[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.

[In vitro exposure of U937 cells to potassium dichromate: study of apoptosis]. / Esposizione in vitro di cellule U937 a dicromato di potassio: studio dell'apoptosi.

The aim of our study is to evaluate the genotoxic damage of cells treated with different concentrations of potassium dichromate. For this reason we have utilised U937 cells, a cellular line derived from acute promyelocytic leukaemia. Our results show that the minimum concentration of potassium dichromate induces apoptosis in the U937 cells and is of 600 microM, already after 12 hours, the cells treated with potassium dichromate with a concentration of 500 microM presented an apoptosis of 27% while the respective control showed a base apoptosis of 9.5%. Our experimental data indicate that the model adopted by us, may be a valid instrument to study the cytotoxic effects of compounds containing Chromium. In particular we have evidenced a clear genotoxic effect of these compounds demonstrated by a significant increase of the apoptosis percentage which is time and dose dependent.

[Techniques for administering inhalation anesthetic agents, professional exposure, and early neurobehavioral effects]. / Tecniche di somministrazione di agenti anestetici per inalazione, esposizione professionale ed effetti neurocomportamentali precoci.

BACKGROUND: Occupational exposure to high concentrations of anaesthetic gases can cause neurobehavioral effects in operating room personnel. The measures taken to reduce waste gas exposures, including the installation of active scavenging devices and airconditioning systems, are not effective, so that the NIOSH recommendations for maximum exposure are currently unattainable in practice. OBJECTIVES: The aim of the present study was to measure operating room pollution and neurobehavioral functions in a group of anaesthesiologists during open-system and low-flow anaesthesia. METHODS: Environmental concentrations of N2O and isoflurance were measured by an infrared gas analyzer (Brüel & Kjaer) in open system and in low flow anaesthesia. Under the same stress condition, but with different exposure levels to anaesthetic gases, psychomotor vigilance and response speed were evaluated four times with the Reaction Time Test at the beginning and at the end of the first weekday shift and at the beginning and at the end of the last weekday shift. Exclusion criteria were considered excessive alcohol and coffee intake and use of CNS medication. RESULTS: Concentrations of N2O and isoflurane in the operating room were 4.83 ppm and 0.4 ppm respectively, which are lower compared with open systems: 301 ppm and 11.1 ppm respectively. The mean of the Reaction Time was significantly higher (p < 0.01) during work with the open system compared to work in low flow at the end of the first weekday shift and at the end of the last weekday shift. CONCLUSIONS: Low-flow anaesthesia appears to be effective in reducing waste gas exposure: lower flows produced lower values and protect the integrity of neurobehavioral functions.

[Prevalence of HCV in health care workers in Southern Italy]. / Prevalenza dell'HCV negli operatori sanitari del Sud Italia.

PURPOSE: To assess the prevalence of hepatitis C virus (HCV) in the population exposed to biological risk of two hospitals in southern Italy. PATIENTS AND METHODS: All health care workers of two main hospitals of Sicily, potentially exposed to biological risk underwent health surveillance. Health care personnel were arranged into seven occupational group, and five age bands (< 30, 31-40 years, 25-30 years, 41-50, 51-60 years, > 60 years). We estimated the prevalence of hepatitis C infection in 1800 healthcare workers by means of nucleic acid amplification and genotype by means of sequencing, the workers were also tested for liver function. RESULTS: The overall prevalence of anti-HCV was 2.1%, corresponding to 39 persons. The prevalence in health workers was higher in nurses than in surgeon, group perceived to be at greatest risk of occupational exposure, and higher in elderly workers (> 45 years) than in younger ones. CONCLUSION: Prevalence of anti-HCV in our study was higher than in blood donors, and lower than in general population in southern of Italy. The 45% of HCV infected healthcare workers were unaware of their condition and their potential to infect patients. Testing for HCV infection should be routinely performed for health care workers to detect the infection, which frequently results in a chronic asymptomatic carrier state for many years before the development of symptomatic liver disease, and perform precocious therapy with interferon.

[Environmental monitoring of occupational exposure to glutaraldehyde at a hospital]. / Monitoraggio ambientale dell'esposizione professionale ad aldeide glutarica in una azienda ospedaliera.

BACKGROUND: To evaluate the air pollution in operating theatres of a Sicily Hospital produced by 2% alkaline solutions of glutaraldehyde, which is used to disinfect flexible endoscopy units, filling tanks and cleaning surfaces. Personnel reported subjective symptoms as: headache, dizziness, anxiety, drowsiness on the job, loss of attention, irritation of the skin and respiratory tract. METHODS: Environmental valuation of glutaraldehyde was made by infrared photoacustic spectroscopy. RESULTS: The final results is not very comforting infact we found value of glutaraldehyde which exceeded the upper limit value (0.05 ppm) due to behavioral rules, to not well ventilated workplaces and to not automated washing units.

[Occupational hand injuries in an area of high prevalence of farming and craft work]. / Infortuni della mano sul lavoro in un'area a prevalenza agricolo-artigianale.

Hand injuries exceed 20% of all occupational injuries. This article reviews the history of 237 hand injuries mostly occurred in craftsmen and farmers. The results allow us to make some considerations on the role of occupational physician in their prevention.

[Suspected glutaraldehyde poisoning: a case report]. / Sospetta intossicazione da glutaraldeide: case report.

AIMS: To report a case of anxiety, possibly due to glutaraldehyde poisoning in a female anaesthesiologist working in an operating room and exposed to 2% solution of glutaraldehyde, the only chemical used for disinfection of flexible endoscopic instruments. METHODS: A clinical evaluation was made and neurobehavioural functions were explored by sensitive neuropsychological testing: testing included a simple and complex reaction time and examination of the autonomic nervous system. The atmospheric concentration of glutaraldehyde was measured by means of a Brüel & Kjaer Multigas Monitor type 1302 analyzer. RESULTS: Adverse neurobehavioural effects, including headache, loss of attention, dizziness, anxiety, drowsiness on the job, alteration of homeostatic reflexes, were observed, and sensitive neuropsychological testing confirmed neurobehavioural impairment. No blood alterations related to exposure were found. Very high levels of glutaraldehyde were detected in the operating theatre. After ten days away from exposure to glutaraldehyde no symptoms and no behavioral effects on the central and autonomic nervous systems were detectable. CONCLUSIONS: Although conclusions cannot be drawn from a single case, exposure to a high level of glutaraldehyde, subjective symptoms, alteration of neurobehavioural performance, no consumption of CNS medication, no neurological or psychiatric disorders, no coffee consumption and alcohol intake, no exposure to other neurotoxic agents, complete recovery after removal from exposure to glutaraldehyde, are indicative of glutaraldehyde poisoning.

[Occupational exposure to formaldehyde at a service of pathologic anatomy]. / Esposizione occupazionale a formaldeide in un servizio di anatomia patologica.

OBJECTIVE: Aim of the present study is to evaluate the air pollution produced by formaldehyde in pathological anatomy. METHODS: This study was made with instrumental approach based on environmental evaluation of 10% formaldehyde used in pathological anatomy, by an infrared gas analyser (Brüel & Kjaer), and clinical approach of pathological anatomy personnel. RESULTS: The final result is not very comforting because we found values of formaldehyde during specific activities which exeeded the current limits proposed by industrial hygienist, infact we found in a different settings 1.81 ppm, 3.78 ppm, 8.3.05 ppm. The personnel exposed reported subjective symptoms as reactive airway symptoms, headache, skin problems. CONCLUSIONS: To reduce air pollution we have indicated technical precautions as forced ventilation which is a major engineering control for reducing risk from chemical agents, use of personal protective equipment (PPE) as last resort for protection, behavioral rules and health surveillance.

[Environmental monitoring and health monitoring for personnel exposed to inhalation anesthetics]. / Monitoraggio ambientale e sorveglianza sanitaria per il personale esposto ad anestetici inalatori.

OBJECTIVES: The aim of this study is to verify the results of medical surveillance for personnel exposed to inhaled anaesthetics in operating rooms (300 exposed), and estimate the level of pollution in operating theatres of a university hospital. METHOD: Determination of the baseline and final value of the environmental anaesthetics by infrared photoacoustic spectroscopy; medical check-up and blood tests. RESULTS: During our observation we found in all rooms (new rooms and older rooms) values of nitrous oxide and isoflurane acceptable, all the anaesthetic's concentration are below the limits proposed by C.M. number 5 of the 14/03/89. Personnel reported subjective symptoms especially anxiety, but no blood alteration related to exposure were found. CONCLUSIONS: Technical precautions as use of low flow system, replacement of nitrous oxide with air, careful check of anaesthetic machine, and behavioral rules have decreased the emission of anaesthetics in the environment. Blood tests are found are not a valid index of possible damage caused by exposure. A large percentage of anaesthesiologists are found to have anxiety.

[Spinal diseases in the health setting. Epidemiologic findings at a hospital in eastern Sicily]. / La patologia del rachide nel comparto sanità. Rilevamenti epidemiologici in una azienda ospedaliera della Sicilia orientale.

The importance of spinal column disorders has long been known, both for their frequency in working environments and the social consequences they provoke, i.e. absence from work and social insurance costs. Our study focussed on 800 health care workers: nursing personnel who provide direct patient care, and 150 office workers of Sicily Hospital. We estimated column pathologies by using Colombini, Occhipinti, Grieco method. On the basis of our results we may affirm that the column disorders are more frequent in hospital assistants: S.A.P. II degree 22% S.A.P. III degree 10%, in office workers S.A.P. II degree 6% S.A.P. III degree 3%.