-source OpenAir R package. The analysis was carried out on the daily concentrations of the most widespread allergenic taxa in Italy: Asteraceae, Betulaceae, Corylaceae, Cupressaceae/Taxaceae, Poaceae, Oleaceae, Urticaceae and the Alternaria spores.

(1) Background: Rome is a municipality with an area of 1287 km2 and presents floristic-vegetational complexity that is reflected in the composition of aerospora, which are responsible for pollinosis. The presence of airborne pollen can be detected by pollen monitoring. The large extent of the city’s territory makes it possible to verify possible changes in pollen composition in different sites of the city. With this in mind, a study was conducted to assess the differences in airborne pollen concentration, considering phenological and production indicators at three different sites in the city. (2) Methods: Pollen data of eight taxa were considered, Alnus spp., Castanea sativa Miller, Cupressaceae-Taxaceae, Olea europaea L., Platanaceae, Poaceae, Quercus spp., and Urticaceae, during 2020 and 2021, using three monitoring samplers. The airborne pollen concentration and the seasons of the three centers were calculated and compared with each other. (3) Results: The diversity between the three samplers shows a phenological succession in accordance with the microclimatic diversity present in the city. The heterogeneity of the airborne pollen concentration reflects the floristic-vegetational diversity, while qualitative and quantitative parameters indicate a homogeneous flowering trend reflecting the seasonality of the various species. (4) Conclusions: The present work and the Italian geographic context suggest the need for a greater number of sampling points to guarantee a true localization of the data. Having several sampling stations also contributes to the protection of health and green areas, which are difficult to manage, conserve, and maintain.

Background Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. Objectives To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. Methods As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. Results Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073). Conclusions PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics., EAACI Fellowship Award of the European Academy of Allergology and Clinical Immunology; Euroimmun [118583], SA was supported by the EAACI Fellowship Award of the European Academy of Allergology and Clinical Immunology. The study has been supported by an unrestricted grant from Euroimmun (grant number 118583). The ESEP assay has been provided by Euroimmun. The Informatics Platform AllergyCARD (TM) and the app AllergyMonitor (R) have been provided by TPS Production.

In the last few years, we have witnessed an important development in the medical field of both Mobile Health, such as the use of mobile communication devices, and other telemedicine tools in general, in order to support the surveillance of diseases from the moment of the first diagnosis to the therapeutic follow‐up. Long before COVID‐19, some authors had analyzed various possible evidence‐based scenarios and had indicated how the use of telemedicine could prove to be extremely useful in epidemic situations, especially for the management of chronic patients, such as immune‐allergic ones, who are notoriously in greater need of regular follow‐up; however, as expected, the advent of the COVID‐19 pandemic has amplified the differences between various countries, from the point of view of the propensity to use technological solutions in the health sector. The hope is that one positive outcome of the ongoing pandemic is that it will lead to an acceleration, by all the stakeholders involved, of the process of modernization of health care.

The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic.Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases.

Nowadays, technology permeates every aspect of human activity, from the professional to the recreational side, and the recent pandemic crisis has only amplified a clearly defined trend. Through portable devices, people play, work, and get information. The immediacy of information and of many aspects of our life is a condition that, once acquired, is difficult to give up. However, immediate information must also be correct, and not all issues can easily be simplified to the point of being understandable in the absence of basic theoretical notions to a large audience. This aspect is particularly relevant when dealing with issues related to human health and the communication problems encountered in recent months concerning the spread of SARS-CoV-2, and the vaccination campaign is there to prove it. With the intent of clarifying the advantages and disadvantages of fast and accessible information, in this article, some of the most widespread applications for mobile devices, dedicated to pollen allergens, air quality, parks, gardens, and green areas, were examined. A widespread lack of clarity on the sources of the data and on the criteria used to formulate synthetic judgments-that often confuse the final users-was noted.

BACKGROUND Mobile health technologies enable allergists to monitor disease trends by collecting daily patient-reported outcomes of allergic rhinitis. To this end, patients with allergies are usually required to enter their symptoms and medication repetitively over long time periods, which may present a risk to data completeness and quality in the case of insufficient effort reporting. Completeness of patient’s recording is easily measured. In contrast, the intrinsic quality and accuracy of the data entered by the patients are more elusive. OBJECTIVE The aim of this study was to explore the association of adherence to digital symptom recording with a predefined set of parameters of the patient-generated symptom and medication scores and to identify parameters that may serve as proxy measure of the quality and reliability of the information recorded by the patient. METHODS The @IT.2020 project investigates the diagnostic synergy of mobile health and molecular allergology in patients with seasonal allergic rhinitis. In its pilot phase, 101 children with seasonal allergic rhinitis were recruited in Rome and instructed to record their symptoms, medication intake, and general conditions daily via a mobile app (AllergyMonitor) during the relevant pollen season. We measured adherence to daily recording as the percentage of days with data recording in the observation period. We examined the patient’s trajectories of 3 disease indices (Rhinoconjunctivitis Total Symptom Score [RTSS], Combined Symptom and Medication Score [CSMS], and Visual Analogue Scale [VAS]) as putative proxies of data quality with the following 4 parameters: (1) intravariation index, (2) percentage of zero values, (3) coefficient of variation, and (4) percentage of changes in trend. Lastly, we examined the relationship between adherence to recording and each of the 4 proxy measures. RESULTS Adherence to recording ranged from 20% (11/56) to 100% (56/56), with 64.4% (65/101) and 35.6% (36/101) of the patients’ values above (highly adherent patients) or below (low adherent patients) the threshold of 80%, respectively. The percentage of zero values, the coefficient of variation, and the intravariation index did not significantly change with the adherence to recording. By contrast, the proportion of changes in trend was significantly higher among highly adherent patients, independently from the analyzed score (RTSS, CSMS, and VAS). CONCLUSIONS The percentage of changes in the trend of RTSS, CSMS, and VAS is a valuable candidate to validate the quality and accuracy of the data recorded by patients with allergic rhinitis during the pollen season. The performance of this parameter must be further investigated in real-life conditions before it can be recommended for routine use in apps and electronic diaries devoted to the management of patients with allergic rhinitis.

Background: Allergen immunotherapy (AIT) is the only disease-modifying treatment in patients with seasonal allergic rhinoconjunctivitis (SAR). Its efficacy depends on the precise identification of the triggering allergen. However, diagnostics based on retrospective clinical history and sensitization to whole extracts (SWE) often leads to equivocal results. Objectives: To assess the usability and impact of a recently established algorithm for a clinical decision support system (@IT2020-CDSS) for SAR and its diagnostic steps [anamnesis, SWE (skin prick test or serum IgE), component resolved diagnosis, CRD, and real-time digital symptom recording, eDiary] on doctor's AIT prescription decisions. Methods: After educational training on the @IT2020-CDSS algorithm, 46 doctors (18 allergy specialists, AS, and 28 general practitioners, GP) expressed their hypothetical AIT prescription for 10 clinical index cases. Decisions were recorded repeatedly based on different steps of the algorithm. The usability and perceived impact of the algorithm were evaluated. Results: The combined use of CRD and an eDiary increased the hypothetical AIT prescriptions, both among AS and GP (p < .01). AIT prescription for pollen and Alternaria allergy based on anamnesis and SWE was heterogeneous but converged towards a consensus by integrating CRD and eDiary information. Doctors considered the algorithm useful and recognized its potential in enhancing traditional diagnostics. Conclusions and clinical implications: The implementation of CRD and eDiary in the @IT2020-CDSS algorithm improved consensus on AIT prescription for SAR among AS and GP. The potential usefulness of a CDSS for aetiological diagnosis of SAR and AIT prescription in real-world clinical practice deserves further investigation.

In aerobiological monitoring and agriculture there is a pressing need for accurate, label-free and automated analysis of pollen grains, in order to reduce the cost, workload and possible errors associated to traditional approaches. Methods: We propose a new multimodal approach that combines electrical sensing and optical imaging to classify pollen grains flowing in a microfluidic chip at a throughput of 150 grains per second. Electrical signals and synchronized optical images are processed by two independent machine learning-based classifiers, whose predictions are then combined to provide the final classification outcome. Results: The applicability of the method is demonstrated in a proof-of-concept classification experiment involving eight pollen classes from different taxa. The average balanced accuracy is 78.7 % for the electrical classifier, 76.7 % for the optical classifier and 84.2 % for the multimodal classifier. The accuracy is 82.8 % for the electrical classifier, 84.1 % for the optical classifier and 88.3 % for the multimodal classifier. Conclusion: The multimodal approach provides better classification results with respect to the analysis based on electrical or optical features alone. Significance: The proposed methodology paves the way for automated multimodal palynology. Moreover, it can be extended to other fields, such as diagnostics and cell therapy, where it could be used for label-free identification of cell populations in heterogeneous samples.

Background: Mobile health technologies enable allergists to monitor disease trends by collecting daily patient-reported outcomes of allergic rhinitis. To this end, patients with allergies are usually required to enter their symptoms and medication repetitively over long time periods, which may present a risk to data completeness and quality in the case of insufficient effort reporting. Completeness of patient’s recording is easily measured. In contrast, the intrinsic quality and accuracy of the data entered by the patients are more elusive. Objective: The aim of this study was to explore the association of adherence to digital symptom recording with a predefined set of parameters of the patient-generated symptom and medication scores and to identify parameters that may serve as proxy measure of the quality and reliability of the information recorded by the patient. Methods: The @IT.2020 project investigates the diagnostic synergy of mobile health and molecular allergology in patients with seasonal allergic rhinitis. In its pilot phase, 101 children with seasonal allergic rhinitis were recruited in Rome and instructed to record their symptoms, medication intake, and general conditions daily via a mobile app (AllergyMonitor) during the relevant pollen season. We measured adherence to daily recording as the percentage of days with data recording in the observation period. We examined the patient’s trajectories of 3 disease indices (Rhinoconjunctivitis Total Symptom Score [RTSS], Combined Symptom and Medication Score [CSMS], and Visual Analogue Scale [VAS]) as putative proxies of data quality with the following 4 parameters: (1) intravariation index, (2) percentage of zero values, (3) coefficient of variation, and (4) percentage of changes in trend. Lastly, we examined the relationship between adherence to recording and each of the 4 proxy measures. Results: Adherence to recording ranged from 20% (11/56) to 100% (56/56), with 64.4% (65/101) and 35.6% (36/101) of the patients’ values above (highly adherent patients) or below (low adherent patients) the threshold of 80%, respectively. The percentage of zero values, the coefficient of variation, and the intravariation index did not significantly change with the adherence to recording. By contrast, the proportion of changes in trend was significantly higher among highly adherent patients, independently from the analyzed score (RTSS, CSMS, and VAS). Conclusions: The percentage of changes in the trend of RTSS, CSMS, and VAS is a valuable candidate to validate the quality and accuracy of the data recorded by patients with allergic rhinitis during the pollen season. The performance of this parameter must be further investigated in real-life conditions before it can be recommended for routine use in apps and electronic diaries devoted to the management of patients with allergic rhinitis.

Background: Allergen immunotherapy(AIT) is the only disease-modifying treatment with long-term effects in patients with seasonal allergic rhinoconjunctivitis(SAR). Its efficacy depends on the precise identification of the pollen triggering symptoms. However, a diagnostic approach based on retrospective clinical history and sensitization to extracts often does not lead to unequivocal results. Objectives: To assess the usability and impact of a recently established algorithm for a potential clinical decision support system (@IT.2020-DSS) for pollen allergy and its diagnostic steps (including anamnesis, SPT, component resolved diagnosis, CRD, and real-time digital symptom recording, eDiary) on doctor’s AIT prescription decisions. Methods: After a concise educational training on the @IT.2020-DSS algorithm, 46 doctors (18allergy specialists, AS, and 28general practitioners, GP) expressed their hypothetical AIT prescription for 10 clinical index cases. Decisions were recorded repeatedly based on different steps of the support algorithm. The usability and perceived impact of the algorithm on individual clinical performance were evaluated. Results: The combined use of CRD and an eDiary increased the hypothetical AIT prescriptions, both among AS and GP (p

[No Abstract Available], Euroimmun [118583], This study was supported by a grant from Euroimmun (code 118583).

Pollen exposure in occupational settings involves different categories of workers. In this paper the effects of diurnal pollen variations have been evaluated in two sites characterized by different vegetation and urbanization: the suburban site of Tor Vergata (TV) and the rural site of Monte Porzio Catone (MPC). Aerobiological and meteorological monitoring was performed in the two sites during the winter of 2017. The data analysis focuses on the comparison between pollen concentrations observed in relation to meteorological variables. In general, it can be stated that the indoor and outdoor dynamics for MPC and TV are different, with the outdoor concentration of pollen for MPC always higher than for TV, in accordance with significant presence of vegetation. The high nocturnal peaks detected in MPC and completely absent in TV could be caused by the presence of particular conditions of stagnation combined with greater emissions from the pollen sources. Furthermore the higher I/O ratio observed during the working hours in TV compared to MPC could be ascribed to the workers’ behavior. Exposure to pollen can be responsible for several health effects and the knowledge of its level can be useful to improve the evaluation and management of this biological risk.

Il cambiamento climatico rappresenta una delle maggiori minacce per l’umanità e la natura, in grado di influenzare sia la salute dell’uomo e degli animali che il ciclo vitale delle piante. Numerosi studi hanno infatti evidenziato effetti sugli ecosistemi descrivendo un trend di anticipo generale negli eventi fenologici, sia per le specie vegetali sia per quelle animali. Gli Autori considerano tra i vari fattori responsabili nel contribuire a queste variazioni i parametri climatici, principalmente la temperatura e gli inquinanti atmosferici, in particolare l’anidride carbonica. Le complesse interazioni tra fattori climatici ed inquinanti ambientali, causa di aumentata crescita di specie arboree allergeniche e produzione di pollini, possono incrementare il rischio di manifestazioni allergiche nei soggetti sensibilizzati attraverso meccanismi quali: il danno della mucosa delle vie aeree con compromissione della clearance mucociliare, l’aumentata permeabilità con conseguente facilitata penetrazione di allergeni, la stimolazione della risposta immunitaria con aumentata produzione di IgE. L’aumentata concentrazione nell’aria di allergeni inalanti aumenta in questi soggetti il rischio di rinite allergica ed asma, nonché di riacutizzazioni di malattia in forme anche gravi. Le misure volte a contenere il degrado ambientale devono tener conto della peculiare vulnerabilità dei bambini al fine di proteggerli da esposizioni nocive con conseguenze potenzialmente irreversibili sulla salute.

Urban green is an important aspect in the quality of life of citizens of modern cities. Nevertheless some ornamental plants cause allergic diseases in sensitive subjects that may be worsened by air pollution. Studies on air quality are usually addressed to the evaluation of single substances and their specific effects: little is known about the cumulative effect that different pollutants may have on human health. Even less is known about possible combined action of traditional air pollutants with pollen and spores that have huge effects, in terms of allergies and asthma, on citizenship of the urban areas. In this work the synergistic effect of PM10, PM2.5, NO2, O3 and airborne pollens (belonging to 4 taxa: Cupressaceae/Taxaceae, Graminaceae, Olea and Urticaceae) was studied in the city of Rome during six years (from 2010 to 2015). For air pollutants, concentration values recorded by air-quality monitoring network of Rome were used. Pollens and spores data were detected by the Aerobiological Monitoring Centre of the University of Rome Tor Vergata. Effects on human health were evaluated on a group of 100 patients (aged between 4 and 18) by the Allergymonitor™a application that records daily symptoms of hay fever, bronchial asthma and the prescribed therapies. Data collected in the medical record were processed by 2 different Symptom Medication daily Scores and compared with time series of air concentration of mentioned pollutants, pollen and spores. Statistical analysis allowed highlighting when concomitant high levels of allergenic species and air pollution occur, the influence of meteorological parameters, of the flowering calendar, of taking drugs and how these aspects affect symptoms in patients.

Aerobiology studies the biological particles suspended in the atmosphere in order to know what types are present in the air and how their concentrations vary spatially or seasonally. The measurement of airborne pollen concentration requires a standardized methodology. Normally, the analysis of the slides obtained after samplings is carried out according to national network procedures. Different networks use different slide counting methods (longitudinal sweeps, transverse sweeps or random fields), and a different number of lines/fields are routinely read. In this study, we compared two slide counting methods adopted by two monitoring centres belonging to different aerobiology networks that operate in southern Europe, the University of Malaga (Spanish Aerobiology Network, the REA) and the University of Roma Tor Vergata (Rete Italiana di Monitoraggio in Aerobiologia, the RIMA). For that, the same samples were counted following the two methodologies consisting on the reading of four (REA) and six (RIMA), respectively, longitudinal sweeps at a magnification of 400X (REA). Statistical analysis was performed in order to search the degree of association between the two series of data obtained, as well as whether or not there were significant differences between them. The results showed highly significant correlation and regression coefficients. On the other hand, Wilcoxon tests, in general, did not showed significant differences between the series for the total pollen as well as for the major pollen types. This confirms that the two methods can be used indistinctly although it would be convenient for the different networks to standardize and unify methodologies in order to follow the same operating procedures.

Introduction Allergic respiratory diseases, especially rhinitis and asthma, is of relevant importance within emerging occupational diseases in the last decades. It is therefore fundamental monitoring airborne pollen concentrations for allergic disease prevention. Many factors are able to influence airborne pollen concentrations: meteorological parameters (air temperature, relative humidity, wind speed), seasonal variations, geographical location, human habits and activity. In this context, for research purposes, we have carried out samplings at two different heights to investigate variations of concentrations of several types of airborne pollen in indoor and outdoor environments according to standard methods of the UNI 11108/2004 and following. Methods Airborne pollen grains have been collected using a volumetric sampler, Lanzoni VPPS 2000 type Hirst based on impact collection of atmospheric biological particles. Sampling have been performed in one room office using two samplers located to different heights of the suction nozzle (at 1,10 m and 0,6 m) during 2016–2017 and in outdoor environment (urban area) using two same samplers situated to two different level (at ground level in Trajan Forum and at 45 m on ground level on Calandrelli Tower) during 2002–2003. Monitoring stripes were cut and stained with glycerine jelly with fuchsine and then observed with optical microscope to 40X. Results We observed that pollen concentration are higher at low altitude in both indoor and outdoor samplers. Normally, the outdoor pollen concentration at low level is six or seven times higher than at high altitude, while the indoor pollen is about two time higher. Conclusion The versatility of sampling at different heights is a very valuable tool to explain how many factors both environmental and personal influence space-time distribution and turbulence related to aerodynamics of these biological particles. The results suggest that pollen gradients at lower level is about five time greater than in indoor respect to outdoor sites.

La qualità dell’ambiente urbano è sempre più oggetto di attenzione sia da parte degli amministratori che dei cittadini. Il verde, inteso come l’insieme delle diverse tipologie di impianti presenti nelle città, costituisce un fondamentale elemento per misurare la qualità dell’ambiente urbano. Le sue modificazioni storiche, la sua progettazione e manutenzione assumono rilievo importante soprattutto se si considera la presenza di specie allergeniche che possono condizionare la vita di un’importante fetta della popolazione presente. Tra le diverse soluzioni praticabili per ridurre l’esposizione dei pazienti allergici al polline iniziano a diffondersi anche le moderne tecnologie, come app dedicate alla presenza di polline in atmosfera e alla registrazione di sintomi allergici da parte dei pazienti.

I funghi provocano talora disturbi dell’apparato respiratorio e sebbene alcuni semplici provvedimenti possano rivelarsi determinanti per prevenirne lo sviluppo in ambiente domestico, la loro ubiquità fa sì che essi si sviluppino sia outdoor che indoor. Un fattore predisponente allo sviluppo di asma bronchiale è la sensibilizzazione allergica, mentre l’inquinamento ambientale gioca un altro ruolo di rilievo anche nelle altre patologie legate all’esposizione a muffe: l’aspergillosi broncopolmonare allergica, la rinosinusite, la sick building syndrome e la sindrome da polveri organiche tossiche. L’immunoterapia specifica, in virtù del suo ormai accertato potere desensibilizzante, rappresenta un valido presidio terapeutico, specie in età pediatrica, con valenza preventiva proprio dello sviluppo di asma.

Il fumo di tabacco costituisce un problema ancora attuale e di notevole rilevanza per il grande impatto sulla salute pubblica. Milioni di bambini sono esposti ai danni devastanti del fumo passivo. Questo contribuisce all’inquinamento degli ambienti chiusi apportando significative concentrazioni di nicotina, sostanze irritanti, tossiche e cancerogene, tanto da risultare il principale inquinante degli ambienti chiusi. Oltre al cosiddetto ‘fumo di seconda mano’, miscela costituita dal fumo derivante direttamente dalla sigaretta accesa e da quello esalato dai polmoni dei fumatori, recentemente è stata individuata una nuova forma di esposizione a fumo passivo, denominata ‘fumo di terza mano’. Questo consiste in una miscela di inquinanti che, una volta consumata la sigaretta, si deposita sulle superfici e nella polvere degli ambienti confinati o reagisce con altri composti per formare inquinanti secondari. L’esposizione a fumo passivo ha gravi effetti sulla salute dei bambini, i quali, inoltre, sono più sensibili degli adulti ai suoi effetti nocivi. I maggiori rischi da esposizione riguardano in particolare la salute respiratoria. Relativamente alle allergie, gli studi sull’associazione tra esposizione a fumo di sigaretta e rischio di sensibilizzazione atopica ad oggi pubblicati non sono numerosi e non giungono a conclusioni univoche. La discrepanza dei risultati è probabilmente legata a differenze di carattere demografico nelle popolazioni studiate nonché ai diversi disegni di studio utilizzati dai vari autori. Tuttavia, i danni da fumo passivo sulla salute sono ben noti, motivo per cui la protezione dei bambini da questo rischio deve diventare prioritaria in tema di salute pubblica.

Background Many different symptom (medication) scores are nowadays used as measures of allergic rhinoconjunctivitis severity in individual patients and in clinical trials. Their differences contribute to the heterogeneity of the primary end-point in meta-analyses, so that calls for symptom (medication) score harmonization have been launched. Objective To prospectively compare six different severity scores for allergic rhinitis (AR) against pollen counts at both population and individual levels. Methods Two groups of children with seasonal AR and grass pollen sensitization were recruited in Ascoli, Italy (n = 76) and Berlin, Germany (n = 29). Symptoms and drug intake were monitored daily for 40 and 30 days of the grass pollen season in 2011 (Ascoli) and 2013 (Berlin), respectively, through an Internet-based platform (AllergyMonitor(™) , TPS Production srl, Rome, Italy). From the gathered data, the informatics platform automatically generated one symptom score (RTSS) and five symptom-medication scores (RC-ACS(©) , ACS, RTSS[LOCF], RTSS[WC] and AdSS). Values were then statistically normalized for reciprocal comparison and matched against the daily variations of local grass pollen counts (Spearman's rank correlation). Results The grass pollen counts were higher in Ascoli than in Berlin (peak values 194 vs. 59 grains/m(3) ). At population level, the trajectories of the normalized average values of the six scores differed only slightly in both studies and correlated well with the pollen counts (ranges r(2) : 0.38-0.50 in Ascoli, 0.41-0.56 in Berlin). By contrast, in individual patients, trajectories of different scores were often quite heterogeneous. The RTSS[WC] had a very low discriminatory power and generated in many patients long, flat horizontal segments. Conclusions Disease severity scores for seasonal AR, as evaluated via an Internet-based platform, tend to provide similar results at population level but can often produce heterogeneous slopes in individual patients. The choice of the disease severity score might have only a low impact on the outcome of a very large clinical trial, but it may be crucial in the management of individual patients.

Forecasting pollen concentrations in the short term is a topic of major importance in aerobiology. Forecasting models proposed in the literature are numerous and increasingly complex, but they fail in at least 25 % of cases and are not available for all botanical species. This work makes it possible to build a forecast model from meteorological data for estimating pollen concentration over a certain threshold of Poaceae, an allergenic family. In Italy, about 25 % of the population suffer from allergies, these in 80 % of cases being caused by airborne allergens, including taxa of agricultural interest such as Poaceae. The pollen dispersion in air is determined by both the phenological stage of plants and the meteorological conditions; the pollen presence varies according to the year, month and even the time of the day. There is a correlation between environmental factors, pollen concentrations and pollinosis. A partial least squares discriminant analysis approach was used in order to predict the presence of Poaceae pollen in the atmosphere with a time lag of 3, 5, 7 days, on the basis of a data set of 14 meteorological and pollen variables over a period of 14 years (1997–2010). The results show a high accuracy in predicting pollen critical concentrations, with values ranging from 85.4 to 88.0 %. This study is hopefully a positive first step in the use of a statistical approach that in the next future could have clinical applications.