Papers by Silvia Bruzzone
Madrid e Barcellona: tra le più amate dagli italiani
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[Occupational mortality in the population employed at 1991 Census]
La Medicina del lavoro, 2005
Despite limitations and problems connected to occupational surveillance systems based on mortalit... more Despite limitations and problems connected to occupational surveillance systems based on mortality data, mortality from specific causes continues to be a crucial indicator for evaluating the differences in health among various occupations. To evaluate the potential of a surveillance system of occupational mortality based on census and mortality data obtained from ISTAT (Italian Central Statistics Institute). By means of record-linkage between Census data and death records from ISTAT, occupational mortality was assessed during the twelve month period following the 1991 census, limited to subjects aged 18-64 years for whom occupational information was available. The study population consisted of deceased subjects, 19,527 of whom were men and 3,547 were women. A cross-sectional model was used to evaluate odds ratios for cause-specific mortality. The risk estimates were then compared to the results obtained in a previous analysis on Census data gathered in the 1981 census. Among the sig...
WIT Transactions on The Built Environment
Tunnel extension is an under-analysed variable in road tunnel accidents despite being a dimension... more Tunnel extension is an under-analysed variable in road tunnel accidents despite being a dimensioning parameter for the purposes of users' safety according to Directive 2004/54/EC. Recent studies have shown a correlation between the tunnel length and consequences of accidents. The analysis of fire events which occurred in tunnels indicates that in many cases fires are triggered by road accidents. By analysing the road accidents in Italy, the study aims to assess the relative risk of accidents with serious consequences for different classes of road tunnels. The second objective was to assess, using a vehicle type (or size) approach, the corresponding probability of accidents involving vehicles or trucks and special vehicles resulting in serious consequences (domino effect). We analysed the Italian National Institute of Statistics (Istat) dataset on tunnel accidents which occurred between 2018 and 2020 on Italian public roads, involving at least one vehicle. Of these, we extracted tunnel accidents, classified by tunnel length and estimated the corresponding probability of serious consequences. The analysis identified 1,885 case studies of tunnel accidents that occurred in approximately 265 long tunnels and 450 short tunnels and underpasses. Compared with "controls", "size" was found to be more than double in long tunnels where the related probability of serious accident consequences exceeded 50% more than those of short tunnels. We found that the related probability associated with serious accident consequences in tunnels over 500 m in length was higher than in short tunnels, except for trucks and special vehicles. Road accidents and research on risk evaluation of the effects associated with long and short tunnels are rare. The study aims to fill these gaps.
ERA - Epidemiologia e Ricerca Applicata Atlante 2009 - Ospedalizzazione evitabileper genere e unità sanitaria territoriale
Concordanza della codifica delle schede di morte tra Regione Friuli-Venezia Giulia ed Istat, 1999-2001
Association between extreme ambient temperatures and general indistinct and work-related road crashes. A nationwide study in Italy
Accident Analysis & Prevention, 2021
Despite the relevance of road crashes and their impact on social and health care costs, the effec... more Despite the relevance of road crashes and their impact on social and health care costs, the effects of extreme temperatures on road crashes risk have been scarcely investigated, particularly for those occurring in occupational activities. A nationwide epidemiological study was carried out to estimate the risk of general indistinct and work-related road crashes related with extreme temperatures and to identify crash and occupation parameters mostly involved. Data about road crashes, resulting in death or injury, occurring during years 2013-2015 in Italy, were collected from the National Institute of Statistics, for general indistinct road crashes, and from the compensation claim applications registered by the national workers' compensation authority, for work-related ones. Time series of hourly temperature were derived from the results provided by the meteorological model WRF applied at a national domain with 5 km resolution. To consider the different spatial-temporal characteristics of the two road crashes archives, the association with extreme temperatures was estimated by means of a case-crossover time-stratified approach using conditional logistic regression analysis, and a time-series analysis, using over-dispersed Poisson generalized linear regression model, for general indistinct and work-related datasets respectively. The analyses were controlled for other covariates and confounding variables (including precipitation). Non-linearity and lag effects were considered by using a distributed lag non-linear model. Relative risks were calculated for increment from 75th to 99th percentiles (hot) and from 25 to first percentile (cold) of temperature. Results for general indistinct crashes show a positive association with hot temperature (RR = 1.12, 95 % CI: 1.09-1.16) and a negative one for cold (RR = 0.93, 95 % CI: 0.91-0.96), while for work-related crashes a positive association was found for both hot and cold (RR = 1.06 (95 % CI: 1.01-1.11) and RR = 1.10 (95 % CI: 1.05-1.16). The use of motorcycles, the location of accident (urban vs out of town), presence of crossroads, as well as occupational factors like the use of a vehicle on duty were all found to produce higher risks of road crashes during extreme temperatures. Mitigation and prevention measures are needed to limit social and health care costs.
Mortality for non-AIDS-defining cancers among people with AIDS
Journal of Clinical Oncology, 2010
1590 Background: In the era of highly active antiretroviral therapies, the impact of non-AIDS-def... more 1590 Background: In the era of highly active antiretroviral therapies, the impact of non-AIDS-defining cancers on mortality of people with HIV/AIDS has been rarely quantified. To evaluate the risk of death for non-AIDS-defining cancers, among Italian people with AIDS (PWA). Methods: Population-based, retrospective, cohort study. 10,391 Italian citizens, aged 15 years or more, diagnosed with AIDS, in Italy, between 1999 and 2006, were included in the study. Record-linkage with mortality databases of the Italian Institute of Statistics was carried out to retrieve vital status and death certificates. Follow-up was calculated from date of AIDS diagnosis to date of death, or to December 31, 2006 for PWA who were still alive. Standardized mortality ratios (SMRs) and 95% confidence intervals (CIs), in comparison with the Italian population, were calculated for each non-AIDS-defining cancer, which was the underlying cause of death. Results: Among 3,209 deceased PWA, 7.4% died for non-AIDS-defining cancers, with a...
Journal of Global Health, 2018
Burden of suicide presented as one of the leading causes of death: uncover facts or misrepresent ... more Burden of suicide presented as one of the leading causes of death: uncover facts or misrepresent statistics? Background Suicide is a relatively rare incident. Nevertheless, parts of the literature on intentional self-harm behaviour state that suicide is one of the leading causes of death. We aimed to assess the evidence behind the statement that suicide is a leading cause of death across all ages, with reference to the methods of ranking causes of death. Methods Two sets of data were used: For the European Union (EU) we used cause specific mortality statistics from the European Statistical Office (Eurostat) for the data-year 2014, and globally and for the WHO European Region we used data from Global Health Estimates (GHE) 2015. We used different sets of rules to select mutually exclusive leading underlying causes of mortality for Europe (EU28). We also present lists with estimates of leading causes of death globally, and for the WHO European Region based on the GHE 2015. Results In 2014, 1.2% of all reported deaths in the Europe Union (EU28) were due to suicide, and 1.4% globally (2015) according to the WHO estimates. In Europe, suicide was ranked as number 11 and 15 in the two different ranking lists we used, and according to GHE-2015, suicide was ranked as the 17 th leading cause globally, and number 14 in the WHO European Region. Looking at the differences by sex, suicide for males was ranked as the ninth and the tenth leading cause of death in two ranking lists for the European Union. For females, suicide was number 13 in the first and 23 in the second list, respectively. Conclusions Different cause lists and rules for ranking produce different leading causes of mortality. The quality of data can also affect the ranking. Our rankings suggested that suicide was not among the ten leading causes of death in Europe or globally. To ensure that ranking causes of death is not driven by political motives and funding considerations, standard methods and official tabulation lists should be used. The rankings do not necessarily present the causes of mortality of greatest public health importance.
This paper compares the effects of two reforms implemented in Italy in 2003 and 2016 – respective... more This paper compares the effects of two reforms implemented in Italy in 2003 and 2016 – respectively the Penalty Points System (PPS) and the Road Homicide (RH) – aimed at reducing road accidents and mortality. In terms of the two main parameters characterizing enforcement – probability and intensity of the penalty – the two policies are opposite. In fact, with the PPS it is very easy to lose points but the maximum penalty – that is, temporary withdrawal of the license – is not dramatic. The RH, instead, introduced heavy penalties in the rare event of dead and injured people. We find a stronger decrease of dead and injured people with the PPS than with the RH. We compare the costs and benefits of the two policies and conclude that, in this context, strong penalties like incarceration are not socially beneficial.
Association between mobile phone traffic volume and road crash fatalities: A population-based case-crossover study
Accident; analysis and prevention, Jan 12, 2018
Use of mobile phones while driving is known to cause crashes with possible fatalities. Different ... more Use of mobile phones while driving is known to cause crashes with possible fatalities. Different habits of mobile phone use might be distracting forces and display differential impacts on accident risk; the assessment of the relative importance is relevant to implement prevention, mitigation, and control measures. This study aimed to assess the relationship between the use of mobile phones at population level and road crash fatalities in large urban areas. Data on road crashes with fatalities were collected from seven Italian metropolitan areas and matched in time and space with high resolution mobile phone traffic volume data about calls, texts, Internet connections and upload/download data. A case-crossover study design was applied to estimate the relative risks of road accident for increases in each type of mobile phone traffic volumes in underlying population present in the small areas where accidents occurred. Effect modification was evaluated by weekday/weekend, hour of the da...
Towards an integrated surveillance system of road accidents
46Th Scientific Meeting of the Italian Statistical Society, Apr 14, 2012
How to compare european countries and trends regarding deaths from accidental falls:results from the Anamort project
Background Accidental falls are known as an important cause of death accounting for nearly 50 000... more Background Accidental falls are known as an important cause of death accounting for nearly 50 000 deaths reported in the 25 former countries of the European Union in 2003. Production of death statistics is organized in by national medical authorities who are responsible for the medical certification of causes of deaths, as well as their codification and the selection of an underlying cause (when multiple causes exist). Countries follow the International Codification of Diseases (ICD) rules published by the World Health Organisation (WHO). Individual data are aggregated, centralized and disseminated at European level by Eurostat or at world level by WHO. Nevertheless, methods of death statistics production are known to vary from country to countries and over time. The Anamort project has been developed in order to produce recommendations to improve the comparability death statistics in general and more specifically in the field of injuries. The application to deaths from falls is pre...
Non-transmission of death certificates of non-residents to their country of residence: an important bias for comparing injury related deaths between European countries (results from the ANAMORT project)
Background Differences in production processes of mortality statistics between European countries... more Background Differences in production processes of mortality statistics between European countries could lead to misclassifications of underlying causes of death and lack of data coverage. This could have an influence on data comparability and would limit their interpretation. The ANAMORT project aims to identify biases specifically regarding injury related deaths and to propose recommendations in order to correct them. One of the biases possibly lies in non-transmission of death certificates of non residents to their country of residence, although transmitting those is recommended by the World Health Organization and Eurostat. The impact of this bias is presented hereafter. Methods Within the ANAMORT project, a questionnaire regarding production of mortality statistics has been completed by specialists of mortality or injury statistics in 36 countries in Europe (during first half of 2006). Answers were obtained from the 27 European Union countries, the three candidate countries (Cro...
Foreigners/non-nationals in Italy: a focus on mortality conditions
Background The increasing presence of foreigners in Italy (including immigrants, foreigners born ... more Background The increasing presence of foreigners in Italy (including immigrants, foreigners born in Italy, those living in Italy for a long or short period) has an effect on the main sociodemographic variables: in order to understand present trends an in-depth multidimensional analysis of this heterogeneous reality is conducted. For this purpose the reference official statistical source is the Survey on causes of death that collects exhaustive information on all deaths occurring in Italy, and is controlled and processed by the Italian National Statistical Institute. Methods Foreigners above 1 year of age who died in Italy have been subdivided into Residents (foreigners regularly living in Italy) and Non-Residents (foreigners who were ‘temporarily’ in Italy when death occurred, such as non-regular immigrants and tourists). In order to study risk factors, standardized death rates are constructed for residents aged 18–64 years and analysed by nationality and cause. Results Data on deat...
Infant mortality among foreigners/non-nationals living in Italy
Background Since infant mortality (deaths of infants aged one or younger per 1.000 live births) i... more Background Since infant mortality (deaths of infants aged one or younger per 1.000 live births) is known to be associated with health, environmental and social conditions, it represents a marking sign of the welfare level achieved also with regard to population subgroups of particular interest such as foreigners living in Italy. Methods Only official statistical sources are used such as the death forms in the first year of life, that are entirely controlled and processed by the Italian National Statistical Institute. All information related to events are collected in a current, total and exhaustive way; it is possible to disaggregate them according to main variables. As to citizenship, it is only available since 1997; the present work relates therefore to events occurred between 1997 and 2007 (last year available). Infant mortality rates are calculated keeping neonatal mortality separated, that is further distinguished into neonatal and precocious infant mortality (infants aged 1 we...
Oral Oncology Supplement, 2005
Italian supercentenarians: Age validation of deaths from 1969 to 2000
Demographic Research Monographs, 2010
This report describes the first stage of the age validation process of Italian supercentenarians.... more This report describes the first stage of the age validation process of Italian supercentenarians. The process is still in progress and to date has only concerned supercentenarians deceased in the period 1969-2000. Of 35 potential supercentenarians included in the Italian National Institute of Statistics (Istituto nazionale di statistica, or Istat) database, 21 cases (three males and 18 females) are fully
Migration and health in Europe: data sources, epidemiology and public health
Epidemiologia e prevenzione
[AIDS and injecting drug use: survival determinants in the highly active antiretroviral therapy era]
Epidemiologia e prevenzione
to estimate survival, after AIDS diagnosis, in people who got infected with HIV through injecting... more to estimate survival, after AIDS diagnosis, in people who got infected with HIV through injecting drug use (IDUs), to identify among variables collected at AIDS diagnosis those which were associated to prognosis and to assess the frequency of morbid conditions at death. population-based, longitudinal study. 4,040 IDUs diagnosed with AIDS in Italy between 1999 and 2005. vital status up to 2006, was retrieved through a record-linkage procedure with italian mortality database. Kaplan-Meier method and multivariate Cox model were used to estimate survival curves and compute hazard ratios of death (HR), and corresponding 95% confidence intervals (95% CI), for several prognostic factors, respectively. the 2-year and 5-year survival probabilities after AIDS diagnosis of IDUs were 72% and 60%, respectively. Elevated risks of death emerged for IDUs with older ages (HR=2.0 95% CI 1.6-2.4 for>45 years old vs.<35 years old), lower education (HR=1.4 95% CI 1.2-1.7 for elementary school vs. ...
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Papers by Silvia Bruzzone