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.

Assessment of liver function in two groups of outdoor workers exposed to arsenic.

PURPOSE: To evaluate whether the exposure to arsenic (As) causes alterations of liver enzymes in two groups of outdoor workers. METHODS: Total urinary As and the levels of AST/GOT, ALT/GPT, and GGT were measured on 80 traffic policemen and 50 police drivers. Personal air samples were obtained for assessing the exposure to As on a subgroup of 20 traffic policemen and 20 police drivers. RESULTS: Mean values of personal exposure to As, urinary As, AST/GOT, and ALT/GPT were significantly higher in traffic policemen than in the police drivers. Multiple linear regression models showed associations between urinary As and airborne As, ALT/GPT and the job variables, and BMI and urinary As. CONCLUSIONS: These findings contribute toward the evaluation of the hepatic effects of exposure to As in the urban workers.

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.

Urinary nickel and prolactin in workers exposed to urban stressors.

The aim of our study is to verify whether the exposure to low Ni doses in urban air may have some effects on the prolactin values of outdoor workers exposed to urban pollutants. 334 workers have been included in the study and divided on the basis of gender, job, age, length of service and smoking habits. Each worker underwent urinary Ni and prolactin sampling. The t-test for independent samples, the Mann-Whitney U test for two mode variables (gender, smoking habit), the univariate ANOVA test and the Kruskal Wallis test for the variables in more than two modes (age, length of service and job duties) were performed on the total sample. Pearson's correlation coefficient (p two-tailed) among the parameters was evaluated both in the total sample and after the stratification by gender, smoking habit and job. Multiple linear regression was performed after taking account of the major confounding factors on the total sample and on the subcategories. The statistical tests showed a significant correlation between urinary Ni and prolactin both in the total sample and in the subcategories. We believe that the occupational exposure to low doses of Ni present in urban pollution may influence the prolactin values in exposed workers.

[Biological risk among health workers]. / Rischio biologico in operatori sanitari.

INTRODUCTION: In health care the contact with body fluids, such as saliva or blood is frequent. The aim of our study was to analyze whether the exposure to biological risks in health care, in particular exposure to HBV and HCV, could cause alterations of some liver parameters. MATERIALS AND METHODS: Our study analyzes of 254 health care workers of a big hospital in Rome. The subjects exposed to biological risks were divided into two groups, one exposed to a high biological risk and the other one exposed to a low biological risk, according to individual duties and/or the departments where they carry out their work. We checked the markers for hepatitis B and C in order to highlight a possible infection, the possible vaccine coverage and the control of the antibody titer by previous infection. We measured the values of transaminases, GGT, alkaline phosphatase, total bilirubin and fractional proteinaemia total and electrophoresis. RESULTS: In health care workers exposed to high risk the average values of transaminases, total protein, alkaline phosphatase, gamma GT, total bilirubin were not significant compared to the some values formed in workers exposed to low risk (p > 0.05). Subjects positive for hepatitis B and C were 4% in the group of workers exposed to high risk (class 1) while in the group of workers exposed to low risk (class 2) the percentage of exposed individuals was 0.01% for the hepatitis B and 2.6% for hepatitis C. DISCUSSION AND CONCLUSIONS: We found a small numbers of positive cases of hepatitis B and C in people exposed to biological agents. We did not find alterations of the average values of transaminases, total protein, alkaline phosphatase, gamma GT, total bilirubin and albumin in positive cases, so that we can say that the proper use of personal protective equipment, training and information of workers and the observance of universal precautions are effective in protecting workers.

[Alienation to burn-out. Psyche and the Universe of Technology]. / Dall'Alienazione al Burn-out. la Psiche e l'Universo della Tecnica.

The new D. Lgs. N 81, 2008 Article 28 paragraph 1 sanctions that the risk assessment must involve all the possible risks to safety and health of workers, including the work-related stress factors. Stressors at work may vary as to: quantity of work assigned, whether excessive or inadequate; lack of recognition or reward for good job performance; degree of responsibility; precariousness of work; emotional pressures exerted on workers; violence and harassment of psychological nature, poor balance between work and private life. The need man has to understand the causes of his psycho-physical and social disease are old. Only the words we use when dealing with the topic has changed over the time: once it was Alienation now it is Burn-out. The concept of alienation, which has been very important over the time, has many different aspects and has had countless interpretations (which have followed one another), the psycho-analytical, the sociological analysis and the Marxist one, Burnout is actually a syndrome characterized by three interrelated dimensions: exhaustion, cynicism and inefficacy. Therefore it is important to prevent, eliminate or reduce problems related to occupational stress. Among preventive measures, the Europe Agreement identified in the management and in the communication the information necessary to define the goals of the company and the role each employee has. Moreover information and formation are considered the necessary elements to increase awareness and understanding of the problem, its potential causes and possible ways of approading it. Our research group, has developed targeted questionnaires, biological indicators and medical instrumental examinations the occupational doctors can make use of to assess these issues.

Professional exposure to urban stressors and effects on urinary metanephrines.

The aim of the study is to assess whether occupational exposure to urban stressors could cause alterations in urinary metanephrines levels in traffic policemen vs administrative staff of municipal police. A total of 258 subjects were included in the study: 129 traffic policemen exposed to urban stressors (68 males and 61 females) and 129 controls (68 males and 61 females). Urinary metanephrines mean levels were significantly higher in male traffic policemen compared to controls (p < 0.01). No significant differences were in female traffic policemen compared to controls. In the control group, urinary metanephrines mean levels were significantly higher in females compared to males (p < 0.01). There were no significant differences in urinary metanephrines mean levels in female traffic policemen vs male traffic policemen. The increase in urinary metanephrines mean levels observed in male exposed compared to controls could be related to chronic occupational exposure to low doses of chemical, physical and psychosocial urban stressors.

Hemopoietic system in traffic police exposed to urban stressors.

The aim of the study is to evaluate if occupational exposure to urban stressors could cause alterations in red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), mean cell volume (MCV), mean cell hemoglobin (MCH), mean corpuscular hemoglobin concentrations (MCHC) in traffic police compared to a control group. 694 subjects were included in the study: 347 traffic police and 347 controls matched by sex, age and length of service after excluding the subjects with the principal confounding factors. The levels of RBC, HGB, HCT were significantly higher in male (respectively p<0.001, p<0.05, p<0.01) and in female (respectively p<0.05, p<0.001, p<0.01) traffic police than in controls. The authors hypothesise that occupational exposure to urban stressors in traffic police can alter hemopoietic system.

Exposure to urban stressor and effects on free testosterone in female workers.

BACKGROUND: The aim of the study is to evaluate if occupational exposure to chemical, physical and psycho-social urban stressor could cause alterations in plasma free testosterone (T) levels and related diseases in female traffic police vs. control group. PATIENTS AND METHODS: The research was carried out on initial sample of 468 female Municipal Police employees (209 traffic police and 259 controls). After excluding the principal confounding factors, traffic police were matched with controls by age, working life, menstrual cycle day, BMI, drinking habit, cigarette smoking habit, liquorice and soy intake in diet, habitual consumption of Italian coffee. There were 96 female traffic police and 96 controls included in the study. RESULTS: T mean levels were significantly higher in female traffic police compared to controls (p=0.000). The distribution of T values in traffic police and in controls was significant (p=0.000). No significant differences were found comparing the percentage in traffic police and controls concerning dystocial, premature and post-term birth. An increase in mental health disorders was found in traffic police compared to controls but the difference was not significant. CONCLUSION: The increase in T plasma levels observed in traffic police vs. controls can be due to a chronic working exposure to low doses of environmental chemical urban stressor. According to our previous researches T could be used as an early biological marker even before the onset of the related disorders.

Immune parameters in female workers exposed to urban pollutants.

Urban outside workers, such as traffic police, are daily exposed to air pollutants and psychosocial stressors: for these workers, the working environment corresponds to the living environment of the general population. Studies in the literature have shown that immune parameters could be affected by chronic exposure to various chemical pollutants. The aim of this study is to evaluate whether occupational exposure to urban pollutants can cause alterations in NK, IL-2, IFN-gamma and C3 plasma levels in female traffic police compared to a control group. After excluding subjects with the principal confounding factors, 86 female traffic police and 87 controls were matched by age, years of police work and habitual alcohol consumption. The distribution of NK values in female traffic police and controls was significantly different (p=0.000); NK values above the upper limit of the normal laboratory range were observed in 23 female traffic police and in 2 controls (p=0.000). IL-2 mean levels were higher in traffic police compared to controls, but the difference was not significant. The mean and the distribution of IFN-gamma values in female traffic police and controls were not different. C3 mean levels were higher in female traffic police versus controls, but the difference was not significant. Considering that the subjects with the principal confounding factors were excluded from the study and that female traffic police and controls were matched by the above-mentioned variables, our results suggest that chronic occupational exposure to low doses of chemical stressors, which may interact with and add to psychosocial ones, can affect both innate and adaptative immunity.

Plasma IL-2, NK, IFN-γ, and C3 in male workers exposed to traffic pollutants.

The aim of the study is to evaluate if the occupational exposure to urban stressors could cause alterations in interleukin-2 (IL-2), NK, interferon-γ (IFN-γ) and C3 plasma levels in male traffic police officers compared to controls. After excluding the principal confounding factors, 108 traffic police officers were matched with 108 controls by age, working life, habitual consumption of alcohol and spirits. IL-2 mean levels were significantly higher in traffic police officers compared to controls (p=0.04). The distribution of IL-2 values in traffic police officers and in controls was significant (p=0.01). The distribution of NK value percentage in traffic police officers and in controls was significant (p=0.000). IFN-γ and C3 mean levels were not significant in traffic police officers compared to controls. Our results suggest that the occupational chronic exposure to low doses of urban stressors could affect NK and IL-2 plasma concentrations in traffic police officers of male sex.