[Indicators and biological mechanisms of impairment of the respiratory system by environmental pollutants. An operational example: epidemiological studies of the delta of Po and the region of Pisa].

The Author, on the basis of the epidemiological surveys personally performed and of the documents of the European Community-Series on Air Pollution Epidemiology, describes the conventional bio-markers, especially those derived from epidemiological surveys using questionnaires (e.g. respiratory symptoms/diseases) and objective methods investigating lung function (e.g. spirometry, CO diffusing capacity, bronchial responsiveness, monitoring of peak expiratory flow). After fully reporting the findings derived from the application of conventional bio-markers in the epidemiological surveys of Po Delta and of the urban-suburban area of Pisa-Cascina, some studies of controlled human exposure are described, in order to elucidate the pathophysiological mechanisms of damage due to reducing (e.g. SO2) and to oxidizing pollutants (e.g. O3, NO2). The Author treats the new bio-markers, i.e. markers of internal dose (e.g. lead), markers of biologically effective dose (e.g. carboxyhemoglobin, DNA adducts), markers of early biological effect (e.g. sister chromatid exchanges, micronuclei), also reporting their application in the 2nd epidemiological survey of Pisa-Cascina.