Download ISDE Italia News

ISDE Italia News
A cura dell'Associazione Medici per l'Ambiente
Number 260 (29th January 2008)
In this issue…
1.
XXI Residential Summer Course in “Epidemiology and social inequalities in
health in Europe”
2. “Comparison bias and dilution effect in occupational cohort studies” by
Stefano Parodi, Valerio Gennaro, Marcello Ceppi, Pierluigi Cocco.
3. “Outdoor environmental tobacco smoke: a relevant contribution to outdoor
pollution in selected city areas” by G. Invernizzi, M. Nebot, M.J. lopez, G.
Gorini, A. Gasparrini, A. Ruprecht.
4. Health Systems. Health and Wealth
5. World Cancer Congress: call for abstracts
6. IV Annual Brussels Climate Change Conference 2008. EU climate change policy
after Bali
7. When briefing/workshop: communicating climate change & health
8. World Sustainable Energy Days 2008
9. “The effectiveness of health impact assessment. Scope and limitations of
supporting decision-makingin Europe” by M. Wismar, J. Blau, K. Ernst,Jj.
Figueras.
10. Low-dose effects: a manufactured controversy?
11. Doctors against forced organ harvesting (DAFOH)
XXI RESIDENTIAL SUMMER COURSE IN EPIDEMIOLOGY AND SOCIAL
INEQUALITIES IN HEALTH IN EUROPE
From 23 June to 11 July 2008, there will be three week main course "21st Residential
Summer Course in Epidemiology" and from 16 June to 20 June 2008 there will be one
week course "Social Inequalities in Health in Europe". These events will take place in
Florence (Italy). The courses are taught in English by lecturers mostly from European
Universities and Research Institutes and are held in residential form in the
"Studium" centre on the hills close to Florence. The main three week course offers in
the first two weeks five general modules on epidemiological study design and
statistical analysis of epidemiological data. In the third week six special modules,
ranging from cancer epidemiology and cardiovascular epidemiology to the impact of
changes of global climatic environment cover topics of current relevance for health
(students can choose which modules to follow). The morning and afternoon sessions
include lectures, computer based analyses (using the “Stata” package), exercises and
discussion sessions. To follow profitably this course, students are expected to
possess some knowledge of epidemiological and statistical methods at introductory
level. The one week course on “Social Inequalities in Health in Europe” is addressed to
students with special interest in these areas and a sound background knowledge of
epidemiological and statistical methods. All students should have a working knowledge
of written and spoken English.
Info: http://www.eepe.org/courses.html
COMPARISON BIAS AND DILUTION EFFECT IN OCCUPATIONAL COHORT
STUDIES by Stefano Parodi, Valerio Gennaro, Marcello Ceppi, Pierluigi Cocco.
From International Journal of Occupational and Environmental Health;13(2):143-52.
Health effects of occupational exposures are frequently evaluated by comparing the
mortality of a whole cohort of workers with that of the general population. This
study design may be affected by two major biases: a dilution effect (DE), due to the
inclusion of unexposed subjects in the study cohort, and a comparison bias (CB), due
to the different distribution of risk factors in the reference population. A
theoretical model of the joint effect of DE and CB is proposed. Their impact was
evaluated in two actual cohorts, selecting specific causes of death based on a priori
hypotheses of an association. A linear relationship between the risk estimates and
the two biases was found after applying either direct or indirect standardization to
adjust for confounding. In the two cohorts, higher risks in exposed workers emerged
only after adjusting for DE and CB. Cohort studies without an internal referent group
may provide unreliable results.
Info: http://www.ijoeh.com/pfds/IJOEH_1302_Parodi.pdf
OUTDOOR ENVIRONMENTAL TOBACCO SMOKE: A RELEVANT
CONTRIBUTION TO OUTDOOR POLLUTION IN SELECTED CITY AREAS by G.
Invernizzi, M. Nebot, M.J. Lopez, G. Gorini, A. Gasparrini, A. Ruprecht.
A growing number of cities have adopted policies or ordinances that restrict tobacco
smoking in outdoor locations. In the USA current policies ban or limits tobacco use on
park and recreation grounds, sidewalks, outdoor dining patios, and within a short
distance from opening of public buildings and workplaces. The reason of the bans is to
protect people from the health hazards of environmental tobacco smoke (ETS). So
far, however, the contribution of ETS to outdoor pollution did not raise concern
regarding an urban area as a whole. Historical neighborhoods of many European cities
are visited by thousands of tourists, who gather every day into a slow stream of
people walking along an obligate car-free itinerary of narrow streets closed side by
side by a continuous line of old buildings, usually 4-5 floors high. This architectural
feature makes the tracks be called “street canyons” with a limited possibility of
natural air exchange. Since many tourists smoke, and since along the promenade there
are many outdoor patios where smoking is still allowed, the concern about the
possibility of a worsening of the outdoor air quality from ETS pollutants is
reasonable. The aim of the study is to compare the particulate levels in the “Brera”
car-free neighborhood in the Milan Old Town, where the renowned Pinacoteca is
placed, with the surrounding high-traffic areas, and to relate any exceeding pollution
in Brera to outdoor ETS.
Info: [email protected]
HEALTH SYSTEMS. HEALTH AND WEALTH
The Conference on Health Systems: “Health systems. Health and wealth” will take
place in Tallin (Estonia) from 25th to 27th June 2008. It’s organized by
WHO/Europe and hosted by the Government of the Republic of Estonia. The
Conference aims to place health systems high on the political agenda. Specifically it
will lead to better understanding of the impact of health systems on people's health
and therefore on economic growth in the WHO European Region; take stock of recent
evidence on effective strategies to improve the performance of health systems,
given the increasing pressure on them to ensure sustainability and solidarity. It will
bring together ministers of health from the 53 Member States in the WHO
European Region.
Info: http://www.euro.who.int/healthsystems2008
WORLD CANCER CONGRESS: CALL FOR ABSTRACTS
One of the major strengths of the World Cancer Congress is the diversity of cultural
representation (125 nationalities in 2006), professional backgrounds of delegates,
and topics (ranging from cancer prevention to palliative care). Wherever you are,
whatever your profession and whatever your interests, please do consider submitting
an abstract. The collective wealth of many diverse contributions can only help the
global community to grow in understanding of the challenges we face today and the
solutions that will change tomorrow. All abstracts submitted will help us to move
towards a world where cancer is no longer a life-threatening disease.
Info: http://www.uicc-congress08.org/; http://abstract.mci-group.com/cgibin/mc/startabs.pl?ID=UICC2008ABS
IV ANNUAL BRUSSELS CLIMATE CHANGE CONFERENCE 2008. EU CLIMATE
CHANGE POLICY AFTER BALI
The year 2007 saw a series of high profile events related to climate change such as
the G8 summit or the major economies meeting. Activities culminated at the climate
change negotiations in Bali, Indonesia with the adoption of the Bali Action Plan that
sets out the negotiations mandate for the following two years and which is meant to
lead to a global climate change agreement by the end of 2009. Important further
steps will be taken in 2008. This joint CEPS/Epsilon conference will take stock of the
state of international negotiations, explore the key issues for the post-2012
agreement and notably focus on the links between the EU and global developments.
The Conference will take place on 26 and 27 February 2008 in Brussels (Belgium).
Issues to be covered include post-2012 after Bali and before the Hokkaido G8
summit, progress of EU integrated energy and climate package, burden-sharing
renewables and technology, EU Emissions Trading Review with a focus on investment,
aviation, road transport... and much more!
Info: http://www.climate-policy.eu/; [email protected]
WHEN BRIEFING/WORKSHOP: COMMUNICATING CLIMATE CHANGE &
HEALTH
In Geneva (Switzerland) on 23 and 24 January 2008 there was WHEN Briefing and
Workshop on Communicating Climate Change and Health. “Protecting Health from
Climate Change” was selected as the theme of World Health Day 2008. As part of
WHO’s preparation for the day and beyond, WHEN was invited to hold this workshop.
The aim of the workshop was twofold. Firstly, the briefing provided attendees with
an exclusive, early overview of the latest WHO data and strategic thinking on the
current and projected impact of climate change on the global burden of disease.
Secondly, the meeting aimed to highlight some examples of good communication
practice related to climate change and health and provide WHO with some guidance
on how to strengthen health considerations in the climate change debate. To this end,
this briefing/workshop looked at initiatives which are communicating information to
six target audiences: the general public, local authorities, the transport sector, the
youth/education sector, corporations and health professionals. These initiatives
included a massive effort to reduce the carbon footprint of the UK’s National Health
Service, municipality-based campaigns, and programmes targeted at young people, the
transport sector and health professionals. Key communicators actively engaged in
these initiatives presented their learning to date.
Info: [email protected]; [email protected]
WORLD SUSTAINABLE ENERGY DAYS 2008
The World Sustainable Energy Days, the largest annual conference in this field in
Europe, offer a inique combination of events on sustainable energy production and
use, covering energy efficiency and renewable energy sources for buildings, industry
and transport. From 5 to 7 March 2008 seven conferences and seminars, which
present the la test technology trends, outstanding examples and European strategies
and the “Energiesparmesse”, an important energy exhibition, offer ideal opportunities
to establish new partnerships. The conference makes an important contribution to
awareness raising for green energy and energy efficiency. Since 16 years, experts
and decision makers from all over the world flock to Upper Austria to attend the
events (in 2007 the conference attracted more than 1000 participants from 61
countries!).
Info: www.wsed.at; www.esv.or.at; [email protected]
THE EFFECTIVENESS OF HEALTH IMPACT ASSESSMENT. SCOPE AND
LIMITATIONS OF SUPPORTING DECISION-MAKINGIN EUROPE by M. Wismar,
J. Blau, K. Ernst, J. Figueras.
Health Impact Assessment (HIA) is considered as a major opportunity to integrate
health policies. HIA promises to influence the decision-making process, addressing all
determinants of health, tackling inequities and providing a new impetus for
participation and empowerment in health. No wonder that HIA generates a lot of
enthusiasm, but there is also a lot of scepticism too. The scepticism is linked to the
crucial but as yet unanswered question, does HIA work? This simple question remains
unanswered due to a number of highly complex methodological issues surrounding the
evaluation of HIA. Outcome evaluation of a given HIA focusing on health gain or loss
for an affected population is difficult, if not impossible, to conduct. An alternative
and feasible strategy to assess the effectiveness of HIA is not to choose health gain
or health loss as the end-point of the evaluation, but instead the influence of HIA on
the decision-making process. In order to address these issues, in August 2004, the
European Observatory on Health Systems and Policies launched a three year multicountry project on the effectiveness of HIA, co-funded by the European Commission
under the Public Health Programme. There are currently 17 project partners from 14
Member States, as well as national coordinators from 5 countries. There overall aim
is to map the use of HIA, evaluate its effectiveness and identify the determinants
for its successful implementation. Effectiveness whitin the context of the project
refers to the capacity to influence the decision-making process and be adequately
taken into account by decision-makers. The project is already producing a continuous
stream of evidence.
Info: http://www.euro.who.int/observatory/Studies/20040310_1
LOW-DOSE EFFECTS: A MANUFACTURED CONTROVERSY?
Endocrinologists know that hormones normally stimulate their receptors at low
concentrations, while high concentrations can inhibit these pathways by saturating
receptors. But the notion that a substance can produce effects at low levels that
disappear at higher levels fundamentally challenges traditional toxicological
approaches. Faced with conflicting reports of harm from a chemical in mass
circulation, the Environmental Protection Agency (EPA) asked the National Toxicology
Program (NTP) to review the evidence on bisphenol A. If the panel decided the
evidence was compelling, it would mean that the EPA's current risk-assessment
methods, which assume “the dose makes the poison,” are outdated. It would also mean
that a significant share of the chemical industry's portfolio of pesticides and
industrial chemicals—many of which are suspected endocrine disruptors—would be
subject to a new standard of risk assessment, with potentially substantial financial
implications. “The moment we published something on bisphenol A, the chemical
industry went out and hired a number of corporate laboratories to replicate our
research. What was stunning about what they did... was they hired people who had no
idea how to do the work”. The EPA estimates safe human exposures to a chemical
based on animal studies that find the lowest harmful dose and the highest benign
dose, then dividing one of the doses by a safety factor to account for variable human
sensitivities and uncertainties in extrapolating to humans. Experiments from the
1980s, which found the lowest harmful dose at 50 milligrams of bisphenol A per
kilogram body weight per day, were used to calculate the current safe dose of
bisphenol A (50 micrograms bisphenol A per kilogram body weight per day). “It's just
through hand waving that the regulatory community says if you divide that number by
1,000 that it's a safe human exposure dose”, vom Saal says. “The public is told it's a
safe dose, but nobody ever tests that”.
Info: http://biology.plosjournals.org/perlserv/?request=getdocument&doi=10.1371/journal.pbio.0050193; [email protected]
DOCTORS AGAINST FORCED ORGAN HARVESTING (DAFOH)
Doctors Against Forced Organ Harvesting (DAFOH) is an international group of
health professionals working to raise awareness about unethical organ harvesting
practices currently taking place in detention centres and hospitals. They argue, with a
compelling evidence base, that these crimes constitute the greatest violations of
medical ethics of our time, the scope of which has not been seen since the holocaust.
In recent years mounting evidence indicates that since 2001, in China alone,
systematic killing of prisoners has been conducted to provide for the lucrative and
growing transplant business. However, DAFOH’s concerns are not limited to China.
Info: https://www.dafoh.org/