Here is why the dairy products you eat

are safe and fresh

m Idea– Ministero della Salute– Istituto Zooprofilattico della

Lombardia e dell’Emilia Romagna

m edItors– Istituto Zooprofilattico della

Lombardia e dell’Emilia Romagna •Dr.CandottiPaolo– GeneralDirectorateforHygiene,

FoodSafetyandNutrition-OfficeIIIDGSAN

•Dr.MarconeMariaFelicita •Dr.DiSandroAlessandra

m teXts– Dr.CandottiPaolo

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.CapuaClaudia

ASL Mantova– Dr.FedrizziGiorgio

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.GiorgiMaurilio

ASL Cremona– Dr.MarconeMariaFelicita

Ministry of Health– Dr.SalatiFulvio

IZS della Sardegna “G. Pegreffi”– Dr.SalogniCristian

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.TosiGiovanni

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.VariscoGiorgio

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.ZaghiniLoris

ASL Mantova

m draWINGs– Prof.RizziPietro

I.I.S. Stanga, Cremona

MINISTERO DELLA SALUTE (MINISTRY OF HEALTH)Viale Giorgio Ribotta 5 - 00144 Roma, ltalyTel. +39 06 5994.1 - email: urpminsalute@sanita.it

ISTITUTO ZOOPROFILATTICO DELLA LOMBARDIA E DELL’EMILIA ROMAGNA B. UBERTINIVia Bianchi 7/9 - 25124 Brescia, ltalyTel. +39 030 22901 - Fax +39 030 2425251 - email: info@izsler.it

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PRESENTATION

The safety of foodstuffs is essential for our wellbeing, as food which is contaminated from a microbiological point of view or contains harmful elements or chemicals, could be a health hazard, with effects that can appear after a short amount of time, as in the case of acute food-borne outbreaks, but even many years later, in severe chronic diseases.The whole food chain, “from the field to the table”, and therefore from production to the processing, distribution and serving of foodstuffs, must therefore ensure compli-ance with a series of risk reducing measures provided for in the current legislation, which preserve the quality of the food, safeguarding the health of the consumers at the same time.In addition to this, to the same end, both the production sector and the authorities implement a series of checks on foodstuffs, using increasingly advanced testing tech-niques that also serve to expose any potentially harmful adulteration.Consumers also play a fundamental role in this general framework, especially by look-ing out for improper behaviour by sector operators or for products on the shelves which are not compliant in terms of labelling and preservation.They also contribute to keeping foodstuffs safe from a hygiene point of view in the final handling stage, in the home. Citizens who have been adequately informed, albeit not by means of specialist meth-ods, can therefore more fully appreciate the measures taken to bring safe food to our tables from a hygiene and composition point of view, and will do their own bit, with correct storage procedures and correct handling and preparation of foodstuffs.The collection of dossiers you are holding was created with this in mind, thanks to a collaboration between the Ministry of Health and the Istituto Zooprofilattico Speri-mentale of Lombardy and Emilia Romagna; featuring appealing graphics and a few clear instructions, the aim of these dossiers is to provide a tool which is scientifically correct but at the same time easy for all consumers to read.It is with great pleasure that I present the second edition of these publications, which have been updated and published to mark the Expo Milano 2015, which, as we all know, is dedicated to food-related themes, including food safety. I hope you enjoy reading the collection. I would like to invite you to bear in mind the recommendations you read as you turn over the pages, and remember that you can do your bit for your health by making correct and informed choices.

Dr. Giuseppe RuoccoDirector General for food hygiene and safety and nutrition

The Ministry of Health

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PRESENTATION

The great attention paid to food safety issues developed in recent years by all the responsible institutions and promoted by great media interest have made consumers aware of the need to ensure high levels of health at the various stages of food production, distribution and consumption.Further information is needed so this awareness can become virtuous consumer behavior, so as to be able to choose the best of what the food industry has to offer.This is why the Ministry of Health and the Zooprophylactic Institute of Lombardy and Emilia Romagna “B. Ubertini” joined forces in this pub-lishing project, which provides end users with the essential knowledge to identify both the safety “signs” of the products for sale and the vari-ous institutions that act as watchdogs to guarantee these products are constantly under public scrutiny.These easily understandable brochures, with their approachable style and essential information level, are valuable tool to help consumers in the daily task of actively safeguarding their food safety.

Prof. Stefano CinottiGeneral Manager

Zooprophylactic Institute of Lombardy and Emilia Romagna “B. Ubertinl”

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Whenever I buy milk or cheese, I want to be informed about what I’m buying, for the safety of my loved ones and my own: what things should I pay most attention to?

Italy produces 11 million tons of cow milk, 500,000 tons of sheep milk,218,400 tons of buffalo milk and 60,500 of goat milk. That’s a lot of milk, isn’t it? We all consume milk, whether fresh or processed; it is an incredibly versatile ingredient, a food suitable for all ages which, precisely because of these reasons, can only be sold to us, the consumers, after having passed several quality controls.

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This is a great opportunity to learn more about the fantastic world of milk, but first, allow me to introduce myself. My name is Filippo and I am an Official Veterinarian of the National Health Service. I will take you on a journey backwards through the…

…PRODUCTION CHAIN of MILK, from the store all the way back to its production in the farm. MILK can be sold with different names: let’s take a close look at the meaning of each one. Based on the fat content, we have: WHOLE MILK, which is subjected to a heat treatment and contains at least 3.50% of fat; SEMI-SKIMMED MILK, which is subjected to a heat treatment and contains something between 1.50% and a maximum of 1.80% of fat; SKIMMED MILK, which is subjected to a heat treatment and contains a maximum 0.50% of fat.

The generic term Milk always refers to cow milk; when the milk is produced by another animal, the word milk must be followed (in Italian) by the type of animal that produced it (e.g. latte di capra, i.e. goat milk).

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Milk for storage in the refrigerator:RAW MILK: milk not subjected to a temperature greater than 40°C,nor to a treatment that has an equivalent effect;PASTEURIZED MILK, obtained by heat treatment of raw milk with a treatment time between 15’’ and 30” and temperatures between 63°C and 80°C. The time/temperature combinations used allow the inactivation of pathogenic germs and minimise the de-naturant effect of the heat. Depending on the combination of time-temperature ranges and on other specific characteristics we have:l high-temperature pasteurised milk: milk that may have undergone multiple

heat treatments;l fresh pasteurized milk: raw milk subjected to heat treatment within 48

hours of milking;l high-quality, fresh pasteurized milk: high quality fresh pasteurized milk;

in addition to the requirements of fresh pasteurised milk, this milk must contain at least 15.5% of soluble non-denatured whey protein and at least 3.2% of protein, and come from approved stables for high quality;

l pasteurized micro-filtered milk: raw milk that first undergoes a micro-filtration treatment through ceramic membranes with very small holes that eliminate most of the microbial flora, and is then pasteurized.

Milk for storage at room temperature until opened:LONG-SHELF LIFE UHT MILK: milk which has undergone a treatmentof at least 135°C for an appropriate time (for at least 1 second), followed by aseptic packaging.STERILIZED MILK: a rare type of milk, for which the heat treatmenttakes place after packaging the product at high temperature.For these types of milk, high temperature heat treatment ensures the total absence of micro-organisms that would grow in usual conditions of conservation, i.e. milk that is stable at room temperature. The milk thus obtained has the advantage that it can be stored at room temperature for a long time and therefore can also be transported over long distances.

Based on the heat treatments, we distinguish two types of milk: milk for storage in the refrigerator and milk for storage at room temperature.

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Let’s start our journey from the store. When you buy milk, cheese or milk-based products, what do you have to pay attention to? First of all, take a look at the counter, shelves and showcasing of products in general to get an idea of the store’s order and cleanliness: these are important factors, especially when it comes to food!

And then ... look at the label!

The labels “speak”, but you have to know how to read them! I will now try to give you some tips on how to read the labels of the most common dairy products, which we all have in our refrigerators!

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As I was mentioning, the label: it will be a little different depending on the type of milk.

Let’s start with FRESH MILK; on the carton of this type of milk we will find:l name of the food;l ingredients, allergens;l net quantity;l nutritional declaration (since December 2016);l expiration date (‘’best before...”);l milking area/area of origin;l the manufacturer’s name and address;l the manufacturer’s site (may not include the

identification mark);l the carton may include the wording EU or

indicate a Third Country origin;l indication of lot identification;l In addition, “the storage temperature», i.e.

the temperature at which the milk should be kept and stored, even when you bring it home.

FRESH MILK PASTEURIZEDKeep max. at 4°C

Milking area: Region (e.g. Lombardia)

Expiration date: 05/31/2011

IT00 / 000

CE

Country of origin

Area of origin

Number of the

establishment issued by the

competent Authority

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In general, every industrial carton of milk will include a set of mandatory and commercial information for the consumer, but also the IDENTIFICATION MARK (manufacturing site), which guarantees that the milk was processed in a factory under the supervision of the Official Veterinarian.

The identification mark is an important indication for the responsible supervisory authorities (Official Veterinarians of the Local Health Units, Regions, Ministry of Health), because it allows them to trace the manufacturing site by entering the corresponding number in a National Database. It is not a piece of information for consumers.

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What about the labels of other products, like cheese or mozzarella?

FRESH STRING CHEESE (fior di latte, mozzarella and similar cheeses) can be marketed only if appropriately pre-packaged at the origin, i.e. you will not find them for sale in the store as loose goods. The packaging must feature information for the consumer: l sales name, l list of ingredients (only if there are other ingredients other than basic ones; l for instance, if the product contains salt, it must be indicated on

the label), l indication of quantity unless the products are weighed in the presence of the purchaser, l expiry date, l the manufacturer’s name and site (the latter may not appear on the label, as the identification mark validly replaces it), l storage method, l batch identification (if the date is complete, it may not be specified).The label also includes information for thesupervisory authorities, like the IDENTIFICATION MARK of the manufacturing site (factory).

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You can buy unpackaged fresh string cheese only at the dairy farms!

The packages of SEASONED or SEMI-SEASONED cheeses (Caciotta, Provolone, Parmesan Cheese, Gorgonzola, Taleggio, etc.) and other dairy products (yoghurt) must include the same information, as well as the IDENTIFICATION MARK, unless the manufacturer is granted specific exemptions. The label must also specify if the cheese has been produced from RAW MILK.

Do you know how many jars of yoghurt are consumed each year in Italy? More than a

billion and a half. And many Italian families produce their own at home!

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For BULK PRODUCTS (cheeses, ricotta, etc.) sold by retail, the manufacturer must exhibit signs in the store departments to provide the required information to the consumer. The amount of information for these products is less (food name, list of ingredients, except in case ofexemption, storage method, if required). The same requirement applies to products PRE-PACKAGED FOR IMMEDIATE SALE …

… and prepared by retailers in anticipation of the daily flow of customers (i.e. those that are exposed in different portions and that you can take away without asking for the store clerk’s assistance).

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Now let’s take a look at UHT MILK (LONG SHELF-LIFE)! On the label you will find the printed date, which however, does not indicate the EXPIRATION, but the MINIMUM STORAGE TIME (TMC in Italian, meaning “best before...”). Storing the milk past the TMC does not entail a health hazard, but the possible deterioration of the milk’s quality.

The expiration date and minimum storage time are established by the MANUFACTURER (if not established by law), who is responsible for producing safe foods. Manufacturers have a vested interest that consumers fully appreciate their product for its freshness and taste. They use a smart combination of obstacles (heat treatments, temperature control, acidity, humidity) for the growth of the micro-organisms that are responsible for altering foods, to help maintain the microbiological stability and safety of milk and of derivative products, helping to establish the foods’ SHELF LIFE (durability). This explains why the law does not establish a fixed expiration date …

… for many products. There are several methods of production and preservation of food, and only the manufacturer knows its product. The Official Veterinarians are responsible for verifying, through routine quality controls, that the manufacturer knows the shelf-life of its products. Particular attention is paid to the presence of possible allergens in the product, which must always be indicated on the label.

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Some information provided on the label is important also for us manufacturers, because together with the commercial documents accompanying the food, it helps us TRACE the product, when needed. The BATCH NUMBER helps us know a whole deal about how the product was manufactured. The batch number is determined by the manufacturer: it is not required if the TMC and expiration date specify the day/month.

The traceability system allows us to trace the ingredients, animal feed, animal or group of animals that were used in producing the food and to WITHDRAW AND/OR RECALL the BATCH involved by the hazard (e.g. risk of material in contact, contaminated animal feed, etc.).

What does it means withdrawal or recall?

WITHDRAWAL: in case of a hazard, all those involved (Manufacturers and Authorities) must withdraw the milk or derivative from sale.RECALL: if there is a hazard and the milk or derivative has managed to nonetheless arrive on the consumer’s table, it must be recalled using all the means of information available (warnings in stores/shops, newspapers, radio and TV, etc.), in order to prevent its consumption.

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And here is the stable, which is the first and most important link in the food chain! Let’s see what the production method and the safeguards adopted in the farm are!

First of all we must bear in mind that in order to guarantee “safety from the stable to the table” of milk and dairy products, every farmer must first be able to trace the origin of the milk/product: this is the TRACEABILITY, i.e. the ability to trace and follow the path taken by the milk/product through the stages of production, processing and distribution. The traceability system, therefore, must allow us to trace the stable of origin of the milk (and of the dairy products obtained from it) we purchase.

In order to ensure traceability, therefore, every stable is registered with the responsible Local Health Unit, with its own MANUFACTURER’S CODE, which consists of the ISTAT code of the Town/City of the farm, the province’s code and the progressive number assigned to the individual farm (e.g. 036CR178).

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Now, let me introduce you farmer Aldo!

The management of animals for the production of milk in the stable is entrusted to me, the owner; to stay updated, though, I rely on veterinary consultants and nutritionists. Everyone knows that for milk to be safe for the consumer, it must come from HEALTHY and well bred ANIMALS!

As a breeder, I must therefore make sure that animals live in GOOD CONDITIONS in the farm, treating them in accordance with standards that comply with the needs of the species: environment, nutrition, diseases and genetics must be kept under control at all times.

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I have to make sure that there is dry and clean bedding in the stable for my cows and good udder hygiene, so that the cows are healthy and do not contaminate the milk. In general, I take care of ensuring the health of the animals, protecting them from diseases that could make the milk unsuitable for human consumption.

In fact, only milk from healthy animals may be used: animals with diseases that can contaminate the milk must be excluded from milking. In particular, Official Veterinarians keep under strict control all diseases that can be transmitted to humans, like TUBERCULOSIS and BRUCELLOSIS, with appropriate national preventive care plans.

If my animals are healthy, they’ll get sick less and produce safer milk!

Detach, guess and color!

MILK CHEESE

MILK IS AN IMPORTANT FOOD,

BECAUSE IT IS RICH

IN PROTEIN

AND CALCIUM.

FROM MILK WE OBTAIN

__________, __________,

__________, __________,

AND __________

BUTTERRICOTTA

CREAM

YOGURT

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The quality and healthiness of the milk obtained from my animals is checked several times. Samples of milk are repeatedly analysed in specialised labs; these constant controls allow me to guarantee that the milk I produce is healthy and of the best quality.

Specialised staff also routinely checks the milking system, in order to prevent that the udders of my cows are harmed in the process, which would expose them to the infection of pathogenic germs.

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A crucial aspect to consider isthe HYGIENE OF THE MILKING PROCESS, which ensures that the milk produced is safe and of good quality.

The fresh milk is stored temporarily in refrigerated steel containers (tanks) where my “white gold” is kept constantly stirred, until it is loaded onto the truck that will take it to the processing plant.

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The milk must also contain no harmful residues from the pharmacological treatments and feed administered for the animals’ care and nutrition. This is why the administration of drugs, when strictly necessary, must be authorised by a Veterinarian and recorded in specific

registers that are periodically checked by the Official Veterinariansin their DRUG-SURVEILLANCE inspections.

The breeder must ensure compliance with the WITHDRAWAL PERIOD* prescribed for drug administration, before delivering the milk to stores for consumption! For this reason, all cattle are identified with official, individual ear tags that must be recorded in a register, whenever the cows are subjected to treatments. If prescribed by the Veterinarian (and when required), the tag must include the BREEDING CODE.

* The time employed bydrugs to be eliminated by the animal’s body or to leave residues that are harmless to the consumer.

my breastis THE HEALTHIEST of THE Galaxy

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The FEED administered to the cows must also be monitored and kept under control, in order to ensure the animal’s health and to prevent undesirable substances, toxic or harmful, from ending up in the feed and consequently the milk... Where does the feed I administer to my animals come from? Of course it comes from my fields and partly from the feed mill!

For feed such as fodder, silage and grain coming from my fields, I have to beware of pesticide treatments that have been sprayed for protection from pests and parasitic contamination. All the products that I use must be properly stored and handled, which is why I have completed a specific training course. All my products must be stored protected from bad weather conditions and pests, potentially unsafe for the feed and the health of my cows.

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To ensure that the breeding system is fully functional, the Veterinarians of the Local Health Unit conduct OFFICIAL CONTROLS and TAKE SAMPLES from the animals and/or their feed: • in the farm to check for the absence of infectious diseases that can be transmitted to humans and other animals, in order to ensure that they have not been subjected to improper pharmacological treatments and that their feed is healthy and safe, • in the feed mills, to ensure that the feed is healthy and safe.

The main person responsible for the safety of the animal feed is myself, the owner of the feed mill, which is why I have defined a set of work PROCEDURES to ensure compliance with the laws. These procedures are contained in my SELF-CONTROL MANUAL and all my staff must comply with them as part of their work. I also have to establish if there is any CRITICALITY in my work that can cause a hazard for health, not only of my cows, but also of the consumer, which is why I always have to keep all processes under control.

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The milk produced in the stable is directly transported to theprocessing plants, where:

l it is heat-treated and packaged;

l transformed into dairy products (cheese, butter, yoghurt, ice cream, etc.).

Every milk processing plant is approved by the Veterinary officer Services if it is compliant with the structural and operational requirements set by the legislation on food safety. The OFFICIAL VETERINARIANS, in fact, check that all activities are carried out in accordance with the RULES of HYGIENE, and depending on the complexity of processing, periodically carry out CONTROLS and TAKE SAMPLES.

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The person in charge of assuring the safety of the milk is mostly myself, the owner of the processing plant, which is why I have defined a set of work PROCEDURES to ensure compliance with the relevant legislation. These procedures are contained in my SELF-CONTROL MANUAL and all my staff must comply with them as part of their work. I also have to establish if there is any CRITICALITY in my work that can cause a hazard for health of the consumer, which is why I always have to keep all the process under control.

The milk that arrives at my processing plant has been just milked on the FARMS where the cows are bred. All the milk coming from the farms is SCREENED through a set of strict controls to ensure its quality and wholesomeness.

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The milk and dairy products can be delivered directly from the processing plant to the stores to be sold to the END CONSUMER (in supermarkets, shops, etc.). Dairy products must be transported on vehicles that maintain temperatures suitable to their ensure preservation and good hygiene.

The Veterinary Service of the Local Health Unit makes sure that in stores and supermarkets you can buy milk or dairy products without having to worry about their healthiness or safety! VETERINARIAN OFFICERS conduct regular supervisions and assist the STORE-KEEPER in best preserving and showcasing the products. But that’s not all!

I constantly check that employees comply with the SELF-CONTROL PROCEDURES so as to protect consumer health and ensure the quality of products. I make sure my staff is always trained and updated, which is a guarantee that they will help produce safe and healthy milk.

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OH, I ALMOST FORGOT! There is one more way of buying milk and dairy products.

In addition to traditional retail outlets (supermarkets, shops, etc.), I can find fresh milk, yoghurt or typical, local cheese at the FARMS processing and transforming their own milk. Here too, the breeder must ensure compliance with standard hygiene procedures, such as the storage temperature, processing method, personal hygiene of staff, cleaning and suitability of tools and machinery, cleanliness of the premises, use of allowed ingredients, etc.

The Veterinarian Officers check periodically that the breeder adheres to these standard procedures.

You also might have noticed what has by now become a tradition on the corner of streets or squares: distributors of RAW MILK (also known as “BANCOLAT” in Italian, or milk automatic vending machines), which distribute milk from farms that are strictly monitored by the breeder and regularly by the Local Health Unit, with the aid of state-of-the-art equipment.

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These distributors must clearly display:– in RED: “to be consumed only after BOILING”– expiration date (best before... no more than 3 days);– raw milk from.... (cow, goat, sheep, buffalo);– manufacturer: company name and manufacturing site/farm.If the milk is purchased already bottled, the first two indicationsmust be printed on the label.

But always remember to BOIL the milk before you drink it!

If you reuse the bottles to fill them with raw milk, it is very important that you clean them. After drying, seal the bottle tightly: there, it now is ready again to be filled with good raw milk.

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And what about after I’ve purchased the milk?

Now that we have taken a close look at the production chain of these products and know what kind of GUARANTEES accompany our products, we have to REMEMBER to put our knowledge to good use, following a set of important rules for their PRESERVATION AT HOME.

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Raw milk is an organic food and therefore is very delicate:l place it in the refrigerator at 4°C in the shortest time possible after purchase;l don’t leave the milk and all its derivatives in the car or elsewhere, especially if the outside temperature is high;l keep the milk carton sealed in the same conditions you found it when you bought it; any kind of packaged product must be consumed quickly after opening and never after their

expiration date;l cheese should be stored in the refrigerator in closed containers to avoid coming into contact with other foods in the fridge;l wash carefully and regularly the fridge usingspecific products;l the cutting boards, containers and kitchen utensils must be washed thoroughly before being used to prepare other foods;l always remember to wash your hands well before and after each manipulation of foods.

Do not buy foods of which you don’t know the exact origin!

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In addition to the food safety controls that we have just taken a look at, the private labels of large scale retail or Consortia of manufacturers can ask their suppliers to conduct further verification and certification programmes to ensure compliance with voluntary standards: “quality systems, voluntary labelling specifications and production (DOP, IGP), regulations on organic production”. All the better!

A TOP-QUALITY PRODUCT is the goal of every manufacturer! The concept of nutrition cannot obviously ignore the concept of safety, which is at its core... for this reason, public health inspections of veterinary officers and physicians of the National Health Service are very important.

I hope that at the end of our journey, I have convinced you that dairy products deserve your trust.

Higher Institute of

Health

MINISTRY OFAGRICULTURAL

NUTRITIONAL ANDFORESTRY POLICES

REGIONSCOUNCIL OF

AGRICULTURE

ICQRF(Central

Inspectorate for quality protection and repression of agricultural-food product frauds)

PROVINCESMUNICIPALITIES AGENCIES

Game Keepers Forest RangersVoluntary

EnvironmentalGuards

Provincial and Municipal

Police

MINISTRY OF FINANCIAL ECONOMY

Customs brokerage

MINISTRY OF THE ENVIRONMENT

ISPRA ENVIRONMENTAL

INDICATORS

REGIONS

LHU(Local Health Unit)

UVAC(Veterinary Officesfor the fulfilment of

Municipal obligations)

USMAF(Offices of Maritime,

Aerial and Border Health)

Veterinary ServicesSIAN

(Food-Nutritional Hygiene Services)

PIF(Border Inspection Posts)

NAS(Sophistications and

Health)

Carabinieri Police of

Agricultural and Nutritional

Policies

Forestry State Police

Capitaneria di porto

REPARTO PESCA

FinancePolice

Carabinieri Police -

Environmental Protection

ARPA(Regional Agency for

Environmental Protection)

Istituti Zooprofilattici Sperimentali

MINISTRY OF HEALTH

Directorate General for Hygiene, Food Safety

and Nutrition

Food quality

Polic

e

Food safety

Institutions involved in quality controls on foods

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m Idea– Ministero della Salute– Istituto Zooprofilattico della

Lombardia e dell’Emilia Romagna

m edItors– Istituto Zooprofilattico della

Lombardia e dell’Emilia Romagna •Dr.CandottiPaolo– GeneralDirectorateforHygiene,

FoodSafetyandNutrition-OfficeIIIDGSAN

•Dr.MarconeMariaFelicita •Dr.DiSandroAlessandra

m teXts– Dr.CandottiPaolo

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.CapuaClaudia

ASL Mantova– Dr.FedrizziGiorgio

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.GiorgiMaurilio

ASL Cremona– Dr.MarconeMariaFelicita

Ministry of Health– Dr.SalatiFulvio

IZS della Sardegna “G. Pegreffi”– Dr.SalogniCristian

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.TosiGiovanni

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.VariscoGiorgio

IZS della Lombardia e dell’Emilia Romagna “B. Ubertini”– Dr.ZaghiniLoris

ASL Mantova

m draWINGs– Prof.RizziPietro

I.I.S. Stanga, Cremona