Mortality in an Italian cohort of former asbestos cement workers.

BACKGROUND: A pooled study on Italian asbestos cement plant cohorts observed mortality risk for asbestos-related diseases. This study analysed the mortality of workers cohort of an asbestos cement plant in Syracuse, Italy. METHODS: Workers' vital status and causes of death, during 1970-2018, were identified in regional health databases. Standardized mortality ratios (SMRs) by sex and temporal variables were calculated. RESULTS: Of the 900 cohort's subjects (636 men, 259 women, 5 unknown sex), for 867 the vital ascertainment was possible: 505 died during study period. All-cause mortality is similarly to the expected among men and lower among women. Pleural and lung malignant neoplasms (MN) exceeded in men (SMR=27.1, SMR=1.95), retroperitoneal and peritoneal MN in both sexes, no cases of larynx MN were observed. Mortality excess for ovarian MN (SMR=1.5) and asbestosis in both sexes (men: SMR=431.9, women: SMR=116.6) were found. CONCLUSIONS: Exceeding mortality from asbestos-related diseases, particularly in men was highlighted.

Asbestos exposure and asbestosis mortality in Italian cement-asbestos cohorts: Dose-response relationship and the role of competing death causes.

OBJECTIVES: In Italy, asbestos was used intensively until its ban in 1992, which was extended for asbestos cement factories until 1994. The aim of this study was to evaluate the dose-response between asbestos exposure and asbestosis mortality across a pool of Italian occupational cohorts, taking into account the presence of competing risks. METHODS: Cohorts were followed for vital status and the cause of death was ascertained by a linkage with mortality registers. Cause-specific (CS) Cox-regression models were used to evaluate the dose-exposure relationship between asbestosis mortality and the time-dependent cumulative exposure index (CEI) to asbestos. Fine and Gray regression models were computed to assess the effect of competing risks of death. RESULTS: The cohort included 12,963 asbestos cement workers. During the follow-up period (1960-2012), of a total of 6961 deaths, we observed 416 deaths attributed to asbestosis, 879 to lung cancer, 400 to primary pleural cancer, 135 to peritoneal cancer, and 1825 to diseases of the circulatory system. The CS model showed a strong association between CEI and asbestosis mortality. Dose-response models estimated an increasing trend in mortality even below a CEI of 25 ff/mL-years. Lung cancer and circulatory diseases were the main competing causes of death. CONCLUSIONS: Asbestos exposure among Italian asbestos-cement workers has led to a very high number of deaths from asbestosis and asbestos-related diseases. The increasing risk trend associated with excess deaths, even at low exposure levels, suggests that the proposed limit values would not have been adequate to prevent disability and mortality from asbestosis.

Occupational particle exposure and chronic kidney disease: a cohort study in Swedish construction workers.

OBJECTIVES: Increasing epidemiological and experimental evidence suggests that particle exposure is an environmental risk factor for chronic kidney disease (CKD). However, only a few case-control studies have investigated this association in an occupational setting. Hence, our objective was to investigate associations between particle exposure and CKD in a large cohort of Swedish construction workers. METHODS: We performed a retrospective cohort study in the Swedish Construction Workers' Cohort, recruited 1971-1993 (n=286 089). A job-exposure matrix was used to identify workers exposed to nine different particulate exposures, which were combined into three main categories (inorganic dust and fumes, wood dust and fibres). Incident CKD and start of renal replacement therapy (RRT) were obtained from validated national registries until 2021 and analysed using adjusted Cox proportional hazards models. RESULTS: Exposure to inorganic dust and fumes was associated with an increased risk of CKD and RRT during working age (adjusted HR for CKD at age <65 years 1.15, 95% CI 1.05 to 1.26). The elevated risk did not persist after retirement age. Exposure to cement dust, concrete dust and diesel exhaust was associated with CKD. Elevated HRs were also found for quartz dust and welding fumes. CONCLUSIONS: Workers exposed to inorganic particles seem to be at elevated risk of CKD and RRT. Our results are in line with previous evidence of renal effects of ambient air pollution and warrant further efforts to reduce occupational and ambient particle exposure.

Contact with Wet Cement-A Preventable Cause of Chemical Burn: Case Report and Discussion.

GENERAL PURPOSE: To review the management of a patient with a chemical burn from wet cement. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Recognize the clinical presentation of a patient with a chemical burn from contact with wet cement.2. Describe features related to the pathophysiology of alkali burns from wet cement.3. Select the proper decontamination procedure after exposure to wet cement.4. Identify steps in the treatment of a patient with a chemical burn from contact with wet cement.

Alkali burn from wet cement is an often unrecognized and completely preventable chemical injury. The prevalence of cement burns is likely underestimated because of a lack of awareness and knowledge among both individuals who work with cement and healthcare providers. Chemical injuries have important differences compared with thermal burns: they are usually produced by longer exposure to noxious agents as opposed to short-term exposure that is quickly stopped. As a result, first aid approaches are different. Chemical burns from cement can be avoided with adequate skin and eye protection as well as immediate first aid if contact occurs. Manufacturers of bagged cement place warning notices on packaging, but these can be small and go unnoticed by consumers. Construction workers and amateur do-it-yourselfers should avoid direct contact with cement for any prolonged amount of time. Watertight boots, gloves, and clothing will prevent contact, and any accidental splash on exposed skin should be immediately washed away. Education and awareness of the consequences of cement burns are the best prevention.

Caracterización del ambiente físico en viviendas Petrocasas en el Asentamiento Simón Bolívar de Cienfuegos (2008-2009) / Characterization of the physical environment in petrohouses from the village of Simón Bolívar in the province of Cienfuegos (2008-2009)

En varios asentamientos del país se han construido viviendas Petrocasas de policloruro de vinilo, relleno con hormigón sobre balsa y cubierta de lámina de aluminio revestida de papel asfalto por ambas caras. El policloruro de vinilo como material de construcción resulta controversial en relación a sus efectos en la salud. Con el objetivo de caracterizar desde el punto de vista sanitario el ambiente físico en viviendas Petrocasas de Cienfuegos, fue conducido un estudio descriptivo en dos semanas seleccionadas de las estaciones seca y húmeda de 2008 y 2009. Se monitoreó factores de riesgo físico en una muestra de 6 viviendas seleccionadas según la opinión de expertos, del total de las 104 viviendas del asentamiento según su ubicación en las filas de viviendas: centro, culata de fila y fachada. Se estudió el ruido, componente magnético del campo electromagnético de baja frecuencia, iluminación natural, artificial, microclima y penetración del viento. La evaluación del monitoreo se efectuó por descriptores estadísticos, modelos de regresión, varianza y espectro de potencia bivariado con los paquetes estadísticos: SPSS v. 17,0 y Statistica v. 8,0. Durante la estación seca, la temperatura del aire es mayor en la habitación principal de viviendas con fachada al sur. En ambas estaciones, las temperaturas y humedades relativas de las viviendas son más altas que en la intemperie. Las cubiertas y paredes muestran calentamientos ante el asoleamiento. Los coeficientes de iluminación natural presentan elevadas reflexiones. Los valores del campo electromagnético son bajos. En la estación seca los niveles sonoros reflejan una contaminación acústica moderada. Concluimos que el microclima en el interior de las viviendas durante el día es inconfortable(AU)

Petrohouses have been built in several villages in the country. These houses are made of polyvinyl chloride, filled with raft concrete and covered with aluminum sheets coated with asphalt paper on both sides. The health effects of polyvinyl chloride as a construction material is a matter of controversy. With the purpose of carrying out a health characterization of the physical environment in Cienfuegos petrohouses, a descriptive study was conducted during two weeks selected from the dry and wet seasons of 2008 and 2009. Physical risk factors were monitored in a sample of 6 houses selected on the basis of expert opinion, of the total 104 houses in the village, according to their location in the rows: front, mid and end positions. The variables studied were noise, magnetic component of the low frequency electromagnetic field, natural and artificial lighting, microclimate and wind penetration. Monitoring was evaluated with statistical descriptors, regression models, variance and bivariate power spectrum, with the statistical software SPSS v. 17.0 and Statistica v. 8.0. In the dry season, air temperature is higher in the main room of houses with facades facing the south. In both seasons, temperature and relative humidity values are higher inside the houses than outside. Covers and walls heat up when hit by the sun. Natural lighting coefficients show high reflection values. Electromagnetic field values are low. In the dry season, sound levels show moderate acoustic contamination. It is concluded that the microclimate inside houses during the day is uncomfortable(AU)

Trauma ocupacional por corpo estranho corneano superficial / Occupational trauma due to superficial corneal foreign body

OBJETIVO: Avaliar a epidemiologia do trauma ocular por corpo estranho superficial de córnea. MÉTODOS: Os pacientes atendidos no Pronto-Socorro da Universidade Federal de São Paulo entre abril e junho de 2005 que apresentaram corpo estranho superficial de córnea foram entrevistados. Foram avaliados: sexo, idade, profissão, registro legal do emprego, uso, disponibilidade e tipo de equipamentos de proteção utilizados e a fiscalização do seu uso. O conhecimento das complicações deste tipo de acidente também foi avaliado. Os resultados foram analisados com teste do qui quadrado ou teste de Fisher. RESULTADOS: Foram entrevistados 123 pacientes. Apenas 3 eram do sexo feminino e a idade média foi de 36 anos. A maioria destes traumas ocorreu no ambiente de trabalho (86,2 por cento) e 58,4 por cento não possuíam registro legal do emprego. As profissões mais freqüentemente envolvidas foram serralheiro, pedreiro e metalúrgico. Em 79,8 por cento dos locais de trabalho havia equipamentos de proteção e 85,3 por cento dos pacientes eram orientados a usá-los. Em 52,4 por cento dos locais sua utilização era fiscalizada, mas apenas 34,2 por cento usavam no momento do trauma. A utilização foi mais freqüente (p=0,008) e fiscalização mais presente (p=0,0415) entre pacientes com registro legal de emprego. Questionados sobre os riscos, 68,9 por cento dos pacientes tinham consciência das complicações graves deste tipo de acidente. CONCLUSÃO: A maioria dos pacientes tem conhecimento sobre a gravidade do trauma ocular e este tipo de lesão ocorre mesmo em locais com equipamentos de proteção disponíveis, alguns deles até durante o seu uso. Os dados sugerem que enfoque maior da prevenção deve ser na fiscalização e utilização de equipamentos adequados.

PURPOSE: To evaluate the epidemiology of superficial corneal foreign body. METHODS: Patients who were seen at the Emergency Service of the Federal University of São Paulo, from April/05 to June/05, were screened and those with superficial corneal foreign body were interviewed. Data regarding gender, age, occupation, employment status, availability and use of protective devices and supervision of their use were collected. Awareness of the possible complications was also assessed. Results were analyzed using chi-square or Fisher exact test. RESULTS: One hundred twenty-three patients were interviewed. Only 3 patients were female. The mean age was 36 years. Most injuries occurred at the workplace (86.2 percent), and 58.4 percent of the patients did not have a legal employment registration. The occupational activities most frequently reported were construction related activities (44.3 percent) and welding/soldering (11.3 percent). In most workplaces (79.8 percent) protective devices were available and 85.3 percent of the patients were instructed to use them. A safety device was being used during the accident in 34.2 percent of the cases and this was more frequent among patients that had legal employment registry (p=0.008) and among those under supervision (p=0.0415). The majority of the patients (68.9 percent) were aware of the risk of severe complications. CONCLUSIONS: Most patients with superficial corneal foreign body are aware of its severe complications and injuries usually occur in places where safety devices are available and often during their use. Our findings suggest that prevention should focus on supervision and correct use of safety devices.

Estudo de 162 casos de queimaduras oculares atendidos no Hospital Universitário da Universidade Federal de Santa Catarina / Research of 162 cases of taken care ocular burnings at the University Hospital of Federal University of Santa Catarina

Objetivos: Este estudo tem por objetivo descrever os principais tipos de queimaduras oculares, assim como relacioná-los com o sexo, a idade, o agente causador, a lateralidade, a profissão e as complicações oculares associadas, atendidos no ambulatório do Serviço de Oftalmologia do Hospital Universitário da Universidade Federal de Santa Catarina (HU/UFSC).Métodos: Foram estudados 162 pacientes, no período de março de 2003 a setembro de 2004. Foram analisadas as queimaduras oculares nas seguintes categorias: sexo, idade, tipo de queimadura ocular, agente causador, lateralidade, profissão e complicações oculares.Trata-se de um estudo transversal, de caráter descritivo, retrospectivo, não intervencionista. Os critérios de inclusão consistiram somente na análise dos prontuários nos quais continham todas as informações necessárias para o preenchimento dos dados da pesquisa, excluindo-se aqueles prontuários com informações incompletas. Resultados: Houve predominância do sexo masculino (79,6%) sobre o feminino (20,4%). A faixa etária mais acometida foi a de 15 a 35 anos, com 57,4% dos casos. O tipo de queimadura mais freqüente foi a química, com 58% dos casos. Os principais agentes causadores foram aqueles relacionados ao ambiente de trabalho: energia radiante (29,6%) e cal associada a cimento (21%). Quanto à lateralidade, em cerca de 50,6% dos casos, os dois olhos foram afetados. Em relação à ocupação profissional, os pacientes mais comprometidos foram aqueles que trabalhavam na construção civil (33,3%). Entre as complicações oculares encontradas, a erosão corneal foi observada em 72,2% dos casos, seguida pelas conjuntivites traumáticas (41,4%). Conclusão: Indivíduos jovens do sexo masculino foram os mais acometidos, sendo que o principal tipo de queimadura encontrada foi a queimadura química. Na maioria dos casos, os acidentes ocorreram no ambiente de trabalho, relacionados com a construção civil. Os principais agentes causadores foram o cimento...