Background: Face masks are recommended based on the assumption that they protect against SARS-CoV-2 transmission, however studies on their potential side effects are still lacking. We aimed to evaluate the inhaled air carbon dioxide (CO 2 ) concentration, when wearing masks. Methods: We measured end-tidal CO 2 using professional side-stream capnography, with water-removing tubing, (1) without masks, (2) wearing a surgical mask, and (3) wearing a FFP2 respirator (for 5 minutes each while seated after 10 minutes of rest), in 146 healthy volunteers aged 10 to 90 years, from the general population of Ferrara, Italy. The inhaled air CO 2 concentration was computed as: ([mask volume × end-tidal CO 2 ] + [tidal volume − mask volume] × ambient air CO 2 )/tidal volume. Results: With surgical masks, the mean CO 2 concentration was 7091 ± 2491 ppm in children, 4835 ± 869 in adults, and 4379 ± 978 in the elderly. With FFP2 respirators, this concentration was 13 665 ± 3655 in children, 8502 ± 1859 in adults, and 9027 ± 1882 in the elderly. The proportion showing a CO 2 concentration higher than the 5000 ppm (8-hour average) acceptable threshold for workers was 41.1% with surgical masks, and 99.3% with FFP2 respirators. Adjusting for age, gender, BMI, and smoking, the inhaled air CO 2 concentration significantly increased with increasing respiratory rate (mean 10 837 ±3712 ppm among participants ⩾18 breaths/minute, with FFP2 respirators), and among the minors. Conclusion: If these results are confirmed, the current guidelines on mask-wearing should be reevaluated.

None of the available evaluations of the inhaled air carbon dioxide (CO2) concentration, while wearing face masks, used professional, real-time capnography with water-removal tubing. We measured the end-tidal CO2 using professional side-stream capnography, with water-removing tubing (Rad-97™ capnograph), at rest, (1) without masks, (2) wearing a surgical mask, and (3) wearing a FFP2 respirator, in 102 healthy volunteers aged 10-90 years, from the general population of Ferrara province, Italy. The inhaled air CO2 concentration was then computed as: ((mask volume × end-tidal CO2) + ((tidal volume - mask volume) × ambient air CO2)) / tidal volume).The mean CO2 concentration was 4965±1047 ppm with surgical masks, and 9396±2254 ppm with FFP2 respirators. The proportion of the sample showing a CO2 concentration higher than the 5000 ppm acceptable exposure threshold recommended for workers was 40.2% while wearing surgical masks, 99.0% while wearing FFP2 respirators. The mean blood oxygen saturation remained >96%, and the mean end-tidal CO2 <33 mmHg. Adjusting for age, gender, BMI, and smoking, the inhaled air CO2 concentration significantly increased with increasing respiratory rate (with a mean of 10,143±2782 ppm among the participants taking 18 or more breaths per minute, while wearing FFP2 respirators), and was higher among the minors, who showed a mean CO2 concentration of 12,847±2898 ppm, while wearing FFP2 respirators. If these results will be confirmed, the current guidelines on mask-wearing could be updated to integrate recommendations for slow breathing and a more targeted use when contagion risk is low.

Background:We assessed the effectiveness of an HPV vaccination programme in lowering cervical abnormality risk, and conferring herd protection.Methods: Retrospective cohort study using linked screening and vaccination administrative health data of the general population of Ancona Province, Italy. We included all female residents born in 1990-1993, eligible for catch-up HPV vaccination up to age 25y, and adhering to organised screening in 2015-2020 (n=4665). Cervical abnormalities rates were compared between: vaccinated and unvaccinated women, and cohorts with high and low vaccination uptake. Analyses were adjusted for age, country of birth, screening tests number, laboratory, and municipality average income. Main outcomes were ASC-US+ or LSIL+ Pap smears, and CIN1+ or CIN2+ histology.Results: Mean screening age was 26.6±1.5 years, and 1,118 screened women (24.0%) were vaccinated (mean vaccination age 19.2±1.5 years). The diagnosed cervical abnormalities were: 107 LSIL+ (2.3%), 70 CIN1+ (1.5%), and 35 CIN2+ (0.8%). The adjusted odds ratios of LSIL+, CIN1+ and CIN2+ among vaccinated vs unvaccinated women were, respectively: 0.55 (95% confidence interval 0.

Background Investigations regarding knowledge and utilization of contraception for the prevention of unwanted pregnancies as well as of sexually transmitted diseases are carried out regularly in low- and middle-income countries. The same might not happen in high-income countries, were these topics could be regarded with less priority. We aimed to asses trends in contraception use among young adults in Italy. Methods From the Italian Institute of Statistics (ISTAT) Survey on Health Status and Use of Health Care, we collected aggregated data on contraception use among Italians aged 18 to 24 years old, by sex, for the year 2013. From the National Fertility Study of the Italian Higher Institute of Health (ISS) we collected aggregated data on contraception use among a nationally representative sample of Italian university students with a mean age of 22 years old, for both sexes, for years 2017 and 2018. We compared the estimates of prevalence of use of different contraceptives across the two surveys, utilizing, for the 2013 survey, the mean of the results for the two sexes. Results The use of at least one type of contraceptive grew from 89.3% in 2013 to 95.0% in 2017-2018, while the use of condoms increased from 69.7% in 2013 to 71.2% in 2017-2018. The use of coitus interruptus increased as well from 15.9% in 2013 to 24.0% in 2017-2018. The use of modern contraceptive methods was not comparable across the two surveys. Conclusions The two surveys from 2013 and 2017-2018 were not comparable for all the estimates of contraception use. While the prevalence of use of at least one type of contraceptive and of condoms increased from 2013 to 2017-2018, the contemporary increase of use of coitus interruptus raises some concerns. There is a need for reproducible surveys conducted at shorter intervals, and also for investigating trends in access and utilization of medical counselling about contraception, especially among young adults. Key messages Use of any kind of contraceptive and of condoms has slightly increased in Italy from 2013 to 2017-2018, but in the same period the use of coitus interruptus increased by around 8%. Surveillance systems for contraception use in Italy should be strengthened through regular surveys with reproducible methods, including assessments of medical counselling about contraception.