Influenza immunization coverage rates remain far below the optimal value recommended by the World Health Organization, even in groups considered at high risk, such as the elderly. A possible explanation for this suboptimal vaccination uptake may be deprivation. A specifically developed local deprivation index was proposed for the classification of residents in the municipality of Ferrara in order to evaluate the characteristics of subjects over 65 years of age who accepted/refused influenza immunization (2010-2015). The variables building this deprivation index were primarily related to demographic aspects, such as age, widow/widower status, education, family composition and housing characteristics. Influenza immunization coverage rates were unsatisfactory in all categories of deprivation. A statistically significant decreasing trend in coverage rates was observed with decreasing deprivation in the general population and in males, but not in females. In addition to factors composing the local deprivation index, being separated, living in a family of three members and independent contractor were features that hindered immunization among very deprived elderly.

Hepatitis B virus (HBV) is a main cause of chronic and acute hepatitis. Healthcare workers (HCWs), including medical students and resident doctors, have an occupational risk of HBV infection. The study aimed to evaluate the long-term persistence of protective anti-HBs antibody levels in healthcare students and resident doctors at risk for occupational exposure to HBV at 15 years after primary vaccination course. Further objective was to evaluate the anamnestic response observed in non-seroprotected subjects receiving a booster dose. Data were collected from the clinical documentation filled in during the occupational medical check of medical students and resident doctors undergoing Occupational Health Surveillance by the University of Ferrara. Of the 621 included individuals, 27.7% had an anti-HBs concentration < 10 mIU/mL. Subjects vaccinated during infancy had more frequently a concentration < 10 mIU/mL than those vaccinated during adolescence (42.7% vs 6.9%; p-value < 0.001). Multivariate analysis confirmed the statistical significance of the vaccination age. 94 subjects who had an anti-HBs concentration < 10 mIU/mL received a booster dose. The proportion of subjects who had an anamnestic response was higher in those vaccinated in infancy rather than during adolescence (94.1% vs 77.8% respectively). These findings suggest that the anti-HBs concentration decreases below 10 mIU/mL more frequently in subjects vaccinated during infancy. Immunological memory seems to persist after the decline of the anti-HB titer, as observed in response to a booster dose. In conclusion, vaccinated subjects at increased risk of HBV infection should be monitored and a booster dose administered if anti-HBs titer is below 10 mIU/mL.

INTRODUCTION:Hospital infections, or "healthcare associated infections" (HAI) represent the most common and serious complications of healthcare. Adoption of safe care practices able to prevent or control the transmission of infections, both in hospitals and in other healthcare settings is crucial. The aim of the study is to assess the awareness about the risk factors and the most effective measures of prevention of HAI in the University of Ferrara nursing school students, giving particular attention to the hand hygiene practices and the use of standard precautions.METHODS:339 students attending all the three years of course of the same academic year were enrolled. An anonymous questionnaire was administered in order to investigate the knowledge about three specific areas: infections associated with healthcare practices (HAI), standard precautions (SP) and hand hygiene (HH).RESULTS:A sufficient level of knowledge by all the three groups of students was observed only in the SP area. A barely sufficient score was reached only by the third year students with regard to the proper HH. The level of knowledge about HAI was inadequate.CONCLUSIONS:A periodically check of nursing students' knowledge would be advisable in order to fill any gaps, improve training, reduce HAI and increase prevention measures compliance.

The aim of the study is to determine awareness about sexually transmitted diseases (STDs) and their prevention in people aged 14-19 of Ferrara and province. The study was carried out using a self-administered standardised anonymous questionnaire in a sample of students attending to three upper secondary schools. Total number of collected questionnaires was 2695, the average age of interviewed was 17.1. Only 52.3% of respondents correctly recognized STD definition. Over 95% of subjects identified acquired immune deficiency syndrome (AIDS), while properly classification of Hepatitis B increased with age and lowest degree of knowledge concerned herpes infection and Candidiasis. Sex without condom (95.97%) and needle exchange in drugs abusers (94.9%) are considered high risk behaviours. 80.3% of interviewed, without distinction of school attendance, sex, and age considered lack of information as a situation of high risk. Condoms are not used by 46.4% of the subjects in case of sex with a regular partner and by 9.5% with casual partner. Majority of students declared condoms very safe in preventing STDs but an important percentage indicated also contraception methods; correct answers were higher among females and increased with age. Main sources of information were TV (21.6%), school (21.1%) and friends (14.8%) and a few sought information from family doctor (7.4%) and web (4.8%). The study suggests, as priority, to improve teenagers' awareness about risk behaviours and prevention of STDs. School can play an important role in reinforcement of sexual education programmes and directing young people to general practitioners and primary sexual health care services.

Regulations for the commercialization of new disinfectants in Europe are currently going through a transition phase. Up to the present time these were set down by each member State of the European Union while in May 2010 a single European set of regulations (Directive 98/8/CE) will become effective in all Member States, the main aspects of which are discussed in this paper. In particular, we discuss the main points regarding studies and other information to be submitted for obtaining approval of new active substances and for reviewing products already in the market.

Mutagenic properties of terpenes (both synthesis and plant derived) have been tested, up to now, as a single molecule. A terpenes containing hydro-alcoholic solution deriving from frankincense and myrrh resins and hyssop essential oil was assayed for mutagenicity by means of ames test. Extraction technique conducted with electromagnetic fields at room temperature enabled to obtain a solution of free active molecules that did not undergo thermal degradation and characterized by biocidal activity. In order to verify lack of mutagenic hazard in coming into contact with human, the solution was appropriately diluted and tested with Salmonella typhimurium TA98, TA1535 and YG1024 strains, both in absence and in presence of metabolic system S9. For none of the tested conditions a 2-fold increase of induced revertants, as regards to spontaneous, was registered. The ratio between induced and spontaneous His+ revertants (Mutagenic Index) was around 1.00 in all the determinations and no statistically significant differences have been identified comparing the sample and the negative control. A similar result has been obtained for the dose-response curve. In conclusion, we verified that tested terpenes solution lacks of mutagenicity on Salmonella typhimurium with and without metabolic activator so this plant extract can be safely used as biocide.

The paper presents the early results of a study involving a group of 312 non smoking and not professionally exposed subjects (144 males and 168 females) in order to evaluate the probable presence of urinary mutagens possibly derived from aspecific exposures. Urine samples were assayed by the Ames test on the YG1024 Salmonella typhimurium strain in the presence of S9 mix with plate incorporation method with preincubation. At the moment of sample collection, the subjects were invited to fill a questionnaire on their main characteristics and lifestyle. On the basis of laboratory data analysis, it emerged that, on 288 samples with a valuable mutagenic activity, 20 urinary extracts (8 of which were males and 12 were females) showed mutagenicity levels twice as much as spontaneous revertants. Diet and indoor exposure to passive smoking, fireplace and cooking fume exposure seemed to play a major role among the lifestyle behaviours investigated in generating positive mutagenic response with a statistically significant difference between positive and negative samples induction (Chi square, P = 0.0057 and P = 0.0168 respectively). After correction of induced revertants by means of creatinine excretion determination, it appeared that females, who had the higher mean urinary mutagenic activity, showed a mutagenicity level twice as much as men (364 +/- 491 revertants/mmole creatinine for males against 605 +/- 868 revertants/mmole creatinine in females, Mann-Whitney U-test, z = -3.97, P < 0.0001) possibly in consequence of their greater cooking fumes exposure. The study, that carefully evaluated the characteristics of involved subjects, reveals the presence, even though modest, of mutagens in urine of an apparently not significantly exposed population. In addition, standardization of method leads to suppose little feasible a confounding influence of considered features. Moreover, it would be therefore rather interesting to study the effect of low exposure time persistence.

The functional significance of genetic polymorphisms on tobacco smoke-induced CYP1A2 activity was examined. The influence of three polymorphisms of the cytochrome P450 1A2 gene (CYP1A2) (-3860 G -> A (allele *1C), -2467 T -> delT (allele *1D), -163 C -> A (allele *1F)), located in the 5'-noncoding promoter region of the gene, on CYP1A2 activity (measured as caffeine metabolic ratio, CMR), was studied in Caucasian current smokers (n = 95). Tobacco smoke intake was calculated from the number of cigarettes/day. Also, studied was the influence of these CYP1A2 genotypes on smoking-associated urinary mutagenicity, detected in Salmonella typhimurium strain YG1024 with S9 mix, considering the urinary excretion of nicotine plus its metabolites as an internal indicator of tobacco smoke exposure.Smokers with at least one of the variant alleles CYP1A2 -3860A and -2467 delT showed a significantly increased CYP1A2 CMR (-3860 G/A versus G/G, p < 0.05; -2467 delT/delT versus T/delT and T/T, p < 0.01). Multiple regression analysis showed that the increase in CYP1A2 CMR (In values) was again significantly related to the presence of CYP1A2 variants -2467delT and also to variant -163A (p < 0.05), but moderately to -3860A (p = 0.084). No influence of the number of cigarettes smoked per day by each subject was found. Heavy smokers ( n = 48, with urinary nicotine plus its metabolites >= 0.69 mg/mmol creatinine) with variant allele -2467delT or -163A had significantly increased urinary mutagenicity (p < 0.01 and < 0.05).CYP1A2 genetic polymorphisms are shown to influence the CYP1A2 phenotype in smokers, -2467 T -> delT having the main effect. This information is of interest for future studies assessing the possible role of tobacco smoke inducible CYP1A2 genotypes as individual susceptibility factors in exposure to carcinogens. (c) 2005 Published by Elsevier B.V.

We examined the urinary mutagenicity in the YG1024 Salmonella typhimurium strain in the presence of S9 mix, of 31 male non-smoking coke oven workers and an equal number of controls matched for gender and dietary habits. Occupational PAH exposure to the workers was assessed by means of the individual urinary post-shift excretion of 1-pyrenol (mean +/- S.D.: 5.41 +/- 6.06 mumole/mol creatinine). Eleven urinary extracts of workers (35.5%) were clearly mutagenic (with at least a doubling of the number of spontaneous revertants), against only two samples in the control group (6.5%) (chi(2)-test; chi(2) = 7.883; P < 0.01). Moreover, the mean mutagenic activity level corrected for dilution/concentration of the urine was about three times higher in coke oven workers than in matched controls (mean +/- S.D. (range) 495 +/- 407 (89.7-1603) versus 186 +/- 113 (14.2-524) net revertants/mmol creatinine; Mann-Whitney U-test, z = 3.86, P < 0.001). Simple linear regression analysis showed that the coke workers' urinary mutagenic activity is associated with the PAH occupation-related urinary excretion of 1-pyrenol (r = 0.41, P = 0.0215).This study definitely demonstrates an occupation-related exposure of coke oven workers' bladder epithelium to mutagenic PAH metabolites. This factor, mainly in the case of high exposure studied here, may account for a higher bladder cancer risk in coke oven workers. (C) 2004 Elsevier B.V. All rights reserved.

We investigated the polymorphic enzymes cytochrome P450 1A2 (CYP1A2), N-acetyltransferase (NAT2), glutathione S-transferase (GST) M1 (GSTM1), and T1 (GSTT1) in relation to cigarette smoking-associated urinary mutagenicity detected on YG1024 Salmonella typhimurium strain with S9 mix in 97 smokers. In each subject, cigarette smoke intake was checked by analysis of urinary nicotine plus its metabolites. NAT2 and CYP1A2 phenotypes were determined by the molar ratio of urinary caffeine metabolites detected by high-performance liquid chromatography, and GSTT1 and GSTM1 genotypes were determined by PCR. An increase in urinary mutagenicity was significantly related to levels of exposure to cigarette smoke and CYP1A2 N-hydroxylation activity (linear multiple regression analysis t = 4.51 and P < 0.001 and t = 3.09 and P = 0.003; F = 6.31, P < 0.001). Urinary mutagenicity was significantly higher in CYP1A2 extensive metabolizer smokers (n = 49) than in CYP1A2 poor metabolizer ones (n = 48; 2176 +/- 1525 versus 1384 +/- 1206 revertants/mmol creatinine, Mann-Whitney U-test, z = 2.65, P < 0.001). The highest mutagenic activity was seen in subjects CYP1A2 extensive metabolizer/NAT2 slow acetylators (n = 29) with respect to the other phenotype combinations (n = 68; 2392 +/- 1660 versus 1525 +/- 1238 revertants/mmol creatinine, Mann-Whitney U-test, z = 2.37, P = 0.017). NAT2 acetylation activity was slightly but inversely related to urinary mutagenicity, and the association was not significant. No effect of GSTM1 and GSTT1 genotypes in lowering (detoxifying) urinary mutagens was found. The significant enhancement of urinary mutagenicity associated with increased CYP1A2 activity, as already seen for diet-caused urinary mutagenicity, allows for many analogies between the process of mutagen formation derived from cooked meat and that from cigarette smoke condensate. In conclusion, the intensity of tobacco smoke exposure, modulated by CYP1A2 activity, is the major determinant of mutagenic urine among smokers, whereas GSTM1 and GSTT1 genotypes have no influence on this biomarker. This study suggests that CYP1A2 should definitely be determined in future studies involving urinary mutagenicity in cases in which smoking is a factor.

The influence of the metabolic phenotypes NAT2 and CYP1A2 on urinary mutagenicity of 118 smokers was studied. Mutagenicity of urine samples was determined by Ames test (preincubation plate incorporation assay on YG1024 Salmonella typhimurium strain with S9 mix). Urinary nicotine plus its metabolites were determined to check cigarette smoke intake. The N -acetyltransferase (NAT2) and cytochrome P450 1A2 (CYP1A2) phenotypes were measured by the molar ratio of urinary caffeine metabolites, determined by HPLC analysis. Urinary mutagenicity was significantly higher in smokers CYP1A2 extensive (EM) than in CYP1A2 poor metabolizers (PM) (Mann-Whitney U test, p = 0.020). Linear multiple regression analysis shows that an increase in urinary mutagenicity levels was significantly related to cigarette smoke intake and to CYP1A2 N -hydroxylation activity ( t = 5.06, p < 0.001, and t = 2.33, p = 0.021), but not to NAT2 acetylation phenotype. In conclusion, phenotypic differences in metabolic activation of tobacco smoke mutagens are able to modulate the presence of mutagens in urine of cigarette smokers and, consequently, the potential genotoxic risk.

In this work the phenotyping approach was used to study the influence of metabolic polymorphisms NAT2 and CYP1A2 on S9-mediated urinary mutagenicity, detected with Salmonella strain YG1024, in 50 subjects after a meal of pan-fried hamburgers. All 50 post-meal samples, but not pre-meal ones, were clearly mutagenic (number of urine samples able to double number of spontaneous revertants was 50 to 0, respectively). CYP1A2 positively influences urinary mutagenicity: a rise in CYP1A2 activity increases levels of post-meal urinary mutagens (1.16±0.91 vs 1.72±1.19 7-h minimum mutagenic doses (MMDs)/intake), especially in NAT2 slow acetylators (2.18±1.33 vs 0.90±0.54 7-h MMDs/intake, Mann–Whitney U-test, P<0.05). NAT2 rapid acetylators exert lower post-meal urinary mutagenicity than slow ones (1.41±1.02 vs 1.77±2.45 7-h MMDs/intake) and even more if the latter are extensive CYP1A2 metabolizers (1.41±1.02 vs 2.18±1.33 7-h MMDs/intake), but the difference did not reach statistical significance. In conclusion, this study indicates that CYP1A2 and NAT2 activities influence the presence of urinary mutagens after a meal of pan-fried hamburger (rich in HHAs) and consequently their potential genotoxic risk.