Malignant melanoma in Rome, Italy, 1970-9.

An epidemiological study was conducted in the city of Rome and the incidence of malignant melanoma was determined retrospectively for the years 1970-9. All patients had legal residence in Rome and a histological diagnosis of melanoma during that period; only cases of malignant melanoma of the skin (ICD 172, 8th revision) were considered. A total of 17 public and 82 private hospitals were involved in the study with 11 081 and 6127 hospital beds respectively. All the hospitals in the study had one of the following therapeutic and diagnostic facilities: internal medicine, dermatology, oncology, radiology, surgery, plastic surgery, histopathology. Analyses of incidence are based on 500 cases, 237 males and 263 females, collected in the period 1970-9. The data indicate a positive time trend in incidence; the average annual increase is 0.27 cases/year per 100 000. The data show that in a Mediterranean and Latin country such as Italy the incidence of melanoma presents the same ascending trend as that of other Caucasian countries, whether European or not, the slope of the curves is similar for both sexes. The distribution of the primary site for both sexes is closely parallel to that described for all Caucasian populations, the lower limbs being more affected in females and the trunk in males.

Fertility of male workers of the italian mint.

Fertility among workers exposed to metal fumes and solvents in the Italian mint (stampers, founders, and other technical workers) was compared to the reproductive experience of the administrative staff. Data on the reproductive history and time to pregnancy were collected by interview. For workers with children, data on the time to pregnancy (TTP) for the first pregnancy was assessed in relation to occupational risk factors. The groups with the highest prevalence of pregnancy delay beyond 6 months were stampers (21%) and those exposed to solvents (21.5%). Logistic regression did not show a significant association of these job exposures with pregnancy delay, but the power of the study to show an important difference was low. The data are not inconsistent with the hypothesis that male exposure to solvents and metal fumes is associated with an increase in the TTP.

Anophthalmia and benomyl in Italy: a multicenter study based on 940,615 newborns.

Following the report on clusters of anophthalmia and microphthalmia in England and Wales and their possible relation to the pesticide Benomyl, we analyzed the situation in Italy for the period 1986 to 1990 using data from the Italian registries of congenital malformations and national data on Benomyl use. Of 940,615 consecutive births, 33 cases of clinical anophthalmia and 78 cases of microphthalmia were reported (birth prevalence: 0.35 and 0.83/10,000). Birth prevalence by region for 18 of Italy's 20 political regions was evaluated for the two malformations, grouped together after exclusion of defects associated with chromosomal anomalies, no dishomogeneity in space or time among registries or among regions was observed for the study period. In no region was a statistically significant difference identified between observed and expected overall birth prevalence. Correlation analysis between the prevalence of micro/anophthalmia and Benomyl use by region showed a negative, nonsignificant coefficient, and an inverse correlation was found when the 18 regions were divided into four groups by increasing levels of Benomyl use. Parental occupation in agriculture did not seem to be associated with micro/anophthalmia when compared to a control group affected with isolated prearicular tags (odds ratio 0.63; CL 0.07-2.52). On the basis of these results, though the limits intrinsic to ecologic correlation studies must be taken into account, an association between Benomyl use and congenital micro/anophthalmia appears to be unlikely.

Solvents in pesticides.

Solvents are extensively used in pesticide formulations. This study concerns the solvents notified to the Italian Registry of Pesticides, which has information on approximately 8000 pesticide formulations. Solvents with evidence of carcinogenicity in humans or animals, including benzene, chloroform, carbon tetrachloride, 1,2-dichloroethane, 1,4-dioxane, and 2-nitropropane, have been notified for use in pesticides. Exposure to such solvents could partly explain some of the reported excesses of leukemia and non-Hodgkin's lymphoma among farmers.

Evaluation of the effects of L-acetylcarnitine on senile patients suffering from depression.

Twenty-eight patients aged between 70 and 80 years affected by depressive disturbance as defined by DSM III R (cat. 300.40) were subdivided at random into two homogeneous groups of 14 each. One group was treated with 500 mg three times a day of L-acetylcarnitine (LAC) in tablet form, while the other received placebo. Each patient was evaluated by the Hamilton Rating Scale for Depression, the Beck Depression Inventory, the Sandoz Clinical Assessment--Geriatric, and by clinical global impression. This investigation establishes that LAC is effective in counteracting symptoms of depression in the elderly. Relief of depressive symptomatology is expressed by decreased scores in the Hamilton Rating Scale for Depression and Beck Depression Inventory and by beneficial effects with regard to behavioural aspects.

[Influence of temperature and humidity on the reproductive efficiency of Ixodes ricinus (Linnaeus, 1758) and Hyalomma marginatum Koch, 1844 (Ixodoidea, Ixodidae)]. / Influenza della temperatura e dell'umidita' sull'efficienza riproduttiva di Ixodes ricinus (Linnaeus, 1758) e Hyalomma marginatum Koch, 1844 (Ixodoidea, Ixodidae).

Laboratory studies have been carried out on two species of ticks, I. ricinus and H. marginatum, showing different seasonal activity and different geographical distribution in nature. The purpose of the present study has been to investigate the effect of different combinations of temperature and humidity on the oviposition of I. ricinus and H. marginatum. An index of reproduction efficiency (no. eggs/wt female), established to relate the capacity of the females to produce eggs to their body weight, has been calculated; for I. ricinus 5 temperatures (18-20-25-27 and 30 degrees C) have been studied (Fig. 1), for H. marginatum 3 (25-30 and 32 degrees C) (Fig. 2) and for both species 2 R.H. (75-95%). An optimal range of temperature, within which the value of such an index doesn't change, has been demonstrated for both species by statistical testing (Table 1). A critical weight value as the minimum engorged female weight required for egg deposition has been identified with the weight of first female which has laid eggs. This weight, different in each species, is influenced by temperature and humidity.

Localized augmentation of the maxillary sinus floor through a coronal approach for the placement of implants.

Excessive pneumatization of the maxillary sinus subsequent to the loss of teeth frequently interferes with the placement of osseointegrated implants. Many techniques have been developed and tested to reduce the size and alter the anatomy of the sinus to augment the quantity of bone available for an adequate number of prosthetically well-placed implants of a satisfactory length. Most of these describe extensive one- or two-stage sinus grafting procedures that are usually performed through a lateral approach. A technique of localized elevation of the maxillary sinus floor through a less-invasive crestal approach is presented here. Ninety-seven implants were placed with this technique between 1991 and 1998. The healing was always uneventful, without any sign of pathologic reaction in the maxillary sinus. Eighty-six implants were successfully loaded for a period between 6 and 90 months (mean 35 months). Eight implants failed to integrate, and three were lost after different periods of function, for a cumulative success rate of 88.6%.

[Human reproduction and environmental risk factors]. / Riproduzione umana e fattori di rischio ambientale.

Environmental pollution is a great cause of concern, in particular, growing attention is being paid to the potential of many chemicals to affect the reproductive system in humans. The key role of prevention and control of reproductive hazards is recognized world-wide. Many chemicals have been shown to impair fertility and/or prenatal and perinatal development in experimental studies. However, a sufficient evidence of an effect on human reproduction is available for some compounds only. The use of biological markers may improve the assessment of exposure to chemicals, contribute to identify mechanisms of action and put into evidence early, reversible, biological effects. Valid biological markers are also needed in epidemiological studies: without reliable data on the level of current and past exposures it is difficult to establish a causal relationship between a pollutant and the occurrence of adverse health effects. A multidisciplinary approach to risk assessment is required. Priorities for interdisciplinary research on environmental chemicals and reproduction include the identification of susceptible population subgroups and risk assessment of exposure to multiple chemicals.

[Relations between coronary risk factors and mortality for cancer in the Italian areas of Seven Countries Study (author's transl)]. / Relazioni tra fattori di rischio coronarico e mortalità per tumore nelle aree italiane del Seven Countries Study.

PIP: An analysis of cancer mortality over a 10-year period in Italy is presented. Data are from the Italian part of the Seven Countries Study, an international investigation into the epidemiology of coronary heart disease. The analysis confirms that coronary risk factors provide a useful guide to the prediction of cancer mortality, particularly in association with factors related to age, smoking habits, body weight, and diabetes. (summary in ENG)^ieng

A database on pesticides in Italy: a progress report.

An existing database on pesticides, running in the DOS/Windows environment, is operative at the National Institute of Health and has yielded useful informations for several published researches. The database is currently being restructured for the purpose of making it available on the Web. An HTML interface, allowing to formulate queries on the database from the Web is presently under development, and it will be made available, once the problems related to confidentiality of certain parts of the database are solved. The database in its present form is presented and necessary changes foreseen in the Web edition are discussed.

[Risk perception and self-assessment of exposure to antineoplastic agents in a group of nurses and pharmacists]. / Percezione del rischio ed autovalutazione dell'esposizione ad antiblastici in un gruppo di infermieri e farmacisti.

Many antineoplastic drugs have shown to be carcinogenic, teratogenic and mutagenic to humans and exposure and absorption have been showed to occur during the preparation and administration in health care practise. More recently, in many countries, national health authorities concern has been focused on promoting actions aimed to protect health of the personnel handling these drugs. The present study reports the results of a survey carried out through a questionnaire among the pharmacists and nurses working in the health care settings located in the province of Rome (Italy), with the aim to survey: occupational risk perception of health care workers; their confidence in the safety measures adopted in the work practice; their knowledge of risk factor and the kind of training received regarding these specific agents. Among the respondents, most of the pharmacists (80%) and nurses (90.4%) show a high concern about antineoplastic drugs dangerousness. At the same time, they state not to have a satisfactory level of knowledge regarding the risk factor and, also that their main information source on occupational risk connected to antineoplastic drugs exposure is not the health care structure, where they are employed. Besides, they do not show a high level of confidence in the safety measures adopted in the health care structures with the aim to protect workers' health. The study results suggest the necessity to promote the development of preventive actions aimed to minimise occupational exposure to these substances through the implementation of procedures and controls in the hospitals, as well as the use of work practice and protective equipment, reinforced by workers education and training.

[Exposure to pesticides in greenhouses and male fertility]. / Esposizione a pesticidi in serra e fertilità maschile.

We attempt to study fertility problems among workers exposed to pesticides, comparing the reproductive experience of greenhouse workers and administrative staff working in the Health Local Units of the same geographical area (reference population). Data on reproductive history and time to pregnancy (TTP) at first pregnancy were collected by personal interview. For workers with children, we collected data on TTP in relation to the occupational risk factors. The analysis of TTP was conducted among 127 greenhouse and 173 administrative workers married and aged 20-55. The greenhouse workers reported 232 pregnancies and a mean number of 1.8 children; the controls 270 and 1.6 respectively. For greenhouse workers the mean TTP in months (5.4 with SD 5.6) resulted longer than for controls (3.9 with SD 5.6). The risk for conception delay (beyond 3 months) by exposure category of the man adjusted for age of woman, smoking of man and woman at first pregnancy resulted 2.4 higher for a subgroup of greenhouse workers with higher exposition (CI 95% 1.2-5.1).

[Occupational exposure and male fertility. Results of an Italian multicenter study in an exposed population]. / Esposizioni occupazionali e fertilità maschile. Risultati di uno studio italiano multicentrico tra popolazioni esposte.

It was believed that occupational exposure to several toxic agents could negatively affect male fertility. This paper reports the results of a study on the fertility of couples in whom the man was occupationally exposed to three different toxics: metals, solvents and pesticides, having effects on reproduction. Fertility was evaluated during the time that elapsed between attempting and achieving the first pregnancy of the couple (time to pregnancy--TTP). Exposure to occupational risks during the period preceding conception was defined on the basis of data collected from 153 workers of a mint (exposed to metal and solvents), 322 agricultural workers licensed to handle pesticides and 127 greenhouse workers. Comparing the groups exposed during the conception period with comparable non-exposed groups, we found a slight delay in conception among couples with male exposure to metals (OR = 1.3; 95% CI 0.5-3.6), to solvents (OR = 1.7; 95% CI 0.6-4.6) and to pesticides among greenhouse workers (OR = 1.6; 95% CI 0.8-3.1 for the moderately exposed and OR = 2.4; 95% CI 1.2-5.1 for the heavily exposed). No increase in the risk of conception delay was observed in agricultural workers with generic exposure to pesticides. The results of this study suggest that the workers exposed to metals and solvents and greenhouse workers exposed to pesticides experienced a delay in conception at the time of their wives' first pregnancy.

[Agricultural antiparasitics evaluated for their potential cancerogenic, mutagenic and toxic reproductive effects]. / Antiparassitari agricoli valutati per potenziali effetti cancerogeni, mutageni E tossico-riproduttivi.

This paper reviews the evaluations of the potential carcinogenic, mutagenic and toxic-reproductive effects of the active ingredients and solvents contained in the pesticide products used in Italy. The information on the products (name and CAS number of the active ingredients and of the solvents, number of the products in which they are present, and the range of concentration percentages of a.i.) were obtained from the Pesticide Registry, a database operating at the Italian National Institute of Health since 1985. The evaluations of the toxic effects of these products are those which have been formulated by the Italian National Advisory Toxicological Committee, the European Union, the International Agency for Research on Cancer, and the Environmental Protection Agency of the United States. The aim of this study was to present an ample organic review of the main information issued by national and international centers on pesticides, chemicals of wide occupational use and diffusion in the environment. The presence is highlighted of some substances with carcinogenic potential (for example, 1,3-dichloropropene, alachlor, formaldehyde) for which it is therefore, necessary to carry out a careful risk assessment regarding exposure to many substances for which further study is indicated, and for others which have not, so far, produced toxic effects (bentazon, cypermetrin). Benzene "a proven human carcinogen" was present in three products. In addition, the presence was observed out of mixtures of active ingredients and solvents for which clear evidence of carcinogenic and/or reproductive toxicity exists. This information can be useful to assess the carcinogenic risk associated to pesticides in the occupationally exposed population, as also established in official regulations.

Mortality among workers of three thermoelectric power plants in northern Italy: a retrospective cohort study.

During the last ten years, interest has been focussed on occupational exposure in thermoelectric power plants (i.e., coal dust, polycyclic aromatic hydrocarbons, dioxin, dielectric liquids, PCB's, asbestos, etc.), although available evidence on its effects on the health status of the occupational population are far from being definitive. A retrospective cohort study was carried out to investigate the association between exposure to risk factors and mortality for cancer in three thermoelectric power plants located in the north-east of Italy. The three plants studied started with oil and coal but since 1968 they utilized mostly coal as fuel. In spite of the different fuel used at the beginning, the production process has been fairly constant since the main conversion from oil to coal with a substantial increase in power production. A total of 1,772 male workers were included in the total study cohort and followed-up from 1968 to 1987, with a total of 22,090 person-years of exposure. Eighty percent of the cohort began to work in the plant before 30 years of age, and had a mean period of employment of 9.5 years. The cohort was completely traced to the end of the follow-up period by using an original computer system based on personal fiscal codes. Causes of death were ascertained in the municipalities where the deaths occurred and coded according to the International Classification of Disease, IX Revision. During the study period 68 deaths were observed with an SMR for all causes of death equal to 0.79.(ABSTRACT TRUNCATED AT 250 WORDS)