An Epidemiological Study to Investigate Links between Atmospheric Pollution from Farming and SARS-CoV-2 Mortality.

Exposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that long-term exposure to farming-related air pollutants might predispose to an increased risk of COVID-19-related death. To test this hypothesis, we performed an ecological study of five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily), linking all-cause mortality by province (administrative entities within regions) to data on atmospheric concentrations of particulate matter (PM2.5 and PM10) and ammonia (NH3), which are mainly produced by agricultural activities. The study outcome was change in all-cause mortality during March-April 2020 compared with March-April 2015-2019 (period). We estimated all-cause mortality rate ratios (MRRs) by multivariate negative binomial regression models adjusting for air temperature, humidity, international import-export, gross domestic product and population density. We documented a 6.9% excess in MRR (proxy for COVID-19 mortality) for each tonne/km2 increase in NH3 emissions, explained by the interaction of the period variable with NH3 exposure, considering all pollutants together. Despite the limitations of the ecological design of the study, following the precautionary principle, we recommend the implementation of public health measures to limit environmental NH3 exposure, particularly while the COVID-19 pandemic continues. Future studies are needed to investigate any causal link between COVID-19 and farming-related pollution.

Balance between Health Risks and Benefits for Outdoor Workers Exposed to Solar Radiation: An Overview on the Role of Near Infrared Radiation Alone and in Combination with Other Solar Spectral Bands.

Near infrared or infrared A (IRA) accounts for over 40% of the solar spectrum (SS) and is able to reach subcutaneous tissue as well as the retina. Outdoor workers are occupationally exposed to solar radiation (SR), but the level of exposure may differ widely depending on the job performed, time spent outdoors, latitude, altitude, season, personal protection, etc. Until now, risk assessment and management for outdoor workers has focused on the prevention of both acute and long-term effects on the eye and the skin due to solar ultraviolet radiation (UVR) with little consideration of the other components of the SS (a possible exception is represented by visible radiation with reference to the eye). A growing body of evidence coming from in vitro studies indicates that IRA is involved in cellular reactive oxygen species (ROS) production and may interfere with the respiratory chain in the mitochondria. Moreover, it can modulate gene expression and some metabolic pathways. The biological action of IRA is only partly attributable to a thermal mechanism, should it be also involved in photochemical ones. The cellular and molecular pathways affected by IRA are partly similar and partly different with respect to those involved in the case of visible ultraviolet A (UVA) and ultraviolet B (UVB) radiation. Consequently, the net effect of the SS is very difficult to predict at different levels of the biological organization, making more difficult the final balance of health risk and benefits (for the skin, eye, immune system, blood pressure, etc.) in a given exposure situation. Moreover, few in vivo studies and no epidemiological data are presently available in this regard. Investigating this topic may contribute to better defining the individual exposome. More practically, it is expected to bring benefits to the risk assessment and management for outdoor workers exposed to SS, contributing to: (1) better definition of the individual profiles of susceptibility, (2) more focused preventive and protective measures, (3) better implementation of the health surveillance and (4) a more effective information and training.

Climate change, vector-borne diseases and working population.

INTRODUCTION: Risks associated with climate change are increasing worldwide and the global effects include altered weather and precipitation patterns, rising temperatures and others; human health can be affected directly and indirectly. This paper is an overview of literature regarding climate changes, their interaction with vector-borne diseases and impact on working population. MATERIALS AND METHODS: Articles regarding climate changes as drivers of vector-borne diseases and evidences of occupational cases have been picked up by public databank. Technical documents were also included in the study. RESULTS: Evidences regarding the impact of climate changes on vector-borne diseases in Europe, provided by the analysis of the literature, are presented. DISCUSSION: Climate-sensitive vector-borne diseases are likely to be emerging due to climate modifications, with impacts on public and occupational health. However, other environmental and anthropogenic drivers such as increasing travelling and trade, deforestation and reforestation, altered land use and urbanization can influence their spread. Further studies are necessary to better understand the phenomenon and implementation of adaptation strategies to protect human health should be accelerated and strengthened.

Climate change and occupational allergies: an overview on biological pollution, exposure and prevention.

INTRODUCTION: Climate change, air pollution, temperature increase and other environmental variables are modifying air quality, contributing to the increase of prevalence of allergic respiratory diseases. Allergies are complex diseases characterized by multilevel interactions between individual susceptibility, response to immune modulation and environmental exposures to physical, chemical and biological agents. Occupational allergies introduce a further complexity to these relationships by adding occupational exposure to both the indoor and outdoor ones in the living environment. OBJECTIVE: The aim of this paper is to overview climate-related allergy affecting environmental and occupational health, as literature data are scanty in this regard, and to suggest a management model of this risk based on a multidisciplinary approach, taking the case of biological pollution, with details on exposure and prevention. CONCLUSIONS: The management of climate-related occupational allergy should take into account preventive health strategies, environmental, public and occupational interventions, as well as to develop, implement, evaluate, and improve guidelines and standards protecting workers health under changing climatic conditions; new tools and strategies based on local conditions will have to be developed. Experimental studies and acquisition of environmental and personal data have to be matched to derive useful information for the scope of occupational health and safety.

[The simple measure of handwashing to prevent the risk from biological agents: what has changed since the theories of Semmelweis]. / La semplice misura del lavaggio delle mani per la prevenzione del rischio da agenti biologici: cosa è cambiato dalle teorie di Semmelweis.

In this manuscript, we consider the importance of hand hygiene as the chief measure of prevention and protection in the occupational context. In particular, we remember the physician who lived in the middle of the 19th century, Ignazio Semmelweis, genius but not understood creator of the theory for infection control, based on hand hygiene. Subsequent studies have clearly demonstrated the validity of Semmelweis' research, through scientific publications and the establishment of international guidelines, such as by the World Health Organization (WHO). It is important to remember the initial work and then, sharpen this tool, resulting in the adoption of simple, but effective behavioural practices, that should be spread by several means and tools of information, education and communication, addressed at all involved, for the reduction of exposure to the occupational biological risk.

Airway inflammation in professional divers: FeNO as a marker.

PURPOSE OF THE RESEARCH: The aim of this present study is examine the airway inflammation using the fractional exhaled nitric oxide (FeNO), to detect differences in FeNO measurements in comparison with spirometry and evaluate the use of this technique in health surveillance programs, also in order to determine the suitability to the specific task. WHAT WAS DONE: Between November 2009 and February 2010 we recruited 74 volunteers, all professional divers from the Italian National Fire Services Department. A clinical-medical history questionnaire was administered, with guidance; then the study protocol was applied. Spirometry was conducted to measure respiratory function, and FeNO was assayed. WHAT WAS FOUND: Neither age nor body mass index (BMI) influenced FeNO, but there were significant differences related to smoking, particularly among ex-smokers (p < 0.05). A FeNO value higher than the threshold of 35 ppb was related to the spirometry results and questionnaire answers. WHAT WAS CONCLUDED: This non-invasive method is useful in checking for respiratory disease; divers with high FeNO should be scheduled for further clinical-instrumental investigation and laboratory tests to make sure they have no diving contraindications.

[A brief update on avian influenza and the protection of workers in view of the implementation of the new EU directive]. / Un breve aggiornamento sull'influenza aviaria e la protezione dei lavoratori alla luce dell'attuazione della nuova direttiva comunitaria.

Influenza virus A(H5N1), since its first appearance in Hong Kong in 1997 killing six people, has continuously recorder by 2003 both new cases and deaths between these. Although the media and social attention received in the years between 2006 and 2008, mainly in Italy is not currently present, the same is not true for the avian flu that still exists in some countries. At the regulatory level, at the beginning of 2006 the Ministry of Health indicated the measures to be taken in the national preparedness and response to a pandemic flu, and the national Legislative Decree 25 January 2010, n. 9 makes implementing the EU Directive 2005/94/CE on Community measures to combat avian flu. Moreover, an article published in June 2010 show a new route of transmission of avian viruses by birds. The topic on avian flu, especially aimed at the protection of workers potentially exposed, has been long the subject of studies, and in particular for operators belonging to the Corpo Nazionale dei Vigili del Fuoco (C.N.VV.F.). In particular, in the context of the measures taken to address any outbreak of avian flu, were carried out one manual addressed to operators by C.N.VV.F. and to so-called managers/operators of the emergency public service workers represented by the operators of the C.N.VVF. and of Police, Civil Protection, and Voluntary Organisations of rescue enclosed in Civil Protection Service. It is necessary to reiterate the importance of continued and growing of the preparation and information for workers, brought to the operators themselves useful about the adoption of preventive and protective measures by the workers belonging to groups at risk of potential exposure to avian influenza viruses.

[Value of the microarray for the study of Laboratory Animal Allergy (LAA)]. / II microarray proteico per lo studio dell'allergia da animali da laboratorio (LAA): principi e prospettive.

Since 1989, the National Institute for Occupational Safety and Health (NIOSH) considers the Laboratory Animal Allergy - LAA a risk for workers and in 1998 the LAA has been recognized as occupational risk in the USA. Rat and mouse are the most source of allergens, not so much for the higher power of allergy respect to the other animals, but because represent the more utilized species in the research. Most of the allergens are members of the lipocalin superfamily, small extracellular proteins represented by at least 50 proteins that mainly bind or carry small hydrophobic molecules. The recent and innovative molecular techniques, as the microarray, have allow the characterization of numerous allergens. The protein microarray gives the possibility to study of IgE profile for each individual, simultaneos analysis of a wide number of parameters concerning the allergy, giving new diagnostic and therapeutic opportunities for the allergies. In the study of occupational allergy--as LAA--the protein microarray could improve: the identification and characterization of new allergens; the individuation of susceptible workers; the study of immunological responses in exposed workers; the strategies of prevention and protection; the environmental and housing conditions. The participation, formation and information of the workers could improve the behavioural and occupational practices, the use of personal and collective protective devices in order to reduce the exposure to LAA in occupational context.

Occupational risk associated with Toscana virus infection in Tuscany, Italy.

BACKGROUND: Sandfly fever virus serotype Toscana is endemic in Mediterranean countries and is a widespread public health problem as it may be associated with acute neurological diseases such as aseptic meningitis. AIM: To assess whether Toscana virus infection is associated with occupational exposure. METHODS: During the summer of 2001, a total of 678 blood samples were taken from healthy subjects residing in Tuscany (349 agricultural and forestry workers and 329 control subjects living in the same areas). Information on age, type of job and lifestyle was collected in a questionnaire, and sera were analysed using enzyme-linked immunosorbent assay for Toscana virus-specific antibodies. RESULTS: Seropositivity to antibodies to Toscana virus was 30% in the control group and 23% in the agricultural and forestry workers (P<0.05). Questionnaire responses suggested that, although the agricultural and forestry workers had a potentially greater continuous exposure to sandfly fever virus (outdoor activities, rural residence and at-risk lifestyle), these risk factors did not add significant information about greater susceptibility to disease. CONCLUSION: Our findings indicate a need for better understanding of the best preventive measures to avoid the risk related to sandfly bites, especially for people who live or work in areas at risk.