How to improve performance and prevent burnout in safety representatives.

BACKGROUND: The present work is part of a greater research project, aimed to examine Safety Representatives' (SRs) role, twenty years after the appointment of this figure. OBJECTIVES: The study aims to investigate the role of some personal and organizational dimensions in the promotion of SRs' well-being, in terms of reducing burnout and improving performance. METHODS: The study involved 455 SRs operating in North East Italy. They completed a self-report questionnaire, regarding conflicts with co-workers, ethical conflict, training satisfaction, work engagement, performance, and burnout. RESULTS: Structural equation models show that work engagement partially mediates (γ=-0.52, p<0.001; ß=0.23, p<0.01) the relationship between conflict with co-workers and performance (γ=-0.26; p<0.01), as well as partially mediating (γ=0.14, p<0.05; ß=0.23; p<0.01) the relationship between training satisfaction and performance (γ=0.21, p<0.001). Moreover, it totally mediates the relationship between conflict with co-workers and burnout (γ=-0.52, p<0.001; ß=-0.40, p<0.001), as well as totally mediating the relationship between training satisfaction and burnout (γ=0.14, p<0.05; ß=-0.40, p<0.001). Finally, ethical conflict is positively associated with burnout (γ=0.047, p<0.001). CONCLUSIONS: This study provides useful information about the improvement of SRs' well-being, highlighting the importance of their involvement in this role.

Aberrant promoter methylation in genes related to hematopoietic malignancy in workers exposed to a VOC mixture.

Occupational exposure to volatile organic compounds (VOCs) may cause hematopoietic malignancy, either by single exposure to benzene or possibly due to a concomitant exposure to several VOCs. Since oxidative stress, inflammation and DNA repair pathways are closely involved in cancer development, the effect of VOC exposure on expression of proteins involved in these pathways has been studied, but epigenetic changes have not been well described. Here, DNA methylation status following occupational exposure to a VOC mixture was assessed by bisulfite sequencing of the promoter regions of seven genes involved in the mentioned pathways. Peripheral blood samples and individual-level VOC exposure data were obtained from healthy leather shoe factory workers (LS, n=40) and gas station attendants (GS, n=36), as well as a reference group of university employees (C, n=66). Exposure levels for acetone, ethylbenzene, methyl ethyl ketone, n-hexane, toluene and xylene were higher in LS (p<0.001); benzene and methyl acetate levels were higher in GS (p<0.001). TOP2A, SOD1, and TNF-α promoter methylation status was increased in LS (p<0.05). In LS, we also found significant correlations between GSTP1 promoter methylation and both iNOS (r=0.37, p=0.008) and COX-2 (r=-0.38, p=0.007) methylation. In exposed groups, ethylbenzene exposure levels showed a significant correlation with TOP2A methylation (ß=0.33). Our results show early, toxic effects at the epigenetic level caused by occupational exposure to high levels of a VOC mixture. These subcellular modifications may represent the initial mechanism of toxicity leading to hematopoietic malignancy, possibly due to a synergistic, hematotoxic effect of VOC mixtures.

Assessment of exposure to oak wood dust using gallic acid as a chemical marker.

OBJECTIVES: The American Conference of Governmental Industrial Hygienists (ACGIH) has classified oak dust as a human carcinogen (A1), based on increased sinus and nasal cancer rates among exposed workers. The aims of this study were to investigate the use of gallic acid (GA) as a chemical marker of occupational exposure to oak dusts, to develop a high-performance liquid chromatography-diode array detector method to quantify GA and to apply the method in the analysis of oak dust samples collected in several factories. METHODS: A high-performance liquid chromatography method was developed to detect GA in oak wood dust. The method was tested in the field, and GA was extracted from inhalable oak wood dust collected using the Institute of Occupational Medicine inhalable dust sampler in the air of five woodworking plants where only oak wood is used. RESULTS: A total of 57 samples with dust concentrations in the range of 0.27-11.14 mg/m(3) were collected. Five of these samples exceeded the Italian threshold limit value of 5 mg/m(3), and 30 samples exceeded the ACGIH TLV of 1 mg/m(3). The GA concentrations were in the range 0.02-4.18 µg/m(3). The total oak dust sampled was correlated with the GA content with a correlation coefficient (r) of 0.95. CONCLUSIONS: The GA in the tannic extracts of oak wood may be considered a good marker for this type of wood, and its concentration in wood dust sampled in the work environment is useful in assessing the true exposure to carcinogenic oak dust.

Woodworkers and the inflammatory effects of softwood/hardwood dust: evidence from nasal cytology.

Our primary aim was to use nasal cytology to compare a group of woodworkers with a group of unexposed subjects to see whether wood dust exposure correlates with specific patterns of inflammatory or infectious rhinitis. A secondary aim was to seek any differences in nasal symptoms or nasal cytology between workers exposed to softwood vs hardwood dust, thereby comparing the inflammatory harmful potential of the two woods. Among 117 woodworkers at factories in the Veneto region (Italy), 40 exposed to either softwood or hardwood dust were assessed by means of a questionnaire, nasal cytology, and personal wood dust sampling, and compared with 40 unexposed controls. Woodworkers reported significantly more nasal symptoms than controls (p = 0.0007). The woodworker group's nasal smears contained significantly more neutrophils (p < 0.00001) and lymphocytes (p = 0.02) than the control group's. The softwood workers had significantly lower levels of personal exposure to wood dust than the hardwood workers (p = 0.04); there were no significant differences in age, history of cigarette smoking, or period of exposure between these two sub-cohorts of woodworkers. A statistical trend indicated that softwood workers had more eosinophils (p = 0.05) and lymphocytes (p = 0.05) in their rhinocytograms. Nasal cytology revealed chronic inflammatory rhinitis in a significant proportion of woodworkers' enroled in this study. It also suggested a different harmful potential for softwood and hardwood dust. Nasal cytology could prove useful in screening woodworkers for chronic inflammatory rhinitis. Further investigations are needed to examine the role of different types of wood dust in nasal inflammation.

High-frequency hearing thresholds: effects of age, occupational ultrasound and noise exposure.

PURPOSE: It has been suggested that high-frequency audiometry (HFA) could represent a useful preventive measure in exposed workers. The aim was to investigate the effects of age, ultrasound and noise on high-frequency hearing thresholds. METHODS: We tested 24 industrial ultrasound-exposed subjects, 113 industrial noise-exposed subjects and 148 non-exposed subjects. Each subject was tested with both conventional-frequency (0.125-8 kHz) and high-frequency (9-18 kHz) audiometry. RESULTS: The hearing threshold at high frequency deteriorated as a function of age, especially in subjects more than 30 years old. The ultrasound-exposed subjects had significantly higher hearing thresholds than the non-exposed ones at the high frequencies, being greatest from 10 to 14 kHz. This hearing loss was already significantly evident in subjects with exposure <5 years and increased with years of exposure and advancing age. The noise exposure group had significantly higher hearing thresholds than the non-exposed group at the conventional frequencies 4 and 6 kHz and at the high frequency of 14 kHz. After stratification for age, there was a significant difference between the two groups at 9-10 and 14-15 kHz only for those under 30 years of age. CONCLUSION: Multivariate analysis indicated that age was the primary predictor, and noise and ultrasound exposure the secondary predictors of hearing thresholds in the high-frequency range. The results suggest that HFA could be useful in the early diagnosis of noise-induced hearing loss in younger groups of workers (under 30 years of age).

Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach.

OBJECTIVES: Recently published works showed that occupational exposure to antineoplastic drugs (ANPD) is still frequent in hospital settings, despite significant safety policy improvements. The aim of this study was to assess the current level of occupational exposure to ANPD and any potentially associated cytogenetic damages in hospital nurses routinely handling ANPD. METHODS: Occupationally ANPD-exposed (n = 71) and ANPD-unexposed (n = 77; control) nurses were recruited on a voluntary basis from five hospitals in Northern and Central Italy. Evaluation of surface contamination and dermal exposure to ANPD was assessed by determining cyclophosphamide (CP) on selected surfaces (wipes) and on exposed nurses' clothes (pads). The concentration of unmetabolized CP­as a biomarker of internal dose­was measured in end-shift urine samples. Biomonitoring of genotoxic effects (i.e., biological effect monitoring) was conducted by analyzing micronuclei (MN) and chromosome aberrations (CA) in peripheral blood lymphocytes. Genetic polymorphisms for enzymes involved in metabolic detoxification (i.e., glutathione S-transferases) were analyzed as well. RESULTS: We observed a significant increase in MN frequency (5.30 ± 2.99 and 3.29 ± 1.97; mean values ± standard deviation; p < 0.0001) in exposed nurses versus controls, as well as in CA detection (3.30 ± 2.05 and 1.84 ± 1.67; p < 0.0001), exposed subjects versus controls. Our results provide evidence that, despite safety controlled conditions, ANPD handling still represents a considerable genotoxic risk for occupationally exposed personnel. CONCLUSIONS: Because both MN and CA have been described as being predictive of group-increased cancer risk, our findings point to a need for improving specific safety procedures in handling and administering ANPD.

The mediating role of interpersonal conflict at work in the relationship between negative affectivity and biomarkers of stress.

This study examined the association between interpersonal conflict at work (ICW) and serum levels of three possible biomarkers of stress, namely the pro-inflammatory cytokines Interleukin 1 beta (IL-1ß), Interleukin 12 (IL-12), and Interleukin 17 (IL-17). Additionally, this study investigated the role of negative affectivity (NA) in the relationship between ICW and the pro-inflammatory cytokines. Data from 121 employees in an Italian healthcare organization were analyzed using structural equation modeling. Results showed that ICW was positively associated with IL-1ß, IL-12, and IL-17, after controlling for the effect of gender. Moreover, ICW completely mediated the relationship between NA and the pro-inflammatory cytokines IL-1ß, IL-12, and IL-17. This mediating effect was significant after controlling for the effect of gender. Overall, this study suggests that work-related stress may be associated with biomarkers of inflammation, and that negative affectivity may influence the stress process affecting the exposure to psychosocial stressors.

[The teaching of occupational medicine in the Master of Science in Medicine in the twenty years since the introduction of Table XVIII]. / L'insegnamento della Medicina del lavoro nel corso di laurea magistrale in Medicina e Chirurgia a vent'anni dall'introduzione della Tabella XVIII.

In 1991, the implementation of the new programme for education and training in Medicine and Surgery has introduced the teaching of Occupational Medicine (OM) as a compulsory subject for all medical students. After two decades from that event and in conjunction with the implementation of the new academic departments introduced by the law 240/2010, the aim of the present study was to address the current status and the main characteristics of education and training, including clinical activities, in OM in Italian Universities and to update the information on the related academic human resources available. A questionnaire was developed to investigate the different features of the academic staff belonging to the area of OM (SSD MED/44), and to evaluate the organization of teaching and the clinical activities performed by the Occupational Medicine sections. The results showed that among the 40 Italian universities with a degree course in Medicine and Surgery, 67% of them have at least one full professor, 72% one associate professor and 78% one assistant professor belonging to the area of OM. Nevertheless, a steady decrease in the number of academic staff is observed with time, which caused a lack of presence of the discipline in some universities. In most degree courses in Medicine and Surgery the teaching of OM is usually included in an integrated course together with other disciplines such as General and Applied Hygiene and/or Forensic and Legal Medicine. Within the integrated course the number of University Education & Training Credits (CFU, corresponding to approx. 25 hrs of teaching overall) assigned to OM is generally between 2 and 3 (61% of cases). The teaching of OM is also present in eight different master degree courses (MSc) and in 33 different triennial degree courses (BSc). To support the teaching clinical activities, such as workers' health surveillance, laboratories, ambulatories, and DH or inpatient activities are performed, in one or more of these forms, by almost all of the OM institutions. The findings of this study, despite being subject to change rapidly with time, still provide an invaluable set of information and should represent, therefore, a rational basis for planning the future recruitment of academic staff and for updating the contents and methodologies of graduate education and training in Occupational Medicine in Italian universities.

Chemical markers of occupational exposure to teak wood dust.

A novel high-performance liquid chromatographic/ultraviolet method was developed to detect lapachol (LP) and deoxylapachol (DLP) in wood dust as chemical markers of teak wood (a suspected human carcinogen). The specificity of this analysis was determined by noting the absence of LP and DLP in 12 other specimens of different woods belonging to the angiosperm family. The consistency was examined by analyzing teak from three different sources, where the percentages (wt/wt) of the chemicals ranged from 0.006 to 0.261 for LP and from 0.038 to 0.497 for DLP, respectively. Although the LP and DLP components of teak varied according to source, a very high correlation coefficient (r (2) > 0.98 always) was found between the content of the two markers in the bulk specimens and in bulk dust derived from them. The method was then applied to teak dust collected on polyvinylchloride filters from aerosol in an exposure chamber in the range of mass loadings between 0.03 and 3.65 mg, which corresponds to a dust exposure between 0.124 and 8.703 mg m(-3) for a sampling time of 2h. A field test was also carried out in a small factory where teak was used. A good correlation was confirmed between LP and DLP versus the dust collected on the filter in both cases. LP and DLP can be markers to estimate the true quantities of teak dust inhaled in a workplace with mixed wood dust, provided the results are matched to the content of LP and DLP in the bulk wood. LP and DLP have also been proposed as the agents responsible for allergic reaction to teak dust. Therefore, it would be useful to evaluate the exposure to these two substances even without a relationship to teak dust exposure.

[The role of occupational physician in the risk assessment]. / II ruolo del medico competente nella valutazione del rischio.

Occupational Physician has a marginal role in the Risk Assessment (RA). He is rarely involved and generally he only reads the documentation of RA made by other specialists in the prevention and safety. The law obliges him to work with the Employer, not only for the planning of health surveillance but also for the preparation of measures for the protection of the health and psycho-physical integrity of workers. But it is mainly for the content and methodology of the RA that it is necessary the contribution of the occupational physician. The RA is in fact a multi-stage and multi-disciplinary activity carried out in close collaboration with industrial hygienists, ergonomists, safety experts, psychologists. The occupational physician for his studies and education is the most appropriate professional to evaluate the quality of the data and to make an integration between indicators of environmental contamination and biological indicators of internal dose and effect or damage. We agree with the Italian Society of Occupational Health and Industrial Hygiene that is necessary to proceed to the recognition of the role of occupational physician as a "consultant" of the company about health and safety in the workplace and involved in RA even when it is not necessary the health surveillance.

Hyaline droplet accumulation in kidney of rats treated with hexachloro-1:3-butadiene: influence of age, dose and time-course.

The present research investigates the occurrence of hyaline droplet (HD) accumulation related to age, dose and time after treatment in male Wistar rats given a single i.p. injection of hexachloro-1:3-butadiene (HCBD). In the study on age, rats from 1 to 12 months of age were treated with 100 mg kg(-1) body weight (b.w.) HCBD dose. Rats treated at 2 months of age showed a greater accumulation of HD than the other age groups; HD accumulation was not observed in 1-month-old rats. In the dose-response study, the treatment with 25, 50 and 100 mg kg(-1) b.w. at 2 months of age caused HD accumulation in the proximal convoluted tubule at all doses, with the 100 mg kg(-1) b.w. group slightly more affected. Finally, in the time-course study, rats treated with a 100 mg kg(-1) b.w. dose at 2 months of age and sacrificed at 6, 12, 24, 48, 72 and 96 h post-dosing showed a time-related HD accumulation in terms of incidence and severity, after 6 h, with a peak at 24 and 48 h and decreasing at 72 and 96 h. The present results show that HD accumulation is an early finding, and is unrelated to dose level and particularly evident in rats of 2 month of age. These findings in male rats treated with HCBD emphasize the importance of considering the age of rats at the start of a study. The more sensitive model was used in the detection of nephrotoxic effects of chemicals.

[Considerations on the limit values for benzene]. / Considerazioni sui valori limite per il benzene.

Occupational exposure limits and guideline values for the general population proposed for benzene by several international bodies are discussed and compared with the Italian and EU occupational limit values, taking also into account the criteria used for their derivation. Benzene is an environmental pollutant, and the EU guideline value for ambient air is 5 microg/m3, based on carcinogenic risk. Presently, occupational exposures are greatly reduced, and in many instances close to those of the general population. Consequently, it does not seem to be appropriate to maintain the Italian and the EU occupational exposure limits of 1 ppm (3.2 mg/m3), which are inconsistent with the ALARA principle and not justified by technological constraints. It should be pointed out that, in any case, preventive interventions should be carried out, beyond the compliance with the established limit values, in order to ensure the lowest exposure and by carrying out biological monitoring as a tool to verify the appropriateness of risk management measures.

[Presenteeism and workers' health: effects of mediation on psycho-physical stress in a longitudinal study]. / Presenteismo e salute dei lavoratori: effetti di mediazione sullo strain psico-fisico in un'indagine longitudinale.

The present work aims to investigate the phenomenon of presenteeism, a construct still little studied, especially in Italy, in its medical, psychological, social and economic implications. In the first part we propose a review of the international literature, and of the meanings, causes and consequences of the phenomenon on individual and organizational health. In the second part, we present a study which involved, for a period of about a year, 326 workers of a company in the engineering industry. This study is, in this writers' knowledge, the first survey--characterized by a longitudinal design and a multi-method approach, both not very present also in the international literature--carried out in our country on the phenomenon of presenteeism. The survey examines the mediating role of presenteeism in the relationship between specific risk factors of work context and content--career growth, conflict with colleagues, social rewards--and the psycho-physical strain. The risk factors were detected through a self-report instrument at the beginning of the year. The workers, at the end of the same year, were subjected to a healthcare surveillance visit in which the competent physician evaluated the psycho-physical strain. The hypothesized relations have been tested by estimating a structural equation model with observed variables. What emerged was a negative association between social rewards and presenteeism and a positive relation between conflict with colleagues and presenteeism. Instead, no association between growth and presenteeism emerged. Presenteeism, in turn, predicts psycho-physical strain. Overall, presenteeism mediates the relationship between social rewards and strain, as well as between interpersonal conflict and strain, but not between growth and strain. This work is characterized by some innovative aspects compared to previous studies conducted on the subject, both in theory and methodology. From a theoretical point of view the hypothesized model aims to capture specific risk factors of the process leading to the formation of work stress, through the role of presenteeism. From a methodological point of view the adoption of a longitudinal and multi-method research design allows a better understanding of the relationships between the variables investigated, often limited by the exclusive use of self-report instruments in cross-sectional designs. Finally, the possible interventions aimed at preventing presenteeism and minimizing its negative consequences on health are discussed.

[Monitoring of the occupational and environmental exposure to low doses of benzene]. / Il monitoraggio dell'esposizione occupazionale ed ambientale a basse dosi di benzene.

AIM: To verify which of the various biomarkers of internal dose of benzene can be considered reliable for biological monitoring of exposure to the low concentrations present nowadays in working and living environments. MATERIALS AND METHODS: The specific literature was analyzed to assess the reliability of the different biomarkers of internal dose. RESULTS AND CONCLUSIONS: T,t-muconic acid is a non specific biomarker for benzene, valid for exposure to concentrations up to one order of magnitude less than the threshold limit of 3250 microg/m3. S-phenylmercapturic acid (SPMA) is a reliable marker even for exposure to concentrations up to two orders below the threshold value of 3250 microg/m3, and can be considered the biomarker of choice for biological monitoring of workers exposed to benzene. Urinary benzene does not seem to have any real advantages over SPMA for monitoring occupational exposure to benzene, but it does seem to be more reliable than SPMA to assess exposure to concentrations like those present in living environments. A smoking habit influences the urinary excretion of all the described biomarkers, and for the current low levels of occupational and environmental exposure to benzene, must be taken into account when interpreting the results of biological monitoring.

[Risk assessment of chemical agents]. / La valutazione del rischio da agenti chimici.

The risk assessment of chemical agents is a well known and applied process carried out by Industrial Hygienists and Occupational Physicians based on exposure evaluation. The application of REACH (CE 1907/2006), CLP (CE 1272/2008) and SDS (UE 453/2010) introduces some changes and instruments to carry out the occupational exposure assessment, like new classification of substances, Exposure Scenario, suggested control measures that the Industrial Hygienist and the Occupational Physician must evaluate. If there is not a similar Exposure Scenario to apply a new risk assessment must carried out also by recommended software (ECETOC Targeted Risk Assessment; Easy to use workplace EMKG; Stoffenmanager). Looking at the relevance of the control measures and evaluation of Exposure Scenario we report the flowchart of risk assessment and management by the Method of Organisational Congruencies carried out with the Prevention and Protection Service and Occupational Physician Office of the Health Service of the Azienda Provinciale of Trento.

[Threshold values for chemical agents in the light of the REACH regulation]. / I valori limite per agenti chimici alla luce del regolamento REACH.

The European Regulation 1907/2006 (REACH--Registration, Evaluation, Authorization and Restriction of Chemicals) obliges manufacture companies and import chemicals to assess the risks arising from their use and to take the necessary measures to manage the risks identified. The Chemical Safety Report provides an accurate assessment of hazards to human health and the environment necessary to prepare an exposure scenario for the "identified uses" of the substance. An exposure scenario is the set of conditions that describe how the substance is manufactured or used during its life cycle and how the manufacturer or importer controls, or recommends downstream users to control the 'exposure to humans and the environment. Firms therefore need specific skills. The spectrum of toxicological risk is extremely large, the information required in some cases are very complex and undoubtedly require a thorough knowledge in toxicology and environmental industry. The expertise and experience in toxicology of the occupational physician in this case may become useful in the environmental field as well as another familiar figure of relevant importance is the occupational hygienist who develop exposure scenarios for workers and their uses experience for the exposure scenarios for the consumer. It provides an obvious involvement of medical toxicologists and occupational hygienists for public tasks of control and inspection of chemical safety reports and, locally, even the accuracy of risk that arise from this.

Validity of new biomarkers of internal dose for use in the biological monitoring of occupational and environmental exposure to low concentrations of benzene and toluene.

OBJECTIVES: This study analyzes the validity of new, more sensitive and specific urinary biomarkers of internal dose, namely, urinary benzene for benzene and urinary toluene and S-benzylmercapturic acid (SBMA) for toluene, to assess their efficacy when compared to traditional biomarkers for biological monitoring of occupational exposure to low concentrations of these two toxic substances. METHODS: Assessment was made of 41 workers occupationally exposed to benzene and toluene, 18 fuel tanker drivers and 23 filling-station attendants, as well as 31 subjects with no occupational exposure to these toxic substances (controls). Exposure to airborne benzene and toluene was measured using passive Radiello personal samplers worn throughout the work shift. In urine samples collected from all subjects at the end of the workday, both the traditional and the new internal dose biomarkers of benzene and toluene were assessed, as well as creatinine so as to apply suitable adjustments. RESULTS: Occupational exposure to benzene and toluene resulted significantly higher in the fuel tanker drivers than the filling-station attendants, and higher in the latter than in controls. Significantly higher concentrations of t,t-muconic acid (t,t-MA), S-phenylmercapturic acid (SPMA), urinary benzene, SBMA and urinary toluene were found in the drivers than the filling-station attendants or the controls. Instead, urinary phenol and hippuric acid were not different in the three groups. In the entire sample, airborne benzene and toluene values were significantly correlated, as were the respective urinary biomarkers, showing coefficients ranging from 0.36 to 0.98. Subdividing the subjects by smoking habit, higher coefficients were evident in non-smokers than in smokers; at multiple regression analysis t,t-MA, SPMA and urinary benzene and toluene were dependent on the number of cigarettes smoked daily and on airborne benzene and toluene, respectively. Instead, SBMA was dependent only on airborne toluene. CONCLUSIONS: Our research confirmed the validity of t,t-MA and SPMA for use in the biological monitoring of exposure to low concentrations of benzene. Urinary benzene showed comparable validity to SPMA; both parameters are affected by smoking cigarettes in the hours before urine collection, so it is best to ask subjects to refrain from smoking for 2 h before urine collection. Urinary toluene was found to be a more specific biomarker than SBMA.

DNA single- and double-strand breaks by alkaline- and immuno-comet assay in lymphocytes of workers exposed to styrene.

Occupational exposure to styrene was studied in 34 workers employed in the production of fiberglass-reinforced plastic sheets and compared to 29 unexposed healthy controls. We evaluated genotoxic effects induced by occupational styrene exposure in lymphocytes by alkaline version of the comet assay to detect single-strand breaks (SSBs), DNA oxidation products (formamido pyrimidine glycosilase (Fpg)- and endonuclease (Endo III)-sensitive sites) and DNA repair kinetics studies, as well as the neutral version of comet assay for DNA double-strand breaks (DSBs). An innovative aspect of this study was the use of immuno-comet assay, a new technique that recognizes DSBs with specific antibody by DAPI/FITC method. The battery of parameters included markers of external and internal exposure. Exposed workers showed significant high levels of SSBs (p<0.0001) and DSBs (p<0.0001) in neutral- and immuno-comet assay. A drastic decrease in DNA repair activity as compared to controls was observed (180 min vs. 35 min). Styrene workplace concentration significantly correlated with alkaline comet parameters (TM, p=0.013; TI, p=0.008), in negative with TL (p=0.022), and with DNA-base oxidation (TM Endo III, p=0.048 and TI Endo III, p=0.028). There was a significant negative correlation between urinary metabolites (MA+PGA) and TM Endo III (p=0.032) and TI Endo III (p=0.017).