This umbrella review provides a comprehensive synthesis of the available evidence on the relationship between digital device use and adolescent sleep. It summarizes results from systematic reviews and meta-analyses, presenting the magnitude and direction of observed associations. A total of seven systematic reviews, including five qualitative reviews and two meta-analyses, were included, comprising 127 primary studies with a combined sample of 867,003 participants. The findings suggest a negative impact of digital device use on various sleep parameters, including sleep duration, bedtime procrastination, and sleep quality. Devices such as smartphones and computers were found to have a greater adverse effect, while television use showed a weaker association. The most significant disruptions were observed in relation to social media and internet use, with problematic usage leading to delayed bedtimes, shorter sleep duration, and increased sleep onset latency. The review also highlights the role of timing and duration of device use, with late-night use particularly contributing to sleep disturbances. Biological, psychological, and social mechanisms are proposed as potential pathways underlying these effects. Despite moderate evidence supporting the negative impact of digital media on sleep, there is considerable heterogeneity across studies, and many relied on self-reported data, which may limit the generalizability of the findings. Future research should aim to standardize exposure and outcome measures, incorporate objective data collection methods, and explore causal relationships through longitudinal studies. This umbrella review underscores the importance of developing targeted public health strategies, parental guidance, and clinical awareness to mitigate the potential adverse effects of digital device use on adolescent sleep and mental health.

Studies investigating the association between urinary Polycyclic Aromatic Hydrocarbons (PAHs) and asthma in children provided inhomogeneous results. We aimed to use Mediation Analysis to discover whether a link between urinary PAHs and lung function exists and if it might be ascribed to a direct or a symptom-mediated (indirect) effect in children with asthma. This single-center prospective study was conducted in Palermo, Italy, between March and July 2017 and involved 50 children with persistent mild-moderate asthma, aged 6–11 years. At each time visit (day 0, 30, 60, and 90), physical examination, spirometry, and urine collection for detection of urinary cotinine and PAHs were performed. A symptom score was computed. The sum of individually calculated molar mass of nine PAH metabolites (ΣPAH), naphthalene metabolites (ΣPAHn) and phenanthrene metabolites (ΣPAHp) were calculated. Three children withdrew from the study due to technical problems (n = 1) and adverse events (n = 2). PAHs indirect effects on FEV₁ (ΣPAH: −0.011, p = 0.04; ΣPAH_n: −0.011, p = 0.04; ΣPAH_p: −0.012, p < 0.001) and FVC (ΣPAH: −0.012, p = 0.02; ΣPAH_n: −0.0126, p = 0.02; ΣPAH_p: −0.013, p < 0.001) were statistically significant. In conclusion, PAHs exposures have significant indirect (symptom-mediated) effects on lung function, emphasizing the role of PAHs-induced respiratory morbidity in decreasing lung function in children with asthma.

Exposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that long-term exposure to farming-related air pollutants might predispose to an increased risk of COVID-19-related death. To test this hypothesis, we performed an ecological study of five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily), linking all-cause mortality by province (administrative entities within regions) to data on atmospheric concentrations of particulate matter (PM_2.5 and PM₁₀) and ammonia (NH₃), which are mainly produced by agricultural activities. The study outcome was change in all-cause mortality during March–April 2020 compared with March–April 2015–2019 (period). We estimated all-cause mortality rate ratios (MRRs) by multivariate negative binomial regression models adjusting for air temperature, humidity, international import-export, gross domestic product and population density. We documented a 6.9% excess in MRR (proxy for COVID-19 mortality) for each tonne/km² increase in NH₃ emissions, explained by the interaction of the period variable with NH₃ exposure, considering all pollutants together. Despite the limitations of the ecological design of the study, following the precautionary principle, we recommend the implementation of public health measures to limit environmental NH₃ exposure, particularly while the COVID-19 pandemic continues. Future studies are needed to investigate any causal link between COVID-19 and farming-related pollution.

Exposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that an interaction between SARS-CoV-2 infection and exposure to farming-related atmospheric pollutants worsens the effect of SARS-CoV-2 on mortality. Our objective was investigate this hypothesis by performing an ecological study in five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily) linking all-cause mortality, by province (administrative entities within regions), to atmospheric particulate matter (PM _2.5 and PM ₁₀ ) nitrous oxide (N ₂ O), ammonia (NH ₃ ) and methane (CH ₄ ) mainly produced by agricultural activities. Study outcome was change in all-cause mortality during March-April 2020, compared to March-April 2015-2019 (period) as assessed by mortality rate ratios (MRRs) estimated using multivariate negative binomial regression models that adjusted for air temperature, humidity and population density. The MRR for the interaction of period with NH ₃ exposure, considering all pollutants together was 1.133, equivalent to a 13.3% increase in mortality over and above that due to period (proxy for COVID-19 mortality) for each ton/km ² increase in NH ₃ emissions. Although the study was ecological, and did not provide evidence of a causal link between SARS-CoV-2 and farming-related pollutants, in accord with the precautionary principle we recommend application of measures to limit NH ₃ exposure particularly while the COVID-19 pandemic continues.