Nickel and blood counts in workers exposed to urban stressors.

Nickel (Ni) and Ni compounds are widely present in the urban air. The purpose of this study is to estimate exposure of individuals to Ni and the correlation between this exposure and the values of blood counts in outdoor workers. This study focused on a sample of 101 outdoor workers (55 male and 46 female; 65 nonsmokers and 36 smokers), all employed in the municipal police in a large Italian city. The personal levels of exposure to Ni were assessed through (a) environmental monitoring of Ni present in the urban air obtained from individual samples and (b) biological monitoring of urinary and blood Ni. The blood count parameters were obtained from the hemochromocytometric tests. Pearson correlation coefficients (r) were calculated to assess the association between the blood and urinary Ni and the complete blood count. Multiple linear regression models were used to examine the associations between the complete blood count and the independent variables (age, gender, years of work for current tasks, cigarette smoking habit (current and never smoker), values of airborne Ni, and blood and urinary Ni). Multiple linear regression analysis performed on the total group of 101 subjects confirms the association among the red blood cells count, the hematocrit, and the urinary Ni (R(2) = 0.520, p = 0.025 and R(2) = 0.530, p = 0.030). These results should lead to further studies on the effects of Ni in working populations exposed to urban pollutants. The possibility that the associations found in our study may be partially explained by other urban pollutants (such as benzene, toluene, and other heavy metals) not taken into consideration in this study cannot be ruled out.

Correlation between urinary cadmium and thyroid hormones in outdoor workers exposed to urban stressors.

OBJECTIVES: The aim of this study is to evaluate whether exposure to low concentrations of cadmium (Cd) can have effects on the thyroid hormone level of outdoor workers exposed to urban pollutants. METHODS: The study was conducted on a final sample of 277 individuals (184 males and 93 females). The environmental monitoring of Cd was evaluated through the use of portable dosimeters, while the biological monitoring was achieved through the assessment of urinary Cd and thyroid hormones. The total sample was divided according to sex and task. The Pearson's correlation coefficient among the variables was calculated after subdivision on the basis of sex and task. The multiple linear regression was performed to take into account the major confounding factors. RESULTS: Statistical tests showed a negative correlation between urinary Cd levels and free triiodothyronine and free thyroxine and a positive correlation between urinary Cd and thyroid-stimulating hormone levels. CONCLUSIONS: Our early results seem to point out that occupational exposure to low concentrations of Cd present in urban air affects the thyroid hormone levels in exposed workers.

Assessment of liver function in two groups of outdoor workers exposed to arsenic.

PURPOSE: To evaluate whether the exposure to arsenic (As) causes alterations of liver enzymes in two groups of outdoor workers. METHODS: Total urinary As and the levels of AST/GOT, ALT/GPT, and GGT were measured on 80 traffic policemen and 50 police drivers. Personal air samples were obtained for assessing the exposure to As on a subgroup of 20 traffic policemen and 20 police drivers. RESULTS: Mean values of personal exposure to As, urinary As, AST/GOT, and ALT/GPT were significantly higher in traffic policemen than in the police drivers. Multiple linear regression models showed associations between urinary As and airborne As, ALT/GPT and the job variables, and BMI and urinary As. CONCLUSIONS: These findings contribute toward the evaluation of the hepatic effects of exposure to As in the urban workers.

Exposure to formaldehyde in health care: an evaluation of the white blood count differential.

The aim of our study is to estimate if the occupational exposure to formaldehyde can cause alterations of leukocytes plasma values in health care workers employed in a big hospital compared to a control group. We studied employees in operating rooms and laboratories of Pathological Anatomy, Molecular Biology, Molecular Neurobiology, Parasitology and Experimental Oncology (exposed to formaldehyde) and employees of the Department of Internal Medicine (not exposed). The sample studied was composed of 86 workers exposed to formaldehyde and 86 workers not exposed. All subjects underwent a clinical-anamnaestic examination and for all subjects were measured the following values: total white blood cells, lymphocytes, monocytes and granulocytes (eosinophils, basophils, neutrophils). Statistical analysis of data was based on calculation of the mean, standard deviation and the distribution into classes according to the nature of each variable. Differences were considered significant when p was < 0.05. The mean and the distribution of values of the white blood cells, lymphocytes, monocytes and eosinophils were significantly higher in male subjects exposed to formaldehyde compared to not-exposed. Not significant differences were found in female subjects exposed compared to not exposed. The results underline the importance of a careful risk assessment of workers exposed to formaldehyde and the use of appropriate preventive measures. The health care trained and informed about the risks he is exposed to should observe good standards of behavior and, where it is not possible to use alternative materials, the indoor concentrations of formaldehyde should never exceed occupational limit values.

Correlation between total blood lead values and peripheral blood counts in workers occupationally exposed to urban stressors.

The aim of the study was to assess the relationship between occupational exposure to airborne lead (Pb) and alterations in peripheral blood counts in workers of the Municipal Police assigned to different types of outdoor tasks. Then, 337 both male and female subjects were enrolled and divided on the basis of sex, cigarette smoking habit and kind of task. Exposure to airborne Pb, dosage of total blood Pb and peripheral blood count were carried out. A significant positive correlation was detected between the values of total blood Pb and values of plasma reticulocytes (%RET) both in the total sample and for all the classes of the subdivision except for police drivers. Some statistically significant correlations were present but discontinuous for other variables of peripheral blood counts. Results suggest that occupational exposure to low doses of airborne Pb is able to influence lines of the hematopoietic system in exposed workers, with special reference to %RET.

[Biological risk among health workers]. / Rischio biologico in operatori sanitari.

INTRODUCTION: In health care the contact with body fluids, such as saliva or blood is frequent. The aim of our study was to analyze whether the exposure to biological risks in health care, in particular exposure to HBV and HCV, could cause alterations of some liver parameters. MATERIALS AND METHODS: Our study analyzes of 254 health care workers of a big hospital in Rome. The subjects exposed to biological risks were divided into two groups, one exposed to a high biological risk and the other one exposed to a low biological risk, according to individual duties and/or the departments where they carry out their work. We checked the markers for hepatitis B and C in order to highlight a possible infection, the possible vaccine coverage and the control of the antibody titer by previous infection. We measured the values of transaminases, GGT, alkaline phosphatase, total bilirubin and fractional proteinaemia total and electrophoresis. RESULTS: In health care workers exposed to high risk the average values of transaminases, total protein, alkaline phosphatase, gamma GT, total bilirubin were not significant compared to the some values formed in workers exposed to low risk (p > 0.05). Subjects positive for hepatitis B and C were 4% in the group of workers exposed to high risk (class 1) while in the group of workers exposed to low risk (class 2) the percentage of exposed individuals was 0.01% for the hepatitis B and 2.6% for hepatitis C. DISCUSSION AND CONCLUSIONS: We found a small numbers of positive cases of hepatitis B and C in people exposed to biological agents. We did not find alterations of the average values of transaminases, total protein, alkaline phosphatase, gamma GT, total bilirubin and albumin in positive cases, so that we can say that the proper use of personal protective equipment, training and information of workers and the observance of universal precautions are effective in protecting workers.

[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.

[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.

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.

Urinary Nickel and Progesterone in Workers Exposed to Urban Pollutants.

OBJECTIVE: The aim of this study is to evaluate whether the exposure to a low dose of nickel could determinate a variation in levels of progesterone in outdoor workers. MATERIALS AND METHODS: Two hundred sixty one subjects were divided by sex, task, age, seniority, and cigarette smoking habit. For each workers was evaluated the dose of blood progesterone and urinary nickel.The statistical analysis was performed. RESULTS: The Pearson correlation showed a statistically significant correlation between urinary nickel levels and progesterone. The multiple linear regression showed a significant correlation between progesterone and urinary nickel in the total sample and in the subgroups of smokers and workers with tasks of traffic direction. CONCLUSIONS: The results of our study suggest that occupational exposure to low doses of nickel present in urban pollution may influence to progesterone levels in outdoor workers.

Exposure to urban stressor and effects on free testosterone in female workers.

BACKGROUND: The aim of the study is to evaluate if occupational exposure to chemical, physical and psycho-social urban stressor could cause alterations in plasma free testosterone (T) levels and related diseases in female traffic police vs. control group. PATIENTS AND METHODS: The research was carried out on initial sample of 468 female Municipal Police employees (209 traffic police and 259 controls). After excluding the principal confounding factors, traffic police were matched with controls by age, working life, menstrual cycle day, BMI, drinking habit, cigarette smoking habit, liquorice and soy intake in diet, habitual consumption of Italian coffee. There were 96 female traffic police and 96 controls included in the study. RESULTS: T mean levels were significantly higher in female traffic police compared to controls (p=0.000). The distribution of T values in traffic police and in controls was significant (p=0.000). No significant differences were found comparing the percentage in traffic police and controls concerning dystocial, premature and post-term birth. An increase in mental health disorders was found in traffic police compared to controls but the difference was not significant. CONCLUSION: The increase in T plasma levels observed in traffic police vs. controls can be due to a chronic working exposure to low doses of environmental chemical urban stressor. According to our previous researches T could be used as an early biological marker even before the onset of the related disorders.

[Scientific evidence in occupational health: meta-analytical study of the burnout syndrome]. / L'evidenza scientifica in medicina del lavoro: studio meta-analitico sulla sindrome del burnout.

BACKGROUND: According to scientific literature, burnout can be described as a multi-dimensional syndrome with three fundamental dimensions: emotional exhaustion, depersonalization and reduced personal accomplishment. OBJECTIVES: Since attention for this phenomenon is increasing, with a large number of articles published in scientific journals in recent years, we set out to evaluate the scientific evidence on this topic by applying the meta-analytical method. METHODS: All comparative studies performed on burnout were identified and examined in order to compute the Effect Size of the results. Forty studies complied with the inclusion criteria of this analysis for a total of 2,031 burnout cases versus 1,950 controls. RESULTS: Our results revealed a significant disparity in the methods of selecting subjects with burnout. This problem emphasizes the lack of a standardized definition of burnout as a univocal clinical entity and, consequently, the lack of a unanimously agreed procedure for the identification of patients to be included in this diagnostic category. CONCLUSIONS: The wide heterogeneity between studies thus considerably reduces the possibility of comparing them and generalizing the results.

Distortion-product otoacoustic emissions in workers exposed to urban stressors.

The study aimed to compare the distortion-product otoacoustic emissions (DPOAEs) with the pure-tone audiometry and to analyze the changes in participants exposed to noise. The results show a prevalence of participants with impaired DPOAEs higher than the prevalence of participants with impaired audiometries in the total sample, in men, and in outdoor workers and a prevalence of impaired DPOAEs and of impaired audiometries in men higher than in women and in outdoor workers higher than in indoor workers. The comparison of mean values between outdoor and indoor workers shows a significant difference only on some frequencies, in the DP-gram. The results suggest a higher effectiveness of DPOAEs compared with the pure-tone audiometry in identifying the presence of any damage in individuals exposed to noise at an early stage.

Plasma 17-alpha-OH-progesterone in male workers exposed to traffic pollutants.

The aim of the study is to evaluate if the occupational exposure to urban pollutants could cause alterations on 17-alfa-hydroxy-progesterone plasma levels and related diseases in male traffic policemen. 17-alpha-OH-P is synthesized in Leydig cells and in adrenals; it influences spermiogenesis, acrosoma reaction, testosterone biosynthesis, blocking of gonadotropin secretion; it regulates learning, memory and sleep. After excluding principal confounding factors, i.e., rotating or night shifts, exposure to solvents, paints and pesticides during time-off and smoking, traffic policemen were matched with controls by age, working life and drinking habit. Finally, 112 traffic policemen and 112 controls were included in the study. In traffic policemen 17-alpha-OH-P mean values were significantly higher vs. controls. The distribution of 17-alpha-OH-P values in both groups was significant. An increased frequency of fertility disorders referred to the questionnaire items were found in traffic policemen vs. controls, but the difference was not significant. The occupational exposure to low doses of chemical urban stressor, interacting with and adding to the psychosocial ones, could alter plasma 17-alpha-OH-P concentrations in traffic policemen vs. controls. 17-alpha-OH-P could be used as an early biological marker, even before the onset of the reproductive and mental health diseases.

Blood pressure in indoor and outdoor workers.

INTRODUCTION: The aim of our study is to evaluate the changes in systolic and diastolic blood pressure in two occupational categories: outdoor workers (traffic policemen and environment technicians) and indoor workers. MATERIALS AND METHODS: The study was conducted comparing the results obtained from three samples of male workers: 175 outdoor traffic policemen, 175 outdoor environment technicians and 175 indoor workers. The outdoor and indoor groups were made comparable by age, length of service, body mass index, alcohol consumption, smoking status. RESULTS: The mean values of systolic and diastolic blood pressure were found higher in traffic policemen and technicians than in indoor workers, as well as higher values of systolic blood pressure in traffic policemen than in technicians. CONCLUSIONS: The results suggest that outdoor working affects the blood pressure, contributing to an increased cardiovascular risk.

Effects on androstenedione in male workers exposed to urban stressors.

The aim of this study is to evaluate whether occupational exposure to urban stressors could cause alterations in androstenedione plasma levels in male traffic policemen compared to a control group. After excluding the principal confounding factors, traffic policemen were matched with controls by age, working life, body mass index (BMI), drinking habit, and habitual soy intake in diet. One hundred and ten traffic policemen and 110 controls were included in the study. In male traffic policemen, mean androstenedione values were significantly lower compared to controls. The distribution of androstenedione values in traffic policemen and in controls was significant. Our results suggest that the occupational exposure to chemical urban stressors, interacting with and adding to the psychosocial ones, could alter androstenedione plasma concentrations in traffic policemen compared to a control group. According to our previous research, androstenedione could be used as an early biological marker, valuable for the group to be employed in occupational settings, even before the onset of the endocrine reproductive health diseases.

Immune parameters in female workers exposed to urban pollutants.

Urban outside workers, such as traffic police, are daily exposed to air pollutants and psychosocial stressors: for these workers, the working environment corresponds to the living environment of the general population. Studies in the literature have shown that immune parameters could be affected by chronic exposure to various chemical pollutants. The aim of this study is to evaluate whether occupational exposure to urban pollutants can cause alterations in NK, IL-2, IFN-gamma and C3 plasma levels in female traffic police compared to a control group. After excluding subjects with the principal confounding factors, 86 female traffic police and 87 controls were matched by age, years of police work and habitual alcohol consumption. The distribution of NK values in female traffic police and controls was significantly different (p=0.000); NK values above the upper limit of the normal laboratory range were observed in 23 female traffic police and in 2 controls (p=0.000). IL-2 mean levels were higher in traffic police compared to controls, but the difference was not significant. The mean and the distribution of IFN-gamma values in female traffic police and controls were not different. C3 mean levels were higher in female traffic police versus controls, but the difference was not significant. Considering that the subjects with the principal confounding factors were excluded from the study and that female traffic police and controls were matched by the above-mentioned variables, our results suggest that chronic occupational exposure to low doses of chemical stressors, which may interact with and add to psychosocial ones, can affect both innate and adaptative immunity.

Plasma IL-2, NK, IFN-γ, and C3 in male workers exposed to traffic pollutants.

The aim of the study is to evaluate if the occupational exposure to urban stressors could cause alterations in interleukin-2 (IL-2), NK, interferon-γ (IFN-γ) and C3 plasma levels in male traffic police officers compared to controls. After excluding the principal confounding factors, 108 traffic police officers were matched with 108 controls by age, working life, habitual consumption of alcohol and spirits. IL-2 mean levels were significantly higher in traffic police officers compared to controls (p=0.04). The distribution of IL-2 values in traffic police officers and in controls was significant (p=0.01). The distribution of NK value percentage in traffic police officers and in controls was significant (p=0.000). IFN-γ and C3 mean levels were not significant in traffic police officers compared to controls. Our results suggest that the occupational chronic exposure to low doses of urban stressors could affect NK and IL-2 plasma concentrations in traffic police officers of male sex.

Assessment of subjective stress in video display terminal workers.

Stress assessment in the workplace has been focused on its environmental, psychological and biological aspects. We carried out an evaluation of the subjective components of stress in a working population of 60 subjects employed in a large Public Service, 30 Video Display Terminal (VDT) workers (15 men and 15 woman) and 30 office-workers not assigned to VDT (15 men and 15 woman), by using the "Rapid Stress Assessment Scale": a short questionnaire of easy administration in work environment. VDT workers of both sexes showed higher total stress score vs. office workers (respectively p<0.05, p<0.05). Gender differences were present: female VDT workers showed higher scores of clusters anxiety (p<0.001) and aggressiveness (p<0.05); male VDT workers' score were significantly higher in somatization (p<0.05) and aggressiveness cluster. Our results showed that in VDT workers are experienced greater subjective response to stress than "office workers" and confirm the gender differences in stress experiencing.