Bollettino Epidemiologico e Prospettive di Sanità Pubblica

Demographic analysis of the Local Health Authority CN2 (year 2023)

2024-12-17T15:52:00+00:00

Piemonte population as of 12/31/2023 amounted to 4,252,581 inhabitants and in this last eleven years (2013-2023) has shrunk by 4.2%; the birth rate has decreased from 8 births per 1000 inhabitants (2013) to 5.9 births per 1000 inhabitants (2023). For more than two decades, the number of deaths has exceeded the number of births (natural negative growth rate); moreover, although the number of those who decide to reside in Piemonte has always been greater than the number of those who decide to settle elsewhere (positive migration balance) since 2014, the migration balance has no longer been able to compensate for the negative natural balance with the effect of a progressive reduction and aging of the population. In 2023 for every 100 residents in Piedmont: 12 are younger than 15 years old, 62 are between 15-64 years old, and 26 are older than 64 years old. The territory of ASL CN2 is made up of 75 municipalities whose population as of 12/31/2023 amounted to 169,270 inhabitants (4% regional population)
and in the last eleven years (2013-2023) has decreased by 1.5%; the birth rate has decreased from 8.8 births per 1,000 inhabitants (in 2013) to 6.6 per 1,000 inhabitants, in absolute terms in 2023 1119 births were observed. As for the entire region for more than two decades we observe a negative birthrate, while the migration balance although always positive, since 2015 has failed to compensate for the negative growth rate. In 2023, for every 100 residents in ASL CN2 municipalities: about 12 are under 15 years old, about 63 are between 15 and 64 years old, and about 25 are over 64 years old. The average age of the population in ASL CN2 in the year 2023 is 46.1 years; while in Piemonte, the average age is 47.4 years.

La mortalità generale e per cause anno 2021

2024-12-17T16:05:39+00:00

Lo studio dei dati di mortalità rappresenta un importante strumento che contribuisce alla descrizione dello stato di salute della popolazione, utile per programmare e organizzare le attività di assistenza e di prevenzione.
I dati di mortalità generale e per causa analizzati nel presente report sono desunti dalla codifica e dalla elaborazione delle informazioni presenti nelle schede di morte ISTAT di fonte B.D.D.E. - Banca Dati Demografica Evolutiva del Piemonte.

Health Profile of the ASLCN2 Alba-Bra Population. Results of the PASSI Survey 2022-2023

2024-12-17T15:57:19+00:00

The PASSI surveillance is a sample survey launched in 2008 and conducted annually in all Italian Local Health Authorities (ASLs). Promoted and coordinated by the Ministry of Health and the National Institute of Health, it involves a random and representative sample of individuals served by the ASLCN2, selected based on gender and age (18–69 years). The collected data enable the analysis of socio-demographic and economic characteristics, health status, behaviors, and determinants influencing population health. This report presents the results of the PASSI surveillance among the individuals served by the ASLCN2 during the 2022–2023 biennium.

La consulenza dietetico nutrizionale nel Dipartimento di Prevenzione per la promozione di stili alimentari salutari

2024-12-17T16:09:37+00:00

Introduzione: Il cibo ha un significato profondo nella nostra vita, sia come fonte di nutrienti essenziali per la salute, sia come elemento culturale, sociale e di identità culturale. Sappiamo che una dieta equilibrata ha grande influenza sulla nostra salute perciò è fondamentale diffondere l’educazione alimentare per prevenire le cattive abitudini alimentari.
Obiettivi: definire un modello di consulenza dietetico nutrizionale e di educazione alimentare per la diffusione delle corrette abitudini alimentari e presentare lo sportello attivato presso il dipartimento di prevenzione della ASL CN2.
Metodi: revisione della letteratura scientifica degli ultimi 20 anni, includendo tutti i disegni di studio che riguardano popolazioni del mondo occidentale nei quali l’educazione alimentare e di counseling nutrizionale è rivolto a soggetti sani. Ricognizione tramite questionario sulle attività di consulenza dietetico nutrizionale presso i dipartimenti di prevenzione nelle ASL italiane.
Risultati: sono stati inclusi 11 lavori che hanno evidenziato l’efficacia del counselling nutrizionale su adulti sani o in stato di obesità di primo grado, donne in gravidanza e bambini celiaci o con intolleranze alimentari. L’indagine del questionario ha rilevato che in Italia l’offerta di servizi di consulenza dietetico-nutrizionale è attiva in 38 Servizi su 109 ASL, utilizzando due modelli: l’ambulatorio e lo sportello. Gli ambulatori si rivolgono a soggetti sani e con patologie o obesità grave, mentre gli sportelli sono orientati alla promozione della salute verso la popolazione sana.
Conclusione: La ricerca internazionale mostra l’efficacia dell’educazione alimentare e del counseling nutrizionale nel migliorare le abitudini alimentari e lo stile di vita, nonché nel promuovere il consumo di alimenti sani. Tuttavia, l’analisi condotta presso i dipartimenti di prevenzione delle ASL italiane rivela una diffusione ancora limitata di questo servizio. L’esperienza della ASL CN2 ha evidenziato 146 prime visite e 86 controlli nei primi 17 mesi di attività.

Promoting Physical Activity in the Workplace: Investment in Corporate Well-Being

2024-12-17T16:18:33+00:00

In recent decades, work has changed significantly, leading to an increase in sedentary behavior and health issues such as obesity and cardiovascular diseases. Therefore, promoting physical activity in the workplace has become a priority for many organizations. This study highlights the benefits for both employees and employers, emphasizing how physical activity can improve physical and mental health, reduce stress, and increase productivity, with economic benefits for companies. To encourage physical activity, companies can adopt strategies such as corporate fitness programs, participation incentives, infrastructure improvements (like showers and walking paths), and awareness campaigns. Flexible working hours can also facilitate the integration of exercise into daily routines. In conclusion, promoting physical activity is an investment that leads to significant improvements in employee health and organizational performance.

Psycho-educational and psycho-social treatments in dementia

2024-12-17T16:24:24+00:00

The implementation of psycho-educational and psycho-social treatments for patients with dementia in the ASL CN2 highlights the importance of these approaches as a complement to pharmacological therapies. The article reports the activation of four main protocols in 2023: (1) cognitive stimulation and reminiscence therapy, (2) individual and group psychological support for patients, (3) psycho-educational treatments for caregivers, and (4) supervised physical activity. The protocols involved 72 patients diagnosed with mild-to-moderate neurocognitive disorder, 62.5% of whom were female and 37.5% male, with an average age of 76.2 years. The interventions, which included the use of digital platforms for cognitive stimulation and psychological support, resulted in the stabilization of the cognitive condition in 75% of patients and an improvement in quality of life in 70% of cases. For caregivers, an 80% reduction in stress was observed, along with high satisfaction with the interventions. The article concludes that psychosocial interventions can significantly contribute to maintaining cognitive function and autonomy, as well as improving psychological well-being and quality of life for both patients and their families, delaying institutionalization and enhancing disease management.

Primary Care Psychologist: Presentation of the regional project and activation of the service at ASL CN2

2024-12-17T16:28:46+00:00

Piemonte is the first Italian region to launch an experimental project in Primary Care Psychology. This initiative addresses the rising levels of psychological distress and mental health disorders exacerbated by the crisis resulting from the Sars-CoV-2 pandemic. The project aims to create a first point of contact for citizens with the healthcare system, using a biopsychosocial approach to meet basic care needs. Primary Care Psychologists work within social-health districts, collaborating with general practitioners and pediatricians. The primary psychological assistance service is coordinated by the company’s psychology services, ensuring communication between different levels of care and maintaining a balance between treatment and prevention. The goal is to provide high-quality, accessible, and rapid psychological support with a favorable cost-effectiveness ratio, thereby reducing both the time and costs for families and the National Health Service.

Monitoring antibiotic consumption and indicators of appropriate use in the ASL CN2 population

2024-12-17T16:39:02+00:00

The excessive use of antibiotics in human and veterinary fields contributes to the selection of resistant bacteria. This study analyzes antibiotic consumption in the ASL CN2, using prescription data. In 2023, the consumption was 13.9 DDD/1000 inhabitants, an increase from the previous year. The most prescribed antibiotics are penicillins (41%), followed by macrolides (22%) and third-generation cephalosporins (14%). There is a ratio of 11.0 between broad-spectrum and narrow-spectrum antibiotics, and seasonal consumption patterns resemble pre-pandemic trends, with higher use in winter. Consumption of antibiotics classified as “Access” is increasing in the post-pandemic period. Careful monitoring of prescriptions is essential to raise awareness among doctors about responsible antibiotic use to combat antibiotic resistance.

Effectiveness of pharmacovigilance initiatives on the consumption of fluoroquinolone antibiotics in ASL CN2

2024-12-17T16:43:07+00:00

Fluoroquinolone antibiotics are associated with significant adverse reactions and should be used cautiously due to their role in promoting bacterial resistance. Regulatory agencies have issued increasingly stringent recommendations regarding their use in 2018, 2019, and 2023. This study aims to analyze the trends in fluoroquinolone prescriptions in ASL CN2 and evaluate the effectiveness of monitoring and pharmacovigilance initiatives. Prescription data for fluoroquinolones from January 2018 to June 2024 was analyzed. The daily defined doses (DDD) per 1,000 inhabitants per day decreased from 1.9 in 2018 to 0.9 in the first half of 2024. The percentage of fluoroquinolones among all systemic antibiotic prescriptions also declined significantly, from 13.3% in 2018 to 6.0% in the first half of 2024. Overall, there has been a marked reduction in fluoroquinolone consumption, attributed to surveillance activities and educational initiatives aimed at prescribers, leading to more rational use of these antibiotics in ASL CN2.

Protocol for the virtual management of the visit for headaches and rare diseases at the headache and rare diseases center of ASL CN2

2024-12-17T16:46:09+00:00

The COVID-19 pandemic has forced healthcare systems to implement alternative solutions to in-person visits in order to continue treating patients. At our center we follow patients suffering from complex headaches and rare diseases, who more than others are in a fragile condition and need treatment. To meet these needs, we have designed and implemented a protocol for taking charge and treating patients using telemedicine. In this article we present the project and report some data on our activity.

Particulate matter in the territory of ASL CN2

2024-12-17T16:50:20+00:00

The International Agency for Research on Cancer (IARC) has classified air pollution as carcinogenic to humans with particular regard to the so-called particulate matter, PM10 and PM2,5, critical pollutants in the Po Valley of the northern Italy. Howewer, during the year 2023 concentration values, measured by the air quality (AQ) monitoring stations of the Piedmont Region, were the lowest of the entire historical data series. In the present work, PM10 and PM2,5 concentrations, measured by AQ stations located in the territory of ASL CN2, were investigated at local scale. 2023 measured data were compared with normative indicators, established by D.Lgs. 155/2010, annual average limit value and daily limit exceedances; further assessment was made taking into account all historical series of available data: as a result concentrations decreasing over time was highlighted and 2023 was confirmed as the best year, according to the regional level. Meteorological conditions contributed to this reduction; the above-average ventilation reduced the number of days of temperature inversion, creating adverse conditions to pollutants accumulation in the atmosphere, despite the negative rainfall anomaly. Therefore meteorological parameter analysis, wind speed and precipitation, was carried out, using data from the meteorological stations located in the territory of ASL CN2. Attention had yet to be focused to the winter period, during which inability of the atmosphere to remove pollutants (temperature inversion at ground level, high atmospheric pressure, absence of precipitation, low or stagnant winds) favoured episodes of pollutant accumulation and as a consequence healthcare demand for the most fragile subjects increased.

Analysis of heat waves in the territory of ASL CN2

2024-12-17T16:54:38+00:00

In the present work, daily temperature trends (average, minimum and maximum) were studied at local level, using data measured by meteohydrographic monitoring stations of Arpa Piemonte located in the territory of ASL CN2; temperature values were also compared with the climate normal temperature of the investigated area.
Using available historical data, climatological indicators tropical nights (number of days with Tmin > 20°C), summer days (number of days with Tmax > 30°C) and frost days (number of days with Tmin ≤ 0°C) were calculated; values thus obtained were compared with the same ones computed for 2023.
The biometeorological index Humidex was used to assess heat waves, periods of abnormally high temperatures able to stress the thermoregulation mechanism of human body; it can objectively express the degree of physiological well-being or annoyance by combining the effects of warm temperatures and humidity.

Work and Health: Accidents, Occupational Diseases, and the Activities of the Prevention and Safety Service in Work Environments of ASL CN2 (2013-2022). A Decade-Long Analysis for Targeted Prevention Based on Emerging Needs

2024-12-17T16:56:43+00:00

Data from the last decade show the evolution of health and safety needs in the workplace, which can be partially linked to preventive activities introduced by long-standing European regulations (Law 626/94). The evolution of the world of work and the substantial stability of accidents and occupational diseases highlight the need for new tools and more effective prevention methods, adapted to these changes.

Work and Health. Occupational Accidents Among Workers in ASL CN2

2024-12-17T16:58:24+00:00

Occupational accidents among ASL CN2 employees were analysed in the national context, showing a significant drop in accidents in the Health sector in 2023, due in part to the pandemic crisis. In 2023, there were 55,427 accident reports in Healthcare, a decrease of 38% compared to 2022. This sector accounts for about 67% of all injuries in this sector, with the pandemic increasing the risk of infection among workers. INAIL data are useful to assess the phenomenon, although comparison with data from individual health authorities is difficult. In Piedmont the situation is similar, with an accident trend influenced by the pandemic. In 2019, 3,114 injuries were recorded, increasing to 20,894 in 2020, then decreasing in 2021 and rising again in 2022 to 14,145 events. In 2023, there were 3,298 accidents, representing 12.80% of the regional total. For ASL CN2, annual accident data are reported, distinguishing between biological and non-biological. In recent years, there has been a decrease in total accidents, although biological accidents increased during the pandemic. In 2023 there were 104 total accidents, of which 38 were biological, showing a decrease in COVID-19 accidents compared to the previous year. Finally, there are differences in the types of injuries, with a prevalence of commuting injuries and a higher incidence in certain departments, such as the emergency room. Over the years, the trend shows a stabilisation of injuries after the pandemic peak period.

Talenti Latenti: governance for the community’s health. A questionnaire to understand the employees’ needs

2024-12-18T08:09:51+00:00

The “Talenti Latenti: governance for the community’s health” project aims to explore the welfare needs of employees from participating companies to create a community-based welfare model. The research involved a questionnaire administered to over 3,000 employees, from a total of 14 companies, including two medium-sized enterprises and eleven small businesses, investigating six key areas of welfare: health and well-being, caregiving, training, mobility, economy and finance, and leisure time. The results revealed a strong demand for health and well-being initiatives, with a significant impact of caregiving responsibilities and economic difficulties on psychological well-being. The study confirms the importance of corporate welfare as a tool to enhance employees’ quality of life, highlighting the need for more personalized and collaborative initiatives. The project contributes to building a territorial network where companies, public and private entities, and communities work together to promote “collaborative health”.

Go Beyond: Risk Limitation and Harm Reduction on the territory of ASL Cn2

2024-12-18T08:14:13+00:00

The article analyzes the evolution of Harm Reduction projects following the inclusion of these practices in the Essential Levels of Care (LEA) under Law No. 47 of April 21, 2017, and their formal adoption in Piedmont with Regional Resolution No. 42-8767 on April 12, 2019. Since then, the local health authorities (ASLs) in Piedmont have launched experimental initiatives to expand access to services through Harm Reduction strategies. The article’s analysis focuses on projects implemented by ASL Cn2, describing their progression from the experimental phase to current implementations, which include data collection on consumption behaviors and consumer well-being. The results highlight the essential role of Harm Reduction in facilitating access to resources and support for those who, due to sociocultural reasons, often remain on the margins of conventional healthcare services.

Nitrites and nitrates: calculation examples in meat based products

2024-12-18T08:19:33+00:00

For decades, nitrites and nitrates have not only helped to preserve food, but have also contributed to making processed meats more appealing by giving them a bright and attractive color that easily captures the attention. In addition to enhancing flavor and appearance, these additives play a crucial role in our diet, protecting us from certain microorganisms such as Clostridium botulinum, responsible for severe food poisoning. However, these preservatives also have delicate aspects: if used incorrectly, they can promote the formation of potentially harmful compounds such as nitrosamines.
To ensure food safety, the European Union has imposed strict regulations on the use of these preservatives, but what tools are used to make sure these standards are respected? This article explores the verification methods used in official controls to monitor the levels of nitrites and nitrates in processed meat products, such as salami, ham, and cotechino sausages, helping to protect food quality and our health.

Safety in Agricultural Enterprises in the Province of Cuneo – Focus on the Years 2010-2023

2024-12-18T08:22:17+00:00

Article 21 of Legislative Decree 81/2008 extended the obligation to use work equipment and personal protective devices compliant with specific regulations to members of family businesses, self-employed workers, direct farmers, and partners in simple agricultural companies. Despite a declining trend, agriculture remains one of the sectors with the highest number of workplace injuries. In 2009, the first National Plan for Occupational Safety in Agriculture was adopted and fully implemented by the Piedmont Region in 2010. Since then, Piedmont’s local health authorities (ASLs) have intensified annual inspections to ensure equipment safety and compliance with health and safety regulations.
Each year, the Piedmont Region publishes a report detailing employment, workplace injuries, and supervisory activities, highlighting ongoing efforts in agricultural occupational safety. This article focuses on the Province of Cuneo, analyzing its local economic and occupational landscape, with particular attention to the assistance and monitoring activities conducted by territorial ASLs.

Vaccination coverage in Asl CN2: historical trends on the 2012-2022 courts

2024-12-18T08:32:49+00:00

Vaccination is a key public health tool for public health in controlling infectious diseases, the ultimate goal of which remains the potential eradication of circulating pathogens. Since the World Health Organization (WHO) established the Expanded Immunization Program (EPI), an estimated 154 million deaths have been prevented, especially among children. Vaccines protect individuals and reduce global health and economic burdens while promoting herd immunity to safeguard vulnerable populations.
This report presents an analysis of vaccination coverage rates for the hexavalent vaccine and the measles, mumps, rubella (MMR) vaccine in the ASL CN2 district for birth cohorts from 2012 to 2022. Data for the 2017-2022 birth cohorts are derived from the Piedmont Region PADDI platform, and for the 2012-2016 cohorts from SEREMI annual reports. Hexavalent vaccine coverage showed slight growth before stabilizing above 95% for cohorts born from 2017 onward. MMR coverage, starting from a minimum of 89% for the 2013 cohort, exhibited more pronounced growth. Despite a slight decline in 2018 and 2019, coverage remained above the threshold for cohorts born from 2016 onward. Despite slight reductions during the COVID-19 pandemic, vaccination rates in the ASL CN2 were above the threshold for cohorts in the years covered by the “Lorenzin” Decree. Sustaining high vaccination rates is crucial for protecting vulnerable populations and preventing the resurgence of preventable diseases.

Promoting health through physical activity at all ages. ASL CN2’s initiatives

2024-12-18T08:36:59+00:00

Physical activity and, in particular, walking programs, offer a moltitude of benefits like preventing chronic diseases, reducing associated mortality, increasing socialisation opportunities and improving mental well-being. A significant proportion of the population of all ages does not reach the recommended levels of physical activity to maintain good health, so sedentary behaviour is a widespread problem. To address these challenges, ASL CN2 promotes several projects aimed at raising awareness of healthy lifestyles. Among these, Walking Groups are an effective way to promote physical activity among adults. For children and adolescents the Muovinsieme project has been implemented: , following the good practice of the Mile a Day it promotes a walk as part of didactics activities. The project involves training teachers and it promotes healthy behaviours for pre-school, primary and secondary school students.
The results of these initiatives are encouraging: both the walking groups and the Muovinsieme project involve a good number of participants and they encourage ASL to continue to work on these topics, with the support of local organisations and volunteer associations.