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Legionella colonization in hot water systems belongs to a great number of factors, while the prevention of infection cases is based, above all, on the correct management of water systems, which includes several continuous disinfection and acute decontamination systems. The aim of our study was to establish Legionella prevalence and load in different types of structures and evaluate the effectiveness of the decontamination treatments most frequently carried on in our territory. We collected hot water samples from the distal points of sports centers, tourist accommodation facilities, retirement homes and group homes. All water samples were tested by culture method for the presence of Legionella, and species and serogroup identification were carried out through Latex test and PCR. For each water sample we determined also the Heterotrophic Plate Count (HPC) at 22 °C and 37 °C. Statistics were performed through STATA. Legionella was found in 26% samples collected from 29% of the inspected structures. L. pneumophila sg1 was detected in 12.4% of samples, while L. pneumophila sg2-14 in 11.6%. The bacterium was more commonly found in Hotels’ (57%), Sports centers’ (41%) and Retirement homes’ (29%) hot water systems. We often identified a high microbial contamination and a significantly higher prevalence of Legionella for both intermediate values of HPC 22 °C and HPC 37 °C. Legionella was still found in the water systems after decontamination in 68% of inspected facilities.The high prevalence of Legionella found represents a health risk for general population, suggesting that the management of the water systems of private facilities often needs to be improved.

In the context of the A3 Action Group-European Innovation Partnership on Active and Healthy Ageing, several intervention programmes have been implemented in order to prevent social isolation, physical decline, malnutrition and adverse drug reactions. Further studies need to investigate the implementation of frailty models within a limited geographical area of a health service organisation context in order to evaluate the organisation of a service network based on the frailty approach as a comprehensive method of addressing chronic diseases and health and social needs and preventing health inequalities.

Environment and human health are now considered an inseparable binomial. Thanks to European policy, environment quality - in the broad sense - has considerably improved in the EU over the last decade, but there are still old and new challenges to be addressed if we wish to significantly reduce that burden of 24% of deaths and 22% of DALYs.

The delivery of health services is the responsibility of NHS England. To achieving fiscal sustainability for the health system, several moves have been implemented, such as the institution of Public Health England, an executive agency within the DH aimed at protecting and improving the nation’s health and wellbeing and reducing health inequalities. A lot of work must be done in the next few years to ensure sustainability and a healthy population.

The Central Government of Spain retains responsibility for healthcare management in the cities with autonomy statutes – Ceuta and Melilla – through the National Health Management Institute (INGESA). The Interterritorial Council of the National Health System is responsible for coordination, cooperation and liaison among the public health administrations operated by the Government and the ACs. There are several barriers for the development of primary care in Spain. Budgets have not increased over the last few years, hospitals still find it difficult to shift to community-based capitation, and an integrated care perspective is not a priority. The current economic downturn should be taken as an opportunity to accelerate the innovative formulae in order to coordinate and integrate care.

Italian prevention services seem able to guarantee a high standard of quality of care, which is remarkable in terms of high life expectancy at birth, and two-thirds of Italians claim to have a good health status. International agencies confirm these data ranked Italian Health System as one of the most effective in the world.