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Prof. Andrea Piana
Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy

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0 Infectious Diseases
0 Molecular Epidemiology
0 Public Health
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Journal article
Published: 22 August 2021 in Water
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The occurrence of Legionella spp. in the water distribution systems of large hospitals and other healthcare facilities is considered particularly dangerous, due to the critical nature of the hospitalized patients. The aim of this study is to present a pluri-annual environmental surveillance in a large university hospital assessing the prevalence of Legionella spp. and underlining its variability over the years. The samples of water were collected in accordance with the Italian National Guidelines and the sampling sites considered in this study were selected favoring wards with very high-risk patients and with patients at increased risk. The laboratory analyzed a total of 305 water samples deriving from 24 different sampling points. Legionella spp. were detected in 39.4% of samples, the majority of which were contaminated by Legionella pneumophila serogroups 2–14 (68.7%). Statistically significant differences were found among different seasons with a linear trend in positive proportion from summer to spring. Several experimental interventions to prevent and reduce Legionella colonization were attempted, but there is no a definitive method for the complete eradication of this microorganism. The permanent monitoring of hospital water distribution systems is fundamental to preventing the potential risk of nosocomial Legionellosis and to implementing procedures to minimize the risk of Legionella spp. colonization.

ACS Style

Giovanna Deiana; Antonella Arghittu; Marco Dettori; Maria Dolores Masia; Maria Grazia Deriu; Andrea Piana; Maria Rosaria Muroni; Paolo Castiglia; Antonio Azara. Environmental Surveillance of Legionella spp. in an Italian University Hospital Results of 10 Years of Analysis. Water 2021, 13, 2304 .

AMA Style

Giovanna Deiana, Antonella Arghittu, Marco Dettori, Maria Dolores Masia, Maria Grazia Deriu, Andrea Piana, Maria Rosaria Muroni, Paolo Castiglia, Antonio Azara. Environmental Surveillance of Legionella spp. in an Italian University Hospital Results of 10 Years of Analysis. Water. 2021; 13 (16):2304.

Chicago/Turabian Style

Giovanna Deiana; Antonella Arghittu; Marco Dettori; Maria Dolores Masia; Maria Grazia Deriu; Andrea Piana; Maria Rosaria Muroni; Paolo Castiglia; Antonio Azara. 2021. "Environmental Surveillance of Legionella spp. in an Italian University Hospital Results of 10 Years of Analysis." Water 13, no. 16: 2304.

Journal article
Published: 07 April 2021 in Environments
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Background: The aim of this preliminary study was to measure radon concentrations in a hospital in order to verify to what extent these concentrations depend on various environmental variables taken into consideration, and consequently to determine the urgency to implement mitigation actions. Methods: The rooms where the concentration of the gas was potentially highest were monitored. Investigators adopted a Continuous Radon Monitor testing device. Qualitative and normally distributed quantitative variables were summarised with absolute (relative) frequencies and means (standard deviations, SD), respectively. As regards environmental variables, the difference in radon concentrations was determined using the rank-based nonparametric Kruskal–Wallis H test and the Mann–Whitney U test. Results: All measurements, excluding the radiotherapy bunkers that showed high values due to irradiation of radiotherapy instruments, showed low radon levels, although there is currently no known safe level of radon exposure. In addition, high variability in radon concentration was found linked to various environmental and behavioural characteristics. Conclusions: The results on the variability of radon levels in hospital buildings highlighted the key role of monitoring activities on indoor air quality and, consequently, on the occupants’ health.

ACS Style

Giovanna Deiana; Marco Dettori; Maria Masia; Antonio Spano; Andrea Piana; Antonella Arghittu; Paolo Castiglia; Antonio Azara. Monitoring Radon Levels in Hospital Environments. Findings of a Preliminary Study in the University Hospital of Sassari, Italy. Environments 2021, 8, 28 .

AMA Style

Giovanna Deiana, Marco Dettori, Maria Masia, Antonio Spano, Andrea Piana, Antonella Arghittu, Paolo Castiglia, Antonio Azara. Monitoring Radon Levels in Hospital Environments. Findings of a Preliminary Study in the University Hospital of Sassari, Italy. Environments. 2021; 8 (4):28.

Chicago/Turabian Style

Giovanna Deiana; Marco Dettori; Maria Masia; Antonio Spano; Andrea Piana; Antonella Arghittu; Paolo Castiglia; Antonio Azara. 2021. "Monitoring Radon Levels in Hospital Environments. Findings of a Preliminary Study in the University Hospital of Sassari, Italy." Environments 8, no. 4: 28.

Journal article
Published: 19 March 2021 in Healthcare
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Achieving sterilization by adopting proper practices is essential to ensure that surgical instruments do not transmit microorganisms to patients. As the effectiveness of sterilization mandates effective cleaning, it is necessary to verify the success of cleaning procedures. In this study, we used the adenosine triphosphate (ATP) bioluminescence method for assessing the efficacy of the manual cleaning procedure during the reprocessing of reusable surgical instruments. The ATP bioluminescence assay was performed on 140 surgical instruments of 12 different types, both before being cleaned (baseline) and after each of the cleaning procedures (i.e., decontamination, manual washing, drying, and visual inspection). For each instrument, two swabs were used as follows: one to sample the entire surface (test point 1) and the other to sample the most difficult part of the surface to clean (test point 2). Overall, for each type of instrument, there was a decrease in contamination ranging from 99.6 to >99.9% (log reduction from 2.40 to 3.76). Thus, in order to standardize the assessment of cleanliness, it may be useful to introduce the bioluminescence method into the daily routine or, at least, at regular time intervals as a complementary check combined with visual inspection. This would allow real-time verification of the achievement of an adequate level of cleanliness.

ACS Style

Maria Masia; Marco Dettori; Grazia Deriu; Sabina Bellu; Lisa Arcadu; Antonio Azara; Andrea Piana; Alessandra Palmieri; Antonella Arghittu; Paolo Castiglia. ATP Bioluminescence for Assessing the Efficacy of the Manual Cleaning Procedure during the Reprocessing of Reusable Surgical Instruments. Healthcare 2021, 9, 352 .

AMA Style

Maria Masia, Marco Dettori, Grazia Deriu, Sabina Bellu, Lisa Arcadu, Antonio Azara, Andrea Piana, Alessandra Palmieri, Antonella Arghittu, Paolo Castiglia. ATP Bioluminescence for Assessing the Efficacy of the Manual Cleaning Procedure during the Reprocessing of Reusable Surgical Instruments. Healthcare. 2021; 9 (3):352.

Chicago/Turabian Style

Maria Masia; Marco Dettori; Grazia Deriu; Sabina Bellu; Lisa Arcadu; Antonio Azara; Andrea Piana; Alessandra Palmieri; Antonella Arghittu; Paolo Castiglia. 2021. "ATP Bioluminescence for Assessing the Efficacy of the Manual Cleaning Procedure during the Reprocessing of Reusable Surgical Instruments." Healthcare 9, no. 3: 352.

Journal article
Published: 12 January 2021 in Pathogens
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Background: The objective evaluation of the olfactory function of coronavirus disease 2019 patients is difficult because of logistical and operator-safety problems. For this reason, in the literature, the data obtained from psychophysical tests are few and based on small case series. Methods: A multicenter, cohort study conducted in seven European hospitals between March 22 and August 20, 2020. The Sniffin-Sticks test and the Connecticut Chemosensory Clinical Research Center orthonasal olfaction test were used to objectively evaluate the olfactory function. Results: This study included 774 patients, of these 481 (62.1%) presented olfactory dysfunction (OD): 280 were hyposmic and 201 were anosmic. There was a significant difference between self-reported anosmia/hyposmia and psychophysical test results (p = 0.006). Patients with gastroesophageal disorders reported a significantly higher probability of presenting hyposmia (OR 1.86; p = 0.015) and anosmia (OR 2.425; p < 0.001). Fever, chest pain, and phlegm significantly increased the likelihood of having hyposmia but not anosmia or an olfactory disturbance. In contrast, patients with dyspnea, dysphonia, and severe-to-critical COVID-19 were significantly more likely to have no anosmia, while these symptoms had no effect on the risk of developing hyposmia or an OD. Conclusions: Psychophysical assessment represents a significantly more accurate assessment tool for olfactory function than patient self-reported clinical outcomes. Olfactory disturbances appear to be largely independent from the epidemiological and clinical characteristics of the patients. The non-association with rhinitis symptoms and the high prevalence as a presenting symptom make olfactory disturbances an important symptom in the differential diagnosis between COVID-19 and common flu.

ACS Style

Luigi Angelo Vaira; Jerome R. Lechien; Mohamad Khalife; Marzia Petrocelli; Stephane Hans; Lea Distinguin; Giovanni Salzano; Marco Cucurullo; Piero Doneddu; Francesco Antonio Salzano; Federico Biglioli; Fabrice Journe; Andrea Fausto Piana; Giacomo De Riu; Sven Saussez. Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients. Pathogens 2021, 10, 62 .

AMA Style

Luigi Angelo Vaira, Jerome R. Lechien, Mohamad Khalife, Marzia Petrocelli, Stephane Hans, Lea Distinguin, Giovanni Salzano, Marco Cucurullo, Piero Doneddu, Francesco Antonio Salzano, Federico Biglioli, Fabrice Journe, Andrea Fausto Piana, Giacomo De Riu, Sven Saussez. Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients. Pathogens. 2021; 10 (1):62.

Chicago/Turabian Style

Luigi Angelo Vaira; Jerome R. Lechien; Mohamad Khalife; Marzia Petrocelli; Stephane Hans; Lea Distinguin; Giovanni Salzano; Marco Cucurullo; Piero Doneddu; Francesco Antonio Salzano; Federico Biglioli; Fabrice Journe; Andrea Fausto Piana; Giacomo De Riu; Sven Saussez. 2021. "Psychophysical Evaluation of the Olfactory Function: European Multicenter Study on 774 COVID-19 Patients." Pathogens 10, no. 1: 62.

Other
Published: 25 August 2020
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SARS-CoV-2 environmental contamination occurs through droplets and biological fluids released in the surroundings from patients or asymptomatic carriers. Surfaces and objects contaminated by saliva or nose secretions represent a risk for indirect transmission of COVID-19. We assayed surfaces from hospital and living spaces to identify the presence of viral RNA and the spread of fomites in the environment. Anthropic contamination by droplets and biological fluids was monitored by detecting the microbiota signature using multiplex RT-PCR on selected species and massive sequencing on 16S-amplicons. A total of 92 samples (flocked swab) were collected from critical areas during the pandemic, including indoor (3 hospitals and 3 public buildings) and outdoor surfaces exposed to anthropic contamination (handles and handrails, playgrounds). Traces of biological fluids were frequently detected in spaces open to the public and on objects that are touched with the hands (>80%). However, viral RNA was not detected in hospital wards or other indoor and outdoor surfaces either in the air system of a COVID-hospital, but only in the surroundings of an infected patient, in consistent association with droplets traces and fomites. Handled objects accumulated the highest level of multiple contaminations by saliva, nose secretions and faecal traces, further supporting the priority role of handwashing in prevention. In conclusion, anthropic contamination by droplets and biological fluids is widespread in spaces open to the public and can be traced by RT-PCR. Monitoring fomites can support evaluation of indirect transmission risks for Coronavirus or other flu-like viruses in the environment. Importance Several studies searched for SARS-CoV-2 in the environment because saliva and nasopharyngeal droplets can land on objects and surfaces creating fomites. However, the ideal indicator would be the detection of the biofluid. This approach was not yet considered, but follows a traditional principle in hygiene, using indicators rather than pathogens. We searched for viral RNA but also for droplets on surfaces at risk. For the first time, we propose to monitor droplets thorugh their microbiota, by RT-PCR or NGS. Even if performed during the pandemic, SARS-CoV-2 wasn’t largely spread on surfaces, unless in proximity of an infectious patient. However, anthropic contamination was frequently at high level, suggesting a putative marker for indirect transmission and risk assessment. Moreover, all SARS-CoV-2-contaminated surfaces showed the droplets’ microbiota. Fomites detection may have an impact on public health, supporting prevention of indirect transmission also for other communicable diseases such as Flu and Flu-like infections. GRAPHICAL ABSTRACT

ACS Style

Andrea Piana; Maria Eugenia Colucci; Federica Valeriani; Adriano Marcolongo; Giovanni Sotgiu; Cesira Pasquarella; Lory Marika Margarucci; Andrea Petrucca; Gianluca Gianfranceschi; Sergio Babudieri; Pietro Vitali; Giuseppe D’Ermo; Assunta Bizzarro; Flavio De Maio; Matteo Vitali; Antonio Azara; Ferdinando Romano; Maurizio Simmaco; Vincenzo Romano Spica. Monitoring COVID-19 transmission risks by RT-PCR tracing of droplets in hospital and living environments. 2020, 1 .

AMA Style

Andrea Piana, Maria Eugenia Colucci, Federica Valeriani, Adriano Marcolongo, Giovanni Sotgiu, Cesira Pasquarella, Lory Marika Margarucci, Andrea Petrucca, Gianluca Gianfranceschi, Sergio Babudieri, Pietro Vitali, Giuseppe D’Ermo, Assunta Bizzarro, Flavio De Maio, Matteo Vitali, Antonio Azara, Ferdinando Romano, Maurizio Simmaco, Vincenzo Romano Spica. Monitoring COVID-19 transmission risks by RT-PCR tracing of droplets in hospital and living environments. . 2020; ():1.

Chicago/Turabian Style

Andrea Piana; Maria Eugenia Colucci; Federica Valeriani; Adriano Marcolongo; Giovanni Sotgiu; Cesira Pasquarella; Lory Marika Margarucci; Andrea Petrucca; Gianluca Gianfranceschi; Sergio Babudieri; Pietro Vitali; Giuseppe D’Ermo; Assunta Bizzarro; Flavio De Maio; Matteo Vitali; Antonio Azara; Ferdinando Romano; Maurizio Simmaco; Vincenzo Romano Spica. 2020. "Monitoring COVID-19 transmission risks by RT-PCR tracing of droplets in hospital and living environments." , no. : 1.

Journal article
Published: 06 July 2020 in International Journal of Environmental Research and Public Health
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The present work is a cross-sectional study aimed at assessing the risk perception and evaluating the community outrage linked to environmental factors among a self-selected sample of citizens living in an area characterized by the presence of industrial structures of high emotional impact. An anonymous questionnaire was administered to the population by publishing a Google form URL code in local and regional newspapers and via social media. The resulting data were entered on Excel and analyzed. Qualitative variables were summarized with absolute and relative (percentage) frequencies. The results showed that the event that causes the greatest worry was air pollution, with 92.6% of the respondents stating that they perceived the problem as “very” or “quite” worrying. Furthermore, all the health problems investigated in relation to environmental quality aroused concern among the interviewees, with 93.1% believing there was a cause-effect relationship between environmental quality and health. Overall, as other studies had previously underlined, the survey shows that the perceived risks are not always in line with the real ones, Thus, it is imperative to articulate interventions aimed at offering the population objective tools to enable them to interpret the risks themselves. In this regard, a fundamental role is played by adequate communication between the competent bodies and political decision-makers and the population.The present work is a cross-sectional study aimed at assessing the risk perception and evaluating the community outrage linked to environmental factors among a self-selected sample of citizens living in an area characterized by the presence of industrial structures of high emotional impact. An anonymous questionnaire was administered to the population by publishing a Google form URL code in local and regional newspapers and via social media. The resulting data were entered on Excel and analyzed. Qualitative variables were summarized with absolute and relative (percentage) frequencies. The results showed that the event that causes the greatest worry was air pollution, with 92.6% of the respondents stating that they perceived the problem as “very” or “quite” worrying. Furthermore, all the health problems investigated in relation to environmental quality aroused concern among the interviewees, with 93.1% believing there was a cause-effect relationship between environmental quality and health. Overall, as other studies had previously underlined, the survey shows that the perceived risks are not always in line with the real ones, Thus, it is imperative to articulate interventions aimed at offering the population objective tools to enable them to interpret the risks themselves. In this regard, a fundamental role is played by adequate communication between the competent bodies and political decision-makers and the population.

ACS Style

Marco Dettori; Paola Pittaluga; Giulia Busonera; Carmelo Gugliotta; Antonio Azara; Andrea Piana; Antonella Arghittu; Paolo Castiglia. Environmental Risks Perception Among Citizens Living Near Industrial Plants: A Cross-Sectional Study. International Journal of Environmental Research and Public Health 2020, 17, 4870 .

AMA Style

Marco Dettori, Paola Pittaluga, Giulia Busonera, Carmelo Gugliotta, Antonio Azara, Andrea Piana, Antonella Arghittu, Paolo Castiglia. Environmental Risks Perception Among Citizens Living Near Industrial Plants: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2020; 17 (13):4870.

Chicago/Turabian Style

Marco Dettori; Paola Pittaluga; Giulia Busonera; Carmelo Gugliotta; Antonio Azara; Andrea Piana; Antonella Arghittu; Paolo Castiglia. 2020. "Environmental Risks Perception Among Citizens Living Near Industrial Plants: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 17, no. 13: 4870.

Journal article
Published: 23 June 2020 in International Journal of Environmental Research and Public Health
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Objectives: Anal cancer is a rare disease. However, its incidence is increasing in some population groups. Infection caused by Human Papillomavirus (HPV) is strongly associated with the risk of anal cancer, whose variability depends on samples, histology, and HPV detection methods. The aim of the study was to assess prevalence and distribution of HPV genotypes in patients diagnosed with anal carcinoma. Methods: An observational, retrospective study was carried out in a tertiary care hospital in North Sardinia, Italy. Specimens of anal cancer diagnosed from 2002–2018 were selected. Demographic, epidemiological, and clinical variables were collected to assess their relationship with the occurrence of anal cancer. Results: The overall HPV positivity was 70.0% (21/30), with HPV-16 being the predominant genotype (~85%). The highest prevalence of anal cancer was in patients aged ≥55 years. HPV positivity was higher in women (p-value > 0.05) and in moderately differentiated samples (G2) (p-value < 0.05). p16INK4a and E6-transcript positivity were found in 57% and 24% of the HPV positive samples, respectively. The OS (overall survival) showed a not statistically significant difference in prognosis between HPV positive sand negatives (10, 47.6%, vs. 4, 44.4%; p-value = 0.25). Conclusions: HPV-DNA and p16INK4a positivity confirmed the role of HPV in anal carcinoma. Our findings could support the implementation and scale-up of HPV vaccination in males and females to decrease the incidence of HPV-associated cancers. Further studies are needed to better clarify the prognostic role of HPV/p16 status.

ACS Style

Narcisa Muresu; Giovanni Sotgiu; Laura Saderi; Illari Sechi; Antonio Cossu; Vincenzo Marras; Marta Meloni; Marianna Martinelli; Clementina Cocuzza; Francesco Tanda; Andrea Piana. Distribution of HPV Genotypes in Patients with a Diagnosis of Anal Cancer in an Italian Region. International Journal of Environmental Research and Public Health 2020, 17, 4516 .

AMA Style

Narcisa Muresu, Giovanni Sotgiu, Laura Saderi, Illari Sechi, Antonio Cossu, Vincenzo Marras, Marta Meloni, Marianna Martinelli, Clementina Cocuzza, Francesco Tanda, Andrea Piana. Distribution of HPV Genotypes in Patients with a Diagnosis of Anal Cancer in an Italian Region. International Journal of Environmental Research and Public Health. 2020; 17 (12):4516.

Chicago/Turabian Style

Narcisa Muresu; Giovanni Sotgiu; Laura Saderi; Illari Sechi; Antonio Cossu; Vincenzo Marras; Marta Meloni; Marianna Martinelli; Clementina Cocuzza; Francesco Tanda; Andrea Piana. 2020. "Distribution of HPV Genotypes in Patients with a Diagnosis of Anal Cancer in an Italian Region." International Journal of Environmental Research and Public Health 17, no. 12: 4516.

Journal article
Published: 25 January 2020 in Vaccines
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The aim of this study was to assess the role of a human papilloma virus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) in reducing recurrent cervical dysplasia. A series of 503 women with cervical dysplasia received LEEP between January 2012 and October 2018. Of these patients, 379 were treated between January 2012 and June 2017, thus ensuring an adequate follow-up time. We made three attempts to establish telephone contact with each patient; 77 women did not respond and were excluded from the final study population, which consisted of 302 patients. One hundred eighty-two (60.7%) women were vaccinated with an HPV vaccine within 4 weeks of LEEP and 103 (34.3%) were followed up with but not vaccinated. Recurrence of cervical dysplasia requiring a further LEEP procedure occurred in 30 (10.5%) women, of whom 17 (16.5%) were not vaccinated and 13 (7.1%) were vaccinated (p-value = 0.010). At univariate analysis, HPV vaccination after LEEP (odds ratio (OR) = 0.4, p-value = 0.020) emerged as an independent protective factor. Choosing as an outcome of the analysis only recurrence as severe cervical lesions, the protective role of HPV vaccination after LEEP was found to be much more relevant with an odds ratio of 0.2 (95% CI = 0.1–0.6, p-value = 0.02). Administration of an HPV vaccine after LEEP seems to reduce the risk of recurrence, thus suggesting that HPV vaccination has a role as an adjuvant treatment after LEEP.

ACS Style

Marco Petrillo; Margherita Dessole; Elettra Tinacci; Laura Saderi; Narcisa Muresu; Giampiero Capobianco; Antonio Cossu; Salvatore Dessole; Giovanni Sotgiu; Andrea Piana. Efficacy of HPV Vaccination in Women Receiving LEEP for Cervical Dysplasia: A Single Institution’s Experience. Vaccines 2020, 8, 45 .

AMA Style

Marco Petrillo, Margherita Dessole, Elettra Tinacci, Laura Saderi, Narcisa Muresu, Giampiero Capobianco, Antonio Cossu, Salvatore Dessole, Giovanni Sotgiu, Andrea Piana. Efficacy of HPV Vaccination in Women Receiving LEEP for Cervical Dysplasia: A Single Institution’s Experience. Vaccines. 2020; 8 (1):45.

Chicago/Turabian Style

Marco Petrillo; Margherita Dessole; Elettra Tinacci; Laura Saderi; Narcisa Muresu; Giampiero Capobianco; Antonio Cossu; Salvatore Dessole; Giovanni Sotgiu; Andrea Piana. 2020. "Efficacy of HPV Vaccination in Women Receiving LEEP for Cervical Dysplasia: A Single Institution’s Experience." Vaccines 8, no. 1: 45.

Review
Published: 18 January 2020 in International Journal of Environmental Research and Public Health
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Enteric fever is a foodborne infectious disease caused by Salmonella enterica serotypes Typhi and Paratyphi A, B and C. The high incidence in low income countries can increase the risk of disease in travelers coming from high income countries. Pre-travel health advice on hygiene and sanitation practices and vaccines can significantly reduce the risk of acquiring infections. Although the majority of the cases are self-limiting, life-threatening complications can occur. Delayed diagnosis and cases of infections caused by multi-drug resistant strains can complicate the clinical management and affect the prognosis. More international efforts are needed to reduce the burden of disease in low income countries, indirectly reducing the risk of travelers in endemic settings. Surveillance activities can help monitor the epidemiology of cases caused by drug-susceptible and resistant strains.

ACS Style

Narcisa Muresu; Giovanni Sotgiu; Bianca Maria Are; Andrea Cossu; Clementina Cocuzza; Marianna Martinelli; Sergio Babudieri; Riccardo Are; Marco Dettori; Antonio Azara; Laura Saderi; Andrea Piana. Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature. International Journal of Environmental Research and Public Health 2020, 17, 615 .

AMA Style

Narcisa Muresu, Giovanni Sotgiu, Bianca Maria Are, Andrea Cossu, Clementina Cocuzza, Marianna Martinelli, Sergio Babudieri, Riccardo Are, Marco Dettori, Antonio Azara, Laura Saderi, Andrea Piana. Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature. International Journal of Environmental Research and Public Health. 2020; 17 (2):615.

Chicago/Turabian Style

Narcisa Muresu; Giovanni Sotgiu; Bianca Maria Are; Andrea Cossu; Clementina Cocuzza; Marianna Martinelli; Sergio Babudieri; Riccardo Are; Marco Dettori; Antonio Azara; Laura Saderi; Andrea Piana. 2020. "Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature." International Journal of Environmental Research and Public Health 17, no. 2: 615.

Journal article
Published: 03 January 2020 in Journal of Clinical Medicine
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In the past, hypothyroidism has been associated with an increased susceptibility to gastric cancer (GC). Although several epidemiological studies have corroborated this association, a precise mechanistic explanation remains elusive. In this study, this hypothesis was tested by using a large database of subjects who underwent upper endoscopy for various reasons. This was a retrospective, case-control, single-center study. Subjects with GC (cases) were compared with subjects without (controls), according to hypothyroidism status. Overall, the prevalence of GC was 0.73% in the total cohort and was significantly higher in males compared to females (1.4% versus 0.4%, p < 0.0001). Multivariate logistic regression analysis confirmed an increased risk in males with hypothyroidism (OR 5.10; p < 0.0001) after adjusting for potential confounders, especially H. pylori infection. Interestingly, only hypothyroidism and not treatment with levothyroxine was a significant predictor of GC, ruling out a possible direct carcinogenic effect of the replacement therapy. The present study suggests a male-restricted association of gastric carcinogenesis with a hypothyroid state. If the results of this study are confirmed by longitudinal studies, an attractive perspective could open up for the better management of males with concomitant hypothyroidism and a higher risk of GC.

ACS Style

Maria Pina Dore; Alessandra Manca; Maria Carolina Alfonso Pensamiento; Alessandro Palmerio Delitala; Giuseppe Fanciulli; Andrea Fausto Piana; Giovanni Mario Pes. Male Predominance of Gastric Cancer among Patients with Hypothyroidism from a Defined Geographic Area. Journal of Clinical Medicine 2020, 9, 135 .

AMA Style

Maria Pina Dore, Alessandra Manca, Maria Carolina Alfonso Pensamiento, Alessandro Palmerio Delitala, Giuseppe Fanciulli, Andrea Fausto Piana, Giovanni Mario Pes. Male Predominance of Gastric Cancer among Patients with Hypothyroidism from a Defined Geographic Area. Journal of Clinical Medicine. 2020; 9 (1):135.

Chicago/Turabian Style

Maria Pina Dore; Alessandra Manca; Maria Carolina Alfonso Pensamiento; Alessandro Palmerio Delitala; Giuseppe Fanciulli; Andrea Fausto Piana; Giovanni Mario Pes. 2020. "Male Predominance of Gastric Cancer among Patients with Hypothyroidism from a Defined Geographic Area." Journal of Clinical Medicine 9, no. 1: 135.

Journal article
Published: 01 January 2020 in International Journal of Environmental Research and Public Health
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This study aims to evaluate HPV16 variants distribution in a population of Italian women living in two different regions (Lombardy and Sardinia) by sequence analyses of HPV16-positive cervical samples, in order to reconstruct the phylogenetic relationship among variants to identify the currently circulating lineages. Analyses were conducted starting from DNA isolated from 67 HPV16-positive cervical samples collected from two different Italian centres (31 from Lombardy and 36 from Sardinia) of women with normal and abnormal cervical cytology. The entire long control region (LCR) and 300 nt of the E6 gene was sequenced to identify intra-type variants. Sequence comparison and phylogenetic analysis were made using a distance-based neighbour joining method (NJ) and Kimura two-parameter model. Data obtained reported that Italian sequences mainly belonged to the European lineage, in particular sublineage A2. Only five sequences clustered in non-European branches: two in North American lineage (sublineage D1), two in African-1 (sublineage B1) and one in African-2. A new 27 nucleotide duplication in the central segment of the LCR region was found in a sequence obtained from a sample isolated in Sardinia. A predominance of European variants was detected, with some degree of variability among the studied HPV16 strains. This study contributes to the implementation of data regarding the molecular epidemiology of HPV16 variants.

ACS Style

Marianna Martinelli; Chiara Villa; Giovanni Sotgiu; Narcisa Muresu; Federica Perdoni; Rosario Musumeci; Romina Combi; Antonio Cossu; Andrea Piana; Clementina Cocuzza. Analysis of Human Papillomavirus (HPV) 16 Variants Associated with Cervical Infection in Italian Women. International Journal of Environmental Research and Public Health 2020, 17, 306 .

AMA Style

Marianna Martinelli, Chiara Villa, Giovanni Sotgiu, Narcisa Muresu, Federica Perdoni, Rosario Musumeci, Romina Combi, Antonio Cossu, Andrea Piana, Clementina Cocuzza. Analysis of Human Papillomavirus (HPV) 16 Variants Associated with Cervical Infection in Italian Women. International Journal of Environmental Research and Public Health. 2020; 17 (1):306.

Chicago/Turabian Style

Marianna Martinelli; Chiara Villa; Giovanni Sotgiu; Narcisa Muresu; Federica Perdoni; Rosario Musumeci; Romina Combi; Antonio Cossu; Andrea Piana; Clementina Cocuzza. 2020. "Analysis of Human Papillomavirus (HPV) 16 Variants Associated with Cervical Infection in Italian Women." International Journal of Environmental Research and Public Health 17, no. 1: 306.

Journal article
Published: 09 December 2019 in International Journal of Environmental Research and Public Health
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Sexually transmitted infections (STIs) represent a major cause of morbidity in women and men worldwide. Human Papillomavirus (HPV) infections are among the most prevalent STIs and persistent infections with high-risk HPV (hrHPV) genotypes can cause cervical dysplasia and invasive cervical cancer. The association of other STIs with HPV cervical infection and/or dysplasia has however not yet been fully elucidated. The aim of this study was to assess the prevalence of HPV and other STIs among women presenting with an abnormal cervical cytology. Cervical infections with 28 HPV genotypes and seven other sexually transmitted pathogens were evaluated in 177 women referred for a colposcopy after an abnormal Pap smear. Positivity for at least one hrHPV genotype was shown in 87% of women; HPV 16 was the most prevalent (25.0%), followed by HPV 31 and HPV 51. The overall positivity for other STIs was 49.2%, with Ureaplasma parvum being the most prevalent microrganism (39.0%). Co-infections between hrHPV and other STIs were demonstrated in 17.5% of women; no significant association was demonstrated between multiple infections and the colposcopy findings. This study provides new epidemiological data on the prevalence of cervical infections associated with HPV and seven other common sexually transmitted pathogens in a population of women presenting with an abnormal cervical cytology.

ACS Style

Marianna Martinelli; Rosario Musumeci; Illari Sechi; Giovanni Sotgiu; Andrea Piana; Federica Perdoni; Federica Sina; Robert Fruscio; Fabio Landoni; Clementina E. Cocuzza. Prevalence of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs) among Italian Women Referred for a Colposcopy. International Journal of Environmental Research and Public Health 2019, 16, 5000 .

AMA Style

Marianna Martinelli, Rosario Musumeci, Illari Sechi, Giovanni Sotgiu, Andrea Piana, Federica Perdoni, Federica Sina, Robert Fruscio, Fabio Landoni, Clementina E. Cocuzza. Prevalence of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs) among Italian Women Referred for a Colposcopy. International Journal of Environmental Research and Public Health. 2019; 16 (24):5000.

Chicago/Turabian Style

Marianna Martinelli; Rosario Musumeci; Illari Sechi; Giovanni Sotgiu; Andrea Piana; Federica Perdoni; Federica Sina; Robert Fruscio; Fabio Landoni; Clementina E. Cocuzza. 2019. "Prevalence of Human Papillomavirus (HPV) and Other Sexually Transmitted Infections (STIs) among Italian Women Referred for a Colposcopy." International Journal of Environmental Research and Public Health 16, no. 24: 5000.

Journal article
Published: 11 September 2019 in International Journal of Environmental Research and Public Health
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Chlamydia trachomatis (Ct) and human papillomavirus (HPV) are the most prevalent sexually transmitted infections throughout the world. Despite the serious complications associated with chronic Ct infections in sexually active women, a screening program is not yet available in Italy. Moreover, HPV/Ct co-infections are also known to occur frequently, increasing the risk of HPV-induced carcinogenesis. The aim of this study was to evaluate the prevalence of Ct infections, the distribution of Ct serovars, and the incidences of Ct/HPV co-infections among women with a recent history of abnormal cervical cytology. Cervical samples were collected from 199 women referred for a gynecological visit following an abnormal Pap test results. All samples were tested for the presence of Ct and HPV DNA using real-time PCR assays; Ct typing of positive samples was performed by PCR-RFLP (restriction fragment length polymorphism) targeting the ompA gene. A high percentage of these women (12.8% and 21.7% with or without abnormal cytology on "retesting", respectively) were found to be Ct positive. Serovar F was the most prevalent type in Ct positive women, followed by E and K. Ct/HPV co-infections were detected in 7% (14/199) of enrolled women, with HPV-16, HPV-51, and HPV-52 being most frequently identified in co-infections. This study provides new epidemiological data on the prevalence of Ct and associated HPV infection in women with a recent history of abnormal cervical cytology in Italy, where notification of cases is not mandatory.

ACS Style

Marianna Martinelli; Rosario Musumeci; Alberto Rizzo; Narcisa Muresu; Andrea Piana; Giovanni Sotgiu; Fabio Landoni; Clementina Cocuzza. Prevalence of Chlamydia trachomatis Infection, Serovar Distribution and Co-Infections with Seven High-Risk HPV Types among Italian Women with a Recent History of Abnormal Cervical Cytology. International Journal of Environmental Research and Public Health 2019, 16, 3354 .

AMA Style

Marianna Martinelli, Rosario Musumeci, Alberto Rizzo, Narcisa Muresu, Andrea Piana, Giovanni Sotgiu, Fabio Landoni, Clementina Cocuzza. Prevalence of Chlamydia trachomatis Infection, Serovar Distribution and Co-Infections with Seven High-Risk HPV Types among Italian Women with a Recent History of Abnormal Cervical Cytology. International Journal of Environmental Research and Public Health. 2019; 16 (18):3354.

Chicago/Turabian Style

Marianna Martinelli; Rosario Musumeci; Alberto Rizzo; Narcisa Muresu; Andrea Piana; Giovanni Sotgiu; Fabio Landoni; Clementina Cocuzza. 2019. "Prevalence of Chlamydia trachomatis Infection, Serovar Distribution and Co-Infections with Seven High-Risk HPV Types among Italian Women with a Recent History of Abnormal Cervical Cytology." International Journal of Environmental Research and Public Health 16, no. 18: 3354.

Brief report
Published: 02 August 2019 in Acta Paediatrica
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Vitamin D deficiency in childhood is a re‐emerging public health problem. Epidemiological studies have shown that it can lead to rickets in children and osteomalacia in adults and may play a role in a variety of extraskeletal disorders, including asthma, type 1 diabetes, infectious and cardiovascular diseases and cancer (1). Vitamin D deficiency is identified by measuring serum 25‐hydroxy‐vitamin D levels and studies of levels between parents and their offspring, and among siblings, suggests the family environment may play a role (2). Other risk factors for vitamin D deficiency include adiposity and female gender (3, 4). This article is protected by copyright. All rights reserved.

ACS Style

Maria Grazia Clemente; Dario Argiolas; Mary E. Blue; Lino Argiolas; Angela Bitti; Laura Saderi; Andrea Piana; Giovanni Sotgiu; Roberto Antonucci. Family‐related factors may affect serum vitamin D levels. Acta Paediatrica 2019, 108, 2301 -2302.

AMA Style

Maria Grazia Clemente, Dario Argiolas, Mary E. Blue, Lino Argiolas, Angela Bitti, Laura Saderi, Andrea Piana, Giovanni Sotgiu, Roberto Antonucci. Family‐related factors may affect serum vitamin D levels. Acta Paediatrica. 2019; 108 (12):2301-2302.

Chicago/Turabian Style

Maria Grazia Clemente; Dario Argiolas; Mary E. Blue; Lino Argiolas; Angela Bitti; Laura Saderi; Andrea Piana; Giovanni Sotgiu; Roberto Antonucci. 2019. "Family‐related factors may affect serum vitamin D levels." Acta Paediatrica 108, no. 12: 2301-2302.

Journal article
Published: 20 March 2019 in International Journal of Environmental Research and Public Health
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The aim of the work is to evaluate the effectiveness of the risk communication strategies in cases of unsafe drinking water supply in Sardinia, the Italian context with the highest population distrust in drinking water safety. During the period 2010⁻2015, the ordinances published on the institutional websites were analyzed, and the population risk perception was evaluated by applying, for the first time in public health threats, the "OUTRAGE Prediction & Management" software released by Sandman. Overall, 417 ordinances issued by the Sardinian Municipalities were found. Only 1.5% of the ordinances reported information about parameters, concentrations, and risks to health, whereas 4.8% indicated only the parameters and non-standard levels. By contrast, 53.2% specified only the non-standard parameter, and 40.5% indicated a generic non-drinking motivation. The outrage assessment showed values exceeding the threshold of risk acceptance, attributable to the lack and low clarity of the information reported by the ordinances. The present study allowed us to highlight critical issues in risk communication of the quality of drinking water.

ACS Style

Marco Dettori; Antonio Azara; Erika Loria; Andrea Piana; Maria Dolores Masia; Alessandra Palmieri; Andrea Cossu; Paolo Castiglia. Population Distrust of Drinking Water Safety. Community Outrage Analysis, Prediction and Management. International Journal of Environmental Research and Public Health 2019, 16, 1004 .

AMA Style

Marco Dettori, Antonio Azara, Erika Loria, Andrea Piana, Maria Dolores Masia, Alessandra Palmieri, Andrea Cossu, Paolo Castiglia. Population Distrust of Drinking Water Safety. Community Outrage Analysis, Prediction and Management. International Journal of Environmental Research and Public Health. 2019; 16 (6):1004.

Chicago/Turabian Style

Marco Dettori; Antonio Azara; Erika Loria; Andrea Piana; Maria Dolores Masia; Alessandra Palmieri; Andrea Cossu; Paolo Castiglia. 2019. "Population Distrust of Drinking Water Safety. Community Outrage Analysis, Prediction and Management." International Journal of Environmental Research and Public Health 16, no. 6: 1004.

Journal article
Published: 18 February 2019 in Sustainability
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Daily walking is a recommended physical activity. It can be an all-age suitable, environment-friendly transport option. However, traffic crashes are a widely recognized risk factor, associated with drivers’ errors or a combination of several environmental factors, including physical characteristics of the road space. The aim of this study was to assess the characteristics of built environments on pedestrian safety. Data on road accidents that had occurred between 2005 and 2015, in Alghero, Italy, were retrieved and matched with spatial and functional street qualities. On-street parking was found to increase the risk of pedestrian accidents by about two times, whereas, narrow travel lanes and intersections reduced the incidence of crashes and their public relevance. These field results could inform urban health and spatial planning policies with the final goal of improving health and providing more sustainable models of urban organization.

ACS Style

Tanja Congiu; Giovanni Sotgiu; Paolo Castiglia; Antonio Azara; Andrea Piana; Laura Saderi; Marco Dettori. Built Environment Features and Pedestrian Accidents: An Italian Retrospective Study. Sustainability 2019, 11, 1064 .

AMA Style

Tanja Congiu, Giovanni Sotgiu, Paolo Castiglia, Antonio Azara, Andrea Piana, Laura Saderi, Marco Dettori. Built Environment Features and Pedestrian Accidents: An Italian Retrospective Study. Sustainability. 2019; 11 (4):1064.

Chicago/Turabian Style

Tanja Congiu; Giovanni Sotgiu; Paolo Castiglia; Antonio Azara; Andrea Piana; Laura Saderi; Marco Dettori. 2019. "Built Environment Features and Pedestrian Accidents: An Italian Retrospective Study." Sustainability 11, no. 4: 1064.

Case report
Published: 20 December 2018 in International Journal of Environmental Research and Public Health
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Listeriosis is a foodborne disease characterized by high hospitalization and fatality rates, especially in vulnerable groups including elderly subjects, pregnant women, etc. We report on the first case of Listeria monocytogenes ST-219 meningo-encephalitis in a woman aged 83 years. An epidemiological and molecular investigation was performed to detect the source of infection and the virulence factors associated with L. monocytogenes invasiveness in this patient. All environmental- and clinical-associated isolates were found to belong to serotype 4b and ST-219 as well as possessing actA, prfA, hlyA, and rrn virulence genes. Antibiotic susceptibility testing also detected resistance to cotrimoxazole, clindamycin, erythromycin, and oxacillin in these isolates. Conventional and molecular surveillance of listeriosis cases, based on the systematic assessment of spatio-temporal trends, virulence genes, and antimicrobial susceptibility testing patterns, are key to preventing and controlling the emergence and spread of L. monocytogenes strains, including hypervirulent clones.

ACS Style

Giovanni Sotgiu; Narcisa Muresu; Marco Dettori; Erica Mura; Andrea Cossu; Maria Dolores Masia; Paola Murgia; Clementina Cocuzza; Enrico Pietro Luigi De Santis; Christian Scarano; Carlo Spanu; Andrea Piana. A Case of Listeria monocytogenes ST-219 Meningo-Encephalitis. International Journal of Environmental Research and Public Health 2018, 16, 8 .

AMA Style

Giovanni Sotgiu, Narcisa Muresu, Marco Dettori, Erica Mura, Andrea Cossu, Maria Dolores Masia, Paola Murgia, Clementina Cocuzza, Enrico Pietro Luigi De Santis, Christian Scarano, Carlo Spanu, Andrea Piana. A Case of Listeria monocytogenes ST-219 Meningo-Encephalitis. International Journal of Environmental Research and Public Health. 2018; 16 (1):8.

Chicago/Turabian Style

Giovanni Sotgiu; Narcisa Muresu; Marco Dettori; Erica Mura; Andrea Cossu; Maria Dolores Masia; Paola Murgia; Clementina Cocuzza; Enrico Pietro Luigi De Santis; Christian Scarano; Carlo Spanu; Andrea Piana. 2018. "A Case of Listeria monocytogenes ST-219 Meningo-Encephalitis." International Journal of Environmental Research and Public Health 16, no. 1: 8.

Correspondence
Published: 22 November 2018 in Travel Medicine and Infectious Disease
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Maria Grazia Clemente; Carlo Mauceri; Nicola Grandi; Marco Dettori; Margherita Arras; Pasqualina Raspa; Giannina Secchi; Roberto Manetti; Andrea Piana; Kathleen B. Schwarz; Paolo Castiglia; Roberto Antonucci. Seroprevalence of anti-HEV antibodies in migrants hosted at one shelter in Sardinia. Travel Medicine and Infectious Disease 2018, 31, 101355 .

AMA Style

Maria Grazia Clemente, Carlo Mauceri, Nicola Grandi, Marco Dettori, Margherita Arras, Pasqualina Raspa, Giannina Secchi, Roberto Manetti, Andrea Piana, Kathleen B. Schwarz, Paolo Castiglia, Roberto Antonucci. Seroprevalence of anti-HEV antibodies in migrants hosted at one shelter in Sardinia. Travel Medicine and Infectious Disease. 2018; 31 ():101355.

Chicago/Turabian Style

Maria Grazia Clemente; Carlo Mauceri; Nicola Grandi; Marco Dettori; Margherita Arras; Pasqualina Raspa; Giannina Secchi; Roberto Manetti; Andrea Piana; Kathleen B. Schwarz; Paolo Castiglia; Roberto Antonucci. 2018. "Seroprevalence of anti-HEV antibodies in migrants hosted at one shelter in Sardinia." Travel Medicine and Infectious Disease 31, no. : 101355.

Journal article
Published: 18 July 2018 in International Journal of Environmental Research and Public Health
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The aims of this study were (i) to evaluate the relationship between official data on invasive meningococcal disease cases in Sardinia and the reporting of the cases by a regional online newspaper and (ii) to identify indicators useful for understanding the community outrage related to health events. Cases of meningococcal disease, selected from articles published between 1999 and 2016 on a regional newspaper database, were compared to those reported to the Infectious Disease Information Service. In order to evaluate the equality of the two distribution records, the Kolgomorov Smirnov test for two samples was applied. A community outrage indicator was obtained by calculating the number of published articles for each case of meningococcal disease identified. The outrage indicator was evaluated in comparison with other phenomena: drinking water supply limitation and domestic accidents. Overall, 2724 articles on meningitis/sepsis referring to 89 cases related to meningococcal disease were considered. Significant differences between the distribution of cases officially reported and those found in the newspaper (combined K-S = 0.39; p = 0.08) were not observed. The meningococcal disease outrage indicator showed an average of seven items per case. Comparing the meningococcal disease outrage indicator with those regarding the limitation of drinking water supplies and domestic accidents, a different risk perception by the reference media was found, with the highest outrage for meningococcal disease. The present study supports the role played by emotional factors as behavioral determinants in emerging threats to public health. The analysis of the data allowed us to highlight that the proposed outrage indicator could be a feasible proxy of emotional epidemiology. Finally, data confirm that meningitis is perceived as a highly outrageous health threat.

ACS Style

Marco Dettori; Benedetto Arru; Antonio Azara; Andrea Piana; Gavino Mariotti; Maria Veronica Camerada; Paola Stefanelli; Giovanni Rezza; Paolo Castiglia. In the Digital Era, Is Community Outrage a Feasible Proxy Indicator of Emotional Epidemiology? The Case of Meningococcal Disease in Sardinia, Italy. International Journal of Environmental Research and Public Health 2018, 15, 1512 .

AMA Style

Marco Dettori, Benedetto Arru, Antonio Azara, Andrea Piana, Gavino Mariotti, Maria Veronica Camerada, Paola Stefanelli, Giovanni Rezza, Paolo Castiglia. In the Digital Era, Is Community Outrage a Feasible Proxy Indicator of Emotional Epidemiology? The Case of Meningococcal Disease in Sardinia, Italy. International Journal of Environmental Research and Public Health. 2018; 15 (7):1512.

Chicago/Turabian Style

Marco Dettori; Benedetto Arru; Antonio Azara; Andrea Piana; Gavino Mariotti; Maria Veronica Camerada; Paola Stefanelli; Giovanni Rezza; Paolo Castiglia. 2018. "In the Digital Era, Is Community Outrage a Feasible Proxy Indicator of Emotional Epidemiology? The Case of Meningococcal Disease in Sardinia, Italy." International Journal of Environmental Research and Public Health 15, no. 7: 1512.

Journal article
Published: 13 April 2018 in International Journal of Environmental Research and Public Health
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Background: The aim of the study was to assess radon concentration in schoolrooms in a city located in the midwest of Italy. Methods: A two-phase environmental study was carried out in 19 school buildings of 16 primary, secondary, and tertiary schools. Results: Median (interquartile range—IQR) indoor radon concentration in schoolrooms was 91.6 (45.0–140.3) Bq/m3. The highest (median 952.8 Bq/m3) radon concentration was found in one (3.6%) classroom, located in a building of a primary school whose median concentration was 185 Bq/m3. Radon concentration was significantly correlated with the number of students and teachers, foundation wall construction material, and with the absence of underground floors. A geopedological survey was performed close to the building with highest radon level, showing the presence of granite and tonalithic granodiorite in the soil. Conclusions: Radon levels should be routinely assessed where individuals live or work. Schools are susceptible targets, because of childhood stay and the long daily stay of occupants. Low-cost interventions, such as implementation of natural air ventilation and school maintenance, can reduce radon levels, limiting individual exposure.

ACS Style

Antonio Azara; Marco Dettori; Paolo Castiglia; Andrea Piana; Paolo Durando; Valentina Parodi; Giovanni Salis; Laura Saderi; Giovanni Sotgiu. Indoor Radon Exposure in Italian Schools. International Journal of Environmental Research and Public Health 2018, 15, 749 .

AMA Style

Antonio Azara, Marco Dettori, Paolo Castiglia, Andrea Piana, Paolo Durando, Valentina Parodi, Giovanni Salis, Laura Saderi, Giovanni Sotgiu. Indoor Radon Exposure in Italian Schools. International Journal of Environmental Research and Public Health. 2018; 15 (4):749.

Chicago/Turabian Style

Antonio Azara; Marco Dettori; Paolo Castiglia; Andrea Piana; Paolo Durando; Valentina Parodi; Giovanni Salis; Laura Saderi; Giovanni Sotgiu. 2018. "Indoor Radon Exposure in Italian Schools." International Journal of Environmental Research and Public Health 15, no. 4: 749.