Relationship between lead exposure and mild cognitive impairment.

INTRODUCTION: Since it is still controversial whether-low-to moderate long-term lead below current threshold values causes neurobehavioural deficits in adults. METHODS: Forty lead-exposed workers subjects with a mean blood lead (PbB) level of 56.4 µg/dL and 40 non-lead-exposed aged matched subjects (PbB: 15.4 µg/dL) with the same socio-economic background were investigated. Participants were administered a neuropsychological tests consisting of BAMT (Branches Alternate Movements Task), FT (Finger Tapping Speed), DS (Digit Span) POMS (Profile of Mood States). RESULTS: Authors noted a significant relationship between the exposed and the referent groups in tests mainly involving executive functions, short time memory and psycho-emotional variables. In addition, Poisson regression test performed on single psychoemotional factors (POMS), has allowed to evidence a significant influence of Pb e ZPP levels on tension, anxiety and depression. CONCLUSIONS: The present study showed that lead exposure among adults at levels previously considered safe, results in impairment of certain cognitive abilities.

[Assessment of occupational stress among shopping centre employees]. / Valutazione dello stress lavoro correlato nei lavoratori di un centro commerciale.

Occupational stress literature emphasizes the importance of assessment and management of work related stress. The recognition of the harmful physical and psychological effects of occupational stress on both individuals and organizations is widely studied in Europe. In Italy such legislation was introduced by Legislative Decree 81/2008. Objective of the present study was to evaluate the occupational stress level of a shopping centre employees. A sample of 50 workers, 54% male (n = 27) and 46% female (n = 23) underwent to the Occupational Stress Index (OSI) questionnaire, used to examine occupational stress level of employees through the evaluation of work organization, individual characteristics, coping strategies, and psychosomatic effects of the stress. The results of OS were compared to the stress levels of a reference population. Results of data analysis provided evidence that the work organization of the examined shopping centre was good and there was no correlation between work characteristics, personality patterns, coping strategies and the psychosomatic effects of the stress. In addition a negative relationship between job satisfaction and length of service was found. Improvements in working conditions as well as early diagnosis are essential for preventing further increases in these disorders among workers. The next step would be multidisciplinary intervention studies aimed at the work environment, with the goal of identifying scientifically-based strategies that are most effective in preventing occupational stress.

[Column and upper limb muscoloskeletal disorders in drivers helpers]. / Valutazione dei disturbi e delle patologie muscolo- scheletriche del rachide e degli arti superiori in autisti soccorritori.

The past two decades have witnessed a sharp rise in the incidence of work-related musculoskeletal disorders (WMSD) off the upper extremities and low back pain. The high frequency of these Pathologies and the estimated costs induced a large number of searcher to indentify causes etiological and preventive measure. Epidemiological surveys have inquired people mainly devoted to health clinic, where nurses and health assistants partner; are few data on the rescuers drivers and operators of emergencies. In the sample considered the 3.9% presented abnormalities in at least one section of the column, the 3.8% presented borne disorders of the cervical spine and backbone for the past 12 months. No major disturbances emerged dependents of the upper limbs, pain in the wrist, paraesthesia day and night; No subject also reported disturbances hands as evidenced from examination goal. The 2.3% reported having had an accident at work with prognosis of less than 30 days and 06% over 30 days. The results showed that, through prevention program it is possible to reduce musculoskeletal disorders in specific occupations such as drivers and operators of emergencies.

[Prevalence of Staphylococcus aureus methicillin-resistant (MRSA) among health care workers]. / Prevalenza di Staphylococcus aureus meticillino-resistente (MRSA) tra gli operatori sanitari.

Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of Staphylococcus that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. Staphylococcus infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities. The present study was performed to investigate the in vitro activity of oxacillin and other antimicrobial agents against S. aureus strains obtained from nursing personnel. The study included 56 hospital personnel of Universitary Policlinic of Messina. S. aureus strain was isolated in 14 samples (25%); resistent patterns have been studied and results have demonstrated: none methicillin resistant, while 14% oxacillin and tetraciclin resistant. The incidence of methicillin sensitive was 100%, while 86% proved to be sensitive to oxacillin and tetraciclin. In conclusion, the usually hygienic methods (disposable gowns, hygienic hand disinfection after each patients contact, masks use when is a risk of aerosolization of MRSA) are indicate for significantly reducing of these strains. Continuing education programmes can help to increase awareness among hospital staff.

[Asthenopia in VDT users: our experience]. / Astenopia e lavoro al VDT: nostra esperienza.

The aim of this study was to investigate the relationship between asthenopia and work with video display terminals (VDT). 62 office workers (29 males and 33 females), that use VDT for more than 20 hours each week, were investigated by means of standardized questionnaires (elaborated by the Italian Society of Occupational Medicine and Industrial Hygiene). The authors analyzed the prevalence of occupational asthenopia and its correlation with the duration of weekly VDT use and the presence of refractive alterations. It was demonstrated a prevalence of asthenopia of 51% and a statistically significant correlation between the entity of asthenopic symptoms and number of weekly hours and years of work at VDT, in particular in subjects with presbyopia.

[Work related low-back pain: prevention and strategies of rehabilitation]. / Lombalgia lavoro correlata: prevenzione e strategie riabilitative.

Back disorders are a major health problem in many occupations. Physical loads at work, such as manual materials handling frequent bending and twisting, lifting, and forceful movements, have been identified as possible risk factors for low back pain (LBP). Aim of the present study was to evaluate the rehabilitative treatment in the chronic lumbago.

[Hand-arm vibration syndrome and upper limbs diseases in the forest workers of Italia meridionale]. / Sindrome da vibrazioni mano-braccio e patologie degli arti superiori in lavoratori forestali dell'Italia meridionale.

Vibration exposure of the hand-arm system is associated with an increased risk of upper-limb vascular, neurological and musculoskeletal lesions, or hand-arm vibration syndrome (HAVS). The prevalence of occupational HAVS and upper-limb disorders was studied among 278 Forestry Service workers in Sicily and Calabria. Subjects who used chain-saws (18 weeks/year) had a greater prevalence of peripheral sensory-neural disturbances (28%), upper-limb musculoskeletal disorders (33%) and carpal tunnel syndrome (19%) compared with 260 manual workers from the same Corps not exposed to hand-transmitted vibration. Raynaud's phenomenon was comparable in exposed and control subjects (5.3% vs. 4.7%.) Upper-limb neuropathies were significantly associated with energy-equivalent frequency-weighted acceleration; exposure duration; and cumulative vibration dose (m2/s4h). The variable "years of work with vibrating tools" was strongly associated with peripheral neuropathies; carpal tunnel syndrome; and upper-limb musculotendinous syndromes. Data suggest that in Sicily and Calabria, where the climate is milder than in other areas of Italy, forestry work with hand-held vibrating tools does not entail a greater prevalence of peripheral vascular disorders (Raynaud's phenomenon), while the prevalence of occupational upper-limb neurological and musculoskeletal disorders, in which combined ergonomic and mechanical risk factors have a large pathogenic role, is significantly increased.

[Screen dermatitis and visual display units]. / Screen dermatitis e videoterminali.

Over the last fifteen years, the increasing prevalence of screens and electromagnetic devices used in a number of activities has determined the occurrence of new emerging clinical problems. Hence the need to evaluate the ergonomic aspects of the professions using such equipment to study the effects of electromagnetic fields on human health. The objective difficulties to standardize the studies on this field makes controversial the debate on the evidences in support of these nosographical entities and on the possible causative factors. One interesting area is that of dermatological diseases. The authors present the results of a study on the incidence of dermatological diseases of the face and of the neck in a population of screen workers. To achieve this goal subjects underwent dermatological counselling during the periodic of monitoring visits. Subjects were then identified in two groups: screen workers and as a control group, subjects not exposed to electronic equipments. Members of the first group when compared with those of the second, suffered more frequently from skin diseases, although there was just a statistical trend. However skin diseases were distributed with different frequency in the two groups and seborrheic dermatitis was much more represented among screen workers.

[Air pollution in urban areas as a risk factor for health in the general population and in workers. Environmental and biologic monitoring of 1-3 butadiene]. / L'inquinamento atmosferico delle aree urbane come fattore di rischio per la salute della popolazione generale e lavorativa. monitoraggio ambientale biologico dell'1-3 butadiene.

Exposure to 1,3-butadiene (BD), a probable carcinogen to humans, was investigated in two groups of subjects working in a refinery plant: 28 occupationally exposed workers and 21 subjects non-occupationally exposed controls. BD in blood was higher in the exposed workers than in controls. Excretion of urinary mercapturic acids N-acetyl-S-(3,4-hydroxybutyl)-l-cysteine (MI), was not influenced by occupational exposure. The present study shows that unmetabolised BD in biological fluids, represents the biomarker of choice for assessing occupational exposure to low airborne concentrations of BD.

Simulating real-life exposures to uncover possible risks to human health: A proposed consensus for a novel methodological approach.

In real life, consumers are exposed to complex mixtures of chemicals via food, water and commercial products consumption. Since risk assessment usually focuses on individual compounds, the current regulatory approach doesn't assess the overall risk of chemicals present in a mixture. This study will evaluate the cumulative toxicity of mixtures of different classes of pesticides and mixtures of different classes of pesticides together with food additives (FAs) and common consumer product chemicals using realistic doses after long-term exposure. Groups of Sprague Dawley (CD-SD) rats (20 males and 20 females) will be treated with mixtures of pesticides or mixtures of pesticides together with FAs and common consumer product chemicals in 0.0, 0.25 × acceptable daily intake (ADI)/tolerable daily intake (TDI), ADI/TDI and 5 × ADI/TDI doses for 104 weeks. All animals will be examined every day for signs of morbidity and mortality. Clinical chemistry hematological parameters, serum hormone levels, biomarkers of oxidative stress, cardiotoxicity, genotoxicity, urinalysis and echocardiographic tests will be assessed periodically at 6 month intervals. At 3-month intervals, ophthalmological examination, test for sensory reactivity to different types of stimuli, together with assessment of learning abilities and memory performance of the adult and ageing animals will be conducted. After 24 months, animals will be necropsied, and internal organs will be histopathologically examined. If the hypothesis of an increased risk or a new hazard not currently identified from cumulative exposure to multiple chemicals was observed, this will provide further information to public authorities and research communities supporting the need of replacing current single-compound risk assessment by a more robust cumulative risk assessment paradigm.

[Influence of microclimate factors on ocular discomfort in video display terminal workers]. / Influenza dei fattori microclimatici sul discomfort oculare in lavoratori addetti al VDT.

The objective of the present research was to evaluate the effect of environmental parameters (temperature, air velocity, relative humidity, illumination level, cubature) on ocular symptoms (tiredness, tearing, redness, blinking, itching, burning, photophobia, foreign body sensation, and heaviness) in a group of 54 male Video Display Terminal (VDT) workers. The subjects were employed in a public office placed in Messina and naturally ventilated; the investigation was performed in Spring time. Information about the ocular symptoms, occurring during the workshift, were gathered through a questionnaire; environmental measurements were performed by a data collector LSI. The results showed that 43 subjects out of 54 (79%) reported a lack of eye comfort; in addition the illumination level, temperature and air velocity were not consistent with those suggested by the Italian Regulatory Authority. A significant correlation between illumination level, temperature, air velocity and eye discomfort (tearing, heaviness, blinking, photophobia itching, respectively) was found. The Authors conclude that the inadequate environmental condition, possibility in interaction with the indoor chemical contaminants and the workload at VDT, may be responsible for the irritative eye symptoms complained by VDT-workers at workplace.

[Occupational brucellosis in slaughtering of sheep and goats: study of five cases from a municipal abattoir in south-eastern Sicily]. / Brucellosi professionale nella macellazione degli ovi-caprini: studio di 5 casi di un mattatoio comunale della Sicilia orientale.

BACKGROUND: Brucellosis is a world-wild zoonosis of bacterial origin. In Italy, where reporting of the disease is mandatory, the incidence is 2.1 cases every 100,000 inhabitants, but tends to be higher in southern regions. However, the incidence decreased from 1999 to 2002. CASES: Five cases of occupational brucellosis, four slaughter-house operators and one veterinary surgeon, were reported in a slaughter-house in south-eastern Sicily employing 15 people. RESULTS: A study of the slaughtering process for sheep and goats led to identification of 23 different operations, some of which involved greater probability of infection: animal consignment; unloading and leading animals from the stable to the trap; strangling and bleeding; skinning and removal of mammary glands; removal and processing of abdominal viscera; post-mortem examination; mobile equipment and facility maintenance, and washing/disinfection. All affected workers had participated in one or more of these operations. CONCLUSION: Eradication of brucellosis in stock-farms should lead to the disappearance of the human disease, since the two are closely related. Despite legislation aimed at eradicating brucellosis in cattle, which has been in force since 1992, the prevalence of the human disease has risen in Italy, especially in Sicily. Within the framework of prevention, occupational physicians should exercise specific surveillance of brucellosis risk by carefully examining the plasma antibody content of workers involved in the slaughtering process. Occupational health physicians should also provide ad hoc information regarding the infectious agent and modes of transmission during slaughtering operations as well as specific training in the use of protective equipment, which is the only way of providing protecting from contagion by infected animals.

The veterinary surgeon in natural disasters: Italian legislation in force.

Law No. 225/1992 established a National Service of Civil Protection, with the important role of 'safeguarding life, goods, settlements and the environment from damage deriving from natural disasters, catastrophes and calamities' (art. 1). This law arranges civil protection as a co-ordinated system of responsibilities administrated by the state, local and public authorities, the world of science, charitable organisations, the professional orders and other institutions, and the private sector (art. 6). The President of the Republic's Decree No. 66/1981 'Regulation for the application of Law No. 996/1970, containing norms for relief and assistance to populations hit by natural disasters--Civil Protection' mentions veterinary surgeons among the people that are called upon to intervene. In fact, in natural disasters the intervention of the veterinary surgeon is of great importance. The authors examine these laws and other legislation relating to the National Service of Civil Protection.

[Chronic pelvic pain in women and prevalent orthostatic work. Preliminary results of a study on health staff of the surgical field]. / Dolore pelvico cronico nella donna e lavoro ortostatico prevalente. Risultati preliminari di uno studio condotto sul personale sanitario dell'area chirurgica.

BACKGROUND: The purpose of this research is to estimate the causal and/or pre-existing causal influence of some working factors, such as the standing (position) in pelvic pain syndrome, in relation to the reduction in working performance. METHODS: The research was carried out by means of an inclusive questionnaire, the purpose being to analyse anamnestic and working information. The questionnaire was proposed to a group of female sanitary staff selected in relation to their working activity. RESULTS: Examination of the questionnaire shows prominently the association between pelvic pain and orthostatic working activity, kept not below 4-6 hours each duty. In fact, 70% of the people selected have reported this mutual relationship. CONCLUSIONS: Working activities in the orthostatic position can produce pelvic pain, whose origin and intensity seem to be related to extended orthostatic working activity. The mechanism by which the upright position can produce an outbreak of pelvic pain in women seems to be linked to the compression on abdominal vessels, with slowing-down and reduction of the hematic uterine discharge.

Alteration in alpha 2 integrin immunocytochemical expression on cultured human gingival fibroblasts following nicotine exposure.

BACKGROUND: Clinical epidemiologic studies carried out in smokers versus non smokers support the concept that tobacco-related factor may affect the periodontal tissues and wound healing. METHODS: In this study, the role of nicotine on the integrin alpha 2 chain immunocytochemical expression, in human gingival fibroblasts (HGF) was investigated in vitro. The kinetic induction of this type of integrin on HGF in response to increasing percentage of nicotine was been characterized. A human gingival fibroblast strain, derived from a healthy individual with non-inflamed gingiva, was used in this study. The cells were then grown on acetylated microscope slides and fixed with cold ethanol, samples were then incubated for 16 to 19 hrs at 4 degrees C to anti-human alpha 2 integrin chain monoclonal antibody. RESULTS: In control cultures and in HGF treated with 0.025 microM nicotine the initial higher expression of alpha 2 chain decreased (grade 1 in both culture) while in HGF treated with 0.075 microM increased (grade 3). After 48 hours HGF exposed to 0.075 microM nicotine, increased further their expression of alpha 2 chain. CONCLUSIONS: The results obtained demonstrate a dose-time dependent nicotine influence on immunocytochemical expression of alpha 2 integrin chain. These data suggest that nicotine may promote a collagene breakdown via an increase of alpha 2 integrin chain expression.

[Work and eye discomfort: relationship between symptoms and signs of conjunctival changes. A protocol for health surveillance]. / Lavoro e discomfort oculare: relazione tra sintomi e segni di alterazioni congiuntivali. Un protocollo di sorveglianza sanitaria.

The purpose of this paper is to present a surveillance health protocol concerning the procedures and measurement suitable to highlight the "Office Eye Syndrome". Some researches showed that fully enclosed environment, with air conditioning system and sealed windows promotes objective changes accompanied by self reported complaints. Therefore it is important to perform a regular health check-up to prevent the ocular surface disturbances.

[Noise-related occupational risk aboard fishing vessels: considerations on prevention and the protection of exposed workers]. / Il rischio rumore a bordo dei pescherecci: alcune considerazioni sulla prevenzione e protezione degli esposti.

Recent legislation regarding the safety of workers aboard fishing vessels requires the appointment by ship owners of a Reference Physician in charge of health surveillance, preventive inspections and related tasks. As maritime workers, especially fishermen, have always been excluded from legal protection of occupational health, there are no exhaustive data on the incidence of their occupational disease. Several epidemiological studies of fishermen have evidenced a high prevalence and incidence of occupational conditions, among which noise-related hypoacousia. We report data of a phonometric survey conducted aboard six fishing vessels carrying a crew of less than six fishing in the mid-Adriatic. Measurements were performed during fishing and navigation aboard five vessels fitted with a fixed-pitch propeller and during fishing only aboard one vessel fitted with an controllable pitch propeller. Measurements were conducted: 1) in the engine rooms; 2) in the work area on deck; 3) at the winch; 4) in the wheelhouse; 5) in the mess-room and kitchen; 6) in the sleeping quarters. Results show that the equivalent sound pressure level in the engine rooms consistently exceeded 90 dBA on all vessels. The speed of the vessels fitted with the fixed-pitch propeller is 3-4 knots in the fishing phase and around 10 knots during navigation to and from the fishing grounds; noise emission is lower with the former regimen because of the smaller number of engine revolutions per minute. Our survey demonstrated considerably different noise levels in the various areas of vessels. One key element in workers' exposure, the tasks assigned and the environmental working conditions is of course the type of fishing in which the vessel is engaged. Further phonometric studies are required to assess the daily level of exposure per crew member, which represents the reference for the noise-related risk of each subject. Knowledge of the sound pressure levels in the work environment and the length of daily exposure of each crew member will allow to assess the level of occupational exposure and consequently enact the proper prevention and protection measures by the Reference Physician.

[Occupational activity with risk of leptospirosis. Prevention and health surveillance]. / Rassegna delle attività lavorative a rischio d'infezione da leptospire. Prevenzione e sorveglianza sanitaria.

The analysis of the epidemiological studies carried out in Italy give us the idea for a very precise survey of the occupational leptospirosis. We have identified the occupational hazards and the precautionary measures. In Italy the first epidemiological data about human leptospirosis goes back to 1917. During following decades were highlighted several occupational forms of leptospirosis, specifically seasonal epidemics among rice-workers. Epidemiological studies carried out in Italy from 1950 to 1990 showed that leptospirosis was again widespread although precautionary measures and there was a probable spread of the "minor leptospirosis" at the same time of common cases of "major leptospirosis". The latest data issued by Ministry of the Health related years '94-'97 confirm the persistence of leptospirosis, for the most part in the north. However there is a problem of underestimate because many times human leptospirosis show itself with minor clinical forms. In the working environment is essential the function of the Medico Competente. He must avail himself of the precautionary measures for the biological risk specified in D.lgs 626/94.

[Work and video terminals: eye discomfort and blepharitis. Preliminary data]. / Lavoro al videoterminale: discomfort oculare e blefariti. Dati preliminari.

Blefaritis is one of the most common ocular disorders encountered in clinical practice. The clinical manifestation primarily occurs along the lid margin, and the predominant symptoms are itching and burning. In addition, the inflammation could cause a dysfunction of meibomian gland; this condition leads to ocular surface abnormalities. Objective of the present study was to determine if the Visual Display Terminals (VDT) work get worse the signs and symptoms of blefaritis in a group of 35 VDT operators. Results showed a correlation between burning, itching and corneal fluorescein staining and hour number a day of VDT work in the workers affected by blefaritis. The Authors concluded that VDT work can get worse the signs and symptoms of blefaritis.

[Retrospective study on the prevalence of latex allergic pathology in health personnel]. / Studio retrospecttivo sulla prevalenza di patologia allergica da latice negli operatori sanitari.

To evaluate the prevalence of latex sensitisation and latex-related symptoms, we performed a study on 837 hospital employees. All subjects were asked for medical and occupational history, and underwent Skin Prick Test (SPT) with latex and other airborne allergens. The results showed a prevalence of latex sensitisation of 6.1% and a prevalence of symptoms of 5.26%. The most frequent symptoms were oculorhinitis, dermatitis and asthma. The one-year retrospective evaluation showed, in a group of 767 hospital attendants selected by the whole population, an incidence of sensitisation of 0.26%; no new cases of latex-related symptomatology were observed. The improvement of symptoms was due to the reduction of the exposure to latex gloves. The results of the study confirm the importance of prevention strategies.