Mixed-dust pneumoconiosis in a dental technician: a multidisciplinary diagnosis case report.

BACKGROUND: In dental laboratories, exposure to crystalline silica can occur during procedures that generate suspended mineral dusts, e.g. dispersion of mixing powders, removal of castings from molds grinding, polishing of castings and porcelain, and use of silica sand for blasting. There is also a large list of toxic agents (acrylic resins, polymeric materials, etc.) used to produce removable and fixed prostheses, but also impression materials and more. Using personal protective equipment and other aids reduces the exposure to these potentially harmful agents. CASE PRESENTATION: We report the case of a 42-year-old male dental technician who began to suffer from a dry cough and exertional dyspnea after approximately 15 years of work. The operations he conducted for his job resulted in the generation of crystalline silica, aluminum, chromium and titanium dust. The worker did not regularly wear personal protective equipment and some of the above operations were not carried out in closed circuit systems. The Chest X-ray showed diffused micronodules in the pulmonary interstitium of the upper-middle lobes, bilaterally, and a modest left basal pleural effusion. Simple spirometry showed small airway obstruction in its initial stage. High Resolution Computerized Tomography of the chest showed bilateral micronodulation of a miliariform type, with greater profusion to the upper lobes, also present in the visceral pleura, bilaterally. Histological examination showed aggregates of pigment-laden macrophages forming perivascular macules or arranged in a radial pattern around a core of sclerohyalinosis. Scanning Electron Microscopy and Energy Dispersive Spectrometry revealed several mineral particles, typically characterized by the presence of crystalline silica and metal aggregates. The environmental concentrations of total dust and its respirable fraction were all lower than the relative TLV-TWA-ACGIH, yet not negligible. CONCLUSIONS: The above findings and a multidisciplinary assessment led to the diagnosis of mixed dust pneumoconiosis s/q with 2/2 profusion of occupational origin. This diagnosis in a dental technician was supported for the first time in literature by environmental exposure analysis.

Interplay Between Adherence to the Mediterranean Diet and Lipid Profile: A Comparative Survey Between Day-Time Healthcare and Non-healthcare Female Workers.

Introduction: Occupational physicians, as an aspect of the periodic health surveillance of workers prescribed by law, must develop preventive programs against adverse health-related occurrences (Legislative Decree 81/2008, art.25) to reduce major risk factors for non-communicable/chronic diseases. Eating habits play an important role in defining risk trajectories in the workplace. Methods: We randomly and cross-sectionally evaluated 147 females, of which 59 were healthcare workers (HCWs) and 88 were non-HCWs. The assessment included a dietary screening for adherence to the Mediterranean diet (MD) and a clinical baseline collection of major fluid biomarkers and anthropometric indicators for cardiovascular and metabolic risk. Results: The HCW group exhibited greater adherence to the MD than the non-HCW group. Nevertheless, they showed higher serum levels of triglycerides and total cholesterol. Menopause and type of work significantly and unfavorably affected triglyceride serum levels among HCWs. Conclusion: Greater preventive efforts are needed in the context of periodic health surveillance by occupational physicians. Disseminating additional information on a healthier lifestyle, particularly among female workers of perimenopausal age, is a key issue.

[Experimental measurement of the real reduction (PAR) of seven ear plugs]. / Misura sperimentale del "PAR" di sette inserti auricolari.

SUMMARY: The study aimed to evaluate, through the use of the EA-RfitTM Validation System, the real reduction (PAR) for the right ear (AuD), for the left ear (AuS) and biaural reduction related to each of the seven earplugs currently produced by 3M. In addition, we wanted to verify any difference between the aforementioned PARs in consideration of the tendency to predominantly use the right hand (right-handed) or the left hand (left-handed) and in relation to gender. Finally, for each insert and for each subject, an audiometric examination was conducted with the insert worn, to compare the average PAR value obtained by the EA-RfitTM system for each of the seven inserts and for all selected subjects, with the determined abatement curve through the audiometric measurement of the hearing threshold with the insert worn. The use of the E-ARfitTM system for the choice of the ear insert leads to important advantages in the protection of all workers. Moldable acoustic PPE generally proved to be more efficient than non-moldable, so much so that the higher SNRs (provided by the manufacturer), especially when referring to non-moldable inserts, were found to be misleading as to the real personal abatement capacity of the inserts. The average audiometric curves, obtained with the different inserts worn, confirmed that all of them guarantee a higher reduction for high frequencies than for "social" ones.