Risk assessment of vascular disorders by a supplementary hand-arm vascular weighting of hand-transmitted vibration.

PURPOSE: To provide an updated epidemiological validation for a supplementary method for assessing the risk of vascular disorders from hand-transmitted vibration. METHODS: The occurrence of vibration-induced white finger (VWF) in the vibration-exposed workers of the Italian cohort of the EU VIBRISKS study was related to measures of daily vibration exposure expressed in terms of r.m.s. acceleration magnitude normalised to an 8-h day, frequency weighted according to either the frequency weighting Wh defined in international standard ISO 5349-1:2001 [Ah(8) in ms- 2] or the hand-arm vascular frequency weighting Wp proposed in the ISO technical report (TR) 18570:2017 [Ap(8) in ms- 2]. To estimate a threshold value for vascular hand-arm vibration risk, the Wp-weighted vibration exposure value Ep,d (in ms- 1.5) was calculated according to the ISO/TR document. The difference in the predictions of VWF between the exposure measures calculated with the frequency weightings Wh or Wp was investigated by means of logistic modelling. RESULTS: Measures of daily vibration exposure constructed with the frequency weighting Wp [Ap(8) and Ep,d], which gives more importance to intermediate- and high-frequency vibration, were better predictors of the occurrence of VWF in the vibration-exposed workers than the metric derived from the conventional ISO frequency weighting Wh [Ah(8)]. There was some epidemiological evidence for a threshold value of Ep,d for the onset of VWF in the vibration-exposed workers. CONCLUSIONS: Measures of daily vibration exposure evaluated with the vascular weighting Wp performed better for the predictions of VWF than those obtained with the frequency weighting Wh recommended in ISO 5349-1.

[The evaluation of optical radiation hazards: methods, case studies and critical aspects]. / La valutazione dei rischi da radiazioni ottiche: metodi, casi studio, criticità.

SUMMARY: Purpose. Currents methods for the evaluation and control of optical radiation hazards at workplaces are presented. Methods. Safe exposure criteria that may be readily applied to practical situations are discussed. Hazard evaluation techniques are discussed for a number of intense optical radiation sources. Examples include arc welding, germicidal lamps in medical and laboratories activities, metal and glass melting. Results. Hazard data and PPE choice criteria are provided, taking account of varied critical aspects from the case studies discussed. Conclusions. Some critical aspects in the optical radiation safety management have been discussed. The improvement of protection programmes is needed to raise awareness of the health hazards of optical radiation, and to achieve the application of simple engineering controls and/or administrative controls aimed at ensuring that workers are made aware of the presence of potentially harmful optical radiation and providing information to avoid such harmful exposure, according to AOR Directive.

[Assessment of the risk due to exposure to EMF with particular reference to the protection of sensitive subjects]. / La valutazione del rischio da esposizione a CEM con particolare riguardo alla tutela dei soggetti sensibili.

SUMMARY: Purpose. The work illustrates useful elements for the risk assessment for workers exposed to electromagnetic fields, also in reference to sensitive subjects such as those with active implantable medical devices (AIMD). Methods. The approach introduced by Legislative Decree 81/08 for risk assessment does not explicitly include operational criteria and specific measures for the protection of sensitive subjects. In the case of workers with DMIA, the employer may refer to relevant harmonized technical standards. Results. They are shown the results of in vitro tests performed on pacemakers following the indications of the technical reference standard and employing sources of electromagnetic fields that, due to the type of signal emitted, do not allow to exclude an a priori influence on the operation of the device. Conclusions. Workers at particular risk are generally protected if the requirements established for the population are respected. This measure may, under certain conditions, not be sufficient,making it necessary to carry out more in-depth and individual assessments. However, the cases illustrated here for AIMD showed interference phenomena only in limited experimental configurations despite the levels of the electric and magnetic fields generated by the sources exceeding the limits for the general population.

Blue Light and Ultraviolet Radiation Exposure from Infant Phototherapy Equipment.

Phototherapy is the use of light for reducing the concentration of bilirubin in the body of infants. Although it has become a mainstay since its introduction in 1958, a better understanding of the efficacy and safety of phototherapy applications seems to be necessary for improved clinical practices and outcomes. This study was initiated to evaluate workers' exposure to Optical Radiation from different types of phototherapy devices in clinical use in Italy. During infant phototherapy the staff monitors babies periodically for around 10 min every hour, and fixation of the phototherapy beam light frequently occurs: almost all operators work within 30 cm of the phototherapy source during monitoring procedures, with most of them commonly working at ≤25 cm from the direct or reflected radiation beam. The results of this study suggest that there is a great variability in the spectral emission of equipments investigated, depending on the types of lamps used and some phototherapy equipment exposes operators to blue light photochemical retinal hazard. Some of the equipment investigated presents relevant spectral emission also in the UVA region. Taking into account that the exposure to UV in childhood has been established as an important contributing factor for melanoma risk in adults and considering the high susceptibility to UV-induced skin damage of the newborn, related to his pigmentary traits, the UV exposure of the infant during phototherapy should be "as low as reasonably achievable," considering that it is unnecessary to the therapy. It is recommended that special safety training be provided for the affected employees: in particular, protective eyewear can be necessary during newborn assistance activities carried out in proximity of some sources. The engineering design of phototherapy equipment can be optimized. Specific requirements for photobiological safety of lamps used in the phototherapy equipment should be defined in the safety product standard for such equipment.

Measures of internal lumbar load in professional drivers - the use of a whole-body finite-element model for the evaluation of adverse health effects of multi-axis vibration.

The present study aimed to (1) employ the method for evaluation of vibration containing multiple shocks according to ISO/CD 2631-5:2014 (Model 1) and DIN SPEC 45697:2012 in a cohort of 537 professional drivers, (2) deliver the results for a re-analysis of epidemiological data obtained in the VIBRISKS study, (3) clarify the extent to which vibration acceleration and individual variables influence risk values, such as the daily compressive dose S(ed) and the risk factor R, and (4) compare the results with in vivo measurements and those obtained in previous studies with similar models. The risk factor R was influenced by the acceleration, lifetime exposure duration, sitting posture, age at the start of exposure and body mass/body mass index in order of decreasing effect. Age and annual and daily exposure duration had only a marginal effect. The daily compressive dose S(ed) and the risk factor R showed weak linear association with the daily vibration exposure A(8) and the vibration dose value VDV. The study revealed high shear forces in the lumbar spine. PRACTITIONER SUMMARY: In a re-analysis of an epidemiological study of professional drivers, a software tool available with standards DIN SPEC 45697:2012 and ISO/CD 2631­5:2014 Model 1 was used to calculate the risk to the lumbar spine in terms of daily compressive dose S(ed) and risk factor R. The tool was found to be suitable for risk assessment in a large cohort.

Occupational exposure to physical agents: the new Italian database for risk assessment and control.

This article presents the new Italian database of physical agents, which is available at http://www.portaleagentifisici.it. It supports in risk assessment employers who have to comply with Italy's Legislative Decree 81/2008 (transposing into law European Union Directives 2003/10/EC, 2002/44/EC, 2004/40/EC and 2006/25/EC). The database currently contains measurements and declared European Community (EC) values from over 2540 machines; in particular, the database hosts data on mechanical vibration from over 1430 hand-held power tools (e.g., pneumatic and electric hammers, chainsaws, grinders, drills, sanders and saws) and from over 1020 whole-body machines (e.g., buses, fork lifts and wheel tractors). The database is continuously updated as soon as new experimental and declared data are acquired.

Germicidal lamps using UV-C radiation may pose health safety issues: a biomolecular analysis of their effects on apoptosis and senescence.

The battle against the COVID-19 pandemic has spurred a heightened state of vigilance in global healthcare, leading to the proliferation of diverse sanitization methods. Among these approaches, germicidal lamps utilizing ultraviolet (UV) rays, particularly UV-C (wavelength ranging from 280 to 100 nm), have gained prominence for domestic use. These light-emitting diode (LED) lamps are designed to sanitize the air, objects, and surfaces. However, the prevailing concern is that these UV lamps are often introduced into the market without adequate accompanying information to ensure their safe utilization. Importantly, exposure to absorbed UV light can potentially trigger adverse biological responses, encompassing cell death and senescence. Our research encompassed a series of investigations aimed at comprehending the biological repercussions of UV-C radiation exposure from readily available domestic lamps. Our focus centered on epithelial retinal cells, keratinocytes, and fibroblasts, components of the skin and ocular targets frequently exposed to UV irradiation. Our findings underscore the potential harm associated with even brief exposure to UV, leading to irreversible and detrimental alterations in both skin cells and retinal cells of the eye. Notably, epithelial retinal cells exhibited heightened sensitivity, marked by substantial apoptosis. In contrast, keratinocytes demonstrated resilience to apoptosis even at elevated UV doses, though they were prone to senescence. Meanwhile, fibroblasts displayed a gradual amplification of both senescence and apoptosis as radiation doses escalated. In summary, despite the potential benefits offered by UV-C in deactivating pathogens like SARS-CoV-2, it remains evident that the concurrent risks posed by UV-C to human health cannot be ignored.

[Solar ultraviolet radiation risk in outdoor workers: a specific project of Tuscany Region (Italy)]. / Rischio da radiazione solare ultravioletta nei lavoratori outdoor: piano mirato della Regione Toscana.

OBJECTIVE: The aims of Tuscany Regional project were: to study the sun protection attitude of outdoor workers; to measure solar ultraviolet (UV) exposure in work environment; to describe the frequency of photoaging, precancerous lesions, and skin cancers in outdoor workers; to collect information on solar ultraviolet radiation exposure from incident cases of Non-Melanoma Skin Cancer (NMSC) recruited from Tuscany Cancer Registry. DESIGN: Outdoor workers completed a questionnaire devoted to collect information on sun protection attitudes during a typical summer working week. Environmental and personal measurements were carried out. Expert dermatologists examined outdoor workers to assess the frequency of photoaging, precancerous lesions, and skin cancer. A structured questionnaire was mailed to incident cases of NMSC. Information were collected on personal habits and working history, focusing on solar ultraviolet radiation exposure. SETTING AND PARTICIPANTS: Agriculture, construction, quarrying and fishing activities were considered: 292 employees responded to questions about the type of clothing used in the morning and in the afternoon,while working outdoors; 637 outdoor workers underwent skin examination. We contacted 743 cases of NMSC occurred in 2004; 498 subjects accepted to participate in this study. RESULTS: The clothing worn by surveyed subjects was often inadequate compared to the high level of exposure to UV. The skin examination of 637 outdoor workers highlighted 2 melanomas, 7 epitheliomas and 35 actinic keratoses. Among the 498 cases of NMSC, 135 (27%) were diagnosed in outdoor workers. Most represented economic activity sectors were: agriculture, construction, transport, sports. CONCLUSION: The characterization of outside workers revealed unsatisfactory sun protection behaviours. Moreover, previously undetected skin cancers were diagnosed. The study on MNSC confirms the complexity of studying the exposure to UV radiation. The Tuscany Regional project provided useful information on the risk of solar ultraviolet radiation in outdoor workers. Prevention programs are needed.

[WBV risk in maritime and port operators]. / II rischio vibrazioni nelle attività marittime e portuali.

Whole Body Vibration (WBV) is the shaking or jolting of the human body through a supporting surface, usually a seat or floor. The risk from vibration is related to the overall time the operator or driver is exposed to the vibration and the number of shocks and jolts they experience each day. In the 27 countries of Europe the EC Physical Agents Directive, effective 6th July 2010, requires all employers to control exposure to a number of hazards including noise and vibration. The EC Vibration Directive sets out regulations for the control of health and safety risks from the exposure of workers to hand arm vibration (HAV) and whole body vibration (WBV) in the workplace. The maritime sector needs to comply: high exposure WBV levels can be found when operating RIBs and High Speed Craft. Marine sectors affected by Whole Body Vibration (WBV) include military, search & rescue, government agencies, local authorities, police, water sports, oil & gas, thrill ride, charter and all organisations operating boats, RIBs (Rigid Inflatable Boat) and High Speed Craft.

Workers' Perception Heat Stress: Results from a Pilot Study Conducted in Italy during the COVID-19 Pandemic in 2020.

Many workers are exposed to the effects of heat and often to extreme temperatures. Heat stress has been further aggravated during the COVID-19 pandemic by the use of personal protective equipment to prevent SARS-CoV-2 infection. However, workers' risk perception of heat stress is often low, with negative effects on their health and productivity. The study aims to identify workers' needs and gaps in knowledge, suggesting the adaptation of measures that best comply with the needs of both workers and employers. A cross-sectional online questionnaire survey was conducted in Italy in the hottest months of 2020 (June-October) through different multimedia channels. The data collected were analyzed using descriptive statistics; analytical tests and analysis of variance were used to evaluate differences between groups of workers. In total, 345 questionnaires were collected and analyzed. The whole sample of respondents declared that heat is an important contributor to productivity loss and 83% of workers did not receive heat warnings from their employer. In this context, the internet is considered as the main source of information about heat-related illness in the workplace. Results highlight the need to increase workers' perception of heat stress in the workplace to safeguard their health and productivity. About two-thirds of the sample stated that working in the sun without access to shaded areas, working indoors without adequate ventilation, and nearby fire, steam, and hot surfaces, represent the main injuries' risk factors.

A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment among Healthcare Workers during the COVID-19 Pandemic in Italy.

The pandemic has been afflicting the planet for over a year and from the occupational point of view, healthcare workers have recorded a substantial increase in working hours. The use of personal protective equipment (PPE), necessary to keep safe from COVID-19 increases the chances of overheating, especially during the summer seasons which, due to climate change, are becoming increasingly warm and prolonged. A web survey was carried out in Italy within the WORKLIMATE project during the summer and early autumn 2020. Analysis of variance (ANOVA) was used to evaluate differences between groups. 191 questionnaires were collected (hospital doctor 38.2%, nurses 33.5%, other healthcare professionals 28.3%). The impact of PPE on the thermal stress perception declared by the interviewees was very high on the body areas directly covered by these devices (78% of workers). Workers who used masks for more than 4 h per day perceived PPE as more uncomfortable (p < 0.001) compared to the others and reported a greater productivity loss (p < 0.001). Furthermore, the study highlighted a high perception of thermal stress among healthcare workers that worn COVID-19-PPE and this enhances the need for appropriate heat health warning systems and response measures addressed to the occupational sector.

Electromagnetic fields in neonatal incubators: the reasons for an alert.

BACKGROUND: Neonatal incubators are important tools for sick newborns in the first few days of life. Nevertheless, their electric engine, often very close to the newborn's body, emits electromagnetic fields (EMF) to which newborns are exposed. Aim of this paper is to review the available literature on EMF exposure in incubators, and the effects of such exposures on newborns that have been investigated. METHODS: We carried out a systematic review of studies about EMF emissions produced by incubators, using Medline and Embase databases from 1993 to 2017. RESULTS: We retrieved 15 papers that described the EMF exposure in incubators and their biological effects on babies. EMF levels in incubators appear to be between 2 and 100 mG, depending on the distance of the mattress from the electric engine. In some cases, they exceed this range. These values interfere with melatonin production or with vagal tone. Even caregivers are exposed to high EMF, above 200 mG, when working at close contact with the incubators. CONCLUSION: EMF have been described as potentially hazardous for human health, and values reported in this review are an alert to prevent babies' and caregivers' exposure when close to the incubators. A precautionary approach should be adopted in future incubator design, to prevent high exposures of newborns in incubators and of caregivers as well.

Occupational exposure to mechanical vibration: the Italian vibration database for risk assessment.

The Italian vibration database is presented. It is hosted by a web server at the National Institute of Occupational Prevention and Safety (ISPESL) in Rome, Italy (http: / /www.ispesl.it/vibrationdatabase). It supports in risk assessment employers who have to comply with Legislative Decree 187/05, now replaced by Legislative Decree 81/08, which transposes into law Vibration Directive 2002/44/EC. The database currently contains measurements and EC-declared values from over 980 hand-held power tools (such as pneumatic and electric hammers, chainsaws, grinders, drills, sanders and saws) and from over 420 vehicles (such as buses, forklifts and wheel tractors). The database is continuously updated as soon as new experimental and declared data are acquired.

Otoacoustic emission sensitivity to low levels of noise-induced hearing loss.

With the aim of investigating the capability of otoacoustic emission (OAE) in the detection of low levels of noise-induced hearing loss, audiometric and otoacoustic data of young workers (age: 18-35) exposed to different levels of industrial noise have been recorded. These subjects are participating in a long-term longitudinal study, in which audiometric, exposure (both professional and extra-professional), and OAE data (transient evoked and distortion product) will be collected for a period of several years. All measurements have been performed, during routine occupational health surveillance, with a standard clinical apparatus and acquisition procedure, which can be easily used in the occupational safety practice. The first study was focused on the correlation between transient evoked OAE signal-to-noise ratio and distortion product (DPOAE) OAE level and the audiometric threshold, investigating the causes of the rather large intersubject variability of the OAE levels. The data analysis has shown that, if both OAE data and audiometric data are averaged over a sufficiently large bandwidth, the correlation between DPOAE levels and audiometric hearing threshold is sufficient to design OAE-based diagnostic tests with good sensitivity and specificity also in a very mild hearing loss range, between 10 and 20 dB.

Evaluation of human exposure to complex waveform magnetic fields generated by arc-welding equipment according to European safety standards.

In this paper, a procedure is described for the assessment of human exposure to magnetic fields with complex waveforms generated by arc-welding equipment. The work moves from the analysis of relevant guidelines and technical standards, underlining their strengths and their limits. Then, the procedure is described with particular attention to the techniques used to treat complex waveform fields. Finally, the procedure is applied to concrete cases encountered in the workplace. The discussion of the results highlights the critical points in the procedure, as well as those related to the evolution of the technical and exposure standards.

Frequency weightings of hand-transmitted vibration for predicting vibration-induced white finger.

OBJECTIVE: The aim of this study was to investigate the performance of four frequency weightings for hand-transmitted vibration to predict the incidence of vibration-induced white finger (VWF). METHODS: In a longitudinal study of vibration-exposed forestry and stone workers (N=206), the incidence of VWF was related to measures of vibration exposure expressed in terms of 8-hour frequency-weighted energy-equivalent root-mean-square (rms) acceleration magnitude [A(8)] and years of follow-up. To calculate A(8), the rms acceleration magnitudes of vibration were weighted by means of four frequency weightings: (i) W(h) (the frequency weighting specified in ISO 5349-1:2001); (ii) W(h-bl) (the band-limiting component of W(h)); (iii) W(hf) (a frequency weighting based on finger vibration power absorption); and (iv) W(hT) (a frequency weighting based on a Japanese study of VWF prevalence). The relations of VWF to alternative measures of vibration exposure were assessed by the generalized estimating equations (GEE) method to account for the within-subject dependency of the observations over time. RESULTS: Data analysis with a GEE logistic model and a measure of statistical fit suggested that calculating A(8) by weighting the tool rms accelerations with W(h-bl)gave better predictions of the cumulative incidence of VWF than the other alternative measures of daily vibration exposure. Values of A(8) derived from the currently recommended ISO frequency weighting Wh produced poorer predictions of the incidence of VWF than those obtained with frequency weightings W(hf)or W(hT). CONCLUSIONS: This prospective cohort study suggests that measures of daily vibration exposure which give relatively more weight to intermediate and high frequency vibration are more appropriate for assessing the probability of VWF.

Evaluation and characterization of fetal exposures to low frequency magnetic fields generated by laptop computers.

Portable - or "laptop" - computers (LCs) are widely and increasingly used all over the world. Since LCs are often used in tight contact with the body even by pregnant women, fetal exposures to low frequency magnetic fields generated by these units can occur. LC emissions are usually characterized by complex waveforms and are often generated by the main AC power supply (when connected) and by the display power supply sub-system. In the present study, low frequency magnetic field emissions were measured for a set of five models of portable computers. For each of them, the magnetic flux density was characterized in terms not just of field amplitude, but also of the so called "weighted peak" (WP) index, introduced in the 2003 ICNIRP Statement on complex waveforms and confirmed in the 2010 ICNIRP Guidelines for low frequency fields. For the model of LC presenting the higher emission, a deeper analysis was also carried out, using numerical dosimetry techniques to calculate internal quantities (current density and in-situ electric field) with reference to a digital body model of a pregnant woman. Since internal quantities have complex waveforms too, the concept of WP index was extended to them, considering the ICNIRP basic restrictions defined in the 1998 Guidelines for the current density and in the 2010 Guidelines for the in-situ electric field. Induced quantities and WP indexes were computed using an appropriate original formulation of the well known Scalar Potential Finite Difference (SPFD) numerical method for electromagnetic dosimetry in quasi-static conditions.

Use of sound-absorbing panel to reduce noisy incubator reverberating effects.

OBJECTIVES: To assess the amplification and distortion of noise in incubators by measuring noise levels from various sources under various conditions. STUDY DESIGN: We recorded sound pressure levels (SPL) of background noise, baby crying, alarms and porthole closing with the incubator hood open or closed. Then we tried to reduce the sound level in the incubator by applying a sound absorbing panel to the ceiling of the hood. RESULTS: The sound sources analysed produced very high SPL. In free field baby crying and porthole noise were, respectively, 81-83 dB and 70-71 dB, closing the hood they raised to 84-87 and 73-74 dB: this means that the noise perceived by a baby in the incubator had twice the SPL of the same noise emitted in a free field; alarm noise was 56-57 dB inside incubators. Sound emitted inside the hood was also distorted, i.e. it had different features from the same source in a free field. The insulating panel prevented amplification and distortion due to the hood and reduced the SPL of alarms. Only background noise did not decrease with the panel. Sound absorbing panel reduced baby's crying, porthole noise and alarm noise SPL to 82-85, 70-71 and 50-51 dB, respectively. CONCLUSIONS: Incubators are reverberating environments, which amplify the baby's cry and other noises produced inside the hood. The frequency components of noises are altered by the hood. The sound absorbing panel reduced this phenomenon.