Sensitive profiling of biogenic amines in human urine by capillary electrophoresis with field amplified sample injection.

In order to monitor biogenic amines in human urine, a method based on field-amplified sample injection combined with capillary electrophoresis and direct UV absorption detection was developed. Dopamine, tyramine, tryptamine, serotonin and epinephrine were effectively separated and identified in human urine samples, and detection limits were 0.072, 0.010, 0.027, 0.010 and 0.120 µmol/L, respectively. Detection limits comparable to laser-induced fluorescence detection or solid phase extraction combined with capillary electrophoresis were achieved. Parameters affecting electrophoretic system detection sensitivity were investigated. Optimal separation conditions were obtained using as background electrolyte a pH 6.5 mixture of 2-(morpholino)ethanesulfonic acid 20 mmol/L and 30 mmol/L phosphate buffer, containing 0.05% hydroxypropylcellulose and 10% v/v methanol. Injections of the sample solution were performed by applying a voltage of 12 kV for 50 s. Recovery and accuracy ranged between 89.4 and 94.9%, and 89 and 112%, respectively. The method was successfully applied on actual urine samples (from a healthy volunteer): target bioamine content was consistent with endogenous levels reported in the literature. The proposed method is simple, fast and inexpensive and can be conveniently employed in work-related stress studies. The affordability and noninvasive sampling of the method allow epidemiological studies on large number of exposed persons to be performed.

Relationship between occupational exposure to cadmium, transaminases and γ-GT in workers exposed to urban stressors.

BACKGROUND: The exposure to Cd has been linked to many disease and liver is the major target organ of Cd toxicity following acute or chronic exposure.No study has ever evaluated the association between liver function tests and exposure to Cd present in urban air in outdoor workers. MATERIALS AND METHODS: In order to assess the relationship between the exposure to urban Cd and the associated changes in liver functionality markers, we conducted a study on 110 municipal policemen divided into 2 groups according to their tasks: 60 traffic policemen and 50 drivers, underwent tests for the determination of the urinary values of Cd correlated with the blood levels of transaminases and ?-GT. Moreover we investigated the exposure to Cd in the air through a personal dosimetry on a subgroup of 40 subjects (20 traffic policemen 20 police drivers). RESULTS: The results showed that the average personal exposure to air Cd was significantly higher in traffic policemen than drivers. Furthermore, in the subset of 40 subjects and in the total sample of 110 subjects, the mean values of urinary Cd were significantly higher in traffic policemen rather than in the police drivers. No significant difference was observed in the mean values of liver functionality in both groups. CONCLUSIONS: Due to the few studies on the effects of the exposure to Cd in big cities, the results of the present study offers useful information about occupational exposure to Cd on the road and in the car and the lack of effects on liver function.

Meta-analysis of studies examining long-term construction injury rates.

BACKGROUND: The construction industry is one of the employment sectors with the highest risk of injuries. AIMS: To evaluate the injury trend in the construction industry from data published from 1987 to 2010. METHODS: All papers with at least two measurements of injuries within a medium- to long-term period were included. The numbers of fatal and non-fatal injuries were examined in two separate groups: 100,000 workers per year and 200,000 worked hours per year. RESULTS: All injuries significantly decreased between the first and the second measurement, with fatal injuries decreasing by 35% and non-fatal ones by 33% in workers/year and by 22% in worked hours/year. There was high heterogeneity among the sources of data for workers/year index (I(2) = 49% for fatal injuries, 99% for non-fatal injuries) but no heterogeneity for worked hours/year index (I(2) = 0). Meta-regression analysis showed a significant linear relationship between time and risk reduction for fatal injuries (r = 0.63; P < 0.001; a 6% reduction per year); trend reduction for non-fatal injuries was not related to the time taken between the measurements. CONCLUSIONS: Fatal injuries have a reduction trend that depends on large interventions, whereas non-fatal injuries are more prone to episodic changes. Furthermore, while the workers/year index allows easier evaluation of the injury rate variation in a single working environment, the worked hours/year index is better at comparing the injury rate variation in different working environments because it reduces the sources of heterogeneity.

[Meta analysis blood and urinary values in urban pollution exposed workers]. / Meta-analisi di indicatori di effetto in lavoratori esposti ad inquinamento urbano.

INTRODUCTION: Aim of this study is evaluating alteration of neuro-immune-endocrine parameters in exposed workers and estimating whether urban pollution can modify them. METHODS: Literature research. Different categories of exposed workers were included in the study (7287) and compared with controls (8054). To calculate results Effect Size (ES) and confidence interval were used. RESULTS: A correlation between urban pollution exposition and some neurogenic mediators and metabolites alterations was demonstrated; blood values can be alterated by toxicity of benzene and by xenobiotic metabolites' mechanism; follicle stimulating hormone is significantly increased in exposed versus controls. CONCLUSIONS: High heterogeneity and literature limitations, together with results of this meta analysis, induce to believe that is necessary to deepen the research about urban pollution effects on these parameters.

[Meta analysis indices of genotoxic damage in urban pollution exposed workers]. / Meta analisi degli indici di danno genotossico in lavoratori esposti a inquinamento urbano.

OBJECTIVES: The aim of this study is to examine if urban pollution can modify indices of genotoxic damage. METHODS: Research of articles inherent in the evaluation of these alterations. Differents categories of exposed workers are included in the study (cases, in number of 7287) and compaired with no exposed workers (controls, in number of 8054). To calculate the result of meta-analysis the Effect Size (ES) was used and the confidence interval was calculated. RESULTS: In this category we evaluated 54 studies and we observed significantly differences in the complex. CONCLUSIONS: Starting from the individual variables analysis investigated, between exposed and not exposed group, we underline the utility to deepen the studies concerning of these parameters, to appreciate their benefits and to safeguard health of exposed workers.

Occupational exposure to traffic pollutants and peripheral blood counts.

Aim of the study is to evaluate whether occupational exposure to low doses of pollutants present in the air of the city selected for the study could cause alterations in peripheral blood counts in workers of the Municipal Police with outdoor tasks vs workers with indoor tasks. 279 non smoker males were enrolled and divided on the basis of their different kind of task. The dosage of air pollutants was carried out through the use of personal air samplers on a representative group of workers. Data obtained were subject to statistical evaluation consisting of Homogeneity of variance test, ANOVA univariate test with post hoc Bonferroni correction, Jonckheere-Terpstra test and multiple linear regression analysis. The differences were considered statistically significant when p values were lower than 0.05. Mean levels of RBC, HB, MCHC, WBC and neutrophil cells were significantly higher in traffic policemen and police drivers compared to controls (workers with indoor tasks). Mean levels of MCV, MCH and lymphocytes were significantly lower in traffic policemen and police drivers compared to controls. These results were confirmed by Multiple linear regression test and Jonckheere-Terpstra test. The results suggest that prolonged occupational exposure to low doses of traffic pollutants can alter some lines of the hematopoietic system in exposed workers.

[Phlebopathies and occupation]. / Flebopatie e lavoro.

Chronic venous disorder is a public health problem that affects the western industrialized countries. The aim of this study is to evaluate the etiology and prevalence of venous disease of the lower limb in workers, and to identify some risk factors using a detailed and systematic analysis of the literature from 1964 to 2011. There is an important relationship between standing position at work and venous disease. The prolonged orthostatic position of the body implies: venostasis, high pressure and risks of blood clots and thrombosis; in standing workers there is an overproduction of reactive oxygen species (ROS) with oxidation of the components of cell membranes, endothelial damage and increase in vascular permeability. Other risk factors were investigated: sitting during work time, weight lifting-moving and exposure to heat sources, the data suggest that this risk factors are less important than orthostatic body position. Age, sex and familiarity are relevant as the extra-occupational risk factors. For a more accurate study of the role of the prolonged orthostatic position on the development of venous disease in the lover limb all authors should define exactly the population, the role and the length of standing time at work. They should also set a universal language to define the correct standing position (ie. within 1 m2 or steps) and time (ie. one hour or 50%-70% of work time). Attention should be given to prevention, to use early therapeutic measures in view of mortality as a consequence of venous disease, of the high social costs related to the loss of working days, of medical care and of residual disability.

Professional exposure to ionizing radiations in health workers and white blood cells.

BACKGROUND: The aim of this study is to estimate if low dose of occupational exposure to ionizing radiations can cause alterations of plasma concentrations of total white blood cells, lymphocytes, monocytes and granulocytes (eosinophils, basophils, neutrophils), in the health workers of a big hospital. METHODS: 266 non smokers subjects of both sexes (133 health workers and 133 controls) were included in this study, compared on the basis of sex, age and working seniority. The complete blood count (CBC) was performed in all included workers. RESULTS: The differences between the mean values were compared using Student T-test for unpaired data. The frequencies of the single variables were compared using Chi (2) test with Yates correction. The differences were considered significant when the P values were < 0.05. The mean values and the distribution of the mean values of total white blood cell were significantly decreased in health workers of both sexes compared to controls. The average values of granulocytes neutrophils were significantly low in female health workers compared to female controls. CONCLUSIONS: The obtained results suggest that low dose of occupational exposure to ionizing radiations is able to influence some lines of the hematopoietic system in exposed workers.

Perceived stress and stress-related parameters.

BACKGROUND: The purpose of this study is to evaluate, using a questionnaire developed by our research group, whether occupational exposure to physical, chemical and psychosocial urban stressors can lead to alterations in perceived stress in a group of both male and female outdoor workers. The study also examines possible correlations between the levels of stress as inferred from the scores of the questionnaire and the levels of certain stress-related parameters (prolactin levels, consumption of coffee, chocolate, alcohol and cigarette smoking). METHODS: We evaluated a final sample of 480 subjects (342 male and 138 female). All workers included in the study were divided into three groups on the basis of scores of the questionnaire. RESULTS: About 60% of workers showed a moderate or severe stress condition, with a statistically significant prevalence of female workers and younger subjects. There was a statistically significant correlation between the questionnaire score and the mean levels of stress-related parameters. The increase of perceived stress increases significantly the mean levels of prolactin and the consumption of coffee, chocolate and cigarettes. There was no statistically significant differences for alcohol consumption. CONCLUSIONS: The results show that exposure to chemical physical and psycho-social urban stressors can influence perceived stress in outdoor workers. The questionnaire used in our research could be an useful instruments for physicians during the health surveillance visits

Environmental and biological monitoring of polycyclic aromatic hydrocarbon levels in outdoor workers exposed to urban stressor.

BACKGROUND: Purpose of this study is to evaluate and to compare the excretion of urinary 1-hydroxypyrene (1-OHPu) in traffic policemen (TP) and drivers (D) of a large Italian city and to evaluate the existence and the degree of correlation between airborne exposure to 15 different polycyclic aromatic hydrocarbons (PAHs) and 1-OHPu levels in the examined population. METHODS: 192 male workers, 115 TP and 77 D, were monitored for 1-HOPu. A subgroup of non-smoking workers (subgroup B: 59 TP and 15 D) was also examined and 15 environmental PAHs was monitored through the personal samplings for the measurement of the particulate phase. RESULTS: The 1-OHPu levels and the values of personal airborne exposure to PAHs were significantly higher among non-smoking TP than among non-smoking D (p < 0.05). In subgroup B the levels of environmental exposure to all the 15 PAHs measured in TP and only 6 of 15 PAHs measured in D were significantly correlated with the values of 1-OHPu (p < 0.05). CONCLUSIONS: Our results suggest that the use of 1-OHPu as an indicator of exposure to PAHs is reliable also for what concerns the study of the low-dose work-related exposure in urban outdoor workers.

Cadmium blood/urine levels and blood pressure in workers occupationally exposed to urban stressor.

BACKGROUND: Cadmium (Cd) is a metal, which induces hypertension in animals. This may not be relevant to the human population because the number of studies is inconsistent. OBJECTIVE: Our aim is to identify an association between levels of blood/urinary cadmium and blood pressure in a group of employees of the municipal police assigned to outdoor activities. MATERIALS AND METHODS: 349 subjects of both sexes were enrolled and sorted on the basis of gender, job function and smoking habit. Blood and urinary cadmium levels and blood pressure readings were collected for each subject. The data were subjected to statistical evaluation. Pearson correlation coefficient between the variables and a linear regression curve was drawn. After eliminating the confounding factors, the multiple linear regression analysis assessed statistical differences. Associations were considered significant at p < 0.05. RESULTS AND CONCLUSIONS: The Pearson correlation showed a positive association between urinary cadmium levels and blood pressure especially for groups of women and non-smokers. The simple and multiple linear regression and t-tests confirmed these associations and underlined the influence cadmium has on diastolic blood pressure, higher than systolic blood pressure. No association was found between blood cadmium and blood pressure. In conclusion, we can say that there is a statistically significant association between urinary cadmium and diastolic blood pressure, supporting the hypothesis that cadmium has a long-term effect on diastolic blood pressure (BP).

Pulmonary nodules in workers exposed to urban stressor.

By multilayer spiral low-dose computed tomography (LD-CT) of the chest this study assesses the early detection of lung lesions on a sample of 100 traffic policemen of a big Italian city professionally exposed to urban pollutants and 100 controls non-occupationally exposed to urban pollutants matched by sex, age, length of service and cigarette smoking habit. Exposure to urban pollutants in traffic policemen was characterized using the annual average concentrations of PM(10), NO2 and benzene in the period 1998-2008 measured by fixed monitoring stations located in different areas of the city. A significant and increasing number of suspicious lung nodules with diameters between 5 and 10 mm was observed: in traffic policemen (including smokers and non-smokers) vs. controls (including smokers and non-smokers); in total smokers (including traffic policemen and controls) vs. total non-smokers (traffic policemen and controls); in smoker traffic policemen vs. smoker controls and vs. non-smoker traffic policemen; in non-smoker traffic policemen vs. non-smoker controls. The RR of finding cases with at least one lung nodule with diameters between 5 and 10mm in traffic policemen (including smokers and non-smokers) compared to controls (including smokers and non-smokers) is 1.94 (CI 1.13-3.31); in total smokers vs. non-smokers the RR is 1.96 (CI 1.20-3.19). The comparison between the interaction exposure and smoking shows an increase in smoker traffic policemen than in smoker controls (RR=2.14; CI 1.02-4.52). The RR for smoker traffic policemen was higher than in non-smoker traffic policemen (RR=2.09; CI 1.19-3.66). The results of our study show that: (1) while smoker workers have a higher risk for developing solid suspicious lung nodules, the simple routinely exposure to urban pollutants is unable to produce the same kind of increased risk; (2) the interaction of smoking and exposure to urban pollutants greatly increases the risk for the development of solid suspicious lung nodules. In conclusion, the use of chest LD-CT in workers at risk helps identify suspicious solid lung nodules at early stage.

[Protection of working woman's health]. / Tutela della salute della donna lavoratrice.

INTRODUCTION: In the past the role of women was mainly that of wife and mother, over the centuries, this role has changed: women assert themselves in every social field and workplace. OBJECTIVES: Analyze the history of women's work, from prehistory to the present day highlighting the evolution of women's role over the centuries. Identify which may be the different occupational stressors, in particular the organizational and psycho-social ones, to which is submitted a working woman. MATERIALS AND METHODS: The authors have analyzed the most relevant data from literature, in particular on the issue of mental health. RESULTS: Provide the main forms of prevention that have to be implemented. DISCUSSION: The main challenge for women today, is to balance work outside the home and housework. This added to job stressors, may interfere with the psychological and physical wellbeing of the worker.

[Algorithm for assessment of exposure to asbestos]. / Proposta di algoritmo per la valutazione stimata dell'esposizione lavorativa ad amianto.

There is no universally approved method in the scientific literature to identify subjects exposed to asbestos and divide them in classes according to intensity of exposure. The aim of our work is to study and develope an algorithm based on the findings of occupational anamnestical information provided by a large group of workers. The algorithm allows to discriminate, in a probabilistic way, the risk of exposure by the attribution of a code for each worker (ELSA Code--work estimated exposure to asbestos). The ELSA code has been obtained through a synthesis of information that the international scientific literature identifies as the most predictive for the onset of asbestos-related abnormalities. Four dimensions are analyzed and described: 1) present and/or past occupation; 2) type of materials and equipment used in performing working activity; 3) environment where these activities are carried out; 4) period of time when activities are performed. Although it is possible to have informations in a subjective manner, the decisional procedure is objective and is based on the systematic evaluation of asbestos exposure. From the combination of the four identified dimensions it is possible to have 108 ELSA codes divided in three typological profiles of estimated risk of exposure. The application of the algorithm offers some advantages compared to other methods used for identifying individuals exposed to asbestos: 1) it can be computed both in case of present and past exposure to asbestos; 2) the classification of workers exposed to asbestos using ELSA code is more detailed than the one we have obtained with Job Exposure Matrix (JEM) because the ELSA Code takes in account other indicators of risk besides those considered in the JEM. This algorithm was developed for a project sponsored by the Italian Armed Forces and is also adaptable to other work conditions for in which it could be necessary to assess risk for asbestos exposure.

[Meta-analysis of respiratory function of workers exposed to asbestos]. / Meta-analisi sulla funzionalità respiratoria nei lavoratori esposti ad amianto.

The monitoring of health conditions in workers exposed to asbestos for prolonged periods is a problematic issue. The Occupational Health physician being required to carry out his activity of prevention of the medical consequences and protection of the workers can use various instruments among which there is the evaluation of lung function. We have performed a meta-analysis on the scientific evidence on this matter in order to identify significant alterations of the lung function parameters in subjects professionally exposed to asbestos compared with controls. By the means of a bibliographic search and the application of selected inclusion and exclusion criteria, we identified 21 articles presenting data from controlled studies. Our results show that the number of controlled trials is very small compared to the totality of studies performed on this matter (1 to 70 ratio) and that the number of the subjects included in the majority of the analyzed studies is oddly divided in the experimental and control group. For this and other reasons the analyzed studies are very heterogeneous. Despite these difficulties, the meta-analysis evidences that some parameters of respiratory functioning are more likely to be influenced by asbestos exposure taking into account the smoking habit and that other parameters are sinergically influenced by both asbestos exposure and smoking. Our meta-analysis points out the necessity to define a common methodology about the technical and operatives procedures in the evaluation of the effects on lung function measures determined by an occupational exposure to asbestos and a thorough examination of the intensity of abnormality levels that could allow using the values obtained from the above mentioned measures in a discriminating diagnostic way.

[Food service workers and cooks: occupational risk assessment]. / Mense e personale addetto alle cucine: valutazione dei rischi occupazionali.

The aim of the study is to evaluate the occupational risks among food service workers and cooks. During the occupational risks assessment the following risk factors must be evaluated: musculoskeletal disorders, chemical risk (cleaning kitchen work surface, dishes, utensils ecc.) biological risk (contact with foods or biological agents) cancerogenic risk (by baking smoke inhalation), and psycho-social stress. In this study the preventive measures and protective equipment to prevent health hazards for these workers have been evaluated (i.e. aspiration hood, adapted ventilation, chosen of less harmful methods of baking, ecc.). In particular the performance of rigid behavioural norms and hygienic procedures is very important for cooks and food service workers to reduce the risk of occupational infections.

[Evidence based medicine and mobbing]. / Evidence based medicine e mobbing.

The phenomenon of the physical, moral or psychical violence in the working environment, variously indicated as "mobbing", "workplace bullying" or "workplace harassment", is to date object of numerous studies, mostly of epidemiological type, which are yet to clear, in a sufficient way, the aspects of that phenomenon, the possible causes, risk factors, constituent characteristics and consequences. Our search, a systematic review of the existing studies in literature and a meta-analysis of the jobs chosen to such scope, has shown that only a small percentage of the researches conducted on the topic is represented from studies that collected original information on the subject. The results of the meta-analysis show that in the category of the mobbed workers the psychosomatic disturbs, stress, and anxiety are greater than in the group of controls and that the perception of the surrounding environment is more negative in the victims of mobbing compared with the not mobbed workers. The value of such results is reduced by the characteristics and the heterogeneity of the studies.

[Night workers and plasmatic cortisol]. / Lavoratori notturni e cortisolo plasmatico.

The aim of the study is to evaluate whether occupational exposure to night work could cause alterations in the levels of plasmatic cortisol. The interest toward this argument arises form several studies in scientific literature referring the presence of an alteration in the synthesis and release of cortisol in workers exposed to night work. We studied a population of workers employed in night security service and monitoring service of alarm systems in different museums compared to a control group not performing shift-work and/or night work. The exposed and control subjects were compared by age, length of service, smoking habit (n. cigarettes per day), habitual consumption of alcoholic drinks (n. glass of wine/beer per day). We evaluated the levels of plasmatic cortisol on 50 workers exposed to night work, all males of whom 30 smokers and 20 non-smokers and on 50 controls of whom 30 smokers and 20 non-smokers.

Plasma 17-alpha-OH-progesterone in female workers exposed to urban pollutants.

The aim of this study is to evaluate whether occupational exposure to urban pollutants could cause alteration in plasma 17-alpha-OH-P levels in female workers. After excluding the subjects with the principal confounding factors, traffic police and controls were matched by age, working life, age of menarche, menstrual cycle day, BMI, drinking habits, habitual consumption of soy and Italian coffee. 68 traffic police and 82 controls (7th day; follicular phase of the ovarian cycle), 37 traffic police and 20 controls (21st day; lutheal phase of the ovarian cycle) were included in the study and matched for the above mentioned variables. In follicular and lutheal phase of ovarian cycle, 17-alpha-OH-P mean levels and the distribution of 17-alpha-OH-P values were significantly higher in traffic police vs. controls. A higher instance of mental health disorders in traffic police vs. controls was found, although the difference was not significant. Considering that the potential confounding effect of extraneous factors was controlled by restricting the study population and by matching traffic police vs. controls on the above mentioned variables, our results suggest that occupational exposure to urban pollutants may alter plasma 17-alpha-OH-P concentrations. 17-alpha-OH-P could be used in an occupational setting as an early biomarker of exposure to urban pollutants, valuable for a group, even before the onset of related pathologies.

Anxiety, musculoskeletal and visual disorders in video display terminal workers.

AIM: The increase in the working population assigned to video display terminals (VDT) has led to ever growing attention to reports on health effects. We studied musculoskeletal and visual disorders and levels of anxiety in 2 groups of VDT operators with different tasks, in order to evaluate if they could be influenced by organizational and intrinsically working factors. METHODS: The study included 190 VDT operators, subdivided into 2 groups (A and B) on the basis of tasks performed and average hours/ week spent at VDT (25 vs 36), and 190 controls not assigned to VDT. Ocular and musculoskeletal subjective symptoms and objective findings were assessed for all subjects, and the State-Trait Anxiety Inventory (STAI) test was administered. RESULTS: For VDT operators of the 2 groups, the relationship between ocular and musculoskeletal symptoms and findings, working life (P=0.0001) and number of hours spent at the VDT (symptoms P=0.001 and P=0.0001; findings P=0.002 and P=0.007), was significant. Group B VDT operators showed significantly higher state anxiety (S-anxiety) levels vs those in Group A and controls (P=0.001); trait anxiety (T-anxiety) was significantly higher in Group B and controls vs Group A (P=0.001 and P=0.03). CONCLUSIONS: Our results confirm the literature data about musculoskeletal and visual disorders and, as for anxiety, seem to denote a higher relevance of factors related to labor organization vs VDT use per se.