[Biological agents in animal breeding: an ancient but still relevant risk]. / Agenti biologici in allevamento: un rischio antico e sempre attuale.

Agricultural activities expose workers to biological risk, due to the close contact that could occur with pathogens' reservoirs, such as soil, animals, manure and animal products. The paper describes factors that have contributed on the reduction or eradication of zoonoses, such as brucellosis, salmonellosis and bovine tuberculosis (monitoring and prevention of animal infectious diseases, industrialization and mechanization of agricultural activities), and on the other hand the emergence of new risks and new diseases (adaptability of microorganisms, generation of new strains, antibiotic resistance, dissemination of vectors). The role of Occupational Medicine in the prevention of zoonoses is discussed.

[Migrant workers in agriculture and animal husbandry: experiences of health surveillance]. / Lavoratori migranti in agricoltura e zootecnia: esperienze di sorveglianza sanitaria.

In Italy, 5 millions migrants live and work. Among them, the employment rate is much higher in comparison with the Italians' one (75% versus 62%). The well known "healthy migrant effect" is confirmed by statistics from the National Institute for Statistics: according to it, migrants access the National Health System for pregnancy and delivery and for accidents. The chronic pathology is not a major concern. Moreover, their work ability is generally complete, without any limitation. Nevertheless, migrants seem to represent a vulnerable subgroup with regard to the risk of 1) occupational injuries: this is strongly linked with the risk of Tetanus infection; 2) disorders of the metabolism, like hyperglycaemia and hyperlipemia, which is linked to a higher cardiovascular risk. In this light data from health surveillance carried out by the International centre for Rural Health of the San Paolo University Hospital in agricultural setting in the Region of Lombardy and the participation of the Centre itself to the Promovax EC-cofunded project are presented.

[Diet as a key element of health promotion at the workplace in scientific research and practice. First results of the EU project FAHRE]. / La dieta come elemento cardine della promozione della salute ne luoghi di lavoro nella ricerca scientifica e nella pratica. Primi risultati del progetto EU FAHRE.

The globalization of markets have led to rapid changes in diet and lifestyle in the developed countries, where living standards have improved, and availability and variety of food has increased while physical activity decreases have led to an augment in chronic diseases (obesity and diabetes mellitus), cardiovascular diseases and some specific cancers. In this context there is a need to develop health promotion activities. Workers represent a very appropriate group for such activities because they are relatively homogeneous, easily reachable because they can be found together in the same place and time and the occupational physician has good knowledge of the of health status of individual worker. In this scenario, a renew interest must be posed to the relationship between diet and health. In this context our Group is participating at the FAHRE project (Food and Health Research in Europe). The project aims to establish the state of the art of research at the interface of nutrition and health in the European Union, identifying its strengths and weaknesses in order to propose strategies to increase coordination and improve its functioning as a European Research Area.

[Biological risk prevention in agriculture and animal breeding: immunization strategies]. / Strategie vaccinali per la prevenzione del rischio biologico in agricoltura e zootecnia.

Vaccine preventable diseases are, so far, a main focus of Public Health programmes all over the world since people still die in consequence of Dyphteria or Tetanus. Biological risk is widely represented in agriculture and animal breeding, due to environmental characteristics and to injury typology. Moreover, aged people and migrants represent a significant part of the workforce. These two groups are, for instance, more exposed to Clostridium tetani infection because not fully immunized. Among infectious diseases that can affect agricultural workers, just tetanus can be well controlled by immunization programmes. Teaching and training activities are the most important tools to get protection against Leptospira interrogans, Salmonella spp and hepatitis E Virus infection. As for every training activity, linguistic and cultural barriers have to be taken into account.

[The occupational health physician and the health surveillance in agriculture]. / Il medico del Lavoro Competente e la Sorveglianza Sanitaria in Agricoltura.

Despite the underreporting of occupational diseases in agriculture, available data clearly show a significant health risk, and therefore the need of health surveillance at the workplace. The implementation of health surveillance programs for agricultural workers relies on the possibility of creating a system able to reach the workers at their workplaces, with the collaboration of employers' associations, able to support enterprises in several issues, including risk assessment and management. The health surveillance program can be organized in a component common for all workers, based on physical examination, chemistry, electrocardiography, hearing and lung functions examinations, and on tests addressing specific risks, if present: vibration, physical overload, chemicals, biological agents, allergens. The frequency of examinations must be decided based on risk assessment and health surveillance outcomes.

[Occupational and environmental exposure to anilide and dicarboximide pesticides]. / Esposizione ambientale e professionale a pesticidi propionanilidici e dicarbossimidici.

Dicarboximide fungicides (DF) such as vinclozolin, iprodione, procymidone are widely used on vines, fruit and vegetables, and anilide herbicides (AH) such as diuron, linuron, propanil are used to control weeds on hard surfaces, such as, roads, railway tracks, paths, and in crops, forestry. Italian reports on food safety found many samples contaminated by pesticides belonging to these categories, even though only few exceeding L.M.R. Since adverse effects on human health, such as endocrine disruption, have been reported, biological monitoring is essential for exposure assessment both of occupationally exposed subjects and of the general population. Common metabolites of DF and AH are dichloroanilinines such as 3,4-DCA and 3,5-DCA, urine samples from 153 subjects living in Novafeltria, central Italy, were collected for analysis of 3,4- and 3,5-DCAs, each participant was invited to complete a very detailed questionnaire. A total of 151 out of 153 samples were found to be positive for 3,5-DCA, and 81.7% were positive for 3,4-DCA. Also 33 workers, engaged in application of propanil on rice in northern Italy, were involved in the study and 3,4-DCA was determined as marker of exposure. 3,4 and 3,5 dichloroaniline are useful and promising biological indicators for monitoring occupational and environmental exposure to these classes of pesticides.

[Evaluation and management of pesticide risk in agriculture: the experience of the Region of Lombardy (Italy)]. / Valutazione e gestione del rischio da antiparassitari in agricoltura: l'esperienza della Regione Lombardia.

The evaluation of chemical risk in agriculture is complicated because of difficulties in obtaining measures representative of working conditions. This is the reason why experiences finalized at producing risk estimates are running. In this frame, a Regional working group has developed the project "Pesticide exposure and risk profiles in agriculture". Priority scenarios have been selected and the main variables correlated with pesticide exposure have been pointed out. A value for each variable has been defined. The sum of these values allows the definition of "Exposure Indices" (EI), which can be reduced by multiplication for a coefficient calculated based on use of personal protective devices, training and education and equipment conditions. A Risk Index is calculated as the product of EI per a toxicity index, calculated based on the risk phrases of the substances used ("Risk Profile"). Risk Profiles allow the production of risk estimates and the definition of the appropriate preventive interventions. Next phase will be addressed at the validation of the model, to be carried out through the determination of the levels of concordance between the risk class allocation obtained from the model and the one obtained from environmental and biological measures, in the same groups of workers.

[Occupational exposure to fungicides in floriculture in Ecuador]. / Esposizione professionale a fungicidi in floricoltori dell'Ecuador.

Floriculture represents one of the major sources of income in the Ecuadorian Andean Region that can be carried out either in open fields as in greenhouses by using chemical compounds, growing hormones and xenobiotics. Among pesticides, ethylenbisdithiocarbamate (EBDTCs) fungicides represent the most extensively used. The aim of the study was the assessment of exposure to EBDTCs in Ecuadorian floricultural workers by the determination of the urinary excretion of the main metabolite of these compounds, ethylenethiourea (ETU). For this purpose, thirty-six floriculture workers and 7 unexposed healthy subjects were recruited for the study. Median level of ETU excretion in agricultural workers before the work shift was 3.2 micrograms/g creatinine, ranging from 0.4 to 34.5 micrograms/g creatinine. After pesticide application, urinary ETU increased to 6.2 micrograms/g creatinine (1.5-26.5) microgram/g creatinine. Urinary ETU resulted significantly higher in overall workers, taken as pre- and post-shift samples, when compared to controls (0.7, 0.4-2.1 micrograms/g creatinine, p < 0.01). According to jobs, applicators showed the highest levels of ETU excretion whereas growing, post-harvesting and maintenance workers showed similar levels of exposure. Higher level ETU excretion was observed in greenhouse compared to open field workers.

[Evaluation of the neurotoxic and nephrotoxic effects following long-term exposure to metallic mercury in employed at a chlorine/sodium-hydroxide plant]. / Valutazione degli effetti neurotossici e nefrotossici conseguenti all'esposizione a lungo termine a mercurio metallico dei lavoratori addetti agli impianti Cloro-Soda.

OBJECTIVES: Within the frame work of a wide multicentre study, a sub-study was developed in order to explore the occurrence of early effects on the central nervous system, on the kidney and on the neuro-immune system in the workers of a chloro-alkali production plant exposed to metallic mercury at airborne concentration levels lower than 0.025 mg/m3 (TLV-TWA). They were compared to a control population of employees of the same huge petrochemical plant with different job that did not implicate exposure to mercury vapors. Specifically, the study aimed at revealing the occurrence of early effects on the central nervous system related with mercury exposure, as can be assessed through neurophysiological and neurobehavioral tests. METHODS: The excretion of urinary mercury was measured by atomic absorption spectrometry. The study of renal function was assessed by measurement of the urinary excretion of some high and low molecular weight protein markers (albumin, beta 2-microglobulin, retinol-binding protein, fibronectin, specific proximal tubule brush border antigens, N-acetyl-beta-D-glucosaminidase). The neurobehavioral status of the study subjects was assessed by means of several test parameters (Simple Reaction Time, Color Word Vigilance Test, Symbol Digit, Finger Tapping, Mood Scale of Kjellberg and Iwanowski, Subjective symptoms questionnaire (QSS), Luria Nebraska Motor Scale, Branches Alternate Movement Task and Tremometry). RESULTS: The values of urinary excretion averaged 12 +/- 8 micrograms Hg/g of creatinine for the exposed workers group (n = 38), while for the reference group (n = 34 cases) urinary excretion was statistically lower, averaging 4 +/- 6 micrograms Hg/g of creatinine. Neither the parameters selected for the assessment of renal functions, nor those chosen to probe the neurobehavioral status of the probands revealed statistically reliable differences between the group of exposed workers (length of exposure: range 1-34 years) and the control group. Nevertheless, some minor but still statistically reliable correlations were found between some neurobehavioral parameters and some demographic variables describing the whole group of tested workers, but not to the level of occupational exposure to mercury. CONCLUSIONS: The results of the study confirm the lack of toxic effects of clinical importance on the central nervous system and on the kidney for values of mercury urinary excretion lower than the suggested index of biological exposure (IBE) of 35 micrograms Hg/gram of creatinine.