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Djuric O, Larosa E, Cassinadri M, Cilloni S, Bisaccia E, Pepe D, Bonvicini L, Vicentini M, Venturelli F, Giorgi Rossi P, Pezzotti P, Mateo Urdiales A, Bedeschi E. Effect of an enhanced public health contact tracing intervention on the secondary transmission of SARS-CoV-2 in educational settings: The four-way decomposition analysis. eLife 2024; 13:e85802. [PMID: 38416129 PMCID: PMC10901504 DOI: 10.7554/elife.85802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
Background The aim of our study was to test the hypothesis that the community contact tracing strategy of testing contacts in households immediately instead of at the end of quarantine had an impact on the transmission of SARS-CoV-2 in schools in Reggio Emilia Province. Methods We analysed surveillance data on notification of COVID-19 cases in schools between 1 September 2020 and 4 April 2021. We have applied a mediation analysis that allows for interaction between the intervention (before/after period) and the mediator. Results Median tracing delay decreased from 7 to 3.1 days and the percentage of the known infection source increased from 34-54.8% (incident rate ratio-IRR 1.61 1.40-1.86). Implementation of prompt contact tracing was associated with a 10% decrease in the number of secondary cases (excess relative risk -0.1 95% CI -0.35-0.15). Knowing the source of infection of the index case led to a decrease in secondary transmission (IRR 0.75 95% CI 0.63-0.91) while the decrease in tracing delay was associated with decreased risk of secondary cases (1/IRR 0.97 95% CI 0.94-1.01 per one day of delay). The direct effect of the intervention accounted for the 29% decrease in the number of secondary cases (excess relative risk -0.29 95%-0.61 to 0.03). Conclusions Prompt contact testing in the community reduces the time of contact tracing and increases the ability to identify the source of infection in school outbreaks. Although there are strong reasons for thinking it is a causal link, observed differences can be also due to differences in the force of infection and to other control measures put in place. Funding This project was carried out with the technical and financial support of the Italian Ministry of Health - CCM 2020 and Ricerca Corrente Annual Program 2023.
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Affiliation(s)
- Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
- Centre for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), University of Modena and Reggio EmiliaModenaItaly
| | - Elisabetta Larosa
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Mariateresa Cassinadri
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Silvia Cilloni
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Eufemia Bisaccia
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Davide Pepe
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Laura Bonvicini
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Francesco Venturelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di SanitàRomeItaly
| | | | - Emanuela Bedeschi
- Public Health Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio EmiliaReggio EmiliaItaly
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Molina Grané C, Mancuso P, Vicentini M, Venturelli F, Djuric O, Manica M, Guzzetta G, Marziano V, Zardini A, d'Andrea V, Trentini F, Bisaccia E, Larosa E, Cilloni S, Cassinadri MT, Pezzotti P, Ajelli M, Rossi PG, Merler S, Poletti P. SARS-CoV-2 transmission patterns in educational settings during the Alpha wave in Reggio-Emilia, Italy. Epidemics 2023; 44:100712. [PMID: 37567090 DOI: 10.1016/j.epidem.2023.100712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/17/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Different monitoring and control policies have been implemented in schools to minimize the spread of SARS-CoV-2. Transmission in schools has been hard to quantify due to the large proportion of asymptomatic carriers in young individuals. We applied a Bayesian approach to reconstruct the transmission chains between 284 SARS-CoV-2 infections ascertained during 87 school outbreak investigations conducted between March and April 2021 in Italy. Under the policy of reactive quarantines, we found that 42.5% (95%CrI: 29.5-54.3%) of infections among school attendees were caused by school contacts. The mean number of secondary cases infected at school by a positive individual during in-person education was estimated to be 0.33 (95%CrI: 0.23-0.43), with marked heterogeneity across individuals. Specifically, we estimated that only 26.0% (95%CrI: 17.6-34.1%) of students and school personnel who tested positive during in-person education caused at least one secondary infection at school. Positive individuals who attended school for at least 6 days before being isolated or quarantined infected on average 0.49 (95%CrI: 0.14-0.83) secondary cases. Our findings provide quantitative insights on the contribution of school transmission to the spread of SARS-CoV-2 in young individuals. Identifying positive cases within 5 days after exposure to their infector could reduce onward transmission at school by at least 30%.
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Affiliation(s)
- Carla Molina Grané
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy; Department of Mathematics, University of Trento, Trento, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Venturelli
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy; Department of Biomedical, Metabolic and Neural Sciences, Centre for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Public Health Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Mattia Manica
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Giorgio Guzzetta
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | | | - Agnese Zardini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Valeria d'Andrea
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Filippo Trentini
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy; Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Eufemia Bisaccia
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Larosa
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Cilloni
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Teresa Cassinadri
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Ajelli
- Laboratory for Computational Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Merler
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy
| | - Piero Poletti
- Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.
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Boriani G, Guerra F, De Ponti R, D'Onofrio A, Accogli M, Bertini M, Bisignani G, Forleo GB, Landolina M, Lavalle C, Notarstefano P, Ricci RP, Zanotto G, Palmisano P, De Bonis S, Pangallo A, Talarico A, Maglia G, Aspromonte V, Nigro G, Bianchi V, Rapacciuolo A, Ammendola E, Solimene F, Stabile G, Biffi M, Ziacchi M, Malpighi PSO, Saporito D, Casali E, Turco V, Malavasi VL, Vitolo M, Imberti JF, Bertini M, Anna AS, Zardini M, Placci A, Quartieri F, Bottoni N, Carinci V, Barbato G, De Maria E, Borghi A, Ramazzini OB, Bronzetti G, Tomasi C, Boggian G, Virzì S, Sassone B, Corzani A, Sabbatani P, Pastori P, Ciccaglioni A, Adamo F, Scaccia A, Spampinato A, Patruno N, Biscione F, Cinti C, Pignalberi C, Calò L, Tancredi M, Di Belardino N, Ricciardi D, Cauti F, Rossi P, Cardinale M, Ansalone G, Narducci ML, Pelargonio G, Silvetti M, Drago F, Santini L, Pentimalli F, Pepi P, Caravati F, Taravelli E, Belotti G, Rordorf R, Mazzone P, Bella PD, Rossi S, Canevese LF, Cilloni S, Doni LA, Vergara P, Baroni M, Perna E, Gardini A, Negro R, Perego GB, Curnis A, Arabia G, Russo AD, Marchese P, Dell’Era G, Occhetta E, Pizzetti F, Amellone C, Giammaria M, Devecchi C, Coppolino A, Tommasi S, Anselmino M, Coluccia G, Guido A, Rillo M, Palamà Z, Luzzi G, Pellegrino PL, Grimaldi M, Grandinetti G, Vilei E, Potenza D, Scicchitano P, Favale S, Santobuono VE, Sai R, Melissano D, Candida TR, Bonfantino VM, Di Canda D, Gianfrancesco D, Carretta D, Pisanò ECL, Medico A, Giaccari R, Aste R, Murgia C, Nissardi V, Sanna GD, Firetto G, Crea P, Ciotta E, Sgarito G, Caramanno G, Ciaramitaro G, Faraci A, Fasheri A, Di Gregorio L, Campsi G, Muscio G, Giannola G, Padeletti M, Del Rosso A, Notarstefano P, Nesti M, Miracapillo G, Giovannini T, Pieragnoli P, Rauhe W, Marini M, Guarracini F, Ridarelli M, Fedeli F, Mazza A, Zingarini G, Andreoli C, Carreras G, Zorzi A, Zanotto G, Rossillo A, Ignatuk B, Zerbo F, Molon G, Fantinel M, Zanon F, Marcantoni L, Zadro M, Bevilacqua M. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing). Intern Emerg Med 2023; 18:137-149. [PMID: 36352300 PMCID: PMC9646282 DOI: 10.1007/s11739-022-03140-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care. METHODS A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched. RESULTS A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined. CONCLUSIONS The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.
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Affiliation(s)
- Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo 71, 41121, Modena, Italy.
| | - Federico Guerra
- Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital Umberto I-Lancisi-Salesi, Ancona, Italy
| | - Roberto De Ponti
- Department of Heart and Vessels, Ospedale di Circolo-University of Insubria, Varese, Italy
| | - Antonio D'Onofrio
- Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples, Italy
| | | | - Matteo Bertini
- Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara "Arcispedale S. Anna", Cona, Ferrara, Italy
| | - Giovanni Bisignani
- Cardiology Division, Castrovillari Hospital, ASP Cosenza, Castrovillari, Italy
| | | | | | - Carlo Lavalle
- Department of Cardiology, Policlinico Universitario Umberto I, Rome, Italy
| | | | | | - Gabriele Zanotto
- Department of Cardiology, Mater Salutis Hospital, Legnago, Verona, Italy
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Djuric O, Larosa E, Cassinadri M, Cilloni S, Bisaccia E, Pepe D, Vicentini M, Venturelli F, Bonvicini L, Giorgi Rossi P, Pezzotti P, Mateo Urdiales A, Bedeschi E. Surveillance, contact tracing and characteristics of SARS-CoV-2 transmission in educational settings in Northern Italy, September 2020 to April 2021. PLoS One 2022; 17:e0275667. [PMID: 36215304 PMCID: PMC9550042 DOI: 10.1371/journal.pone.0275667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/21/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The role of school contacts in the spread of the virus and the effectiveness of school closures in controlling the epidemic is still debated. We aimed to quantify the risk of transmission of SARS-CoV-2 in the school setting by type of school, characteristics of the index case and calendar period in the Province of Reggio Emilia (RE), Italy. The secondary aim was to estimate the speed of implementation of contact tracing. METHODS A population-based analysis of surveillance data on all COVID-19 cases occurring in RE, Italy, from 1 September 2020, to 4 April 2021, for which a school contact and/or exposure was suspected. An indicator of the delay in contact tracing was calculated as the time elapsed since the index case was determined to be positive and the date on which the swab test for classmates was scheduled (or most were scheduled). RESULTS Overall, 30,184 and 13,608 contacts among classmates and teachers/staff, respectively, were identified and were recommended for testing, and 43,214 (98.7%) underwent the test. Secondary transmission occurred in about 40% of the investigated classes, and the overall secondary case attack rate was 4%. This rate was slightly higher when the index case was a teacher but with almost no differences by type of school, and was stable during the study period. Speed of implementation of contact tracing increased during the study period, with the time from index case identification to testing of contacts being reduced from seven to three days. The ability to identify the possible source of infection in the index case also increased. CONCLUSIONS Despite the spread of the Alpha variant during the study period in RE, the secondary case attack rate remained stable from school reopening in September 2020 until the beginning of April 2021.
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Affiliation(s)
- Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Biomedical, Metabolic and Neural Sciences, Centre for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Public Health Unit, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Larosa
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mariateresa Cassinadri
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Cilloni
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Eufemia Bisaccia
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Davide Pepe
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Venturelli
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Laura Bonvicini
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Emanuela Bedeschi
- Public Health Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Larosa E, Djuric O, Cassinadri M, Cilloni S, Bisaccia E, Vicentini M, Venturelli F, Giorgi Rossi P, Pezzotti P, Bedeschi E. Secondary transmission of COVID-19 in preschool and school settings in northern Italy after their reopening in September 2020: a population-based study. Euro Surveill 2020; 25:2001911. [PMID: 33303065 PMCID: PMC7730487 DOI: 10.2807/1560-7917.es.2020.25.49.2001911] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/10/2020] [Indexed: 12/29/2022] Open
Abstract
We report epidemiological investigations of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 41 classes of 36 schools in Reggio Emilia province, northern Italy, from their reopening on 1 September to 15 October 2020. The overall secondary case attack rate was 3.2%, reaching 6.6% in middle and high schools. More timely isolation and testing of classmates could be effective in reducing virus transmission in this setting.
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Affiliation(s)
- Elisabetta Larosa
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Olivera Djuric
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Center for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Mariateresa Cassinadri
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Cilloni
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Eufemia Bisaccia
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Venturelli
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Emanuela Bedeschi
- Public Health Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Filippini T, Adani G, Malavolti M, Garuti C, Cilloni S, Vinceti G, Zamboni G, Tondelli M, Galli C, Costa M, Chiari A, Vinceti M. Dietary Habits and Risk of Early-Onset Dementia in an Italian Case-Control Study. Nutrients 2020; 12:nu12123682. [PMID: 33260315 PMCID: PMC7760835 DOI: 10.3390/nu12123682] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/17/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022] Open
Abstract
Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake (>400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Giorgia Adani
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Caterina Garuti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Silvia Cilloni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
| | - Giulia Vinceti
- Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (G.V.); (G.Z.)
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
| | - Giovanna Zamboni
- Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy; (G.V.); (G.Z.)
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
| | - Manuela Tondelli
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
- Primary care Department, Modena Local Health Authority, 41124 Modena, Italy
| | - Chiara Galli
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
- Primary care Department, Modena Local Health Authority, 41124 Modena, Italy
- Department of Neuroscience, Psychology, Pharmacology and Child Health (NeuroFARBA), University of Florence, 50139 Florence, Italy
| | - Manuela Costa
- Neurology Unit of Carpi Hospital, Modena Local Health Authority, 41012 Carpi, Italy;
| | - Annalisa Chiari
- Neurology Unit, Modena Policlinico-University Hospital, 41126 Modena, Italy; (M.T.); (C.G.); (A.C.)
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (T.F.); (G.A.); (M.M.); (C.G.); (S.C.)
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Correspondence: ; Tel.: +39-059-2055481
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7
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Chawla R, Filippini T, Loomba R, Cilloni S, Dhillon KS, Vinceti M. Exposure to a high selenium environment in Punjab, India: Biomarkers and health conditions. Sci Total Environ 2020; 719:134541. [PMID: 31862262 DOI: 10.1016/j.scitotenv.2019.134541] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
Seleniferous areas have been identified and described in many parts of the world. Despite the interest in selenium as a trace element of considerable toxicologic and nutritional relevance, however, only a few studies have been carried out on human health effects of such high selenium environments. We collected blood, hair and nail samples from 680 adult volunteers (267 men and 413 women) living in seven villages located in the seleniferous area of Punjab, India. We measured selenium levels in these specimens. We also administered a questionnaire to collect information about diet and other lifestyle characteristics, to identify the sources of selenium exposure and to correlate it with a number of health conditions. Serum and hair selenium contents were highly correlated, while the association of these biomarkers with nail selenium content was weaker. Serum selenium showed limited association with consumption of locally produced foods, while pulses and vegetables, along with cereals and pulses, were associated to higher hair and nail selenium contents, respectively. Association of a number of adverse health endpoints with serum and hair selenium was stronger than for nail selenium contents. Such endpoints included higher prevalence of nausea and vomiting, bad breath, worm infestation, breathlessness exert and bad breath, chest pain, hair and nail abnormalities and loss, garlic odor, edema, spontaneous abortion, and overall selenosis. In contrast, we gathered no evidence of dermatitis or loss of appetite in residents most exposed to selenium. Overall, and despite some statistical imprecision in effect estimates, these results confirm the occurrence of adverse health effects in subjects exposed to high levels of environmental selenium. Nail selenium contents may be less adequate to reflect and monitor such overexposure, compared with blood and hair levels.
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Affiliation(s)
- Rajinder Chawla
- Christian Medical College & Hospital, Ludhiana, India; Accuscript Consultancy, Ludhiana, India
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Rinchu Loomba
- Christian Medical College & Hospital, Ludhiana, India
| | - Silvia Cilloni
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
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8
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Loomba R, Filippini T, Chawla R, Chaudhary R, Cilloni S, Datt C, Singh S, Dhillon KS, Vinceti M. Exposure to a high selenium environment in Punjab, India: Effects on blood chemistry. Sci Total Environ 2020; 716:135347. [PMID: 31843317 DOI: 10.1016/j.scitotenv.2019.135347] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Many studies have shown that overexposure to environmental selenium may exert a wide pattern of adverse effects on human health, but much uncertainty still surrounds some of them as well as the exact amounts of exposure involved. In particular, very few studies have addressed the possible changes in blood chemistry following high selenium exposure. In a Northeastern part of Punjab, India, very high soil selenium content has been documented, with a value exceeding 2 mg/kg (up to 5) as compared with the <0.5 mg/kg selenium content characterizing the surrounding referent areas. In seven villages located in that seleniferous areas, we carried out a survey by recruiting volunteers and sampling blood, hair and nail specimens. We administered a questionnaire to the participants and analyzed the specimens for the selenium, along with a series of biochemical and haematological parameters in blood. We included 680 adult volunteers (267 men and 413 women), who showed median selenium levels of 171.30 µg/L in serum, 1.25 µg/g in hair, and 5.7 µg/g in nails. Overall, increasing selenium exposure tended to correlate with higher levels of total cholesterol, albumin, free triiodothyronine, deionidase activity, and with red cell and platelet counts. After stratifying the subjects according to category of selenium exposure, we observed a dose-response relation between serum selenium and risk of high total cholesterol, and between hair selenium and risk of high total and low-density lipoprotein cholesterol, high pancreatic lipase, altered thyroid-stimulating hormone and free triiodothyronine levels. Nail selenium exposure category positively correlated with risk of high alanine-aminotransferase, altered albumin levels, high pancreatic lipase and low levels of thyroid-stimulating hormone. Chronic selenium overexposure appears to adversely affect lipid profiles and pancreatic, liver, and thyroid function, with selenium biomarkers having different abilities to predict such effects.
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Affiliation(s)
- Rinchu Loomba
- Christian Medical College & Hospital, Ludhiana, India
| | - Tommaso Filippini
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Rajinder Chawla
- Christian Medical College & Hospital, Ludhiana, India; Accuscript Consultancy, Ludhiana, India
| | | | - Silvia Cilloni
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Chander Datt
- ICAR-National Dairy Research Institute, Karnal, India
| | | | | | - Marco Vinceti
- CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Reggio Emilia, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
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9
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Vinceti M, Chawla R, Filippini T, Dutt C, Cilloni S, Loomba R, Bargellini A, Orsini N, Dhillon KS, Whelton P. Blood pressure levels and hypertension prevalence in a high selenium environment: results from a cross-sectional study. Nutr Metab Cardiovasc Dis 2019; 29:398-408. [PMID: 30782506 DOI: 10.1016/j.numecd.2019.01.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Recent human and laboratory studies have suggested the possibility that selenium overexposure may increase blood pressure. We sought to ascertain whether adults living in a seleniferous area exhibit an association between selenium exposure and both blood pressure levels as well as prevalence of hypertension. METHODS AND RESULTS We measured selenium levels in blood (serum), hair and nail samples obtained from 680 adult volunteers (267 men and 413 women), living in seven Punjabi villages in a seleniferous area and related them to health outcomes, including systolic and diastolic blood pressure and presence of hypertension. In a multivariable restricted cubic spline regression model, adjusted for age, sex and history of hypertension, we found a positive association between systolic blood pressure and both serum (P = 0.004) and hair (P = 0.058) selenium levels, but not with nail selenium content. Little association emerged between the three selenium biomarkers and diastolic blood pressure. Hypertension prevalence was positively associated with the three exposure indicators (P < 0.001). The associations we found were generally stronger in women than in men. CONCLUSIONS Overall, these findings suggest that chronic overexposure to environmental selenium may increase blood pressure, though there were inconsistencies for this association according to the choice of exposure indicator, the study endpoint and the sex.
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Affiliation(s)
- M Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States.
| | - R Chawla
- Christian Medical College & Hospital, Ludhiana, India; Accuscript Consultancy, Ludhiana, India
| | - T Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - C Dutt
- National Dairy Research Institute, Karnal, India
| | - S Cilloni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - R Loomba
- Christian Medical College & Hospital, Ludhiana, India
| | - A Bargellini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - N Orsini
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - K S Dhillon
- Punjab Agricultural University, Ludhiana, India
| | - P Whelton
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, United States
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10
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Filippini T, Tancredi S, Malagoli C, Cilloni S, Malavolti M, Violi F, Vescovi L, Bargellini A, Vinceti M. Aluminum and tin: Food contamination and dietary intake in an Italian population. J Trace Elem Med Biol 2019; 52:293-301. [PMID: 30732896 DOI: 10.1016/j.jtemb.2019.01.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 12/13/2022]
Abstract
Aluminum and tin are ubiquitous in the environment. In normal biological systems, however, they are present only in trace amounts and have no recognized biological functions in humans. High exposure to these metals can result in adverse health effects such as neurodegenerative diseases. In non-occupationally exposed subjects, diet is the primary source of exposure. In this study, we aimed at estimating dietary aluminum and tin intake in an Italian adult population. We measured aluminum and tin concentrations through inductively-coupled plasma mass spectrometry in 908 food samples. We also estimated dietary intake of these two metals, by using a validated semi-quantitative food-frequency questionnaire administered to 719 subjects (319 men and 400 women) recruited from the general population of the Emilia Romagna region, Northern Italy. We found the highest aluminum levels in legumes, sweets, and cereals, while the highest tin levels were in sweets, meat and seafood. The estimated median daily dietary intake of aluminum was 4.1 mg/day (Interquartile range - IQR: 3.3-5.2), with a major contribution from beverages (28.6%), cereals (16.9%), and leafy vegetables (15.2%). As for tin, we estimated a median intake of 66.8 μg/day (IQR: 46.7-93.7), with a major contribution from vegetables (mainly tomatoes) (24.9%), fruit (15.5%), aged cheese (12.2%), and processed meat (10.4%). This study provides an updated estimate of the dietary intake of aluminum and tin in a Northern-Italy adult population, based on data from a validated food-frequency questionnaire. The intake determined for this population does not exceed the established thresholds of tolerable intake.
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Affiliation(s)
- Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy.
| | - Stefano Tancredi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Silvia Cilloni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Marcella Malavolti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Federica Violi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Luciano Vescovi
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Annalisa Bargellini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, USA
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11
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Bonvicini F, Cilloni S, Fornaciari R, Casoni C, Marchesi C, Greci M, Monici L, Nicolini F, Vinceti M. Compliance with Tuberculosis Screening in Irregular Immigrants. Int J Environ Res Public Health 2018; 16:ijerph16010028. [PMID: 30583597 PMCID: PMC6339090 DOI: 10.3390/ijerph16010028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 12/27/2022]
Abstract
Tuberculosis (TB) is a serious public health problem in many regions of the world, especially in the poorest areas. For this reason, screening for active and latent forms must be considered when dealing with high-risk groups such as irregular immigrants in Western countries. We conducted a retrospective cohort study by recruiting subjects aged ≥15 years who underwent a tuberculin skin test at a dedicated National Health Service Centre in a northern Italian province between 1 January 2012 and 31 December 2013. These participants were followed up until 31 December 2016. We aimed at evaluating an experimental protocol for active and latent tuberculosis screening, focusing on patient compliance, feasibility, and capability to detect clinical forms of the disease. We enrolled 368 irregular immigrants, i.e., immigrants not having a valid residence permit and who were therefore not entitled to choose a general practitioner. In total, 90.22% of these completed all the steps for the screening of active TB, while 87.33% also undertook screening for the latent form of the disease. Homelessness, self-reported prostitution, female sex, and employment status adversely affected compliance. Chronic alcohol consumption was associated with increased risk of no beginning or interruption of the procedures. All of the five patients with active TB successfully completed the treatment. Overall, adherence to the screening program was high compared to other studies in immigrants, possibly owing to organizational factors such as the availability of cultural mediators, the network between the different health services, the presence of dedicated nursing staff and a free-of-charge service. In addition, selected vulnerable subgroups should be targeted using tailored screening and follow-up programs.
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Affiliation(s)
- Francesca Bonvicini
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Silvia Cilloni
- Università degli Studi di Modena e Reggio Emilia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Modena 41125, Italy.
| | - Rossano Fornaciari
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Carmen Casoni
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Cristina Marchesi
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Marina Greci
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Lucia Monici
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Fausto Nicolini
- Azienda Unità Sanitaria Locale di Reggio Emilia, Reggio Emilia 42122, Italy.
| | - Marco Vinceti
- Università degli Studi di Modena e Reggio Emilia, Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Modena 41125, Italy.
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12
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Filippini T, Cilloni S, Malavolti M, Violi F, Malagoli C, Tesauro M, Bottecchi I, Ferrari A, Vescovi L, Vinceti M. Dietary intake of cadmium, chromium, copper, manganese, selenium and zinc in a Northern Italy community. J Trace Elem Med Biol 2018; 50:508-517. [PMID: 29548610 DOI: 10.1016/j.jtemb.2018.03.001] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 02/06/2023]
Abstract
This study provides the dietary intakes of six trace elements (cadmium, chromium, copper, manganese, selenium and zinc), generally characterized by both nutritional and toxicological features depending on their exposure. Being diet the most relevant source of exposure to trace elements in non-professionally exposed subjects, we measured content of these trace elements in foods composing the typical Italian diet using inductively coupled plasma-mass spectrometry, and assessing dietary habits using a validated semi-quantitative food frequency questionnaire we eventually estimated dietary daily intake of trace elements in a Northern Italian community. In the 890 analyzed food samples, the main contributors to cadmium intake are cereals, vegetables and sweets, while cereals, beverages and vegetable are to primary source of manganese. The primary contributors for copper are cereals, fresh fruits and vegetables, while for chromium are beverages, cereals and meat. The main source of selenium intake are cereals and meat, followed by fish, seafood and milk and dairy products, while of zinc intake are meat, cereals, milk and dairy products. In our Italian population sample, the estimated median (interquartile range) dietary daily intakes are 5.00 (3.17-7.65), 56.70 (36.08-86.70) and 66.53 (40.04-101.32) μg/day for cadmium, chromium and selenium, and corresponding figures are 0.98 (0.61-1.49), 2.34 (1.46-3.52) and 8.50 (5.21-12.48) mg/day for copper, manganese and zinc. The estimated intakes are generally within the average intake reported in other European populations, and in such cases well above the daily dietary intakes recommended by national international agencies, avoiding the risk of excess or deficiency. The present estimated intake data can be used to examine a specific trace element of interest and would afford enhanced health protection from those trace elements characterized by both nutritional and toxicological effects.
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Affiliation(s)
- Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Silvia Cilloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Federica Violi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marina Tesauro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy
| | - Ilaria Bottecchi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Angela Ferrari
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | | | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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13
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Filippini T, Malavolti M, Cilloni S, Wise LA, Violi F, Malagoli C, Vescovi L, Vinceti M. Intake of arsenic and mercury from fish and seafood in a Northern Italy community. Food Chem Toxicol 2018; 116:20-26. [PMID: 29626577 DOI: 10.1016/j.fct.2018.04.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 03/27/2018] [Accepted: 04/04/2018] [Indexed: 11/29/2022]
Abstract
Regular consumption of fish is generally recommended by authorities because fish is an important source of essential nutrients. However, the presence of potentially toxic contaminants in fish has raised many concerns about the food's safety for human health. In the present study, we used a validated semi-quantitative food frequency questionnaire to assess the dietary habits of a representative sample of 719 individuals (319 males and 400 females) aged 18-87 years residing in Northern Italy. We estimated weekly dietary intakes of Arsenic (As) and Mercury (Hg), and we compared them with safety standards set by the European Food Safety Authority. In this population, fish was the main contributor to As and Hg intake. The highest levels of As were in sardine, sole/flounder and cephalopods, and of Hg in the biggest, predatory fish. About the other foods, cereals were the second contributor to the intake of these elements, especially rice for As and bread for Hg, and high levels of As and Hg were also found in mushrooms, coffee and wine. Average weekly intake of both contaminants was below recommended safety limits.
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Affiliation(s)
- Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Silvia Cilloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Federica Violi
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy
| | | | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center - Section of Public Health - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 287 Via Campi, 41125 Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
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14
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Abstract
The relation between selenium and cancer has been one of the most hotly debated topics in human health over the last decades. Early observational studies reported an inverse relation between selenium exposure and cancer risk. Subsequently, randomized controlled trials showed that selenium supplementation does not reduce the risk of cancer and may even increase it for some types, including advanced prostate cancer and skin cancer. An increased risk of diabetes has also been reported. These findings have been consistent in the most methodologically sound trials, suggesting that the early observational studies were misleading. Other studies have investigated selenium compounds as adjuvant therapy for cancer. Though there is currently insufficient evidence regarding the utility and safety of selenium compounds for such treatments, this issue is worthy of further investigation. The study of selenium and cancer is complicated by the existence of a diverse array of organic and inorganic selenium compounds, each with distinct biological properties, and this must be taken into consideration in the interpretation of both observational and experimental human studies.
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Affiliation(s)
- Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy; Boston University School of Public Health, Boston, MA, United States.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Cilloni
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), University of Modena and Reggio Emilia, Modena, Italy
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, United States
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15
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Vinceti M, Filippini T, Cilloni S, Bargellini A, Vergoni AV, Tsatsakis A, Ferrante M. Health risk assessment of environmental selenium: Emerging evidence and challenges (Review). Mol Med Rep 2017; 15:3323-3335. [PMID: 28339083 PMCID: PMC5428396 DOI: 10.3892/mmr.2017.6377] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 02/20/2017] [Indexed: 12/22/2022] Open
Abstract
New data have been accumulated in the scientific literature in recent years which allow a more adequate risk assessment of selenium with reference to human health. This new evidence comes from environmental studies, carried out in populations characterized by abnormally high or low selenium intakes, and from high-quality and large randomized controlled trials with selenium recently carried out in the US and in other countries. These trials have consistently shown no beneficial effect on cancer and cardiovascular risk, and have yielded indications of unexpected toxic effects of selenium exposure. Overall, these studies indicate that the minimal amount of environmental selenium which is source of risk to human health is much lower than anticipated on the basis of older studies, since toxic effects were shown at levels of intake as low as around 260 µg/day for organic selenium and around 16 µg/day for inorganic selenium. Conversely, populations with average selenium intake of less than 13–19 µg/day appear to be at risk of a severe cardiomyopathy, Keshan disease. Overall, there is the need to reconsider the selenium standards for dietary intake, drinking water, outdoor and indoor air levels, taking into account the recently discovered adverse health effects of low-dose selenium overexposure, and carefully assessing the significance of selenium-induced proteomic changes.
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Affiliation(s)
- Marco Vinceti
- CREAGEN, Research Center of Environmental, Genetic and Nutritional Epidemiology, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- CREAGEN, Research Center of Environmental, Genetic and Nutritional Epidemiology, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Cilloni
- CREAGEN, Research Center of Environmental, Genetic and Nutritional Epidemiology, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Annalisa Bargellini
- CREAGEN, Research Center of Environmental, Genetic and Nutritional Epidemiology, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Valeria Vergoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Aristides Tsatsakis
- Department of Forensic Sciences and Toxicology, University of Crete, Heraklion, Crete, Greece
| | - Margherita Ferrante
- Department of Medical, Surgical Sciences and Advanced Technologies 'G.F. Ingrassia', University of Catania, Catania, Italy
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