Low-Dose Occupational Exposure to Nickel and Thyroid Hormones.

INTRODUCTION: The aim of this study was to evaluate the effects of a low-dose exposure to nickel, as it is present in urban air, on thyroid hormones and on thyrotropin in outdoor workers exposed to urban pollutants. MATERIALS AND METHODS: A total of 164 outdoor workers were studied and divided by sex and smoking habit. Each worker underwent measurement of urinary nickel and of blood triiodothyronine, L-thyroxine, and thyrotropin levels. The statistical analysis was performed. RESULTS: Statistical analysis shows a significant and positive correlation between urinary nickel and L-thyroxine, both in total sample and in males. DISCUSSION AND CONCLUSION: The study suggests that occupational exposure to a low dose of nickel may affect thyroid function in municipal police workers. These data may provide information on other categories of outdoor workers with similar exposure.

Urinary Nickel and Progesterone in Workers Exposed to Urban Pollutants.

OBJECTIVE: The aim of this study is to evaluate whether the exposure to a low dose of nickel could determinate a variation in levels of progesterone in outdoor workers. MATERIALS AND METHODS: Two hundred sixty one subjects were divided by sex, task, age, seniority, and cigarette smoking habit. For each workers was evaluated the dose of blood progesterone and urinary nickel.The statistical analysis was performed. RESULTS: The Pearson correlation showed a statistically significant correlation between urinary nickel levels and progesterone. The multiple linear regression showed a significant correlation between progesterone and urinary nickel in the total sample and in the subgroups of smokers and workers with tasks of traffic direction. CONCLUSIONS: The results of our study suggest that occupational exposure to low doses of nickel present in urban pollution may influence to progesterone levels in outdoor workers.

Practical Clinical and Diagnostic Pathway for the Investigation of the Infertile Couple.

Capsule: This expert opinion summarizes current knowledge on risk factors for infertility and identifies a practical clinical and diagnostic approach for the male and female partners of an infertile couple aimed to improve the investigation and management of fertility problems. Background: Infertility represents an important and growing health problem affecting up to 16% of couples worldwide. In most cases, male, female, or combined factor can be identified, and different causes or risk factors have been related to this condition. However, there are no standardized guidelines on the clinical-diagnostic approach of infertile couples and the recommendations concerning infertility are sometimes lacking, incomplete, or problematic to apply. Objective: The aim of this work is to provide an appropriate clinical and diagnostic pathway for infertile couples designed by a multidisciplinary-team of experts. The rationale is based on the history and physical examination and then oriented on the basis of initial investigations. This approach could be applied in order to reduce variation in practice and to improve the investigation and management of fertility problems. Methods: Prominent Italian experts of the main specialties committed in the ART procedures, including gynecologists, andrologists, embryologists, biologists, geneticists, oncologists, and microbiologists, called "InfertilItaly group", used available evidence to develop this expert position. Outcomes: Starting from the individuation of the principal risk factors that may influence the fertility of females and males and both genders, the work group identified most appropriate procedures using a gradual approach to both partners aimed to obtain a precise diagnosis and the most effective therapeutic option, reducing invasive and occasionally redundant procedures. Conclusions: This expert position provides current knowledge on risk factors and suggests a diagnostic workflow of infertile couples. By using this step-by-step approach, health care workers involved in ART, may individuate a practical clinical management of infertile couples shared by experts.

Prevalence of chronic venous pathology in healthcare workers and the role of upright standing.

BACKGROUND: Chronic venous disease (CVD) affects around 25% of adult population in developed countries and it often represent a health problem for different kind of workers, in particular for who spend much of the working time in upright standing. METHODS: The study was carried out on a population of 173 nonmedical workers of a midsize hospital in Italy (91 nurse, 31 support staff workers and 51 employees). The study protocol was taken from a previous study of our group and included a clinical examination and a questionnaire. RESULTS: From the analysis of data it emerged a particular importance of upright standing as major risk factor for CVD. The prevalence of venous pathology seems to be greater among nurses and auxiliaries than the administrative staff and, as expected, it was significantly higher among female workers than in males. CONCLUSIONS: The results obtained show that the clinical-diagnostic protocol described can be used by doctors for screening venous pathology at workplaces.

No Correlation between Blood Benzene Levels and Luteinizing Hormone Plasma Values in Outdoor Workers.

OBJECTIVE: The purpose of the study is to evaluate whether low-dose exposure to benzene, an environmental pollutant to which male and female traffic policemen are daily exposed to could cause alterations in plasma luteinizing hormone (LH) levels. METHODS: From an initial sample of 1594 workers, we only selected 95 workers of whom study we knew the values of late-shift benzene and LH hormone. All subjects underwent biological monitoring (final blood benzene evaluation) and luteinizing hormone dosing. Excluding subjects with the main confounding factors, the final sample included 76 workers. The normal distribution of the variables was evaluated using the Kolmogorov - Smirnov test, followed by the logarithmic transformation of the LH and benzene values. The comparison among means was performed by using the t-test for the independent samples. The ANOVA test was performed for variables with more than 2 modes (ages and seniority) and Pearson correlation index between variables in the total sample and after subdivision as to sex, job, sports activity and smoking. The results were considered significant when p values were less than 0.05. RESULTS/CONCLUSION: The study did not show a correlation between benzene levels and LH plasma levels in outdoor workers.

Post Vaccinal Temporary Sensorineural Hearing Loss.

In our systematic research we identified four studies concerning the onset of neurological adverse events following vaccination and two excluding this association. A 33-year-old Italian man, belonging to the Italian Army was hospitalized because he suffered from vertigo, nausea and sudden right hearing loss not classified (NDD), that set in 24 h after the administration of tetanus-diphtheria and meningococcal vaccines. Some neurological events arising after vaccination are very difficult to treat. In our case, the functional recovery on low and medium frequencies was possible about 6 months after the morbid event.

Distortion-product otoacoustic emissions in workers exposed to urban stressors.

The study aimed to compare the distortion-product otoacoustic emissions (DPOAEs) with the pure-tone audiometry and to analyze the changes in participants exposed to noise. The results show a prevalence of participants with impaired DPOAEs higher than the prevalence of participants with impaired audiometries in the total sample, in men, and in outdoor workers and a prevalence of impaired DPOAEs and of impaired audiometries in men higher than in women and in outdoor workers higher than in indoor workers. The comparison of mean values between outdoor and indoor workers shows a significant difference only on some frequencies, in the DP-gram. The results suggest a higher effectiveness of DPOAEs compared with the pure-tone audiometry in identifying the presence of any damage in individuals exposed to noise at an early stage.

Blood pressure in indoor and outdoor workers.

INTRODUCTION: The aim of our study is to evaluate the changes in systolic and diastolic blood pressure in two occupational categories: outdoor workers (traffic policemen and environment technicians) and indoor workers. MATERIALS AND METHODS: The study was conducted comparing the results obtained from three samples of male workers: 175 outdoor traffic policemen, 175 outdoor environment technicians and 175 indoor workers. The outdoor and indoor groups were made comparable by age, length of service, body mass index, alcohol consumption, smoking status. RESULTS: The mean values of systolic and diastolic blood pressure were found higher in traffic policemen and technicians than in indoor workers, as well as higher values of systolic blood pressure in traffic policemen than in technicians. CONCLUSIONS: The results suggest that outdoor working affects the blood pressure, contributing to an increased cardiovascular risk.

Workers exposed to low levels of benzene present in urban air: Assessment of peripheral blood count variations.

BACKGROUND: Few studies in the literature have examined the effects of benzene on blood cells. AIM: The aim of this study was to evaluate the possible correlation between the blood benzene levels and the blood cell counts. MATERIALS AND METHODS: From a population of 2658 workers, we studied a group of 215 subjects. Each worker underwent blood sampling for the assessment of the blood benzene levels and the blood cell counts. The Mann-Whitney U test for two-mode variables and the Kruskal-Wallis test for more-than-two-mode variables were performed on all subjects. We estimated the Pearson correlation index between the variables in the total sample and the subgroups divided according to sex, the smoking habit, and job. After the main confounding factors were evaluated, multiple linear regression was performed on both the total sample and the subgroups. RESULTS: A significant inverse correlation was found among the blood benzene levels and the white blood cells, lymphocytes, and neutrophils in traffic policemen, motorcyclists, and other outdoor workers. We did not find any significant correlation with any other parameters of blood cell count. DISCUSSION AND CONCLUSIONS: Our results, which must be considered preliminary, indicate that increased blood benzene levels in outdoor workers lead to decreased counts of white blood cells, neutrophils, and lymphocytes, because of possible immune effects. These are worth investigating in the future by specific immune tests.

Nickel and blood counts in workers exposed to urban stressors.

Nickel (Ni) and Ni compounds are widely present in the urban air. The purpose of this study is to estimate exposure of individuals to Ni and the correlation between this exposure and the values of blood counts in outdoor workers. This study focused on a sample of 101 outdoor workers (55 male and 46 female; 65 nonsmokers and 36 smokers), all employed in the municipal police in a large Italian city. The personal levels of exposure to Ni were assessed through (a) environmental monitoring of Ni present in the urban air obtained from individual samples and (b) biological monitoring of urinary and blood Ni. The blood count parameters were obtained from the hemochromocytometric tests. Pearson correlation coefficients (r) were calculated to assess the association between the blood and urinary Ni and the complete blood count. Multiple linear regression models were used to examine the associations between the complete blood count and the independent variables (age, gender, years of work for current tasks, cigarette smoking habit (current and never smoker), values of airborne Ni, and blood and urinary Ni). Multiple linear regression analysis performed on the total group of 101 subjects confirms the association among the red blood cells count, the hematocrit, and the urinary Ni (R(2) = 0.520, p = 0.025 and R(2) = 0.530, p = 0.030). These results should lead to further studies on the effects of Ni in working populations exposed to urban pollutants. The possibility that the associations found in our study may be partially explained by other urban pollutants (such as benzene, toluene, and other heavy metals) not taken into consideration in this study cannot be ruled out.

Correlation between urinary cadmium and thyroid hormones in outdoor workers exposed to urban stressors.

OBJECTIVES: The aim of this study is to evaluate whether exposure to low concentrations of cadmium (Cd) can have effects on the thyroid hormone level of outdoor workers exposed to urban pollutants. METHODS: The study was conducted on a final sample of 277 individuals (184 males and 93 females). The environmental monitoring of Cd was evaluated through the use of portable dosimeters, while the biological monitoring was achieved through the assessment of urinary Cd and thyroid hormones. The total sample was divided according to sex and task. The Pearson's correlation coefficient among the variables was calculated after subdivision on the basis of sex and task. The multiple linear regression was performed to take into account the major confounding factors. RESULTS: Statistical tests showed a negative correlation between urinary Cd levels and free triiodothyronine and free thyroxine and a positive correlation between urinary Cd and thyroid-stimulating hormone levels. CONCLUSIONS: Our early results seem to point out that occupational exposure to low concentrations of Cd present in urban air affects the thyroid hormone levels in exposed workers.

[Arterial pressure in workers exposed to urban stressors]. / Pressione arteriosa in lavoratori esposti a stressors urbani.

The aim of this study is to evaluate whether occupational exposure to urban stressors could cause alterations of systolic and diastolic blood pressure in "outdoor" workers. The research was conducted on a sample of 101 municipal policemen. The sample was divided in 2 groups according to length of service: group A (length of service between 1 and 15 years) and group B (length of service > 15 years). Group A and Group B were matched for age, overall length of service, cigarette smoking habit and consumption of alcohol and spirits. Group A was then divided into: Al (length of service between 1 and 7 years) and A2 (length of service between 7 and 15 years). The mean values of systolic and diastolic blood pressure at rest showed statistically significant differences with increased values in group B compared to both groups Al (p<0.05) and A2 (p<0.05). The study suggests that occupational exposure to urban stressors affects the blood pressure regulating system enhancing the risk of blood hypertension.

Overweight and urban pollution: preliminary results.

The aim of this study is to determine whether in workers exposed to urban pollution the risk of developing overweight and obesity is higher in workers exposed to urban pollution compared to a control group. The study was conducted on 150 volunteers, 75 workers exposed to urban pollution (50 women and 25 men) and 75 indoor workers (50 women and 25 men). Once measured the weight and height and calculated body mass index (BMI) for each worker, the research was based on the comparison, between the two groups, of the mean values of the measurements and of the frequency of workers with BMI index higher than the cut-off of normality. The only statistically significant difference found was for the mean value of weight in women, which was higher among outdoor workers compared to indoor workers. The mean values of BMI and the frequency of workers with BMI higher than normal was higher among outdoor workers compared to indoor workers in both sexes, but not statistically significant. The data suggest that outdoor workers may be subject to an additional risk of developing obesity as a result of exposure to urban air pollution (which, like obesity, is a source of oxidative stress). So, our preliminary study encourages to continue this line of research by implementing the sample and considering all the confounding factors. Furthermore, the results highlight the necessity to take account of gender differences in the context of health surveillance of workers.

Work-related stress assessment in a population of Italian workers. The Stress Questionnaire.

The present study shows detailed information about the reliability and validity of the psychosocial risk scale included in the Stress Questionnaire (SQ) developed by our research group. The primary purpose of this work is to test the factor structure of the psychosocial risk scale through a first-order confirmatory factor analysis (CFA) using a large pooled dataset obtained from a population of 2026 employees of 15 Italian medium-large companies. Data were collected by a team of researchers who examined demographic variables, work-related stress, workplace bullying, mental health and other constructs. In addition to these substantive issues, the survey was designed to better understand response bias. After the evaluation of the results we conclude that the psychosocial risk scale reported a satisfactory reliability and validity. In addition, it allowed a careful measurement of work related stress, considering both leader's and follower's perspectives.

Exposure to formaldehyde in health care: an evaluation of the white blood count differential.

The aim of our study is to estimate if the occupational exposure to formaldehyde can cause alterations of leukocytes plasma values in health care workers employed in a big hospital compared to a control group. We studied employees in operating rooms and laboratories of Pathological Anatomy, Molecular Biology, Molecular Neurobiology, Parasitology and Experimental Oncology (exposed to formaldehyde) and employees of the Department of Internal Medicine (not exposed). The sample studied was composed of 86 workers exposed to formaldehyde and 86 workers not exposed. All subjects underwent a clinical-anamnaestic examination and for all subjects were measured the following values: total white blood cells, lymphocytes, monocytes and granulocytes (eosinophils, basophils, neutrophils). Statistical analysis of data was based on calculation of the mean, standard deviation and the distribution into classes according to the nature of each variable. Differences were considered significant when p was < 0.05. The mean and the distribution of values of the white blood cells, lymphocytes, monocytes and eosinophils were significantly higher in male subjects exposed to formaldehyde compared to not-exposed. Not significant differences were found in female subjects exposed compared to not exposed. The results underline the importance of a careful risk assessment of workers exposed to formaldehyde and the use of appropriate preventive measures. The health care trained and informed about the risks he is exposed to should observe good standards of behavior and, where it is not possible to use alternative materials, the indoor concentrations of formaldehyde should never exceed occupational limit values.

Anesthetic gases and occupationally exposed workers.

The aim of this study is to estimate whether the occupational exposure to low dose anesthetic gases could cause alterations of blood parameters in health care workers. 119 exposed subjects and 184 not exposed controls were included in the study. Each worker underwent the complete blood count test (CBC), proteinaemia, leukocyte count, serum lipids, liver and kidney blood markers. The liver blood markers show statistically significant differences in health care workers compared with controls (p<0.05), a statistically significant decrease in neutrophils and an increase of lymphocytes in health care workers compared with controls (p<0.05). The prevalence of values outside the range for GPT, GGT, total bilirubin, lymphocytes and neutrophils was statistically significant in health care workers compared with controls (p<0.05). The results suggest that occupational exposure to low dose anesthetic gases could influence some haematochemical hepatic and hematopoietic parameters in exposed health care workers.

Is urinary 1-hydroxypyrene a valid biomarker for exposure to air pollution in outdoor workers? A meta-analysis.

The aim of this study was to evaluate the usefulness and specificity of urinary 1-hydroxypyrene (1-OHPu) as a biomarker of the exposure from urban pollution to polycyclic aromatic hydrocarbons (PAHs) among outdoor workers in a meta-analysis. Our meta-analysis was performed according to standard methods, and the results show that the concentrations of 1-OHPu tend to be higher in exposed workers than in unexposed workers (if we exclude two highly heterogeneous articles), in exposed non-smokers than in unexposed non-smokers and in exposed than in unexposed workers who were carriers of the CYP1A1 genotype and in those with the glutathione-S-transferase M1 (-)genotype. These genotypes enhance the effect of exposure, particularly in non-smokers. Smoking reduces the differences between exposed and unexposed subjects. In conclusion, our results suggest that the use of the 1-OHPu biomarker appears to be reliable for studying occupational exposure to PAHs from urban pollution, as long as environmental and behavioural factors are considered.

Peripheral blood counts in workers exposed to synthetic fibres.

Acrylonitrile is an intermediary with possible adverse health effects in the synthesis of organic products, such as acrylic fibres. This investigation was undertaken to determine the possible changes in the peripheral blood counts in workers of a polyacrylic fibres plant. The study involved 218 workers exposed to acrylonitrile at low doses and a control group of 200 unexposed workers. The chosen subjects underwent blood tests in order to check their haematological parameters. There were no statistically significant differences between the two groups in terms of the red blood cells, haemoglobin and total number of leukocytes. An increase in the neutrophils associated with a reduction of lymphocytes, both statistically significant, was observed. The authors hypothesized that the neutrophils are influenced by the exposure to acrylonitrile at low doses.