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Ricceri F.,Servizio sovrazonale di epidemiologia | Ricceri F.,University of Turin | Giraudo M.T.,University of Turin | Sieri S.,Fondazione IRCSS Instituto Nazionale dei Tumori | And 10 more authors.
Epidemiologia e Prevenzione | Year: 2015

OBJECTIVES: To investigate the impact of socioeconomic status on dietary habits in Italy. DESIGN: large Italian multicentric prospective cohort study. SETTING AND PARTICIPANTS: more than 45,000 subjects recruited between 1993 and 1998 in five Italian centres (Turin, Varese, Florence, Naples, and Ragusa). Dietary habits, educational level, and other characteristics were collected at baseline using standardised questionnaires. MAIN OUTCOME MEASURES: dietary habits collected for the EPIC study, grouped by food type and summarised by a Mediterranean dietary index. RESULTS: We observed differences in dietary habits and in lifestyle habits by fertile of educational level. Principally, we noticed a positive association between higher education and healthy dietary habits (reduction in intake of processed meat, bread and rice, sweet drinks; increase in intake of fruit and vegetables, yoghurt, fish, olive oil, and tea). CONCLUSION: A relationship between educational level and dietary habits is confirmed also in Italy, even if differences due to gender and residence area are present. This study shows an important role of dietary habits in health inequalities of the population with lower socioeconomic status.


PubMed | The Second University of Naples, Registro dei tumori, Fondazione IRCSS Instituto nazionale dei tumori, University of Naples Federico II and 4 more.
Type: Journal Article | Journal: Epidemiologia e prevenzione | Year: 2015

to investigate the impact of socioeconomic status on dietary habits in Italy.large Italian multicentric prospective cohort study.more than 45,000 subjects recruited between 1993 and 1998 in five Italian centres (Turin, Varese, Florence, Naples, and Ragusa). Dietary habits, educational level, and other characteristics were collected at baseline using standardised questionnaires.dietary habits collected for the EPIC study, grouped by food type and summarised by a Mediterranean dietary index.we observed differences in dietary habits and in lifestyle habits by tertile of educational level. Principally, we noticed a positive association between higher education and healthy dietary habits (reduction in intake of processed meat, bread and rice, sweet drinks; increase in intake of fruit and vegetables, yoghurt, fish, olive oil, and tea).a relationship between educational level and dietary habits is confirmed also in Italy, even if differences due to gender and residence area are present. This study shows an important role of dietary habits in health inequalities of the population with lower socioeconomic status.


Caranci N.,Servizio Sovrazonale di Epidemiologia | Biggeri A.,University of Florence | Biggeri A.,Instituto per lo Studio e la Prevenzione Oncologica ISPO | Grisotto L.,University of Florence | And 5 more authors.
Epidemiologia e Prevenzione | Year: 2010

Objective: the study is aimed at developing a nationwide deprivation index at municipality and census block level, based on the 2001 Census data, and meeting epidemiological needs. Setting and participants: The study uses data drawn from the 2001 General Census of Population and Housing. From the 280 variables defined at census block level (352,605 census tracts with average number of inhabitants 169, standard deviation 225; and average area 0.6 km 2, sd 2.4 km2) five traits that operationally combine to represent the multidimensionality of the social and material deprivation concept have been selected; these are: low level of education, unemployment, non-home ownership, one parent family and overcrowding. The index is calculated by summing standardized indicators and it is also available as categorical by quintiles of population. The same procedure is applied to aggregate frequency data at municipality level. The correlation between mortality and deprivation has been evaluated using 2000-2004 general mortality. Results: considering national data, a strong North-South gradient in deprivation was observed. The municipality deprivation index 2001 is highly correlated to the index likewise calculated on the basis of the previous 1991 Census (r=0.91). General mortality was positively correlated to the index (in particular in population up to 64 years and in larger size municipalities). Conclusion: the pattern described by the deprivation index was coherent with what is already known about geographic distribution of poverty and its impact on mortality. Such outcome bears out the index use for epidemiological purposes.


Ardito C.,University of Turin | D'Errico A.,Servizio Sovrazonale di Epidemiologia | Leombruni R.,University of Turin
Medicina del Lavoro | Year: 2014

Background: Depression among workers is a major health concern and psychological work factors are considered important risk factors.Objectives: To investigate exposure to psychosocial work risk factors and prevalence of depressive symptoms in the European working population, and to identify the psychosocial work characteristics that predict them. Methods: The study is a secondary data analysis based on a sample of 33,907 European employees from the last edition of the European Working Condition Survey (EWCS 2010).The relationship between the outcome variable (depressive symptoms) and the predictors (psychosocial work factors) was analyzed using a multi-stage Poisson model, estimating gender-specific relative risks (RR) and 95 percent confidence intervals. Results: After adjustment for individual and work characteristics, countries and other psychosocial factors, among men the RR of depressive symptoms was significantly increased for exposure to intermediate psychological demands and to high demands for hiding emotions, whereas high skill discretion, high support from colleagues, high support from managers, high job rewards and high job security significantly decreased the risk. Among women, high psychological demands and intermediate emotional demands significantly enhanced the risk of depressive symptoms while high decision authority, intermediate support from colleagues, high support from managers, high social climate, high job rewards and high job security protected against risk. Conclusions: A high prevalence of depressive symptoms was found in the EWCS 2010, although with wide variations between countries. Several psychosocial factors at work were identified as risk factors for depressive symptoms, even after adjusting for workplace co-exposures and other potential confounders.


PubMed | University of Turin, University of Padua and Servizio sovrazonale di epidemiologia
Type: Journal Article | Journal: Epidemiologia e prevenzione | Year: 2016

to describe overall and amenable mortality trends over the last 30 years in the Local Health Authorities (LHAs) of Piedmont Region (Northern Italy). By comparing these trends, it is possible to analyse intraregional variability in the performance of the healthcare system.descriptive study.mortality data from the Italian National Institute of Statistics (Istat) for the population between 0 and 74 years resident in Piedmont Region for the period 1980-2011.overall and amenable age-standardised death rates, by gender and health unit; ratio of the differences in amenable and in all-cause mortality (standardised rate difference - SRD: SRDamenable/SRDall-cause) over the observation period.between 1980 and 2011, overall mortality in Piedmont has decreased from 425.8 x100,000 to 205.5 x100.000 among women, and from 891.6 x100,000 to 390.7 x100,000 among men. The rate of amenable mortality on overall mortality decreased from 40% to 32% among women, and from 33% to 21% among men. Furthermore, amenable mortality contributed to 48% of the overall mortality reduction among women and to 35% among men. Regional results show heterogeneity between health units. This heterogeneity decreased over the three decades and was higher in men than in women.although Piedmont is one of the Italian Regions with the highest amenable mortality rate, a considerable decrease of its contribution to the overall mortality was seen in the last three decades. This improvement was not equally among LHAs, and substantial intraregional differences are still present, probably due to different timing and way of introduction of healthcare innovations for prevention and care for amenable to healthcare diseases. The proportion of amenable mortality on overall mortality is much higher among women than men, and it probably depends on the diseases considered in the definition itself.


Roggeri A.,ProCure Solutions sas | Gnavi R.,Servizio Sovrazonale di Epidemiologia | Dalmasso M.,Servizio Sovrazonale di Epidemiologia | Rusciani R.,Servizio Sovrazonale di Epidemiologia | And 3 more authors.
Critical Pathways in Cardiology | Year: 2013

The objective of this study was to estimate resource consumption and direct healthcare costs of patients with a first hospitalization for acute coronary syndrome (AC S) in 2008 in the Piedmont Region, Italy. Subjects hospitalized with a first episode of AC S in 2008 were selected from the regional hospital discharge database. All hospitalizations, drug prescriptions, and outpatient episodes of care in the 12 months following discharge were considered to estimate resource consumption and direct healthcare costs from the Piedmont Regional Health Service perspective. The analysis was carried out separately for ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA) populations. In the accrual period, 7765 subjects (1.75‰ of the total population) were hospitalized for AC S (64.2% men). The average age was 66.5 for men and 75.4 for women. The average in-hospital mortality was 6.5% (n = 508). The total AC S population was classified as: STEMI 45.2%, NSTEMI 29.4%, and UA 25.4%. The average yearly costs per patient alive at the end of follow-up (n = 6851) were 14,160.8€ (18,678.7 USD): 83.9% for inpatient admissions [11,881.2€ (15,671.8 USD)], 9.3% for drugs [1311.6€ (1730.1 USD)], 5.0% for diagnostic and therapeutic procedures and outpatient visits [708.2€ (934.1 USD)], and 1.8% for 1-day hospital stays [259.8€ (342.7 USD)]. The average yearly direct healthcare costs by AC S event were 14,984.5€ (19,765.2 USD) for STEMI, 14,554.1€ (19,197.4 USD) for NSTEMI, and 12,481.5€ (16,463.6 USD) for UA. In each subpopulation, costs were significantly higher for men than for women. AC S imposes a significant burden in terms of morbidity and mortality and generates major public health service costs. Copyright © 2013 by Lippincott Williams & Wilkins.


OBJECTIVES: to describe occupational injury risk, comparing regular foreign workers with Italians, by main work characteristics and age.DESIGN: analysis of incidence and risk of total and severe occupational injury by Country of birth, stratified by economic activity, skill level, geographical area of work, firm size and age.SETTING AND PARTICIPANTS: sample of 7% of workers registered in the Italian National Institute of Social Insurance (INPS) database. The workers considered were male private sector employees aged from 16 to 55 years old who worked between 2000 and 2005 as apprentice or blue collar. Two groups were distinguished: immigrants from high migratory pressure Countries (PFPM) and immigrants from high-income Countries (PSA; Italians comprised). The three main nationalities considered were the most relevant in Italy: Moroccans, Albanians, and Romanians.MAIN OUTCOME MEASURES: all occupational injuries; severe occupational injuries based on the type of damage.RESULTS AND CONCLUSIONS: PFPM workers have a higher risk of injury compared to PSA both for total (Relative Risk - RR: 1.45) and severe ones (RR: 1.56), particularly in engineering (RR: 1.64) and trade (RR: 1.61). Moroccans have always the greatest risks (RR: 1.86); Romanians are protected on total injuries (RR: 0.80), but have excess of risk of severe injuries (RR: 1.31). Among young people there aren't differences by Country of birth, but the rate decreases as age increases in PSA, while in PFPM it increases as age increases. In this study, injury risk in regular foreign workers were measured more accurately than official statistics: Whip-Salute database can provide useful information for planning prevention programmes of immigrant work-related injuries.


Bena A.,Servizio Sovrazonale di Epidemiologia | Giraudo M.,Servizio Sovrazonale di Epidemiologia
Epidemiologia e prevenzione | Year: 2013

OBJECTIVE: To study the relationship between job tenure and injury risk, controlling for individual factors and company characteristics.DESIGN: Analysis of incidence and injury risk by job tenure, controlling for gender, age, nationality, economic activity, firm size.SETTING: Sample of 7% of Italian workers registered in the INPS (National Institute of Social Insurance) database.PARTICIPANTS: Private sector employees who worked as blue collars or apprentices.MAIN OUTCOME MEASURES: First-time occupational injuries, all occupational injuries, serious occupational injuries.RESULTS AND CONCLUSIONS: Our findings show an increase in injury risk among those who start a new job and an inverse relationship between job tenure and injury risk. Multivariate analysis confirm these results. Recommendations for improving this situation include the adoption of organizational models that provide periods of mentoring from colleagues already in the company and the assignment to simple and not much hazardous tasks. The economic crisis may exacerbate this problem: it is important for Italy to improve the systems of monitoring relations between temporary employment and health.


PubMed | Servizio sovrazonale di epidemiologia
Type: Comparative Study | Journal: Epidemiologia e prevenzione | Year: 2014

to describe occupational injury risk, comparing regular foreign workers with Italians, by main work characteristics and age.analysis of incidence and risk of total and severe occupational injury by Country of birth, stratified by economic activity, skill level, geographical area of work, firm size and age.sample of 7% of workers registered in the Italian National Institute of Social Insurance (INPS) database. The workers considered were male private sector employees aged from 16 to 55 years old who worked between 2000 and 2005 as apprentice or blue collar. Two groups were distinguished: immigrants from high migratory pressure Countries (PFPM) and immigrants from high-income Countries (PSA; Italians comprised). The three main nationalities considered were the most relevant in Italy: Moroccans, Albanians, and Romanians.all occupational injuries; severe occupational injuries based on the type of damage.PFPM workers have a higher risk of injury compared to PSA both for total (Relative Risk - RR: 1.45) and severe ones (RR: 1.56), particularly in engineering (RR: 1.64) and trade (RR: 1.61). Moroccans have always the greatest risks (RR: 1.86); Romanians are protected on total injuries (RR: 0.80), but have excess of risk of severe injuries (RR: 1.31). Among young people there arent differences by Country of birth, but the rate decreases as age increases in PSA, while in PFPM it increases as age increases. In this study, injury risk in regular foreign workers were measured more accurately than official statistics: Whip-Salute database can provide useful information for planning prevention programmes of immigrant work-related injuries.

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