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Liguori G.,Parthenope University of Naples | Parlato A.,Area Dipartimentale di Epidemiologia e Prevenzione | Scaletti A.,Parthenope University of Naples | Belfiore P.,Parthenope University of Naples | And 4 more authors.
Italian Journal of Public Health | Year: 2012

Background: Although the efficacy of pneumococcal vaccination for the more common serotypes of Streptococcus pneumoniae has been demonstrated, the 13-valent vaccine (Prevenar 13®) is still offered in different ways in the Italian regional healthcare units, and in the region of Campania, some local health authorities administer the vaccine free of charge whilst others practice a co-payment. Methods: We performed a budget impact analysis of the possible free administration of Prevenar 13® vaccine to all newborns in the Campania region, by comparing two different delivery settings, one having an active vaccination program and another in which such program was absent. During the operation of the vaccination program, the number of expected cases with 50, 80 and 100% vaccine coverage in the population was considered. The economic advantage resulting from pneumococcal diseases deemed avoidable thanks to the vaccination was compared with the costs of the vaccination program. The analysis considered the direct costs in the 2 years after implementation of the vaccination program. Costs were expressed in € Euros 2010. Results: Although we did not consider the benefits achievable in the 10 years following the vaccination, nor the herd effects, we showed that offering anti-pneumococcal vaccination to all newborns could give economic advantages to the Region, estimated as close to 1 million Euros. Conclusi on: The use of Prevenar 13® can be considered a greatly advantageous public health strategy. Source

De Felip E.,Istituto Superiore di Sanita | Bianchi F.,CNR Institute of Clinical Physiology | Bove C.,ASL CE | Cori L.,CNR Institute of Clinical Physiology | And 17 more authors.
Science of the Total Environment | Year: 2014

To investigate if protracted living in degraded environments of the Caserta and Naples provinces (Campania Region, Italy) had an impact on exposure of local people, highly toxic persistent contaminants were measured in blood, blood serum, and human milk of a large number of healthy donors. Sampling was carried out from 2008 to 2009. Blood was collected from over 850 20-64-year old donors; by pooling, 84 blood and 84 serum samples were obtained. Milk was donated by 52 mothers: specimens were pooled into six samples. Polychlorodibenzodioxins (PCDDs), polychlorodibenzofurans (PCDFs), and polychlorobiphenyls (PCBs, dioxin-like (DL) and non-dioxin-like (σ6PCBs)), arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) were measured in serum (organic biomarkers) and blood (metals); these chemicals and polybromobiphenyl ethers (σ9PBDEs) were analyzed in milk. PCDD+PCDF, DL-PCB, TEQTOT, and σ6PCB concentration ranges (medians) in serum were 6.26-23.1 (12.4), 3.42-31.7 (11.5), 10.0-52.8 (23.9) pgTEQ97/g fat, and 55.5-647 (219) ng/g fat, respectively, while in milk concentration ranges were 5.99-8.77, 4.02-6.15, 10.0-14.2 pgTEQ97/g fat, and 48.7-74.2ng/g fat. Likewise, As, Cd, Hg, and Pb findings in blood spanned 2.34-13.4 (5.83), 0.180-0.930 (0.475), 1.09-7.60 (2.60), 10.2-55.9 (28.8) μg/L, respectively; only Pb could be measured in milk (2.78-5.99μg/L). σ9PBDE levels in milk samples were 0.965-6.05ng/g fat. Biomarkers' concentrations were found to be compatible with their current values in European countries and in Italy, and consistent with an exposure primarily determined by consumption of commercial food from the large distribution system. Based on relatively higher biomarker values within the hematic biomonitoring database, the following municipalities were flagged as possibly deserving attention for health-oriented interventions: Brusciano and Caivano (As), Giugliano (Hg), Pianura (PCDDs+PCDFs), and Qualiano-Villaricca (As, Hg). The analysis of samples' qualitative variability indicated that biomarker composition was sensitive at municipality level, a feature that can potentially drive interventions for future local risk assessment and/or management measures. © 2014 Elsevier B.V. Source

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