1. 20 anni di Epidemiologia delle Malattie Respiratorie Dr. Giovanni Viegi. Direttore f.f., Istituto di Biomedicina e Immunologia Molecolare “Alberto Monroy” CNR, Palermo. Responsabile Scientifico, Unità di Ricerca di Epidemiologia Ambientale Polmonare, Istituto di Fisiologia Clinica CNR, Pisa. Professore di “Effetti dell’inquinamento sulla salute”, Corso di Laurea in Scienze Ambientali, Università di Pisa. September 2006-September 2007 Past President, European Respiratory Society (ERS). 2006-11 Past Member of Planning Group, Global Alliance against chronic Respiratory Diseases (GARD)

2. Mortality

4. A B

5. CNR Epidemiological surveys

6. PO DELTA PISA

7. Materials and methods I Po Delta area, North Italy 1st cross-sectional study (PD1): - carried out in 1980-82, before operation of a large oil-burning thermoelectric power plant - 3284 subjects (78% of expected, age 8-64 yr) 2nd cross-sectional study (PD2): - performed in 1988-91 - 2841 subjects (age 8-73 yr) Pisa, Central Italy 1st cross-sectional survey (PI1): - performed in 1985-88 -3855 subjects (77% of expected, age 5-90 yr) 2nd cross-sectional study (PI2): - carried out in 1991-93, after the construction of a new highway connecting Pisa to Florence - 2841 subjects (age 8-97 yr)

8. Materials and methods II PD study Modified NHBLI questionnaire developed by CNR Special Project on chronic obstructive lung disease (COLD), containing > 70 questions regarding respiratory symptoms, diseases and risk factors Lung function tests Skin prick tests, total serum IgE, bronchial responsiveness to methacholine challenge (PD2) PI study Modified NHBLI questionnaire developed by CNR Special Project on chronic obstructive lung disease (COLD), containing a new part on daily activity pattern Lung function tests (PI2) Skin prick tests, total serum IgE, bronchial responsiveness to methacholine challenge (PI2) Mutagenetic determinations (sister chromatid exchanges, micronuclei), hemoglobin and DNA adducts to benzo(a)pyrene (PI2)

9. Po River Delta Lung function: American Thoracic Society protocol “47804S Hewlett Packard” pneumotachograph Pisa Lung function (2nd survey only): American Thoracic Society protocol Water sealed spirometer Baires, Biomedin Materials and methods IV Spirometry

10. Baldacci et al, J Environ Pathol Toxicol Oncol 1997

11. Prevalence, incidence of respiratory symptoms/diseases and risk factors

12. (1999)

13. Viegi, Int J Tuberc Lung Dis 1999

16. Viegi, Chest 2000

18. Viegi, Chest 2004

20. Viegi, Eur J Epidemiol 1994

21. Figure 2 Classification of subjects based on the distance of each home from the main road. Zoomed map representing the classification of subjects according to the distance of each home from the main road. Highly exposed subjects are those living in the buffer area 0-100 m from the road, moderately exposed subjects living in the buffer area 100-250 m and unexposed are those living between 250 and 800 m from the road. Pisa Study

24. Guerra, Allergy 2005

25. Lung function

26. Methods Natural cubic spline models over the whole age range two “breakpoints” to split the growth, plateau and decline phases

27. Pistelli, AJRCCM 2000

29. Pistelli, Respir Med 2007

31. Viegi, Chest 2001

35. Pistelli, Respir Med 2008

36. Bronchial hyperresponsiveness

38. Paoletti, AJRCCM 1995

43. Maio, Chest 2009

45. Indoor air pollution

47. Arch Environ Health 2002

50. Simoni, J Expo Anal Environ Epidemiol 2004

51. Risks to get respiratory symptoms

52. Risks to get elevated maximum amplitude and diurnal variation of peak expiratory flow (PEF) Simoni, J Expo Anal Environ Epidemiol 2004

53. Mutagenetic evaluations

55. Barale, Environ Mol Mut 1998

57. Petruzzelli, Cancer Research, 1998

59. Skin prick test and IgE

61. Baldacci, Allergy 1996

63. SEASD Study

65. Simoni, Clin Chem Lab Med 2006

67. Studio SEASD Population attributable risk (PAR%): eliminando entrambe le esposizioni al partner e al lavoro si potrebbe ridurre il rischio di sintomi e malattie respiratorie considerate: da un minimo del 5% per fischi e diagnosi di asma ad un massimo del 24% per difficoltà di respiro a riposo. OLD, diagnosi di asma e/o bronchite cronica/enfisema

68. Medicine consumption

70. 2004-2005 1660 sub. 8-81 years

71. Simoni, Respir Med 2008

72. AIFA funded projects

74. Baldacci, Respir Med 2012

76. Maio, Curr Med Res Opin 2012

78. Maio, J Asthma 2012

79. GARD and Italian Ministry funded projects

80. Bousquet, ERJ 2010 Eur Respir J. 2010 Nov;36(5):995-1001

82. Acting Director, CNR Institute of Biomedicine and Molecular Immunology “Alberto Monroy”, Palermo, Italy Head, Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy Professor of “Health Effects of Pollution”, School of Environmental Sciences, University of Pisa, Italy 2006-07 Past-President, European Respiratory Society (ERS) 2006-11 Member of Planning Group, Global Alliance against chronic Respiratory Diseases (GARD) Chief Medical Officers Meeting Italian Presidency of European Council Rome, October 6, 2014 “Burden of chronic respiratory disease in Europe” Giovanni Viegi

83. COMODHES STUDY

84. Maio, Curr Med Res Opin 2014

86. Maio, Curr Med Res Opin 2014

87. Viegi & coll. Risk charts for COPD (National Institute of Health)

88. Viegi & coll. Risk charts for COPD (National Institute of Health)

89. Community Acquired Pneumonia (CAP)

91. Viegi, Respir Med 2006

93. Task Force participations

94. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). ERS Consensus Statement Siafakas NM, Vermeire P, Pride NB, Paoletti P……., on behalf of the Task Force ……….Viegi G, De Backer W, Georgopoulos D, McNee W, Russi E, Stanescu D. Weitzenblum E, Howard P, Del Donno M, Donner H, Lode H, Lofdahl CG, Olivieri D, Robert D, et al Eur Respir J 1995; 8:1398-1420 The pharmacoepidemiology of COPD: recent advances and methodological discussion. Burney P, Suissa S, Soriano JB, Vollmer WM, Viegi G, Sullivan SD, Fabbri LM, Sin DD, Ernst P, Coultas D, Bourbeau J, Mapel DW, Weiss K, McLaughlin T, Price D, Sturkenboom MC, Taylor R, Hagan GW Eur Respir J 2003;43:1s-44s.

99. Pellegrino, Eur Respir J 2005

104. Maio, Eur Respir J 2012

106. Review Articles

107. Part I of II Cough Phlegm Wheeze Attacks of wheeze Chronic bronchitis Emphysema Asthma MEN

108. MALES Viegi’s part

113. Smoking cessation

117. Carrozzi, Int J Environ Res Public Health 2014

118. Other epidemiological research groups connected to SIMeR

119. HESE Study

120. Simoni, Eur Respir J 2010

122. Simoni, Pediatr Allergy Immunol 2011

123. Am J Respir Crit Care Med 1994

124. SIDRIA Studi Italiani sui Disturbi Respiratori nell’Infanzia e l’Ambiente

125. Centres who participated in ECRHS (1991-93), in ISAYA (1998-00) and GEIRD (2008-10) surveys in Italy according to climatic region

126. Prevalenza di asma corrente e rinite allergica in Italia dal 1991 al 2010 (4 centri :Pavia, Torino, Verona, Sassari) (popolazione generale adulti tra 20 e 45 anni) ) Asma corrente Rinite allergica de Marco, Cerveri et al; ERJ 2012

127.  ISAYA Study;1998-2000  6 Italian centres  214 subjects with current asthma followed up for 9 years

128. CHANGES IN ASTHMA CONTROL 1999-2009 ISAYA Study 147 subjects with active asthma at follow-up Controlled asthma Uncontrolled asthma Partially controlled asthma 41% 28% 31% 1999 (at baseline) 2009 (follow-up) 23% 27% Controlled asthma Uncontrolled asthma Partially controlled asthma 50%

129. Prevalence of reported doctor diagnosis of COPD, CB and Emphysema in ITALY * GEIRD 2008-2011 GEIRD 2008-2011 age Prevalence % (95% CI) 20-44 5.1 (4.5-5.6) 45-64 8.4 (7.3-9.7) 65-84 14.1 (11.3-17.3) 20-84 8.5 (7.9-9.1) 8.5 (7.9-9.1) * Survey carried out on random samples from the general population of Verona, Pavia, Torino, Sassari and Palermo. De Marco, Cerveri et Plos One 2013

130. Pisa – Po Delta team: main collaborators of Giovanni Viegi Carlo Giuntini (retired) Giuseppe Pistelli (†) Tristano Sapigni (†) Paolo Paoletti Piera Fazzi (retired) Francesco Di Pede (retired) Laura Carrozzi Marzia Simoni Francesco Pistelli Sandra Baldacci Matteo Bottai Sara Maio Sonia Cerrai Giuseppe Sarno Paola Modena Marzia Pedreschi Mariella Vellutini Emilio Diviggiano Licia Ballerin Patrizia Biavati Umberto Mammini (†) Roberto Barale Gabriella Matteelli Antonio Scognamiglio Anna Angino Franca Martini Patrizia Silvi

132. “Grazie per l’invito e per l’attenzione” Giovanni Viegi