Epidemiologia & Prevenzione最新文献

Objectives: to provide a comprehensive and comparable assessment of life expectancy (LE), health-adjusted life expectancy (HALE), Years Lived with Disability (YLDs), Years of Life Lost (YLLs), and Disability-Adjusted Life Years (DALYs) across Italian regions from 1990 to 2023, identifying temporal, geographical, and sex-specific patterns to inform targeted public health strategies.

Design: descriptive epidemiological study using estimates from the Global Burden of Disease Study (GBD) 2023.

Setting and participants: the analysis covered the Italian population, stratified by sex, five macro-regions, and 21 subnational locations, including 19 Regions and 2 Autonomous Provinces.

Main outcome measures: LE, HALE, all-age and age-standardized rates YLDs, YLLs, and DALYs per 100,000 population; all estimates were presented with their 95% uncertainty intervals.

Results: between 1990 and 2023, LE increased substantially across all regions and in both sexes, despite the temporary decline associated with the COVID-19 pandemic. In 2023, the highest LE was recorded in the North-East, with 81.4 years (95%CI 81.1-81.6) for males and 85.8 years (95%CI 85.6-86.1) for females, while the lowest values were found in the Islands, at 79.7 years (95%CI 79.3-80.1) for males and 84.2 years (95%CI 83.9-84.5) for females. However, differences diminished when considering HALE. YLDs increased steadily over time, reflecting not only population ageing but also the expanding burden of chronic and non-fatal conditions. In contrast, YLLs declined markedly in both sexes, driven particularly by substantial reductions in mortality from neoplasms and cardiovascular diseases. However, in 2023, ischemic heart disease remained the leading contributor to all-age DALYs among males, while Alzheimer's disease was the top cause among females. Anxiety disorders represented the leading cause of age-standardized DALYs in females and showed marked increases since 1990. Among males, ischemic heart disease continued to appear as the primary cause of age-standardized DALYs.

Conclusions: health in Italy improved substantially over the past three decades, primarily due to declining premature mortality. However, the burden of disability increased, particularly among women, and important geographical and sex-specific inequalities persist. Strengthening prevention policies, addressing behavioural and metabolic risk factors and mental health, improving long-term care, and promoting healthy ageing are essential to reducing health disparities.

On 30 January 2025, the European Court of Human Rights condemned the Italian Government for failing to safeguard the right to life of residents in ninety municipalities in the Campania region, an area known as 'Terra dei Fuochi' (literally: Land of Fires). This judgment is historic for two main reasons. First and foremost, it represents the first judicial recognition of severe, decades-long environmental and health deterioration affecting a specific territory. Second, it establishes a significant precedent for environmental litigation, marking the first time the Court has unequivocally affirmed that epidemiological evidence collected within a defined area is sufficient to demonstrate a violation of the right to life of the populations living there. This stance adopted by the Court gives rise to a series of important legal implications: it strengthens the basis for prosecuting environmental crimes and encourages the development of innovative investigative projects that move beyond individual-level data; such projects can capture the collective harms suffered by affected communities and help determine whether these harms can be traced to actions or omissions by public authorities or private-sector actors.

Objectives: to evaluate follow-up patterns after a total prostate-specific antigen (PSA) test performed in the absence of clinical indications among residents of the Agency for Health Protection of the Metropolitan Area of Milan (ATS Milano).

Design: a cohort of men aged 30-84 years residing in the ATS Milano area who underwent at least one PSA test between 2018-2019 and 2021-2023, followed for subsequent investigations through December 2024.

Setting and participants: from the administrative and healthcare databases of the ATS Milano, 414,731 individuals who had at least one PSA test during the study period, presumably for screening purposes, were identified.

Main outcome measures: individual procedures and cumulative follow-up activities within 3, 6, and 12 months from the index PSA test, classified as passive or active, and as conservative (repeat PSA test, ultrasound, or urological visit) or aggressive/therapeutic (CT/MRI imaging, prostate biopsy, or prostate-related hospitalization). Logistic regression was used to estimate the probability of active and aggressive follow-up.

Results: overall, 58% of men had no follow-up procedures within the first year, particularly among those with low PSA values, while the proportion remained above 30% among men with PSA >=4 ng/mL. Among those who underwent follow-up, 84% followed a conservative pathway. At one year, among men aged 50-69 years (55.7% of the total population) with PSA >=3 ng/mL, 38.8% had no follow-up, while 18.7% underwent an aggressive procedure, compared with about 5% among those with PSA <3 ng/mL. Within three months, the most frequent procedures were urological consultation (10.0%) and ultrasound (9.3%). The probability of active follow-up increased with age (including advanced age), index PSA value, >=3 comorbidities, and socioeconomic deprivation. Older age, PSA >= 4ng/mL, and Italian citizenship were associated with a higher likelihood of an aggressive approach.

Conclusions: the high rate of active follow-up among older adults (70-84 years) with multiple comorbidities, even with a lower use of aggressive procedures, indicates the value of an organised programme aimed at concentrating interventions on individuals who are most likely to benefit.

Objectives: to evaluate the preventability of workplace fatalities that occurred in Piedmont Region (Northern Italy) through inspections by Occupational Safety and Health (OSH) inspectors. It was examined whether an inspection carried out the day before the event could have avoided the injury, and also differences in its impact across various sectors were investigated.

Design: descriptive study.

Setting and participants: workplace injury investigations conducted by OSH inspectors on fatalities that occurred in Piedmont from 2002 to 2022, classified according to the InforMo method.

Main outcome measures: using a group of validated criteria of preventability, fatalities were divided into three categories: probably preventable, probably not preventable, and uncertain.

Results: two-thirds of the 786 workers who died were employed in construction and agriculture, while the remaining third worked in manufacturing and other sectors. The analysis on the preventability of fatalities indicates that, in at least half and up to two thirds of the cases, an inspection carried out the previous day probably could not have prevented the fatality. Interviews with OSH inspectors confirmed the validity of the criteria adopted to classify the preventability of injuries.

Conclusions: the results suggest that, although inspections can play a significant role in preventing workplace fatalities, a considerable portion of them probably could not have been avoided with a hypothetical inspection the day before the event. To corroborate this result, it is necessary to extend the analysis to fatalities occurring in other Regions. Nevertheless, it is necessary to strengthen the contribution of the various actors envisaged by Legislative Decree 81/2008 and Legislative Decree 626/1994 (RSPP, RLS, etc.) to improve significantly the workplace safety.

Objectives: to model a real-world probability curve of fertility rates in non-endometriotic and endometriotic women using demographic data and information from Italy.

Design: probabilistic simulation built from available data of Italian population.

Setting and participants: data from the Italian population of the years 2020-2023 were collected on: 1. the actual desire for pregnancy; 2. the infertility rate and outcomes of assisted reproductive technologies (ART); 3. the age at which endometriosis is diagnosed and the impact of endometriosis treatments on fertility; 4. the infertility rate in endometriotic patients and outcomes of ART; 5. the natural decline in fertility with age in women. Data for points 1 to 3 were obtained from Italian institutional websites, while points 4 and 5 were estimated from scientific literature. Normalized estimates of cumulative pregnancy rates and live birth rates in Italian non-endometriotic and endometriotic women were calculated based on Italian family planning behaviour and endometriosis medical care issues. These estimates were combined and plotted by female aging to observe trends.

Main outcome measures: age-specific fertility trends in endometriotic and non-endometriotic Italian women.

Results: treated endometriotic patients show a reduction in fertility potential compared to non-endometriotic and untreated endometriotic patients.

Conclusions: the decline of fertility in Italian endometriotic women is mainly iatrogenic. Women with endometriosis should consider conceiving at a young age.

In data 10.02.2026 è stata caricata la nuova versione del volume SENTIERI - Studio epidemiologico nazionale dei territori e degli insediamenti esposti a rischio da inquinamento. Sesto Rapporto (Epidemiol Prev 2023;47(1-2) Suppl 1. doi: 10.19191/EP23.1-2-S1.003) nella quale è stata aggiornata la tabella AVB_1 (p. 239) relativa alla SIN "Area industriale Val Basento".alla World Health Organization (WHO). Di conseguenza, è stato modificato il paragrafo "Health impact estimation" a p. 14. I PDF nei quali sono segnalate le modifiche sono disponibili alla pagina dell'articolo.

As part of the 'One Health Citizen Science' (OHCS) project, which aims to encourage data collection and health promotion in areas of high environmental risk, particular importance has been given to citizen participation. This article describes the pilot activity carried out in Sulcis Iglesiente, an area of Sardinia known for its various environmental pressures, which is the result of collaboration among the University of Cagliari, the Italian National Research Council and the Anffas Foundation, an association that supports people with intellectual disabilities and neurological development disorders. Interdisciplinary pathways were created to support informed participation of people with intellectual disabilities on the risks of the territory in which they live. To achieve this goal, appropriate scientific methods were used through accessible language and with the mediation of professional educators. In designing the sustainability of this citizen science activity over time, the promoters also included policy makers in the dialogue to provide them with concrete and more representative bases on which to base their decisions.