[Perceived stress, peripheral blood counts and luxury habits]. / Stress percepito, crasi ematica e abitudini voluttuarie.

PURPOSE: The aim of this study is to evaluate whether perceived stress in the workplace can be a risk factor able to change the blood counts in a group of male and female outdoor workers of the Municipal Police. The study examines possible relations among the levels of stress, as inferred from the scores of the questionnaire, blood counts and voluptuary habits. METHODS: We evaluated a final sample of 486 subjects (345 males and 141 females). During the medical examination was performed for each subject: a) the administration of the questionnaire to assess the perception of work-related stress, b) the collection of clinical.anamnestic information related to the consumption of coffee, chocolate, alchool and smoking habit, c) the taking of a venous blood sample. All workers included in the study were divided into three groups on the basis of the scores of the questionnaire. RESULTS: About 61% of workers showed a moderate or severe stress condition, with a statistically significant prevalence (p<0.05) of female workers and younger subjects. The increase of perceived stress coincided with a significant decrease (p <0.05) of the mean levels of white blood cells and with a significant increase (p <0.05) of the consumption of coffee, chocolate and smoking habit. There was no statistically significant differences for alcohol consumption. CONCLUSIONS: The results show that the stress induces a reduction of the white blood cells, an increase of coffee and chocolate consumption and of smoking.

Cadmium and hypertension in exposed workers: A meta-analysis.

OBJECTIVES: In the general population, cadmium seems to be responsible for hypertension, atherosclerosis and an increase in acute coronary events. Therefore, the purpose of this meta-analysis was to analyze controlled studies conducted on cadmium and arterial pressure in occupationally-exposed workers. MATERIALS AND METHODS: After analyzing all the relevant articles found in the literature, 6 publications were selected. RESULTS: A higher prevalence of hypertension and higher values of systolic and diastolic blood pressure were recorded in the exposed subjects. CONCLUSIONS: Cadmium in occupationally-exposed individuals appears to induce an increase in systolic and diastolic blood pressure and an increase in the prevalence of hypertension.

Prevalence of systemic arterial hypertension, electrocardiogram abnormalities, and noise-induced hearing loss in agricultural workers.

ABSTRACT The literature suggests that farmers nowadays are more likely to contract cardiovascular diseases than in the past. This study involved 79 farmers and 64 controls. The workers completed a questionnaire to identify exclusion factors for audiological and cardiovascular risk factors. The participants underwent medical examination, measurement of blood pressure, electrocardiogram, blood tests, audiometry, and measurement of noise exposure. The farmers were found to have a higher prevalence of systolic and diastolic arterial hypertension as well as electrocardiogram (ECG) abnormalities compared with the controls. A significant prevalence of arterial hypertension was detected in the farmers exposed to noise, when compared with those who were not exposed. These results suggest that farmers are at risk of cardiovascular effects and that noise is a cardiovascular risk factor for farmers.

Risk of upper extremity biomechanical overload in automotive facility.

OBJECTIVE: To assess the risk factors for upper extremity-work-related musculoskeletal disorders (UE-WMSD) on 13 production lines in an airbag factory using the threshold limit values-American conference of industrial hygienists- hand activity level (TLV-ACGIH-HAL) method and introduce the ergonomic improvement to reduce the repetitiveness and the peak force (Pf). METHODS: Professional exposure level on 13 production lines in a automobile factory was measured using the TLV-ACGIH-HAL method and a further risk was assessed according to the ergonomic improvement. RESULTS: The first assessment of 9 production lines showed that the professional exposure level was above the TLV or HAL limit. The second assessment showed that the professional exposure level was below the AL limit on all production lines except 1, in which the professional exposure level was between TLV and HAL. CONCLUSION: The assessment of UE-WMSD-related risk can identify the riskiest emplacements and evaluate the reduction of risk in professional exposure through interventions of structural- organizational type.

Spinal and temporo-mandibular disorders in male workers of the State Police.

OBJECTIVE: The aims of this study are to evaluate the prevalence of disorders of the lumbar region and the temporo-mandibular district co-morbidity in drivers and workers of the State Police employed for different office activities. MATERIALS AND METHODS: The study population included 103 drivers as cases and 100 police officers as controls. The study was carried out through questionnaire and clinical evaluation of the spine and temporo-mandibular region. RESULTS: At clinical examination, the drivers were found to have a higher prevalence (p < 0.05) of both symptoms and clinical signs at the spine and temporo-mandibular joint (TMJ), when compared with the controls. The results also showed a higher prevalence (p < 0.05) of co-morbidity in the two districts among the drivers, when compared with the controls. CONCLUSIONS: These results confirm that morbidity related to back and TMJ and increase in co-morbidity between the two districts are higher in professional drivers.

Exposure to arsenic in urban and rural areas and effects on thyroid hormones.

CONTEXT: Arsenic is a ubiquitous element present in urban air as a pollutant, and it may interfere with thyroid hormones. OBJECTIVE: To evaluate the association between the personal exposure to arsenic and levels of TSH, fT4, fT3, and Tg in urban and rural workers. MATERIALS AND METHODS: Total urinary arsenic and thyroid markers were obtained from 108 non-smoking traffic policemen and 77 subjects working as roadmen in a rural area. Fifty subjects were monitored to evaluate airborne exposure to arsenic. RESULTS: The mean value of exposure to arsenic was 2.9 µg/m(3) in traffic policemen, while the mean value was less than 0.1 µg/m(3) in roadmen. The mean values of urinary arsenic (10.4 µg/g creatinine vs. 5.2 µg/g creatinine; p = 0.000), TSH (1.6 µlU/ml vs. 1.3 µlU/ml; p = 0.006), fT3 (3.5 pg/ml vs. 3.7 pg/ml; p = 0.000), fT4 (1.2 ng/dl vs. 1.3 ng/dl; p = 0.000) and Tg (42.8 ng/ml vs. 36.1 ng/ml; p = 0.04) were significantly different between traffic policemen and roadmen. In traffic policemen, urinary arsenic and arsenic in the air were correlated to the airborne arsenic and TSH values, respectively. Urinary arsenic was correlated to TSH, Tg, fT3, and fT4 values. The multiple linear regression models showed the following associations: i) among urinary arsenic, arsenic in the air and job title; ii) among TSH, fT3, Tg and urinary arsenic; and iii) between fT4 and both urinary arsenic and alcohol intake. CONCLUSION: These results provide information about the relationship between exposure to arsenic and thyroid markers and may be useful for other categories of outdoor workers who are similarly exposed.

Urban pollution.

Air pollution represents a health risk for people living in urban environment. Urban air consists in a complex mixture of chemicals and carcinogens and its effects on health can be summarized in acute respiratory effects, neoplastic nonneoplastic (e.g. chronic bronchitis) chronic respiratory effects, and effects on other organs and systems. Air pollution may be defined according to origin of the phenomena that determine it: natural causes (natural fumes, decomposition, volcanic ash) or anthropogenic causes which are the result of human activities (industrial and civil emissions). Transport is the sector that more than others contributes to the deterioration of air quality in cities. In this context, in recent years, governments of the territory were asked to advance policies aimed at solving problems related to pollution. In consideration of the many effects on health caused by pollution it becomes necessary to know the risks from exposure to various environmental pollutants and to limit and control their effects. Many are the categories of "outdoor" workers, who daily serve the in urban environment: police, drivers, newsagents, etc.

[Shift and night work and mental health]. / Lavoro a turni e notturno e salute mentale.

Aim of our study was to evaluate the influence that shift work and night work could have on mental health. A review of literary articles from 1990 to 2011 on shift work and night work was carried out. The results of this review confirmed that the shift work and night work affect mental health with the onset of neuropsychological disorders such as mood disorders, anxiety, nervousness, depressive anxiety syndromes, chronic fatigue and chronic insomnia irritability, sleep disturbances, reduction in levels of attention, cognitive impairments, alteration of circadian rhythm. Night work and shift work cause severe desynchronization of the cronobiological rhythms and a disruption of social life with negative effects on performance at work, on health and on social relationships. In the light of these results and recognizing shift work and night work as risk factors for the health of workers is necessary to implement preventive and periodic health checks by the occupational doctor to ensure the health and safety of workers taking account of the different environmental and individual factors.

Cardiovascular risk in rotogravure industry.

OBJECTIVE: To verify whether the occupational hazards in the rotogravure industry can be associated with cardiovascular effects. METHODS: We evaluated cardiovascular parameters and audiometric tests and analyzed noise, solvents, and shift work in 44 exposed and 44 unexposed workers. RESULTS: Unlike unexposed workers, the rotogravure workers showed significant increase of mean systolic and diastolic blood pressure (BP) values (P = 0.019; P = 0.003), higher frequency of hypertension (P = 0.002) and electrocardiographic abnormalities (P = 0.0001), significant reduction or no variation of BP response to orthostatism (P = 0.0001), and association between high levels of noise and diastolic blood pressure (P = 0.0067). Subjects with hearing loss showed high frequency of hypertension and a reduction or no variation of BP response to orthostatism (both P = 0.05). CONCLUSIONS: Data obtained suggest that these are the effects on the cardiovascular system of rotogravure workers who are exposed to noise.

Assessment of occupational exposure to benzene, toluene and xylenes in urban and rural female workers.

OBJECTIVES: This is the first research study to compare among female, non-smoker workers: (a) the exposure to benzene, toluene and xylenes (BTXs) in urban air during work in the street (traffic policewomen, TP) vs. work in vehicles (police drivers, PD); (b) the exposure to BTXs in urban environments (in street and in car) vs. rural environments (roadwomen, RW); (c) the values of blood benzene, urinary trans, trans muconic acid (t,t-MA) and urinary S-phenylmercapturic acid (S-PMA) in urban areas (in street and in car) vs. rural areas. METHODS: Passive personal samplings and data acquired using fixed monitoring stations located in different areas of the city were used to measure environmental and occupational exposure to BTXs during the work shift in 48 TP, 21 PD and 22 RW. In the same study subjects, blood benzene, t,t-MA and S-PMA were measured at the end of each work shift. RESULTS: Personal exposure of urban workers to benzene seemed to be higher than the exposure measured by the fixed monitoring stations. Personal exposure to benzene and toluene was (a) similar among TP and PD and (b) higher among urban workers compared to rural workers. Personal exposure to xylenes was (a) higher in TP than in PD and (b) higher among urban workers compared to rural workers. Blood benzene, t,t-MA and S-PMA levels were similar among TP and PD, although the blood benzene level was significantly higher in urban workers compared to rural workers. In urban workers, airborne benzene and blood benzene levels were significantly correlated. CONCLUSIONS: Benzene is a human carcinogen, and BTXs are potential reproductive toxins at low dose exposures. Biological and environmental monitoring to assess exposure to BTXs represents a preliminary and necessary tool for the implementation of preventive measures for female subjects working in outdoor environments.

[Alienation to burn-out. Psyche and the Universe of Technology]. / Dall'Alienazione al Burn-out. la Psiche e l'Universo della Tecnica.

The new D. Lgs. N 81, 2008 Article 28 paragraph 1 sanctions that the risk assessment must involve all the possible risks to safety and health of workers, including the work-related stress factors. Stressors at work may vary as to: quantity of work assigned, whether excessive or inadequate; lack of recognition or reward for good job performance; degree of responsibility; precariousness of work; emotional pressures exerted on workers; violence and harassment of psychological nature, poor balance between work and private life. The need man has to understand the causes of his psycho-physical and social disease are old. Only the words we use when dealing with the topic has changed over the time: once it was Alienation now it is Burn-out. The concept of alienation, which has been very important over the time, has many different aspects and has had countless interpretations (which have followed one another), the psycho-analytical, the sociological analysis and the Marxist one, Burnout is actually a syndrome characterized by three interrelated dimensions: exhaustion, cynicism and inefficacy. Therefore it is important to prevent, eliminate or reduce problems related to occupational stress. Among preventive measures, the Europe Agreement identified in the management and in the communication the information necessary to define the goals of the company and the role each employee has. Moreover information and formation are considered the necessary elements to increase awareness and understanding of the problem, its potential causes and possible ways of approading it. Our research group, has developed targeted questionnaires, biological indicators and medical instrumental examinations the occupational doctors can make use of to assess these issues.

Environmental and biological monitoring of arsenic in outdoor workers exposed to urban air pollutants.

The aim of this study is to evaluate personal exposure to As in urban air in two groups of outdoor workers (traffic policemen and police drivers) of a big Italian city through: (a) environmental monitoring of As obtained by personal samples and (b) biological monitoring of total urinary As. The possible influence of smoking habit on urinary As was evaluated. We studied 122 male subjects, all Municipal Police employees: 84 traffic policemen and 38 police drivers exposed to urban pollutants. Personal exposure to As in air was significantly higher in traffic policemen than in police drivers (p=0.03). Mean age, length of service, alcohol drinking habit, number of cigarettes smoked/day and BMI were comparable between the groups of subjects studied. All subjects were working in the same urban area where they had lived for at least 5 yrs. Dietary habits and consumption of water from the water supply and/or mineral water were similar in traffic policemen and in police drivers. The values of total urinary As were significantly higher in traffic policemen (smokers and non smokers) than in police drivers (smokers and non smokers) (p=0.02). In the subgroup of non-smokers the values of total urinary As were significantly higher in traffic policemen than in police drivers (p=0.03). In traffic policemen and in police drivers total urinary As values were significantly correlated to the values of As in air (respectively r=0.9 and r=0.8, p<0.001). This is the first research in literature studying the exposure to As in outdoor workers occupationally exposed to urban pollutants, such as traffic policemen and police drivers. Personal exposure to As in the air, as well as the urinary excretion of As, is significantly higher in traffic policemen compared to drivers. These results can provide information about exposure to As in streets and in car for other categories of outdoor workers similarly exposed.

Follicle-stimulating hormone levels in female workers exposed to urban pollutants.

The aim of this study was to evaluate if there were alterations in FSH plasma levels in female outdoor workers (traffic policewomen and drivers) exposed to chemical urban stressors vs. control group. After excluding subjects with main confounding factors, traffic policewomen, drivers and indoor workers were matched by age, working life, socioeconomic status, marital status, menstrual cycle day, age of menarche, habitual consumption of Italian coffee and soy. A total of 129 female subjects were included in the study: some 63 workers studied during proliferative phase and 66 during secretory phase of menstrual cycle. Proliferative phase of menstrual cycle: FSH mean values were significantly higher in traffic policewomen compared to controls (p < 0.05). Results suggest that in outdoor workers exposed to urban chemical stressors there are alterations in FSH levels; therefore FSH may be used as an early biological marker, valuable for the group, used in occupational set.

Professional exposure to urban stressors and effects on urinary metanephrines.

The aim of the study is to assess whether occupational exposure to urban stressors could cause alterations in urinary metanephrines levels in traffic policemen vs administrative staff of municipal police. A total of 258 subjects were included in the study: 129 traffic policemen exposed to urban stressors (68 males and 61 females) and 129 controls (68 males and 61 females). Urinary metanephrines mean levels were significantly higher in male traffic policemen compared to controls (p < 0.01). No significant differences were in female traffic policemen compared to controls. In the control group, urinary metanephrines mean levels were significantly higher in females compared to males (p < 0.01). There were no significant differences in urinary metanephrines mean levels in female traffic policemen vs male traffic policemen. The increase in urinary metanephrines mean levels observed in male exposed compared to controls could be related to chronic occupational exposure to low doses of chemical, physical and psychosocial urban stressors.

Plasma cortisol concentrations and lifestyle in a population of outdoor workers.

The aim of this study was to assess whether exposure to urban pollution in outdoor workers, may alter plasma cortisol concentrations also in relation to the effect of smoking and drinking habits. The research was carried out on 498 outdoor police workers, divided into three groups; Group A: traffic policemen (TP), Group B: drivers (D), Group C: Other duties (OD). To evaluate separately the effect of using alcohol and smoking, each group was divided into three subgroups: (1) non-smokers and non-drinkers, (2) smokers and non-drinkers, (3) non-smokers and drinkers. Our results show cortisol mean values were significantly higher in the TP group compared to the D and OD groups without significant differences between the last two groups. The results suggest that exposure to pollutants associated with urban psychosocial stress may play a more important role on plasma cortisol levels than smoking and alcohol.

[Stress and new technologies]. / Stress e nuove tecnologie.

The relation between stress and new technologies has always been a vexed question. Experts say technology is a sort of double-edged weapon; it increases the potential of human senses but on the other hand it also involves an adjustment to artificial, unnatural rhythms which have consequences on mental and physical health. Through tests with patients not too prone to socializing Cognitive Ergonomics shows that using web in a correct guided interactive way, instead of the passive way of using media, helps developing concentration and reactivity and improves the way we come into contact with the world around us.

Exposure to urban stressors and free testosterone plasma values.

OBJECTIVES: The chemical agents present in the environment, such as traffic pollutants, may affect male fertility. Traffic policemen are daily exposed to traffic pollutants. The aim of this study is to evaluate whether occupational exposure to urban stressors could cause alterations in free testosterone plasma values in male traffic policemen versus administrative staff of Municipal Police of a big Italian city. METHODS: Both groups were divided into two subgroups based on age (first group: 30-40 years; second group: 41-50 years) to assess whether age could affect laboratory results of free testosterone plasma levels in traffic policemen versus controls. The characterization of exposure to urban pollutants for traffic policemen was assessed using the concentrations of pollutants monitored in fixed stations. A total of 220 subjects were studied: 110 traffic policemen and 110 controls, after excluding subjects with main confounding factors. RESULTS: Mean free testosterone values were significantly lower in traffic policemen than in controls (P < 0.001). Such statistical reduction persisted stratifying the mean testosterone values for classes of age (30-40 and 41-50 year) of workers (respectively P < 0.001 and P < 0.001). The distribution into classes of testosterone values in traffic policemen and in controls was significant (P < 0.001), and this result persisted after the stratification for classes of age of workers (30-40 year: P < 0.001) (41-50 year: P < 0.001). CONCLUSIONS: According to data in literature, free testosterone plasma levels could be used as an early biological marker, to be employed in occupational sets, valuable for the group, even before the onset of values out of range and of fertility disorders.

Hemopoietic system in traffic police exposed to urban stressors.

The aim of the study is to evaluate if occupational exposure to urban stressors could cause alterations in red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), mean cell volume (MCV), mean cell hemoglobin (MCH), mean corpuscular hemoglobin concentrations (MCHC) in traffic police compared to a control group. 694 subjects were included in the study: 347 traffic police and 347 controls matched by sex, age and length of service after excluding the subjects with the principal confounding factors. The levels of RBC, HGB, HCT were significantly higher in male (respectively p<0.001, p<0.05, p<0.01) and in female (respectively p<0.05, p<0.001, p<0.01) traffic police than in controls. The authors hypothesise that occupational exposure to urban stressors in traffic police can alter hemopoietic system.

Plasma dopamine in workers exposed to urban stressor.

The aim of this study is to evaluate if the occupational exposure to urban stressor could cause alterations in dopamine (DA) plasma levels and related diseases in traffic police officers compared to a control group. After excluding subjects with principal confounding factors, 306 traffic police officers (139 female and 167 male) and 301 controls (134 female and 167 male) were included in the study. In traffic police officers, mean DA values were significantly higher compared with controls (P = 0.006 and P = 0.000 in male and female, respectively). The distribution of DA values in traffic police officers and controls was significant (P = 0.000 and P = 0.000 in male and female, respectively). The number of male traffic police officers with a positive response to the questionnaire's items concerning anxiety, depression and panic attacks was higher than controls, though not significant (7.2% traffic police officers versus 4.2% controls). This difference was also not significant in female traffic police officers compared with controls. According to our previous researches on other neuro-immune-endocrine parameters, DA could be used as an early biological marker, valuable for the group to be employed in occupational sets, even before the onset of pathology.