Roberto Bono

Introduction: Seasonal variation plays a crucial role in the occurrence and exacerbation of allergic diseases, yet real-world, large-scale epidemiological evidence remains limited. Asthma attacks can be triggered by pollen and often worsen during the pollen season. However, seasonal patterns may vary across different climatic areas. Objectives: The primary aim of the present study was to assess the seasonality of asthma attacks in Italian adults. Methods: We analyzed GEIRD (Gene Environment Interaction in Respiratory Diseases) data, collected from 2008 to 2014 in seven Italian centers, three (Verona, Pavia, Turin) located in the Po Valley (sub-continental area) characterized by sub-continental climate, and four (Sassari, Ancona, Terni, Palermo) in the Mediterranean area. Seasonality was assessed using a Poisson regression framework incorporating Fourier terms (extended Stolwijk model). Both single-peak (unimodal) and double-peak (bimodal) cyclic trends were investigated. The model selection was based on both pseudo R-squared values (R2; explanatory power) and the Goodness-of-Fit (GoF) test. The model providing the best overall fit was retained. Results: The study included 204 subjects (137 and 67 from sub-continental and Mediterranean areas, respectively) who reported having suffered from asthma attacks for a median of 4 months in the previous year. Both unimodal and bimodal Poisson regression models were fitted to this cyclic pattern of asthma attacks. All unimodal models had acceptable GoF. However, the bimodal models had higher pseudo R-squared values with acceptable GoF. Overall, the seasonal pattern of asthma attacks was characterized by a main peak in April and a secondary peak in September (p<0.001; R2=0.503; GoF=0.95). In the sub-continental area, a primary peak was detected in May and a secondary one in September (p<0.001; R2=0.42; GoF=0.89), with relative increases of 34% and 19%, respectively. In contrast, the seasonality of asthma attacks in the Mediterranean area was characterized by the first peak in May, whereas the second peak occurred in October (p=0.004; R2=0.36; GoF=0.99) with relative increases of 37% and 22%, respectively. Conclusion: Asthma attacks in Italy mainly occur during spring. The bimodal cyclic pattern explained 50% of the monthly variability in asthma attacks. Nevertheless, a weaker secondary peak of asthma attacks was observed in autumn. The sub-continental (Po Valley) and Mediterranean areas had slightly different autumn peaks, which may reflect differences in ragweed and Urticaceae exposure, and warrant further investigation. In addition, the modeling approach identified significant seasonal variation.

Tyre granule-based artificial turf surfaces are currently a matter of debate. Most of the Agencies involved in environmental and health protection have stated a negligible/virtually negligible risk to health and have issued a general call for caution concerning the possible presence of emerging risks. The concern for the potential detrimental effect, especially in children, has attracted significant resonance since the beginning of the use of these surfaces. This review aims to describe the current knowledge in both scientific and grey literature concerning the possible adverse risks to health due to human exposure to artificial turf or playgrounds with tyre-derived crumb rubber. We included 20 original research articles and 13 reports published between 2006 and 2025. The current knowledge about the topic was revealed to be still highly fragmentary, with stark differences in methodological approaches and theoretical assumptions used in the risk assessment. However, most of the research and reports are consistent in their results, assessing, in the majority of cases, a low/negligible risk for both professional and recreational players, even though some chemicals were able to leach or volatilise and, in some cases, the estimated risk was higher than the reference threshold conventionally applied for the risk assessment method employed.

Background: Diet during pregnancy plays a crucial role in promoting healthy dietary behaviours and positive maternal and child health outcomes. However, evidence regarding the factors associated with healthy dietary behaviours among pregnant women is limited. The SaperePer study aims to assess the dietary behaviours of pregnant women and identify the sociodemographic, lifestyle, and health-related factors that influence their choices. Methods: This cross-sectional analysis included 1254 pregnant women recruited from two Northern Italian centres (Turin and Cuneo). Dietary behaviour was assessed using a questionnaire, which generated a diet-related scores. Associations between these scores and participants’ characteristics were investigated using multivariable regression models. Results: Overall, participants reported relatively favourable dietary habits and a low prevalence of risky behaviours. Higher socioeconomic position was found to be one of the strongest contributing factors to dietary behaviour (medium vs. low β (95% CI) = 1.18 (0.93, 1.42); high vs. low β (95% CI) = 1.57 (1.10, 2.04), both p < 0.001). Higher dietary behaviour scores were positively associated with older maternal age, moderate physical activity, and better perceived physical and psychological health, whereas smoking and alcohol consumption were associated with lower scores. Conclusions: Dietary behaviour during pregnancy appears to be shaped by a complex interplay of socioeconomic, behavioural, and health-related factors rather than by nutritional knowledge alone. These findings highlight the need for tailored interventions that address the social and contextual features of dietary behaviour to encourage healthier habits during pregnancy.

Air pollution represents a public health threat; it is co-responsible for millions of premature deaths annually and economic losses. Mega-events create abrupt changes in air pollution providing quasi-experimental settings to investigate related health impacts. This systematic review synthesizes the evidence on air pollution level changes during mega-events and associated short-term health effects, including mortality, hospitalizations and early biological responses. A literature search was conducted in PubMed, Embase, Scopus and Web of Science up to 7 April 2025. Study quality was evaluated using the EPHPP Quality Assessment Tool for Quantitative Studies. Thirty-one studies met the inclusion criteria. Mega-events without effective air pollution control measures were associated with increased pollutant levels and higher risks of respiratory and cardiovascular morbidity. Biomarker studies demonstrated rapid and reversible changes in oxidative stress and inflammatory biomarkers in response to short-term variations in air pollution. Instead, significant reductions in air pollution during mega-events were observed upon emission control measures. The evidence is predominantly from Asian countries, no Europe/Africa studies and only one from North America, limiting generalizability. Findings indicate that mega-events may influence air quality which affects human health, reinforcing the value of temporary emission control measures strategies for future mega-events. The systematic review was registered with Prospero (CRD420251032553).

Human milk is the optimal standard for neonatal nutrition, particularly for preterm infants. Several conditions associated with oxidative stress (OS) may be transmitted from mother to infant through milk, making the preservation of milk quality essential. When maternal milk is unavailable, donor human milk (DM) is commonly used and treated with Holder pasteurization (HoP) to ensure microbiological safety, although this process may affect bioactive components. This study aimed to evaluate the impact of HoP on OS biomarkers, specifically total antioxidant power (TAP) and 15-F2t-isoprostane, using colorimetric and ELISA methods as cost-effective alternatives to analytical gold standards. Twenty paired DM and HoP samples from the Human Milk Bank of Sant’Anna Hospital (Turin, Italy) were analyzed. No significant differences were observed in TAP levels between DM and HoP samples. In contrast, 15-F2t-isoprostane concentrations were significantly lower in DM compared to pasteurized milk (3.16 (1.59–5.27) vs. 0.76 (0.62–1.54), p-value < 0.001). This reduction remained consistent after stratification by sampling day. These findings suggest that HoP may reduce oxidative stress markers in donor milk, potentially limiting neonatal exposure to maternal oxidative imbalance. Although this effect could offer protective benefits for vulnerable preterm infants, further studies are needed to clarify the clinical implications of HoP on redox status and neonatal outcomes.

End-of-life tyre (ELT) management is still a hot topic due to implications for sustainability and human health. This review aims to summarise the findings concerning the chemicals’ bio-accessibility/availability from the granular tyre-derived infill material used in sport surfaces. We included 14 original research articles and 5 reports (grey literature). The results included the analysis concerning volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), phthalates, metal(loid)s and other substances. The release of some dangerous chemicals was demonstrated, even though results must be considered critically. However, the chemicals’ bioaccessibility shows a highly nuanced picture and is not, per se, sufficient to determine the risk for the exposed subjects. The lack of bioavailability and epidemiological studies analysing the exposures in real scenarios resulted in one of the main issues concerning a proper evaluation of the potential risks for human health.

Wastewater-based Epidemiology (WBE) was initially employed as a valuable tool for monitoring pathogens. Nowadays, WBE has expanded its original focus to the quantification of several “community-level metabolism” indicators to complement Public Health monitoring campaigns. Recently, wastewater isoprostanes have been suggested as biological indicators of oxidative stress and community anxiety levels during the COVID-19 pandemic. However, previous studies were lacking of concomitant quantifications linking isoprostanes in sewage with COVID-19 pandemic indicators. This study provides an application case to expand the application of a WBE approach for the investigation of community-wide oxidative stress levels and COVID-19 disease. We quantified the occurrence of three oxidative stress biomarkers in wastewater samples collected from two Italian cities (study sites A and B) from January to December 2022. Among the selected oxidative stress biomarkers, only 8-isoprostaglandin F2α (8-iso-PGF2α) and 5-iso Prostaglandin F2α-VI (5-iPF2α-VI) were detectable, while prostaglandin E2 (PGE2) was undetectable during the entire study period in both sites. The annual trend of 8-iso-PGF2α mass load and SARS-CoV-2 concentration in sewage was significantly and moderately cross-correlated, as a at study site A (Spearman’s rho = 0.62) and study site B (Spearman’s rho = 0.68). The same findings were confirmed for the cross-correlations including 8-iso-PGF2α concentrations instead of per capita mass load. A moderate and significant cross-correlation with the annual trend of monthly average daily COVID-19 cases (Spearman’s rho = 0.67) was observed for one study site and with a time lag = 1. Our findings support the hypothesis that human biomonitoring, via the quantification of oxidative stress biomarkers in sewage, can be effectively used to investigate the emerging field of the community-level metabolism.

Background: Health literacy (HL) promotes the achievement of skills and information useful to endorse health. Food Literacy (FL) is a subtype of HL related to the knowledge necessary to achieve a healthy diet. Methods: This pilot study aimed to assess and improve FL of hospital workers through a survey before and after an educational intervention consisting of nutrition courses, infographics, and updates to the canteen service. FL was evaluated with a questionnaire, and Kruskal–Wallis, Friedman and Wilcoxon test was performed to assess group differences. Results: Of 897 participants, 375 (T1) completed both surveys, while 522 completed only T0. A pairwise comparison stratified by role, age and education revealed a significant improvement in FL scores in the T1 group. Improvements were observed in the T1 group, with overall scores rising from 6.2 ± 2.7 to 6.9 ± 2.1 (p-value < 0.001). An upgrade was noted in healthcare workers (T0 = 6.5 ± 2.2 vs. T1 = 7 ± 2, p-value < 0.001), administrative workers (T0 = 5.5 ± 2.5 vs. T1 = 6.2 ± 2.4, p-value = 0.008), all age groups (T0 = 6.3 ± 2.4 vs. T1 = 6.8 ± 2, p-value = 0.03, T0 = 6.2 ± 2.3 vs. T1 = 6.7 ± 2.2, p-value = 0.02, T0 = 6.2 ± 2.3 vs. T1 = 7 ± 2, p-value = 0.003), low and high education (T0 = 5.7 ± 2.3 vs. T1 = 6.6 ± 2.1, p-value < 0.001, T0 = 6.6 ± 2.3 vs. T1 = 7.1 ± 2 p-value = 0.03). Conclusions: Our survey highlights the efficacy of a multifactorial intervention in enhancing FL and proves the importance of food health promotion within workplaces.