[Health risk assessment in the metal scrap recycle: the case of Brescia]. / Valutazione dei rischi alla salute nell'industria del riciclo dei rottami metallici: il caso di Brescia.

The recycle of metal scraps is one of the most important industrial activity of Brescia: almost 40% of the metal scraps produced in Italy are reprocessed in this Province. The melting process currently used produces air emissions containing dioxins, PCB and other pollutants which are dispersed in the atmosphere giving a contribution to the general environment pollution. This contribution has been and is being extensively studied in terms of air concentration and soil deposition but, because of its complexity and the difficulty to gather the necessary data, very little investigation has been made up to now on its impact on the health of workers and population. The difficulties are overcome by RAMET, a research Consortium established and financed by the main 24 metallurgical and siderurgical companies of Brescia, which can take advantage of the availability of the production facilities of its shareholders as pilot plants and has access to their database and experience. Starting from this unique favourable condition and in collaboration with the University of Brescia, RAMET is working on a research project having as main objective the assessment of the POPs dose adsorbed and the relevant consequences on workers and public health. The general scheme and organization of this project are given in this paper together with the outlines and the results of the main activities already completed or in progress.

[Biological monitoring of exposure to carcinogenic metallic elements and polycyclic aromatic hydrocarbons in four secondary metallurgical sectors]. / Monitoraggio biologico dell'esposizione ad elementi metallici cancerogeni e ad idrocarburi policiclici aromatici in quattro settori metallurgici secondari.

This cross-sectional study was aimed at evaluating in a large sample of male foundry workers the current exposure levels to carcinogenic compounds, including metallic elements [arsenic (As), beryllium (Be), cadmium (Cd), chromium (Cr), nickel (Ni)] and aromatic polycyclic hydrocarbons (PAH) by a biological monitoring approach, using validated biomarkers of exposure. Workers were recruited from 15 aluminium, copper alloy, electric steel and cast iron foundries and provided an end-of-shift urine sample to determine urinary concentrations of As, Be, Cd, Cr, Ni and 1-hydroxypyrene (1-OHP). Metallic elements were determined either by inductively coupled plasma mass spectrometry (Be, Cd and Cr) or by atomic absorption spectrometry (As, Ni), whereas 1-OHP was determined by high pressure liquid chromatography with fluorimetric detection. Most of the determinations fell within the laboratory's reference values. Age and lifestyle habits (smoking, alcohol, diet) played a significant interfering role.

Ninety-six-hour wireless oesophageal pH monitoring following proton pump inhibitor administration in NERD patients.

BACKGROUND: Comparative studies of proton pump inhibitors (PPIs) have revealed that acid reflux is influenced by PPI treatment, formulations and dosing regimens. Wireless pH capsules have circumvented some of the limitations of conventional catheter-based pH testing with the additional advantage of 96-h recording periods. AIM: To clarify the effectiveness of intra-oesophageal acid suppression by omeprazole, pantoprazole and lansoprazole in non-erosive reflux disease patients through a 4-day monitoring of oesophageal pH and related symptoms. METHODS: Twenty-four patients with typical symptoms of gastro-oesophageal reflux disease were enrolled and administered upper endoscopy and placement of a wireless pH capsule. Patients randomly received omeprazole, pantoprazole or lansoprazole for 3 days after the first 24 h. Symptom-reflux associations were expressed using the symptom index (SI). RESULTS: All patients completed the study. Significant decrease in acid exposure occurred on day 2 and in each successive day in all groups. Pantoprazole and omeprazole are more effective than lansoprazole at inducing a normalization of intra-oesophageal acid exposure at days 2 and 3. Significant reduction in SI at day 2 was observed. CONCLUSIONS: Four-day ambulatory oesophageal pH monitoring is feasible and safe. Omeprazole, pantoprazole and lansoprazole have an equivalent potency for normalizing intra-oesophageal acid exposure after 3 days of treatment in non-erosive reflux disease patients.

Short-term treatment with infliximab in chronic refractory pouchitis and ileitis.

BACKGROUND: Chronic refractory pouchitis is a long-term complication after ileal pouch-anal anastomosis and it may be associated with ileal inflammation. AIM: To determine the efficacy of infliximab in treatment of chronic refractory pouchitis complicated by ileitis, using a wireless capsule endoscopy. METHODS: Sixteen patients with chronic refractory pouchitis complicated by ileitis were enrolled. Pouchitis was diagnosed by clinical, endoscopic and histological criteria. Ileitis was documented using wireless capsule endoscopy. Duodenum-jejunum and proximal-middle ileum were evaluated and the presence of small lesions and large lesions were noted. Crohn's disease, intestinal infections were excluded in all patients. Patients were treated with infliximab and clinical response was recorded. Wireless capsule endoscopy was repeated at week 10 and Pouchitis Disease Activity Index score was determined. RESULTS: Ten patients were enrolled and completed the study. Clinical remission was achieved in nine patients. At wireless capsule endoscopy and pouch endoscopy, a complete recovery of lesions was observed in eight patients. One patient presented four small lesions of the ileum at the 6 weeks of treatment and one patient did not show any modification. Clinical and endoscopic remission was maintained in these eight patients at least 6 months. CONCLUSION: These preliminary results indicate that infliximab may be recommended for the treatment of chronic refractory pouchitis complicated by ileitis.