Formaldehyde and Acetaldehyde Exposure in "Non-Traditional" Occupational Sectors: Bakeries and Pastry Producers.

INTRODUCTION: Formaldehyde, a colorless and highly irritating substance, causes cancer of the nasopharynx and leukemia. Furthermore, it is one of the environmental mutagens to which humans are most abundantly exposed. Acetaldehyde was recently classified as carcinogen class 1B and mutagen class 2 in Annex VI EC regulation. Occupational exposure to the two aldehydes occurs in a wide variety of occupations and industries. The aim of this study is to deepen exposure to the two aldehydes in the non-traditional productive sectors of bakeries and pastry producers. METHODS: The evaluation of exposure to formaldehyde and acetaldehyde was conducted in Italy in 2019, in specific tasks and positions of 11 bakeries and pastry producers (115 measures, of which 57.4% were in fixed positions and the rest were personal air sampling). The measurements were performed using Radiello© radial diffusion samplers. A logarithmic transformation of the data was performed, and the correlation between the two substances was calculated. Moreover, linear models considering the log-formaldehyde as the outcome and adjusting for log-acetaldehyde values were used. RESULTS: The study identified high levels of acetaldehyde and formaldehyde exposure in the monitored workplaces. Higher mean values were observed in the leavening phase (8.39 µg/m3 and 3.39 µg/m3 for log-transformed data acetaldehyde and formaldehyde, respectively). The adjusted univariate analyses show statistically significant factors for formaldehyde as the presence of yeast, the presence of type 1 flour, the use of barley, the use of fats, the type of production, the use of spelt, and the presence of type 0 flour. CONCLUSIONS: The measurements confirmed the release of formaldehyde and acetaldehyde in bakeries and pastry industries, especially in some phases of the work process, such as leavening.

Serum heavy metals and breast cancer risk: A case-control study nested in the Florence cohort of the EPIC (European Prospective Investigation into Cancer and nutrition) study.

BACKGROUND: Chronic exposure to heavy metals is of concern for its potential carcinogenic effect. An association with increased breast cancer (BC) risk was hypothesized, but literature data are conflicting and the question remains unresolved. We aimed to investigate the association between heavy metals and BC risk in a case-control study nested within the Florence section of the EPIC (European Prospective Investigation into Cancer and nutrition) cohort. METHODS: We included 150 BC cases and an equal number of controls individually matched to cases by age and year of enrolment. In order to avoid confounding by smoking, the study was restricted to never smokers. Serum levels of six heavy metals (Cd, Co, Cr, Mn, Pb, and Tl) were quantified in pre-diagnostic samples using inductively coupled plasma mass spectrometry. Odds ratios (ORs) and corresponding 95 % confidence intervals (CI) were calculated via multivariable conditional logistic regression models. RESULTS: Serum levels of cobalt were inversely associated with BC risk (OR for the comparison of 3rd vs. 1st tertiles: 0.33, 95 % CI 0.12-0.91, p-value 0.033). None of the other heavy metals under study was significantly associated with BC risk in multivariable models. For Cd, Cr, and Tl, over half of the study participants had serum levels below the limit of quantitation. CONCLUSIONS: Our results do not support the hypothesis that exposure to heavy metals is associated with an increased BC risk among never smokers from the general population. The inverse association between cobalt serum levels and BC risk requires confirmation in future studies.

Levels and determinants of urinary and blood metals in the geothermal area of Mt. Amiata in Tuscany (Italy).

Natural sources and anthropogenic activities are responsible for the widespread presence of heavy metals in the environment in the volcanic and geothermal area of Mt. Amiata (Tuscany, Italy). This study evaluates the extent of the population exposure to metals and describes the major individual and environmental determinants. A human biomonitoring survey was carried out to determine the concentrations of arsenic (As), mercury (Hg), thallium (Tl), antimony (Sb), cadmium (Cd), nickel (Ni), chromium (Cr), cobalt (Co), vanadium (V), and manganese (Mn). The associations between socio-demographics, lifestyle, diet, environmental exposure, and metal concentrations were evaluated using multiple log-linear regression models, adjusted for urinary creatinine. A total of 2034 urine and blood samples were collected. Adjusted geometric averages were higher in women (except for blood Hg) and younger subjects (except for Tl and Cd). Smoking was associated with Cd, As, and V. Some dietary habits (rice, fish, and wine consumption) were associated with As, Hg, Co, and Ni. Amalgam dental fillings and contact lenses were associated with Hg levels, piercing with As, Co, and Ni. Among environmental determinants, urinary As levels were higher in subjects using the aqueduct water for drinking/cooking. The consumption of locally grown fruits and vegetables was associated with Hg, Tl, and Co. Exposure to geothermal plant emissions was associated only with Tl.

Thallium Contamination of Drinking Water: Health Implications in a Residential Cohort Study in Tuscany (Italy).

In 2014-2015, concentrations of thallium above the recommended reference value (EPA: 2 µg/L) were measured in some parts of the drinking water distribution system in the municipality of Pietrasanta (Tuscany, Italy). An extensive campaign of water samples and human biomonitoring surveys were implemented to quantify the exposure of population. A residential cohort epidemiological study was carried out on the population of the municipality of Pietrasanta, aimed at comparing the health status of residents in the areas affected by thallium contamination with residents living in the rest of the municipality. Cohort included people residing in the municipality of Pietrasanta from 1 January 2000 to 31 December 2015. Residence addresses were georeferenced and each subject living in one of the three contaminated areas were defined as exposed. Mortality, hospital discharge data and adverse pregnancy outcomes were taken from administrative health databases. Cox proportional hazard models and logistic models were used to test the association between thallium exposure and health outcome. This study did not show any excess of risk in terms of mortality and hospitalization in the population residing in the areas served by thallium-contaminated aqueduct branches, compared to the rest of the not contaminated area. Increased risks for low birth weight (OR = 1.43 95% CI 0.91-2.25) and pre-term birth (OR = 1.40 95% CI 0.82-2.37) were observed. In view of the paucity of epidemiological studies on thallium, this study is an important contribution to the state of knowledge of the health effects of chronic exposures to low concentrations of thallium.

Determinants of Skin and Respiratory Exposure to Lufenuron During Spraying and Re-entry in Italian Ornamental Plants Greenhouses.

The aim of this study was to evaluate dermal and respiratory exposure of workers to Lufenuron during spraying and re-entry on ornamental plants (stapling) in greenhouses. Potential and real skin exposure were evaluated using filter paper pads, hand contamination by washing, and respiratory exposure by personal air sampling. Dislodgeable foliar residues (DFRs) during re-entry were determined in order to calculate the dermal transfer factor (DTF). Lufenuron was analysed by liquid chromatography-mass detection. Respiratory dose (ReD) was calculated on the basis of a lung ventilation of 15-20 l min-1 and absorbed doses assuming a skin penetration of 13% and a respiratory retention of 100%. During stapling, from the dependence of exposure of hands from DFRs, the mean DTF was 0.575 cm2 h-1 (geometric mean). The ReD was 68.7-74.6 and 0.022-0.636% of the total real dose during spraying and stapling, respectively. The absorbed doses, 0.144-0.171 and 0.005-0.124 µg kg bw-1 during spraying and stapling, respectively, were less than the acceptable operator exposure level of 10 µg kg bw-1. Proper use of equipment and personal protective equipment and personal hygiene are aspects of fundamental importance on which workers must be trained. Adequate occupational hygiene studies are needed to support and verify working practices.

Human biomonitoring to assess exposure to thallium following the contamination of drinking water.

In 2014, in some parts of the water distribution system of the municipality of Pietrasanta (Tuscany, Italy), thallium (Tl) levels above the recommended limits were measured and some restrictions to water usage for drinking and food preparation were imposed. The study aimed to assess Tl exposure and possible health effects by means of a human biomonitoring survey. In the 2014-2016 time frame, 2154 urine and 254 hair samples were taken from different population groups and from a control group. The levels of Tl found in urine and hair were statistically higher in exposed groups than in controls and compared to the reference values for the general population. Concentrations in urine were significantly associated with the geographical origin of the sample, the consumption of drinking water and food grown in local gardens. A significant association was found between urine and hair. No positive associations were found between the Tl levels in hair or urine and several self-reported symptoms and health effects, except for sleep disturbance. The study indicates that the concentration of Tl in drinking water can be traced by urine analysis. Urine and hair have proven to be biological matrices that can be effectively used for the evaluation of Tl exposure. To date, the study represents the most extensive human biomonitoring campaign for the evaluation of the Tl exposure available at international level.

Creation of a database of occupational and environmental concentrations of crystalline silica dust for the purpose of assessing past and current exposures.

BACKGROUND: Professional exposure to respirable dust containing crystalline silica is of great interest for the serious lung diseases resulting from exposure. METHODS: During the period 1986-2019, 3611 exposure data to crystalline silica were collected from companies in central Italy. The data were divided and statistically analyzed based on the sampling system (Cyclone Dorr Oliver, CIP 10-R, Cyclone GS3, SKC plastic selector, Cyclone Higgins-Dewell and Cyclone Lippmann) and the ATECO code (code of economic activity, Italian acronym, used to classify companies when they interface with public institutions) of the companies in which they were collected. For each ATECO code, the division was made according to the type of sampling (personal or static) and the descriptive statistics of the data were calculated. RESULTS: Overall, for personal samples, 8.8% of the data exceeds 0.1 mg/m3, 19.6% exceeds 0.05 mg/m3 and 33.8% exceeds 0.025 mg/m3, the limit values set by the EU Directive 2019/130, suggested by the SCOEL and published by ACGIH respectively. The ATECO codes with the highest worker exposure (geometric means 0.067 and 0.069 mg/m3) were 23.31.00 (manufacture of ceramic tiles for floors and walls) and 23.42.00 (manufacture of ceramic sanitary ware), while the lowest exposure is found in 81.29.91 (cleaning and washing of public areas, removal of snow and ice including shedding of sand) with a geometric mean of 0.002 mg/m3. DISCUSSION: Despite the general reduction over time, there are still many sectors in which data are higher than the current occupational exposure limits; especially in these sectors it is necessary to implement the measures to fully assess worker exposure.

Urinary levels of metal elements in the non-smoking general population in Italy: SIVR study 2012-2015.

The purpose of this study of the Italian Society of Reference Values (SIVR) was to provide the reference values for metals in the urine of the Italian general population. Thirteen sampling centres situated in the north, centre and south of Italy took part in this project. Each sampling centre selected 20 adult subjects. The sample was made up of 120 male and 140 female non-smokers or smokers who had abandoned the habit at least 5 years previously, aged between 18 and 60 years. Urine samples were obtained from the same subjects in June and again in November of the same year. During collection of these two samples, we administered an ad hoc questionnaire designed to assess factors that might influence exposure and the results of the study such as personal characteristics, occupational or extra-occupational activities, dietary habits, the presence of dental fillings containing amalgam, the frequency and mode of exposure to passive smoking and exhaust gases of motor vehicles (traffic). Therefore, the urinary levels of thirteen trace elements (Be, Cd, Co, Cr, Cu, In, Mn, Ni, Pb, Pt, Sb, Tl and V) were determined by Inductively Coupled Plasma Mass Spectrometry. The concentrations obtained (95th percentile) are in µg/L: 0.034, 0.900, 2.24, 0.600, 24.0, 0.013, 1.53, 4.44, 2.64, 0.022, 0.095, 0.759 and 0.855 for Be, Cd, Co, Cr, Cu, In, Mn, Ni, Pb, Pt, Sb, Tl and V, respectively. Further studies with a larger number of subjects are needed in order to continue the biomonitoring of the Italian general population and to monitor the modified levels over time.

Methodology to define biological reference values in the environmental and occupational fields: the contribution of the Italian Society for Reference Values (SIVR).

BACKGROUND: Biological reference values (RVs) explore the relationships between humans and their environment and habits. RVs are fundamental in the environmental field for assessing illnesses possibly associated with environmental pollution, and also in the occupational field, especially in the absence of established biological or environmental limits. OBJECTIVES: The Italian Society for Reference Values (SIVR) determined to test criteria and procedures for the definition of RVs to be used in the environmental and occupational fields. METHODS: The paper describes the SIVR methodology for defining RVs of xenobiotics and their metabolites. Aspects regarding the choice of population sample, the quality of analytical data, statistical analysis and control of variability factors are considered. The simultaneous interlaboratory circuits involved can be expected to increasingly improve the quality of the analytical data. RESULTS: Examples of RVs produced by SIVR are presented. In particular, levels of chromium, mercury, ethylenethiourea, 3,5,6-trichloro-2-pyridinol, 2,5-hexanedione, 1-hydroxypyrene and t,t-muconic acid measured in urine and expressed in micrograms/g creatinine (µg/g creat) or micrograms/L (µg/L) are reported. CONCLUSIONS: With the proposed procedure, SIVR intends to make its activities known to the scientific community in order to increase the number of laboratories involved in the definition of RVs for the Italian population. More research is needed to obtain further RVs in different biological matrices, such as hair, nails and exhaled breath. It is also necessary to update and improve the present reference values and broaden the portfolio of chemicals for which RVs are available. In the near future, SIVR intends to expand its scientific activity by using a multivariate approach for xenobiotics that may have a common origin, and to define RVs separately for children who may be exposed more than adults and be more vulnerable.

Assessment of exposure to pesticides during mixing/loading and spraying of tomatoes in the open field.

Some evidence of exposure-response of metolachlor and pendimethalin for lung cancer and an association of metribuzin with risk of glioma have been reported. The primary objectives in this study were to evaluate exposure and occupational risk during mixing/loading of pesticides and during their application to tomatoes cultivated in open fields. Sixteen farmers were sampled. Respiratory exposure was estimated by personal air sampling using fiberglass filters in a IOM device. Dermal exposure was assessed using skin pads and hand washing. Absorbed doses were estimated assuming 100% lung retention, and 50% or 10% skin absorption for metribuzin, and pendimethalin and metolachlor, respectively. The three pesticides were quantified by gas chromatography tandem mass spectrometry in all matrices. Metolachlor was used as a tracer of contamination of clothes and tractors unrelated to the exposure monitored. Respiratory exposure to metribuzin, used in granular form, was on average more than one order of magnitude higher than exposure to pendimethalin, used in the form of microencapsulated liquid. The actual doses were 0.067-8.08 µg/kg bw, 0.420-12.6 µg/kg bw, and 0.003-0.877 µg/kg bw for pendimethalin, metribuzin, and metolachlor, respectively. Dermal exposure was about 88% of the actual dose for metribuzin and more than 95%, for pendimethalin and metolachlor. For risk assessment, the total absorbed doses (sum of respiratory and skin absorbed doses) were compared with the AOEL for each compound. The actual and absorbed doses of the three pesticides were always lower than the acceptable operator exposure level (AOEL), which are reported to be 234 µg/kg bw, 20 µg/kg bw, and 150 µg/kg bw for pendimethalin, metribuzin, and metolachlor, respectively. In any case, personal protective equipment and spraying devices should be chosen with care to minimize exposure.

[Pollutants from a plant which burns toxic waste in the Province of Arezzo (Tuscany Region, Central Italy): human biomonitoring pilot study to evaluate the possible type of environmental exposure]. / Inquinanti emessi da un impianto di incenerimento di rifiuti speciali nell'area di Arezzo: studio preliminare di monitoraggio biologico umano per identificare la possibile tipologia di esposizione residenziale.

OBJECTIVES: to identify the biomarkers to use in order to evaluate the level and trend of exposure to environmental pollutants from a plant which retrieves and refines precious metals and burns toxic waste. DESIGN: human biomonitoring cross sectional study on a small sample of population resident in the study area. SETTING AND PARTICIPANTS: blood and urinary samples, and questionnaires from volunteers resident at least for 10 years in Civitella in Val di Chiana area (Arezzo Province, Tuscany Region, Central Italy), where the plant is located, and in a control area; they had to be 5-year non-smokers or ex-smokers, in good health status and non occupationally exposed to heavy metals and/or combustion products. MAIN OUTCOME MEASURES: geometric mean and 95th percentile (P95) of mercury (Hg) and cadmium (Cd) blood concentrations, and of the urinary concentrations of antimony (Sb), silver (Ag), arsenic (As), Cd, cobalt (Co), chromium (Cr), Hg, nickel (Ni), platinum (Pt), 1-hydroxypyrene, and trans, trans-muconic acid in the two populations; quantity and pattern of porphyrins in the 24-hour urines of Civitella volunteers. Student's "t" test calculated on the means of data with logarithmic transformation was used to compare the two groups. In case of significant differences linear regression analyses have been performed using questionnaire information. The distribution of observed data was compared with specific reference values. RESULTS: Sb, Cd, and Ni concentrations were significantly higher in Civitella population (39 subjects), while Cr concentration was higher in the control group (18 subjects). No correlations with the individual characteristics have been observed. The 30.3%of subjects who gave their 24- hour urine had a distorted pattern of porphyrins. CONCLUSION: the results confirmed the need to perform human biomonitoring in the Civitella area, increasing the number of samples, using urine as biological matrix, and monitoring at least Sb, Cd, Ni, Pt, Ag, and porphyrins.

[Considerations on the limit values for benzene]. / Considerazioni sui valori limite per il benzene.

Occupational exposure limits and guideline values for the general population proposed for benzene by several international bodies are discussed and compared with the Italian and EU occupational limit values, taking also into account the criteria used for their derivation. Benzene is an environmental pollutant, and the EU guideline value for ambient air is 5 microg/m3, based on carcinogenic risk. Presently, occupational exposures are greatly reduced, and in many instances close to those of the general population. Consequently, it does not seem to be appropriate to maintain the Italian and the EU occupational exposure limits of 1 ppm (3.2 mg/m3), which are inconsistent with the ALARA principle and not justified by technological constraints. It should be pointed out that, in any case, preventive interventions should be carried out, beyond the compliance with the established limit values, in order to ensure the lowest exposure and by carrying out biological monitoring as a tool to verify the appropriateness of risk management measures.

Environmental and biological monitoring in the estimation of absorbed doses of pesticides.

Exposure to pesticides affects most of the population, not only persons occupationally exposed. In a context of high variability of exposure, biological monitoring is important because of the various routes by which exposure can occur and because it assesses both occupational and non-occupational exposure. The main aim of this paper was to critically compare estimates of absorbed dose measured by environmental and biological monitoring in situations in which they could both be applied. The combination of exposure measurements and biological monitoring was found to provide extremely important information on the behaviour of employees, and on the proper use and effectiveness of personal protection equipment.