Papers by Giovanni Leonardi
S-064
Epidemiology, Sep 1, 2012
O-102
Epidemiology, Sep 1, 2012
Perfluoroalkyl substances (PFAS) exposure associated with immune markers
Environmental epidemiology, Oct 1, 2019
Journal of Occupational and Environmental Hygiene, 2010
International Journal of Environmental Research and Public Health, Jun 2, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
BMJ Open, Nov 1, 2019
► Most biochemical factors were considered in the study. ► Most of the carbon monoxide (CO)-poiso... more ► Most biochemical factors were considered in the study. ► Most of the carbon monoxide (CO)-poisoned patients received the hyperbaric oxygen therapy in the hospital. ► The rate of recovery was similar to other studies. ► Some data missing of the patients transferred from other hospitals. ► Give the specific indications for clinical research work and clinical practice with CO-poisoned patients.
Real time carbon monoxide measurements from 270 UK homes
... ISSN: 1420-326X Croxford,B., Hutchinson, E., Leonardi, GS, McKenna, L., Riddington, M., Volan... more ... ISSN: 1420-326X Croxford,B., Hutchinson, E., Leonardi, GS, McKenna, L., Riddington, M., Volans ... beliefs on the presentation and consultation outcome in patients with chemical sensitivities. ... Gupta, K., Perharic, L., Volans, GN, Murray, VSG, Watson, JP, 1997, Apparent poisoning ...
Future arrangements for chemical surveillance reports
Preventive Medicine, Jul 1, 2020
Unintentional non-fire related (UNFR) carbon monoxide (CO) poisoning is a preventable cause of mo... more Unintentional non-fire related (UNFR) carbon monoxide (CO) poisoning is a preventable cause of morbidity and mortality. Epidemiological data on UNFR CO poisoning can help monitor changes in the magnitude of this burden, particularly through comparisons of multiple countries, and to identify vulnerable subgroups of the population which may be more at risk. Here, we collected data on age-and sex-specific number of hospital admissions with a primary diagnosis of UNFR CO poisoning in England (2002-2016), aggregated to small areas, alongside area-level characteristics (i.e. deprivation, rurality and ethnicity). We analysed temporal trends using piecewise log-linear models and compared them to analogous data obtained for Canada, France, Spain and the US. We estimated age-standardized rates per 100,000 inhabitants by area-level characteristics using the WHO standard population (2000-2025). We then fitted the Besag York Mollie (BYM) model, a Bayesian hierarchical spatial model, to assess the independent effect of each area-level characteristic on the standardized risk of hospitalization. Temporal trends showed significant decreases after 2010. Decreasing trends were also observed across all countries studied, yet France had a 5-fold higher risk. Based on 3399 UNFR CO poisoning hospitalizations, we found an increased risk in areas classified as rural (0.69, 95% CrI: 0.67; 0.80), highly deprived (1.77, 95% CrI: 1.66; 2.10) or with the largest proportion of Asian (1.15, 95% CrI: 1.03; 1.49) or Black population (1.35, 95% CrI: 1.20; 1.80). Our multivariate approach provides strong evidence for the identification of vulnerable populations which can inform prevention policies and targeted interventions. Unintentional CO poisoning remains an important cause of preventable morbidity and mortality worldwide (
Carcinogenesis, Dec 12, 2005
Patterns of Age of Puberty in Relation to Pfoa and Pfos Among Children in the Mid-Ohio Valley
Environmental health perspectives, Sep 13, 2011
Maria-Jose Lopez-Espinosa, London School of Hygiene & Tropical Medicine, United Kingdom Tony ... more Maria-Jose Lopez-Espinosa, London School of Hygiene & Tropical Medicine, United Kingdom Tony Fletcher, London School of Hygiene & Tropical Medicine, United Kingdom Ben Armstrong, London School of Hygiene & Tropical Medicine, United Kingdom Bernd Genser, London School of Hygiene & Tropical Medicine, United Kingdom Debapriya Mondal, London School of Hygiene & Tropical Medicine, United Kingdom Giovanni Leonardi, London School of Hygiene & Tropical Medicine, United Kingdom
Environmental Science: Processes & Impacts, 2018
Dust elemental levels can be expressed as concentrations (bulk samples) or surface loadings (wipe... more Dust elemental levels can be expressed as concentrations (bulk samples) or surface loadings (wipe samples). Wipe sampling has not been widely adopted for elements other than lead (Pb). In this study, 433 wipe samples from 130 households in south west England-a region of widespread, natural and anthropogenic arsenic contamination linked with previous mining activities-were analysed to (i) quantify loadings of arsenic (As); (ii) assess the quality of wipe data using QA/QC criteria; (iii) estimate, using published ingestion rates, human exposure to As in dust using loadings and concentrations from 97 bulk samples and (iv) comparatively assess the performance of wipe and bulk sampling using associations with As biomonitoring data (urine, toenails and hair). Good QC performance was observed for wipes: strong agreement between field duplicates, non-detectable contamination of field blank wipes and good reference material recoveries. Arsenic loadings exceeded an existing urban background benchmark in 67 (52%) households. No exceedances of tolerable daily As intake was observed for adult exposure estimates but infant estimates exceeded for 1 household. Infant estimates calculated using bulk concentrations resulted in 4 (3%) exceedances. Neither wipe nor bulk As metrics were sufficiently better predictors of As in biospecimens. Sampling strategies, analytical protocols, exposure metrics and assessment criteria require refinement to validate dust sampling methodologies.
Environmental health perspectives, Aug 17, 2016
P I – 3–9 The burden of carbon monoxide exposure on public health: evaluating the role of carboxyhaemoglobin (cohb) as a biomarker and exploring new approaches for quantification
Background/aim Carbon monoxide (CO) is one of the leading causes of domestic deaths. Exposure occ... more Background/aim Carbon monoxide (CO) is one of the leading causes of domestic deaths. Exposure occurs in- and outdoors, in occupational or accidental (e.g. fires) settings, or by smoking. Current biomarker COHb has poor correlation with symptoms of CO poisoning, which are unspecific. Thus, this study aims to evaluate alternative methods for estimating CO, in order to reduce the error in diagnosis of CO poisoning. Methods We explore a new technique based on gas-chromatography coupled to mass-spectrometry (GC-MS) that measures the total CO amount in blood (TBCO). CO is released from a blood sample (100 µL) by mixing with sulphuric acid in an airtight vial and heating. It is then analysed by GC-MS. This method is then compared to an optical method (CO-oximetry). An assessment of the measurement errors deriving from an analytical perspective is performed for both approaches through monitoring of analytical factors, such as storage conditions (temperature, time, volume, freeze- and thawing cycles, tube reopening, initial concentration levels) and instrumental errors, with analysis of ~2500 bovine blood samples. Results are compared and assessed using descriptive statistics and regression models. Results A novel approach for CO quantification in small amounts of blood was developed and validated for clinical and postmortem range. The total amount of CO present in blood at analysis time is released and analysed through airtight gas syringe (AGS)-GC-MS.Preliminary results of the monitoring study show important statistical influences by all parameters analysed but ‘tube re-opening’ (p-values>0.05). No linear correlation is found between COHb and TBCO, with resulting backcalculated COHb from TBCO concentrations generally higher than COHb measured optically. The approach was applied to real poisoning cases, with resulting COHb between 45%–75%, as opposed to COHb backcalculated from TBCO, which ranges between 83%–275%, suggesting the presence of a part of CO dissolved in blood and not bound to Hb Conclusion CO levels based on optically measured COHb may lead to underestimation of CO exposure. CO not linked to Hb might be of pathophysiological relevance. The use of TBCO as more reliable biomarker of CO exposure in the clinical field requires further testing. Furthermore, the new approach presents lower cost and invasiveness. Storage guidelines can be derived for use in clinical and forensic domains.
“Looking outside the forensic toxicology box – An approach to link results from the lab to public health”
Toxicologie Analytique et Clinique, Sep 1, 2022
Analysis of carbon monoxide hospital admissions in England – what can we learn about accidental poisoning?
Environmental health perspectives, Sep 19, 2013
O-112
Epidemiology, Sep 1, 2012
PLOS ONE, Apr 24, 2013
Background: Studies suggest that ambient sunlight plays an important role in the pathogenesis of ... more Background: Studies suggest that ambient sunlight plays an important role in the pathogenesis of non-melanoma skin cancers (NMSC). However, there is ongoing controversy regarding the relevance of occupational exposure to natural and artificial ultraviolet radiation (UV) radiation. Objectives: We investigated potential associations between natural and artificial UV radiation exposure at work with NMSC in a case-control study conducted in Hungary, Romania, and Slovakia. Methods: Occupational exposures were classified by expert assessment for 527 controls and 618 NMSC cases (515 basal cell carcinoma, BCC). Covariate information was collected via interview and multiple logistic regression models were used to assess associations between UV exposure and NMSC. Results: Lifetime prevalence of occupational exposure in the participants was 13% for natural UV radiation and 7% for artificial UV radiation. Significant negative associations between occupational exposure to natural UV radiation and NMSC were detected for all who had ever been exposed (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.27-0.80); similar results were detected using a semi-quantitative metric of cumulative exposure. The effects were modified by skin complexion, with significantly decreased risks of BCC among participants with light skin complexion. No associations were observed in relation to occupational artificial UV radiation exposure. Conclusions: The protective effect of occupational exposure to natural UV radiation was unexpected, but limited to lightskinned people, suggesting adequate sun-protection behaviors. Further investigations focusing on variations in the individual genetic susceptibility and potential interactions with environmental and other relevant factors are planned.
Climate change and ecological public health: an integrated framework
Abstract Climate and ecological change impacts represent the greatest global health challenge but... more Abstract Climate and ecological change impacts represent the greatest global health challenge but also the greatest opportunity of the 21st century. Interlinking climate and ecological change impacts, with societal change and human health, should form the scientific progress in public health for current and future generations of researchers. Ecological public health approach is proposed to address the challenges faced by public health today, by its aims to integrate complexity, multiple interactions and change of societal and environmental systems, and also as an adaptable approach which can assist in exploring and understanding complex public health questions in a way that are usable to all. The aim of this chapter is to outline why ecological public health approach is a useful framework when trying to understand and measure the public health impacts of complex ecological and climate change, and societal systems transitions. To achieve its aim the chapter highlights key issues within this framework, and also illustrates with a few examples, to make it more explicit on how this system's approach can assist any economic models of cost–benefits of environmental health interventions.
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Papers by Giovanni Leonardi