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.

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.

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.

Noise-induced hearing loss in workers exposed to urban stressors.

The technological and industrial progress together with the intensification of vehicular traffic and the adoption of new social habits are the cause of an increasing noise pollution with possible negative effects on the auditory system. This study aims to assess the noise exposure levels and the effects on the hearing threshold in outdoor and indoor male workers of a big Italian city. The study was carried out on 357 outdoor male workers, exposed to urban noise and on a control group of 357 unexposed indoor workers. Noise levels were measured in 30 outdoor and indoor areas. The subjects underwent tonal liminal audiometry in order to determine the value of their hearing threshold. During their working activity, outdoor and indoor workers are exposed to different noise levels LEX<80 dB(A). At mid-low frequencies (250-2000 Hz), the results show significant differences in the average values of hearing threshold between the two groups in both ears and for all age classes; there are no significant differences between the two groups at higher frequencies. The outdoor noise levels measured are not usually ototoxic and the hearing loss at mid-low frequencies is not characteristic of the exposure to industrial noise. For these reasons the Authors hypothesize that the results may be due to the combined effect of the exposure to noise and to ototoxic air pollutants. The impairment of speech frequencies is disabling and involves the risk of missed forensic recognition.

Cadmium and hypertension in exposed workers: A meta-analysis.

OBJECTIVES: In the general population, cadmium seems to be responsible for hypertension, atherosclerosis and an increase in acute coronary events. Therefore, the purpose of this meta-analysis was to analyze controlled studies conducted on cadmium and arterial pressure in occupationally-exposed workers. MATERIALS AND METHODS: After analyzing all the relevant articles found in the literature, 6 publications were selected. RESULTS: A higher prevalence of hypertension and higher values of systolic and diastolic blood pressure were recorded in the exposed subjects. CONCLUSIONS: Cadmium in occupationally-exposed individuals appears to induce an increase in systolic and diastolic blood pressure and an increase in the prevalence of hypertension.

Prevalence of systemic arterial hypertension, electrocardiogram abnormalities, and noise-induced hearing loss in agricultural workers.

ABSTRACT The literature suggests that farmers nowadays are more likely to contract cardiovascular diseases than in the past. This study involved 79 farmers and 64 controls. The workers completed a questionnaire to identify exclusion factors for audiological and cardiovascular risk factors. The participants underwent medical examination, measurement of blood pressure, electrocardiogram, blood tests, audiometry, and measurement of noise exposure. The farmers were found to have a higher prevalence of systolic and diastolic arterial hypertension as well as electrocardiogram (ECG) abnormalities compared with the controls. A significant prevalence of arterial hypertension was detected in the farmers exposed to noise, when compared with those who were not exposed. These results suggest that farmers are at risk of cardiovascular effects and that noise is a cardiovascular risk factor for farmers.

Effect of plant foods and beverages on plasma non-enzymatic antioxidant capacity in human subjects: a meta-analysis.

Non-enzymatic antioxidant capacity (NEAC) represents a sensitive biomarker measuring the in vivo antioxidant potential of vegetable foods. To evaluate the effectiveness of plant-derived foods and beverages on the plasma non-enzymatic antioxidant system, we analysed all literature published upto May 2010. Data were extracted by two authors independently, and the effect size was summarised using standardised mean differences by a random-effects model. For the analysis, eighty-eight studies were included, reporting a total number of 122 interventions and involving 2890 subjects. There was overall evidence of the effectiveness of fruit, vegetables, dietary patterns based on plant foods, red wine and tea in increasing plasma NEAC. No changes were found for chocolate and fruit juices. We observed an overall effect size three times higher in subjects with risk factors when compared with healthy subjects. Total radical-trapping antioxidant parameter, oxygen radical absorbance capacity and ferric-reducing antioxidant power methods showed a similar increase in plasma NEAC following dietary supplementation, whereas Trolox equivalent antioxidant capacity did not respond to dietary supplementation. Data from the present meta-analysis show that plant-derived foods represent an effective strategy to enhance an endogenous antioxidant network in humans. This is particularly evident in the presence of oxidative stress-related risk factors.

Risk of upper extremity biomechanical overload in automotive facility.

OBJECTIVE: To assess the risk factors for upper extremity-work-related musculoskeletal disorders (UE-WMSD) on 13 production lines in an airbag factory using the threshold limit values-American conference of industrial hygienists- hand activity level (TLV-ACGIH-HAL) method and introduce the ergonomic improvement to reduce the repetitiveness and the peak force (Pf). METHODS: Professional exposure level on 13 production lines in a automobile factory was measured using the TLV-ACGIH-HAL method and a further risk was assessed according to the ergonomic improvement. RESULTS: The first assessment of 9 production lines showed that the professional exposure level was above the TLV or HAL limit. The second assessment showed that the professional exposure level was below the AL limit on all production lines except 1, in which the professional exposure level was between TLV and HAL. CONCLUSION: The assessment of UE-WMSD-related risk can identify the riskiest emplacements and evaluate the reduction of risk in professional exposure through interventions of structural- organizational type.

Spinal and temporo-mandibular disorders in male workers of the State Police.

OBJECTIVE: The aims of this study are to evaluate the prevalence of disorders of the lumbar region and the temporo-mandibular district co-morbidity in drivers and workers of the State Police employed for different office activities. MATERIALS AND METHODS: The study population included 103 drivers as cases and 100 police officers as controls. The study was carried out through questionnaire and clinical evaluation of the spine and temporo-mandibular region. RESULTS: At clinical examination, the drivers were found to have a higher prevalence (p < 0.05) of both symptoms and clinical signs at the spine and temporo-mandibular joint (TMJ), when compared with the controls. The results also showed a higher prevalence (p < 0.05) of co-morbidity in the two districts among the drivers, when compared with the controls. CONCLUSIONS: These results confirm that morbidity related to back and TMJ and increase in co-morbidity between the two districts are higher in professional drivers.

Exposure to arsenic in urban and rural areas and effects on thyroid hormones.

CONTEXT: Arsenic is a ubiquitous element present in urban air as a pollutant, and it may interfere with thyroid hormones. OBJECTIVE: To evaluate the association between the personal exposure to arsenic and levels of TSH, fT4, fT3, and Tg in urban and rural workers. MATERIALS AND METHODS: Total urinary arsenic and thyroid markers were obtained from 108 non-smoking traffic policemen and 77 subjects working as roadmen in a rural area. Fifty subjects were monitored to evaluate airborne exposure to arsenic. RESULTS: The mean value of exposure to arsenic was 2.9 µg/m(3) in traffic policemen, while the mean value was less than 0.1 µg/m(3) in roadmen. The mean values of urinary arsenic (10.4 µg/g creatinine vs. 5.2 µg/g creatinine; p = 0.000), TSH (1.6 µlU/ml vs. 1.3 µlU/ml; p = 0.006), fT3 (3.5 pg/ml vs. 3.7 pg/ml; p = 0.000), fT4 (1.2 ng/dl vs. 1.3 ng/dl; p = 0.000) and Tg (42.8 ng/ml vs. 36.1 ng/ml; p = 0.04) were significantly different between traffic policemen and roadmen. In traffic policemen, urinary arsenic and arsenic in the air were correlated to the airborne arsenic and TSH values, respectively. Urinary arsenic was correlated to TSH, Tg, fT3, and fT4 values. The multiple linear regression models showed the following associations: i) among urinary arsenic, arsenic in the air and job title; ii) among TSH, fT3, Tg and urinary arsenic; and iii) between fT4 and both urinary arsenic and alcohol intake. CONCLUSION: These results provide information about the relationship between exposure to arsenic and thyroid markers and may be useful for other categories of outdoor workers who are similarly exposed.

Urban pollution.

Air pollution represents a health risk for people living in urban environment. Urban air consists in a complex mixture of chemicals and carcinogens and its effects on health can be summarized in acute respiratory effects, neoplastic nonneoplastic (e.g. chronic bronchitis) chronic respiratory effects, and effects on other organs and systems. Air pollution may be defined according to origin of the phenomena that determine it: natural causes (natural fumes, decomposition, volcanic ash) or anthropogenic causes which are the result of human activities (industrial and civil emissions). Transport is the sector that more than others contributes to the deterioration of air quality in cities. In this context, in recent years, governments of the territory were asked to advance policies aimed at solving problems related to pollution. In consideration of the many effects on health caused by pollution it becomes necessary to know the risks from exposure to various environmental pollutants and to limit and control their effects. Many are the categories of "outdoor" workers, who daily serve the in urban environment: police, drivers, newsagents, etc.

[Shift and night work and mental health]. / Lavoro a turni e notturno e salute mentale.

Aim of our study was to evaluate the influence that shift work and night work could have on mental health. A review of literary articles from 1990 to 2011 on shift work and night work was carried out. The results of this review confirmed that the shift work and night work affect mental health with the onset of neuropsychological disorders such as mood disorders, anxiety, nervousness, depressive anxiety syndromes, chronic fatigue and chronic insomnia irritability, sleep disturbances, reduction in levels of attention, cognitive impairments, alteration of circadian rhythm. Night work and shift work cause severe desynchronization of the cronobiological rhythms and a disruption of social life with negative effects on performance at work, on health and on social relationships. In the light of these results and recognizing shift work and night work as risk factors for the health of workers is necessary to implement preventive and periodic health checks by the occupational doctor to ensure the health and safety of workers taking account of the different environmental and individual factors.

Cardiovascular risk in rotogravure industry.

OBJECTIVE: To verify whether the occupational hazards in the rotogravure industry can be associated with cardiovascular effects. METHODS: We evaluated cardiovascular parameters and audiometric tests and analyzed noise, solvents, and shift work in 44 exposed and 44 unexposed workers. RESULTS: Unlike unexposed workers, the rotogravure workers showed significant increase of mean systolic and diastolic blood pressure (BP) values (P = 0.019; P = 0.003), higher frequency of hypertension (P = 0.002) and electrocardiographic abnormalities (P = 0.0001), significant reduction or no variation of BP response to orthostatism (P = 0.0001), and association between high levels of noise and diastolic blood pressure (P = 0.0067). Subjects with hearing loss showed high frequency of hypertension and a reduction or no variation of BP response to orthostatism (both P = 0.05). CONCLUSIONS: Data obtained suggest that these are the effects on the cardiovascular system of rotogravure workers who are exposed to noise.

Assessment of occupational exposure to benzene, toluene and xylenes in urban and rural female workers.

OBJECTIVES: This is the first research study to compare among female, non-smoker workers: (a) the exposure to benzene, toluene and xylenes (BTXs) in urban air during work in the street (traffic policewomen, TP) vs. work in vehicles (police drivers, PD); (b) the exposure to BTXs in urban environments (in street and in car) vs. rural environments (roadwomen, RW); (c) the values of blood benzene, urinary trans, trans muconic acid (t,t-MA) and urinary S-phenylmercapturic acid (S-PMA) in urban areas (in street and in car) vs. rural areas. METHODS: Passive personal samplings and data acquired using fixed monitoring stations located in different areas of the city were used to measure environmental and occupational exposure to BTXs during the work shift in 48 TP, 21 PD and 22 RW. In the same study subjects, blood benzene, t,t-MA and S-PMA were measured at the end of each work shift. RESULTS: Personal exposure of urban workers to benzene seemed to be higher than the exposure measured by the fixed monitoring stations. Personal exposure to benzene and toluene was (a) similar among TP and PD and (b) higher among urban workers compared to rural workers. Personal exposure to xylenes was (a) higher in TP than in PD and (b) higher among urban workers compared to rural workers. Blood benzene, t,t-MA and S-PMA levels were similar among TP and PD, although the blood benzene level was significantly higher in urban workers compared to rural workers. In urban workers, airborne benzene and blood benzene levels were significantly correlated. CONCLUSIONS: Benzene is a human carcinogen, and BTXs are potential reproductive toxins at low dose exposures. Biological and environmental monitoring to assess exposure to BTXs represents a preliminary and necessary tool for the implementation of preventive measures for female subjects working in outdoor environments.

Environmental and biological monitoring of arsenic in outdoor workers exposed to urban air pollutants.

The aim of this study is to evaluate personal exposure to As in urban air in two groups of outdoor workers (traffic policemen and police drivers) of a big Italian city through: (a) environmental monitoring of As obtained by personal samples and (b) biological monitoring of total urinary As. The possible influence of smoking habit on urinary As was evaluated. We studied 122 male subjects, all Municipal Police employees: 84 traffic policemen and 38 police drivers exposed to urban pollutants. Personal exposure to As in air was significantly higher in traffic policemen than in police drivers (p=0.03). Mean age, length of service, alcohol drinking habit, number of cigarettes smoked/day and BMI were comparable between the groups of subjects studied. All subjects were working in the same urban area where they had lived for at least 5 yrs. Dietary habits and consumption of water from the water supply and/or mineral water were similar in traffic policemen and in police drivers. The values of total urinary As were significantly higher in traffic policemen (smokers and non smokers) than in police drivers (smokers and non smokers) (p=0.02). In the subgroup of non-smokers the values of total urinary As were significantly higher in traffic policemen than in police drivers (p=0.03). In traffic policemen and in police drivers total urinary As values were significantly correlated to the values of As in air (respectively r=0.9 and r=0.8, p<0.001). This is the first research in literature studying the exposure to As in outdoor workers occupationally exposed to urban pollutants, such as traffic policemen and police drivers. Personal exposure to As in the air, as well as the urinary excretion of As, is significantly higher in traffic policemen compared to drivers. These results can provide information about exposure to As in streets and in car for other categories of outdoor workers similarly exposed.

Follicle-stimulating hormone levels in female workers exposed to urban pollutants.

The aim of this study was to evaluate if there were alterations in FSH plasma levels in female outdoor workers (traffic policewomen and drivers) exposed to chemical urban stressors vs. control group. After excluding subjects with main confounding factors, traffic policewomen, drivers and indoor workers were matched by age, working life, socioeconomic status, marital status, menstrual cycle day, age of menarche, habitual consumption of Italian coffee and soy. A total of 129 female subjects were included in the study: some 63 workers studied during proliferative phase and 66 during secretory phase of menstrual cycle. Proliferative phase of menstrual cycle: FSH mean values were significantly higher in traffic policewomen compared to controls (p < 0.05). Results suggest that in outdoor workers exposed to urban chemical stressors there are alterations in FSH levels; therefore FSH may be used as an early biological marker, valuable for the group, used in occupational set.