Urine albumin concentration and albumin-to-creatinine ratio at 11(+0) to 13(+6) weeks in the prediction of pre-eclampsia.

OBJECTIVE: To determine the performance of screening for pre-eclampsia by maternal characteristics, urine albumin concentration and albumin-to-creatinine ratio (ACR) at 11(+0) to 13(+6) weeks. DESIGN: Prospective cross-sectional observational study. SETTING: Routine antenatal visit. POPULATION: A total of 2679 pregnant women at 11(+0) to 13(+6) weeks of gestation. METHODS: Maternal variables, urine albumin concentrations and ACR of 51 women who developed pre-eclampsia were compared with 2364 women who were unaffected by hypertensive disorders. Regression analysis was used first to determine which of the factors among the maternal characteristics were significant predictors of urine albumin concentration and ACR in the unaffected group and second to determine the contribution of urine albumin concentration and ACR in the prediction of pre-eclampsia. MAIN OUTCOME MEASURES: Development of pre-eclampsia. RESULTS: In the unaffected group, log urine albumin concentration and log ACR were influenced by ethnic origin, age, body mass index (BMI), parity and smoking. In the prediction of pre-eclampsia, significant contributions were provided by log urine albumin concentration, log ACR, ethnic origin, BMI, age, family and history of pre-eclampsia. The median urine albumin concentration and the median ACR in the pre-eclampsia group were significantly higher than those in the unaffected group. However, in screening for pre-eclampsia, the area under the receiver operating characteristic curve was not significantly improved by the combined models than with maternal variables alone. The value of urine albumin concentration was not improved by correcting for the creatinine concentration. CONCLUSION: In the prediction of pre-eclampsia, urine albumin concentration at 11(+0) to 13(+6) weeks does not provide additional value to maternal variables.

[Human response to vibration. An ergonomic applicability of current knowledge to the automobile]. / Risposta dell'uomo alle vibrazioni. Applicabilità ergonomica all'autoveicolo delle conoscenze attuali.

With technological progress, vibrations as a risk factor for health have now extended beyond the boundaries of the workplace to become a social rather than an occupational risk. Now that we know the local or general damage vibrations can cause, ergonomists and occupational health officers are increasingly involved in the preparation of techniques for the application of their knowledge to preventive measures. Apparently, negative reactions derive form the impact on sensorial structures that develop very slowly with completely new sensorial stimuli. The acoustic and chronic effects of middle frequency vibration on various parts of the body are described both in experimental conditions and on a particular group of workers. Given the complexity of the vibration in human system interaction it is naturally extremely difficult to establish a universally valid scientific criteria to assess the response of the human body. These limitations expressly declared in the ISO 2631 guide are also implicit in the other regulations proposed. Having re-emphasised the need for research that is more relevant to application demands especially in car production, preventive medicine suggests that responses may be more adequately assessed by the application of new instrumental diagnostic techniques and the comparison of data on a vast scale.

[The chronobiology of work]. / Cronobiologia del lavoro.

The arrival of the industrial age and the availability of artificial light, which lengthens the working day and makes night work possible, have created the problem of man's changing biological functions and rhythms. After a brief note on experimental chronobiology (which permits regulated manipulation of experimental environmental conditions and the study of responses), chronopathology is defined and its implications for man are considered. At present there is no legislation regulating shift work, but it is hoped that the law will take chronobiological methods into account. In this context the basic aspects of shift work are discussed and the two main types - semi-continuous and continuous - are analysed. Firms' experience of shift work is compared with reports in the literature. Present hygiene and environmental conditions, ergonomics and automation combine to make work less and less physically demanding and increase adaptability to shift work. It is therefore hoped that research chronobiology, psychology and psychosociology will provide increasingly precise information about ways of using shift work in the hope of constructing an ecology of the working man.

["Markers" of infection with hepatitis A and B viruses among office workers in a heavy industry]. / I "markers" di infezione da virus epatitici "A" e "B" fra gli addetti agli uffici di una grande industria.

The spread of "A" and "B" hepatitis virus in a limited working environment has been evaluated and the main serum "markers" of this infection (HBsAg, anti-HBs, anti-HBc, anti-HAV) have been researched in 187 subjects (males and females) after being taken on by a large company in Northern Italy. This research, carried out again after 8--10 months from hiring, showed a moderate spread of "B"virus in 6,4% of the subjects observed. This finding is probably due to deficient personal hygiene rather than to environmental factors related to work (these may on the contrary condition the spread of "A" virus which, in the cases observed showed insignificant diffusion).

[Aromatic hydrocarbons: environmental pollution and biological effects]. / Gli idrocarburi aromatici: problemi dell'inquinamento dell'ambiente e degli effetti biologici.

A complete explanation of the problem concerning aromatic hydrocarbons as polluting materials is presented. Both collective and individual sources of pollution, the collective sources, due to the human work activities, and the individual ones, caused by the habit to smoking have ben considered. The effects these compounds have in the human organism and particularly the carcinogenic action of polycyclic hydrocarbons have also ben discussed.

[Serum thiocyanate level as a discriminating element in evaluation of exposure to carbon monoxide]. / La misura del tiocianato nel siero come elemento discriminante nella valutazione dell'esposizione a ossido di carbonio.

Blood carbon monoxide concentration levels in two groups of subjects to a different degree of exposure are examined in the light of the subjects declared smoking habits and serum thiocyanate levels. The latter parameter proved an effective pointer to individual exposure to CO due to tobacco combustion. Assessment of the results showed that it could be proposed as an indicative and discriminating test of habitual exposure to CO, so as to enable expired CO and HbCO values to be interpreted in occupationally exposed subjects.

[Markers of hepatitis virus A and B infection in subjects undergoing a hiring examination in a large business]. / I markers di infezione da virus epatitico "A" e "B" in soggetti sottoposti a visita di assunzione presso una grande azienda.

The prevalence of some hepatitis-A and hepatitis-B markers has been studied in 495 individuals (male 291, female 204) attending a preemployment medical examination at a great factory in Northern Italy between November 1978 and April 1979. A 2.0% and 13.7% incidence has been respectively found for HBsAg and anti-HBs in the whole population. A statistically significative difference has been recognized between people coming from Southern and Northern Italy, as well as between first-employment subjects and workmen or countrymen. A higher incidence of anti-HBc has been detected in men, in older age groups, and Southern immigrants, without any statistically significative difference related to their previous activities. Anti-HAV antibody has been found in 57.9% of whole population, with a greater incidence in younger people and in southern immigrants. First-employment group showed a lower incidence of anti-HAV, notwithstanding the great number of southern immigrants in this group.

[Analysis of the seasonal pattern of blood lead levels in relation to different concentrations of atmospheric lead]. / Analisi dell'andamento stagionale della piombemia in rapporto alle differenti concentrazioni di piombo atmosferico.

Blood lead levels have been analysed in a group of people resident in Turin in relation to different concentrations of lead in the atmosphere. Blood samples were taken in three periods of the year corresponding to seasonal maximums of pollution. Blood lead levels showed a marked decrease in the summer when the lowest concentrations are observed but the following autum sample did not show an increase. It is therefore considered likely that blood values would have been found to be increased if the final sample had been put off by 1-2 months.

[Carbon monoxide: environmental and biological aspects]. / Ossido di carbonio: aspetti di tipo ambientale e biologico.

The problem of carbon monoxide as a pollutant is examined. Its physico-chemical features are considered along with the sources of pollution (natural and technological), the characteristics of the pollutant in the environment and, particularly, the effects of car and industrial emissions and of cigarette smoke on the human organism.

[Absenteeism and influenza. Analysis of relationship between the excess morbidity and the influenza phenomenon].

The results are reported of a survey on the influenza phenomenon made on a sampling of about 100,000 subjects from the FIAT working community. The study is based on the absenteeism information for both over and under three days absence, for the time period between October 1976 and April 1977. In addition, a tentative evaluation of the influenza phenomenon has been made not only for the overall working population but also for various age groups.

[Lead. Environmental diffusion and biological aspects]. / Il piombo. Diffusione ambientale e aspetti biologici

The problems raised by ambient lead are examined with reference to its uptake, absorption and metabolism in man, animal metabolism and toxicology, sub-clinical effects, and health aspects. The existing research picture of this very complex field is surveyed.

[Blood levels of lead and erythrocyte ALA-dehydrase in 200 employees of a Turin metallurgical plant. Analysis of variables connected with alcohol drinking and smoking habits]. / Valori ematici del piombo e dell'ALA-deidrasi eritrocitaria in 200 dipendenti di un'industria metalmeccanica torinese. Analisi delle variabili legate all'abitudine all'alcool e al fumo

The relationships between blood value of Pb and activity of Ala-dehydrase erythrocyte enzyme were studied in relation to the following variables: age, activity, residence, smoking habits, drinking habits. 200 adults, subdividable into occupationally exposed were examined. The data obtained showed a relationship between smoking and Aladehydrase; a relationship was also found to exist between alcohol and blood Pb and inhibition of Ala-dehydrase activity.