An Automated Micro Solid-Phase Extraction (µSPE) Liquid Chromatography-Mass Spectrometry Method for Cyclophosphamide and Iphosphamide: Biological Monitoring in Antineoplastic Drug (AD) Occupational Exposure.

Despite the considerable steps taken in the last decade in the context of antineoplastic drug (AD) handling procedures, their mutagenic effect still poses a threat to healthcare personnel actively involved in compounding and administration units. Biological monitoring procedures usually require large volumes of sample and extraction solvents, or do not provide adequate sensitivity. It is here proposed a fast and automated method to evaluate the urinary levels of cyclophosphamide and iphosphamide, composed of a miniaturized solid phase extraction (µSPE) followed by ultrahigh-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) analysis. The extraction procedure, developed through design of experiments (DoE) on the ePrep One Workstation, required a total time of 9.5 min per sample, with recoveries of 77-79% and a solvent consumption lower than 1.5 mL per 1 mL of urine sample. Thanks to the UHPLC-MS/MS method, the limits of quantification (LOQ) obtained were lower than 10 pg/mL. The analytical procedure was successfully applied to 23 urine samples from compounding wards of four Italian hospitals, which resulted in contaminations between 27 and 182 pg/mL.

A New Perspective on SPME and SPME Arrow: Formaldehyde Determination by On-Sample Derivatization Coupled with Multiple and Cooling-Assisted Extractions.

Formaldehyde (FA) is a toxic compound and a human carcinogen. Regulating FA-releasing substances in commercial goods is a growing and interesting topic: worldwide production sectors, like food industries, textiles, wood manufacture, and cosmetics, are involved. Thus, there is a need for sensitive, economical, and specific FA monitoring tools. Solid-phase microextraction (SPME), with O-(2,3,4,5,6-pentafluorobenzyl)-hydroxylamine (PFBHA) on-sample derivatization and gas chromatography, is proposed for FA monitoring of real-life samples. This study reports the use of polydimethylsiloxane (PDMS) as a sorbent phase combined with innovative commercial methods, such as multiple SPME (MSPME) and cooling-assisted SPME, for FA determination. Critical steps, such as extraction and sampling, were evaluated in method development. The derivatization was performed at 60 °C for 30 min, followed by 15 min sampling at 10 °C, in three cycles (SPME Arrow) or six cycles (SPME). The sensitivity was satisfactory for the method's purposes (LOD-LOQ at 11-36 ng L-1, and 8-26 ng L-1, for SPME and SPME Arrow, respectively). The method's linearity ranges from the lower LOQ at trace level (ng L-1) to the upper LOQ at 40 mg L-1. The precision range was 5.7-10.2% and 4.8-9.6% and the accuracy was 97.4% and 96.3% for SPME and SPME Arrow, respectively. The cooling MSPME set-up applied to real commercial goods provided results of quality comparable to previously published data.

Impact of economic crisis on mental health: a 10-year challenge.

The worldwide economic crisis of the last decade, and still unresolved, led to a great recession involving all major economies. Since economic factors may influence mental wellbeing, not surprisingly a rise in poor mental health was observed in different countries, while representing a great challenge to psychiatric interventions. This paper aims at reviewing the available English literature focusing on the impact of the current economic crisis on mental health, with a special focus on depression and suicide. Available studies indicate that consequences of economic crisis, such as unemployment, increased workload or work reorganization, and reduced staff and wages, may constitute important stressing factors with a negative impact on mental health. Although data are not easily comparable in different countries, depression seems to be the most common psychiatric disorders especially in middle-aged men. Even suicide rates seem to be increased in men, mainly in countries with no public welfare or poor family relationships. All these findings require a careful attention from both governments that cut resources on public health instead of investing in it, and psychiatric associations that should implement appropriate strategies to face and to manage this sort of depression epidemic driven by economic crisis. Again, as available data suggest that the impact of the crisis might have been attenuated in countries with higher spending in social protection, they clearly urge policy makers to take into account possible health externalities associated to inadequate social protection systems.

Identification of Amoxicillin Crystals in Urine: a Case Report.

BACKGROUND: The case concerns a 30-year-old woman in the 24th week of pregnancy presenting to the medical emergency room with fever and abdominal pain. Urine sediment microscopy revealed the presence of unknown needle-shaped crystals. METHODS: Crystals identification was performed by Fourier-Transform Infrared Spectroscopy coupled to Attenuated Total Reflectance (FTIR-ATR). RESULTS: Amoxicillin crystals were verified with semiquantitative results of 87.7%. CONCLUSIONS: Drug-induced crystalluria is a frequent finding in urine examination and it may be asymptomatic. FTIR spectroscopy is a rapid and specific tool in identification of crystals and could be useful supporting renal disease diagnosis and monitoring drug therapy.

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.

A contribution to the validation of the Italian version of the work-related quality of life scale.

BACKGROUND: Quality of working life has been shown to play a key role in reducing strain inside and outside the workplace, supporting the fulfillment of workers' wellbeing and increasing workforce productivity. Van Laar et al. in 2007 developed the Work-Related Quality of Life (WRQoL) scale that was applied to several different work environments and translated into nine languages. OBJECTIVES: We aimed to test and validate an Italian version of the WRQoL scale. METHODS: A cross-sectional design was conducted to collect a sample of healthcare professionals (N=430) in 8 hospitals in the Northwest of Italy. Internal consistency of each scale was tested through Cronbach's alpha. A Confirmatory factor analysis was performed. Independent samples t-tests and ANOVA were performed to determine whether the scores on the subscales differed according to various socio-demographic variables. RESULTS: A seven factors structure was confirmed (Control at work; General well-being; Home-work interface; Stress at Work; Job and career satisfaction; Working conditions; Employee Engagement; χ2=682.453, p<.001; χ2 and df(251) ratio=2.71; CFI=.90; RMSEA=.06; SRMR=.06). All subdimensions showed Cronbach's alphas ≥ 0.70 but for Stress at Work (alpha 0.65). The subscales differentiated between groups of people according to several socio-demographic characteristics (i.e., profession, age, length of employment). DISCUSSION: The Italian version of WRQoL is a brief and sufficiently reliable tool that can contribute to a more complex and complete evaluation of the psychological well-being at work due to its multidimensionality. Overall, the use of this tool in occupational health practice, in addition to that of other instruments already available, should prove useful in monitoring workers' well-being before and after interventions.

High HOMA-IR Index in Healthcare Shift Workers.

Background and objectives: Evidence shows that shift work may be correlated with insulin resistance (IR). Therefore its estimation in clinical and prevention practice is of great significance. A cross-sectional study was performed to examine the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) Index among healthcare shift workers (HCSW). Materials and Methods: A total of 272 healthcare workers (HCWs) were invited to participate in the study within an occupational surveillance framework, 137 were HCSW while 135 were healthcare non-shift workers (HCNSW). Fasting glucose, insulin, and HOMA-IR Index were evaluated in each participant and correlated with shift workers. Results: Indicators of glucose metabolism were significantly higher in HCSW p < 0.001, and logistic regression analysis confirmed a significant positive association between increased values of HOMA-IR Index and shift workers (p < 0.05). Conclusions: Shift work could be a risk factor in developing insulin resistance and metabolic syndrome.

Work-related stress in the banking sector: a study on an Italian aged population of over 2,000 workers.

INTRODUCTION: In the European Union, the employment rate for the population in the age group 55-64 years has greatly increased in the last two decades. Companies, especially in sectors such as banking, are looking for new strategies to improve the productivity of workers in this age group. OBJECTIVES: This study was conceived with the purpose of exploring the associations between job characteristics that could influence stress and certain organizational aspects in a large population of banking workers. METHODS: More than 2,000 workers over 50 years of age of an Italian banking group participated in the study. Work-related stress was measured with the Stress Questionnaire (SQ). Organizational aspects of work were measured with a dedicated scale included in the SQ. Demographic aspects were detected by specific questions. Structural equation modelling was used and correlation coefficients were calculated. RESULTS: The results from the structural equation modeling supported the theoretical model. Organizational policies are associated with both stress correlated factors (ß=0.468) and perceptions of supervisor support and social support (ß=0.710). The perception of both parameters is associated with stress outcomes (ß=0.365). The proposed model offered better results than a competitive model, on which a total mediation was tested, rather than a partial one (p<0.001). CONCLUSIONS: The results highlight the importance of an integrated assessment of the effects of organizational aspects of work and stress factors to implement the protection of physical and mental health. Further research will help to understand more thoroughly if the issues emerged are effectively related to age. This can be assessed through a case-control study that also includes younger workers.

Occupational exposure to airborne formaldehyde in hospital: setting an automatic sampling system, comparing different monitoring methods and applying them to assess exposure.

BACKGROUND: In recent years, under-vacuum sealing (UVS) and containers with formalin encapsulated in the lid have been proposed for the reduction of occupational exposure to airborne formaldehyde (FA) in healthcare environments. OBJECTIVES: We are presenting a study focused on the assessment of FA in hospitals: an automatic sampling system was set, different sampling devices were compared, and the concentration of FA was assessed, following its use in different scenarios. METHODS: Three different devices for sampling/measuring FA were compared. They are based on: 1. silica gel cartridges impregnated with 2,4-dinitrophenylhydrazine (2,4-DNPH); 2. SPME® fiber using O-(2,3,4,5,6-pentafluorobenzyl)hydroxylamine; 3. direct reading commercial instrumentation. Three typical scenarios using FA were investigated: operating theatres where small biopsies are soaked into closed-circuit system 4% FA containers, secretariat of pathology laboratories during the registration of biopsies and pathology laboratories during the filling procedure by UVS and the slicing of biopsies. RESULTS: The automatic sampling system allowed short-, long-, and in continuous-sampling time to measure airborne FA. Different sampling devices provided comparable results when tested to assess FA concentration ranging from 0.020-0.320 ppm in a test chamber, although  the devices based on 2,4-DNPH were  the best in terms of sensitivity and accuracy. The results of 246 samples showed that the FA concentration was less than 0.04 ppm in 91% of the measurements. CONCLUSIONS: The automatic methods efficiently allow sampling and measurement of FA in hospital settings. When using safe practices, the concentration of FA is well below occupational limit values.

High-Throughput Analysis of Selected Urinary Hydroxy Polycyclic Aromatic Hydrocarbons by an Innovative Automated Solid-Phase Microextraction.

High-throughput screening of samples is the strategy of choice to detect occupational exposure biomarkers, yet it requires a user-friendly apparatus that gives relatively prompt results while ensuring high degrees of selectivity, precision, accuracy and automation, particularly in the preparation process. Miniaturization has attracted much attention in analytical chemistry and has driven solvent and sample savings as easier automation, the latter thanks to the introduction on the market of the three axis autosampler. In light of the above, this contribution describes a novel user-friendly solid-phase microextraction (SPME) off- and on-line platform coupled with gas chromatography and triple quadrupole-mass spectrometry to determine urinary metabolites of polycyclic aromatic hydrocarbons 1- and 2-hydroxy-naphthalene, 9-hydroxy-phenanthrene, 1-hydroxy-pyrene, 3- and 9-hydroxy-benzoantracene, and 3-hydroxy-benzo[a]pyrene. In this new procedure, chromatography's sensitivity is combined with the user-friendliness of N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide on-fiber SPME derivatization using direct immersion sampling; moreover, specific isotope-labelled internal standards provide quantitative accuracy. The detection limits for the seven OH-PAHs ranged from 0.25 to 4.52 ng/L. Intra-(from 2.5 to 3.0%) and inter-session (from 2.4 to 3.9%) repeatability was also evaluated. This method serves to identify suitable risk-control strategies for occupational hygiene conservation programs.

Analytical strategies for assessing occupational exposure to antineoplastic drugs in healthcare workplaces.

BACKGROUND: Cytotoxic antineoplastic drugs (ADs), widely used in treating cancer, are considered hazardous in the workplace and thus require safe handling practices. An analytical protocol for environmental and biological AD monitoring in the healthcare environment has been developed, since Europe lacks clear guidelines and regulations for cytostatic preparation and handling. MATERIAL AND METHODS: Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used for measuring contemporaneously 20 multi-class cytostatic compounds and urinary α-fluoro-ß-alanine, whereas platinum was detected by inductively coupled plasma mass spectrometry (ICP-MS). Sampling procedures and analytical conditions were optimized and the assays were validated. Environmental AD monitoring data, collected in 2009-2017, for a total of 3749 wipe tests and 57 720 determinations, was evaluated. RESULTS: The proportion of positive samples gradually decreased from 11.7% in 2010 to 1% in 2017, however, 2266 determinations were positive. No urine sample had detectable concentrations of any of the 4 drugs considered (0/398 samples). CONCLUSIONS: These improvements are so large that the key role played by the new, more stringent rules for preparing and administering ADs is evident. Hence, the analytical method involving multi-element determinations allows for a more thorough and complete investigation into the AD contamination of work environments. Med Pr 2018;69(6):589-604.

Bullying among nurses and its relationship with burnout and organizational climate.

Workplace bullying is one of the most common work-related psychological problems. Bullying costs seem higher for organizations composed of health-care workers who perform direct-contact patients-complex tasks. Only a few studies have been carried out among nurses in Italy and integrated models of bullying antecedents and consequences are particularly missing. The aim of this study was to develop a bullying model focused on the interaction between bullying and burnout in the setting of a climate-health relationship. Research involved 658 nurses who completed a survey on health, burnout, bullying and organizational climate. Structural equation modeling was used to test the hypothesis. Results suggest that workplace bullying partially mediates the relationship between organizational climate and burnout and that bullying does not affect health directly, but only indirectly, via the mediation of burnout. Our study demonstrates the key-role of workplace bullying and burnout in the climate-health relationship in order to understand and to improve nurses' health.

[The operational role of the occupational health physician in the assessment and management of health risks related to night risks]. / Il ruolo del medico del lavoro nella valutazione e nella gestione dei rischi correlati al lavoro notturno alla luce della disciplina nazionale e comunitaria.

The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers).

[Prevalence of workplace bullying in a population of nurses at three Italian hospitals]. / Prevalenza del fenomeno mobbing in una popolazione di infermieri di tre aziende ospedaliere italiane.

Negative behaviors could be considered as a risk index of workplace bullying; researching on these events is useful for the planning of preventive interventions. The aim of this study was to investigate the prevalence of negative actions in a population of nurses and their possible association with issues related to mental health. We administered a proper questionnaire, based both on the NAQ-R and on the GHQ12, to 206 subjects, who worked in three hospitals, located in the center and south of Italy. Our results confirmed that the nursing profession presents a clear bullying risk in the workplace, without any notable differences regarding gender or demographics. The prevalence of negative actions was noteworthy, mainly with regard to the job position and the task. Our study also showed that workplace bullying may interfere with the overall health of nurses, particularly connected to psycho-emotional issues.

Comparison of ELISA with automated ECLIA for IL-6 determination in COVID-19 patients: An Italian real-life experience.

Objectives: Coronavirus disease 2019 (COVID-19) has a wide spectrum of clinical severity. A cytokine storm is associated with COVID-19 severity. Of these, IL-6 is significantly associated with higher mortality and is also a marker for predicting disease prognosis. IL-6 may act as a target for therapeutics and, a blockade of IL-6 function by Tocilizumab has been described as a treatment of the inflammatory process COVID-19-related. This study aims to describe our experience comparing two different methods, in detail Human IL-6 Instant ELISA and the Elecsys IL-6 based on ECLIA, for the IL-6 assessment. Design and methods: IL-6 levels from serum samples of 104 COVID-19 patients, admitted to the AOU Careggi (Hospital in Florence -Italy), were assessed by using the two above-mentioned methods, and the results were analysed through Passing-Bablok regression fit and Bland-Altman plot. Results: The regression exhibited a linear relation between the methods with a regression equation (y = - 0.13 + 0.63 x; 95 % C.I. intercept = - 0.13 to 4.55; 95 % C.I. slope = 1.03 to 1.26 with R2 = 0.89, p > 0.05), showing a positive slope. The agreement of the two methods reported a bias of -25.0 pg/mL. Thus, the two methods correlate but do not agree in terms of numeric results. Conclusions: The two assays showed good comparability. However, because of the extremely wide linear range of the ECLIA, its throughput and its capacity for immune profiling, it represents an interesting emerging technology in the immunology field.

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part II - the application of the FMECA method to compare manual vs automated preparation.

Healthcare workers handling antineoplastic drugs (ADs) in preparation units run the risk of occupational exposure to contaminated surfaces and associated mutagenic, teratogenic, and oncogenic effects of those drugs. To minimise this risk, automated compounding systems, mainly robots, have been replacing manual preparation of intravenous drugs for the last 20 years now, and their number is on the rise. To evaluate contamination risk and the quality of the working environment for healthcare workers preparing ADs, we applied the Failure Mode Effects and Criticality Analysis (FMECA) method to compare the acceptable risk level (ARL), based on the risk priority number (RPN) calculated from five identified failure modes, with the measured risk level (MRL). The model has shown higher risk of exposure with powdered ADs and containers not protected by external plastic shrink film, but we found no clear difference in contamination risk between manual and automated preparation. This approach could be useful to assess and prevent the risk of occupational exposure for healthcare workers coming from residual cytotoxic contamination both for current handling procedures and the newly designed ones. At the same time, contamination monitoring data can be used to keep track of the quality of working conditions by comparing the observed risk profiles with the proposed ARL. Our study has shown that automated preparation may have an upper hand in terms of safety but still leaves room for improvement, at least in our four hospitals.

Echinacea Reduces Antibiotics by Preventing Respiratory Infections: A Meta-Analysis (ERA-PRIMA).

Respiratory tract infections (RTIs) are the leading cause of antibiotic prescriptions, primarily due to the risk for secondary bacterial infections. In this study, we examined whether Echinacea could reduce the need for antibiotics by preventing RTIs and their complications, and subsequently investigated its safety profile. A comprehensive search of EMBASE, PubMed, Google Scholar, Cochrane DARE and clinicaltrials.gov identified 30 clinical trials (39 comparisons) studying Echinacea for the prevention or treatment of RTIs in 5652 subjects. Echinacea significantly reduced the monthly RTI occurrence, risk ratio (RR) 0.68 (95% CI 0.61-0.77) and number of patients with ≥1 RTI, RR = 0.75 [95% CI 0.69-0.81] corresponding to an odds ratio 0.53 [95% CI 0.42-0.67]. Echinacea reduced the risk of recurrent infections (RR = 0.60; 95% CI 0.46-0.80), RTI complications (RR = 0.44; 95% CI 0.36-0.54) and the need for antibiotic therapy (RR = 0.60; 95% CI 0.39-0.93), with total antibiotic therapy days reduced by 70% (IRR = 0.29; 95% CI 0.11-0.74). Alcoholic extracts from freshly harvested Echinacea purpurea were the strongest, with an 80% reduction of antibiotic treatment days, IRR 0.21 [95% CI 0.15-0.28]. An equal number of adverse events occurred with Echinacea and control treatment. Echinacea can safely prevent RTIs and associated complications, thereby decreasing the demand for antibiotics. Relevant differences exist between Echinacea preparations.

Simultaneous Determination by Selective Esterification of Trimellitic, Phthalic, and Maleic Anhydrides in the Presence of Respective Acids.

Trimellitic, phthalic, and maleic anhydrides are important building blocks to produce polymers and additives, such as plasticizers. In humans, the exposure to these compounds can cause several health issues. In European Union and USA, their presence in substances and mixtures is restricted by CLP Regulation (no. 1272/2008) and HCS/HazCom 2012, respectively, but no information about the corresponding acids is reported. For this reason, a selective method to determine anhydrides in mixtures, in the presence of acids, could be interesting. Nowadays, methods in the literature are either not selective or use explosive and toxic reagents (as diazomethane). In this work, an innovative, greener, and safer method for the simultaneous recognition and quantification of anhydrides and acids, via direct injection gas chromatography-mass spectrometry, is developed. The sample pretreatment consists in selective esterification with absolute ethanol on the anhydride, followed by a treatment with boron trifluoride-methanol for the methylation of remaining carboxylic groups. The optimization of the functionalization, a crucial step of the method, was optimized by experimental design. The limit of detection-limit of quantification (LOD-LOQ) values for trimellitic, phthalic, and maleic anhydrides are 0.31-0.93, 0.47-1.41, and 0.06-0.18 µg/mL, respectively.

The Influence of the COVID-19 Pandemic Emergency on Alcohol Use: A Focus on a Cohort of Sicilian Workers.

The period between the beginning and the end of the COVID-19 pandemic emergency generated a general state of stress, affecting both the mental state and physical well-being of the general population. Stress is the body's reaction to events or stimuli perceived as potentially harmful or distressing. Particularly when prolonged over time, it can promote the consumption of different psychotropic substances such as alcohol, and thus the genesis of various pathologies. Therefore, our research aimed to evaluate the differences in alcohol consumption in a cohort of 640 video workers who carried out activities in smart working, subjects particularly exposed to stressful situations due to the stringent rules of protection and prevention implemented during the pandemic. Furthermore, based on the results obtained from the administration of the AUDIT-C, we wanted to analyse the different modes of alcohol consumption (low, moderate, high, severe) to understand whether there is a difference in the amount of alcohol consumed that could predispose individuals to health problems. To this end, we administered the AUDIT-C questionnaire in two periods (T0 and T1), coinciding with annual occupational health specialist visits. The results of the present research showed an increase in the number of subjects consuming alcohol (p = 0.0005) and in their AUDIT-C scores (p < 0.0001) over the period considered. A significant decrease in subgroups who drink in a low-risk (p = 0.0049) mode and an increase in those with high (p = 0.00012) and severe risk (p = 0.0002) were also detected. In addition, comparing the male and female populations, it emerged that males have drinking patterns that lead to a higher (p = 0.0067) health risk of experiencing alcohol-related diseases than female drinking patterns. Although this study provides further evidence of the negative impact of the stress generated by the pandemic emergency on alcohol consumption, the influence of many other factors cannot be ruled out. Further research is needed to better understand the relationship between the pandemic and alcohol consumption, including the underlying factors and mechanisms driving changes in drinking behaviour, as well as potential interventions and support strategies to address alcohol-related harm during and after the pandemic.

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part I - medical gloves.

Antineoplastic drugs (ADs) are essential tools in cancer treatment, but their cytotoxicity poses a risk to workers involved in their handling. In a hospital environment fundamental strategies for minimising exposure involve proper use of safety cabinets and closed-circuit transfer devices, along with personnel training and increased awareness of risks. However, medical gloves remain the first line of defence. In this respect the evaluation of glove materials and best choices can improve hospital safety management and prevent potential hazards and long-term consequences. The aim of this study was to assess contamination of gloves in samples taken from AD administration and preparation units of nine Italian hospitals and to raise awareness of the importance of evaluating chemico-physical properties of gloves. Our findings show that 33 % of the analysed gloves were positive for at least one AD, with contaminations ranging from 0.6 to 20,729 pg/ cm2. We proposed the alert glove values (AGVs) for each AD as a limit value for contamination assessment and good practice evaluation. Our findings also point to multiple AD contamination (43 % of positive findings in preparation units), calculated as total AGV (AGV-T), and confirm that gloves should be replaced after 30 min of AD handling, based on cumulative permeation and area under the curve (AUC), to maintain safety and limit dermal exposure.