[Show abstract][Hide abstract] ABSTRACT: Up to now the exposures to hair and skin derivatives of animals have not yet been the subject of systematic studies. The observation of a clinical case has provided the opportunity for a review of the literature. The inpatient was a 49-year-old man, a carder in a textile factory, exposed to angora wool. He noticed the appearance of dyspnea during working hours. There was no eosinophilia in blood, and the results of pulmonary function tests were normal. The nonspecific bronchial provocation test with methacholine demonstrated an abnormal bronchial reactivity. The challenge test with angora wool was positive (decrease in FEV1 of more than 40%) as well as total IGE and specific IgE to rabbit epithelium (433 KU/l and 12.1 KUA/l, resp.). Several sources of allergens were found in the rabbit, and the main allergen was represented by proteins from epithelia, urine, and saliva. Most of these proteins belong to the family of lipocalin, they function as carriers for small hydrophobic molecules (vitamins and pheromones). If the diagnosis of occupational asthma caused by animal hair and skin derivatives may be relatively easy by means of the challenge test, defining etiology is complicated because of the lack of in vitro tests.
[Show abstract][Hide abstract] ABSTRACT: Interventions of health promotion (HP) with the best evidence of effectiveness are reported in literature. However nothing is said about how to apply these interventions in the local specific situations. On the other hand in literature the role of the occupational physician in workplace HP is not highlighted. Currently there is a substantial amount of knowledge on effective HP interventions that meets internationally accepted criteria, but at least in our country it is not systematically applied. While several databases provide useful information on different HP programs, the Cochrane Collaboration systematic reviews should be considered the most reliable source.
Giornale italiano di medicina del lavoro ed ergonomia 01/2010; 32(4 Suppl):448-51.
[Show abstract][Hide abstract] ABSTRACT: Occupationally, there are a number of work processes that constitute a long-term risk as sources of exposure to lead. In these processes the presence of lead is not evident but represents a hidden risk of poisoning.
Study of two cases of hidden exposure to lead that were discovered during renovation work on a historical building.
Acute lead poisoning symptoms appeared in the 2 workers. The current protocol for treatment of lead poisoning was applied, which consisted in administration of a chelating agent (EDTA), with subsequent monitoring of indicators of dose (PbB. blood lead level, PbU: urinary lead level) and indicators of effect (erythrocyte Protoporphyrin IX, urinary delta-aminolevulinic acid (ALA-U), urinary coproporphyrins).
The lead colic and anaemia appeared at PbB values (102 microg/dl e 104 microg/dl) that were higher than the PbB action value (40 microg/dl) and higher than the limit value (60 microg/dl).
The gravity of the symptoms, the high number of persons potentially involved, the difficulty of reclamation and probable urban contamination, with relative consequences concerning particularly infants and women infertile age, are sufficient grounds to require effective legislative action and improvement in the services available at the hospitals involved.
La Medicina del lavoro 01/2010; 101(5):335-40. · 0.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Craft features a strong link with tradition which preserves and perpetuates techniques created and consolidated over time, in a particular historical, cultural and geographical situation. Italy is home to excellent craftsmanship: fashion, furniture, giftware, design. The framework law for the craft n. 433/1985 defines the craft business carried on by the craftsman for a predominant objective of producing goods, including semi-finished or services. The D.L.gs 81/2008 defines the manner in which the employer must conduct risk assessment in the workplace and process the risk assessment document. The aim of the study is to provide employers with a simple methodology that allows the drafting of the first mapping of hazards/dangers identificating risk sources in the working process. The developed methodology is expressed as a model of information gathering, which brings to a first overview of all major risk indicators that may arise in the craftsmanship.
Giornale italiano di medicina del lavoro ed ergonomia 01/2009; 31(3):297-302.
[Show abstract][Hide abstract] ABSTRACT: WORKING HYPOTHESIS OF SIMPLIFIED TECNIQUES FOR THE FIRST MAPPING OF OCCUPATIONAL HAZARDS IN HANDICRAFTS . PART TWO: PHYSICAL AND CHEMICAL RISKS. Craft features a strong link with tradition which preserves and perpetuates techniques created and consolidated over time, in a particular historical, cultural and geographical situation. Italy is home to excellent craftsmanship: fashion, furniture, giftware, design. The framework law for the craft n. 433/1985 defines the craft business carried on by the craftsman for a predominant objective of producing goods, including semi-finished or services. The D.L.gs 81/2008 defines the manner in which the employer must conduct risk assessment in the workplace and process the risk assessment document. The aim of the study is to provide employers with a simple methodology that allows the drafting of the first mapping of hazards/dangers identificating risk sources in the working process. The developed methodology is expressed as a model of information gathering, which brings to a first overview of all major risk indicators that may arise in the craftsmanship.
[Show abstract][Hide abstract] ABSTRACT: The ICOH Scientific Committee on Occupational and Environmental Dermatoses organized an International Workshop on "Dermal risk assessment at workplace" with the aim of focussing on the different ways of approaching the concept of skin notation (S) for chemicals. The Workshop participants presented their ideas on several aspects of S such as the problems related to the absorption through the compromised skin, the different approaches to S and models that can be used as alternatives to S. Participants agreed to produce a position paper with the goal of exploring the actions needed to improve the S system towards international harmonization. They consider that further discussions are needed to obtain an international consensus, but at the same time they believe that by improving and harmonizing systems for setting S we can make an important contribution to improving health of people with potential dermal exposure to chemicals at work.
Regulatory Toxicology and Pharmacology 01/2008; 49(3):301-7. · 2.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to assess the reliability of asbestos fibre concentration in bronchoalveolar lavage fluid (BALF) by carrying out the mineralogical analysis of BALF at different times in the same patient and comparing the results.
Twenty two patients underwent diagnostic fibreoptic bronchoscopy twice: the first was to assess the past asbestos exposure and the second for different clinical reasons. Mineralogical analysis of BALF was carried out.
In 16 patients (72.7%), a reduction of concentration in BALF of all asbestos fibres was observed. The concentrations of both chrysotile and amphiboles in the first bronchoalveolar lavage (BAL) were related to their concentrations in the second BAL and the observed differences were not statistically significant. A significant decrease in asbestos body concentration between the first and the second BAL was found (Wilcoxon test, P < 0.01).
The reliability of the fibre concentration in BALF as a marker of past asbestos exposure seems quite good. In most cases, it allows us to distinguish workers in different classes of exposure and gives useful information on the pattern of exposure. Uncertainties related in general to lung residues and in particular to mineralogical analysis of BALF (mainly due to the high coefficient of variation (CV) at low fibre concentrations and the results of the statistical analysis on total fibres) suggest that this biomarker is more likely suitable for a qualitative/categorical approach to exposure assessment than a quantitative one.
Annals of Occupational Hygiene 07/2007; 51(5):495-500. · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study focuses on the spread of mesothelioma in Siena. The population consisted of 30 patients. The diagnosis was made through histopathological and immunoistochemical or cytological and immunoistochemical analysis. The association between malignant masothelioma and exposure to asbestos was deduced by the occupational history. The mesothelioma was noted both in traditional industries and other jobs such as the chain of manifacture, plumbers, electricians, carpenters, installers of asbestos insulation and construction workers. Thus it is possible to find other malignant and nonmalignant asbestos-related diseases more frequently than mesothelioma. There is an evident risk in rebuilding, so the development of new cases due to these exposures is expected.
Giornale italiano di medicina del lavoro ed ergonomia 01/2007; 29(3 Suppl):332-3.
[Show abstract][Hide abstract] ABSTRACT: In this study the past professional exposure and the health state of sugar refinery workers in Arezzo (Italy) are reviewed. The medical examinations, confirmed by chest CT, showed asbestos pleural thickening and one asbestosis case. Mineralogical analysis of bronchoalveolar lavage fluid (BALF) was carried out in this population to measure the pulmonary burden. Total fiber's concentration was not different in either subjects with or without asbestos-related disease. Notably, comparison between total fiber's concentration in sugar refinery workers and subjects employed in other industries, revealed a lower professional exposure of the former with respect to shipyard workers and electric plants. In other groups of Italian sugar refinery workers, a concentration of asbestos fibers higher than in the studied population was found. Thus, the study highlights the necessity to develop standardized methodologies to carry out health intervention programmes in workers previously exposed to asbestos.
Giornale italiano di medicina del lavoro ed ergonomia 01/2007; 29(3 Suppl):644-6.
[Show abstract][Hide abstract] ABSTRACT: To obtain better insight into the robustness of in vitro percutaneous absorption methodology, the intra- and inter-laboratory variation in this type of study was investigated in 10 European laboratories. To this purpose, the in vitro absorption of three compounds through human skin (9 laboratories) and rat skin (1 laboratory) was determined. The test materials were benzoic acid, caffeine, and testosterone, representing a range of different physico-chemical properties. All laboratories performed their studies according to a detailed protocol in which all experimental details were described and each laboratory performed at least three independent experiments for each test chemical. All laboratories assigned the absorption of benzoic acid through human skin, the highest ranking of the three compounds (overall mean flux of 16.54+/-11.87 microg/cm(2)/h). The absorption of caffeine and testosterone through human skin was similar, having overall mean maximum absorption rates of 2.24+/-1.43 microg/cm(2)/h and 1.63+/-1.94 microg/cm(2)/h, respectively. In 7 out of 9 laboratories, the maximum absorption rates of caffeine were ranked higher than testosterone. No differences were observed between the mean absorption through human skin and the one rat study for benzoic acid and testosterone. For caffeine the maximum absorption rate and the total penetration through rat skin were clearly higher than the mean value for human skin. When evaluating all data, it appeared that no consistent relation existed between the diffusion cell type and the absorption of the test compounds. Skin thickness only slightly influenced the absorption of benzoic acid and caffeine. In contrast, the maximum absorption rate of testosterone was clearly higher in the laboratories using thin, dermatomed skin membranes. Testosterone is the most lipophilic compound and showed also a higher presence in the skin membrane after 24 h than the two other compounds. The results of this study indicate that the in vitro methodology for assessing skin absorption is relatively robust. A major effort was made to standardize the study performance, but, unlike in a formal validation study, not all variables were controlled. The variation observed may be largely attributed to human variability in dermal absorption and the skin source. For the most lipophilic compound, testosterone, skin thickness proved to be a critical variable.
Regulatory Toxicology and Pharmacology 07/2004; 39(3):271-81. · 2.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Mineralogical analysis of bronchoalveolar lavage fluid (BALF) by electron microscopy could be the most suitable method for assessing asbestos exposure. However, it has been claimed that there is not a standardized or systematic approach to the subject of mineralogical analysis.
The aim of the study was to evaluate mineralogical analysis of BALF by transmission electron microscopy (TEM) as biomarker of asbestos fibre load.
BALF was examined in 193 exposed workers (189 men and 4 women) and in 84 patients (65 men and 19 women) who underwent diagnostic fibreoptic bronchoscopy for various clinical purposes. Asbestos bodies (AB) in BALF were counted with a phase contrast microscope, while fibres were counted and analysed by TEM.
Fibre counting by TEM showed a significant difference in the two populations (two tailed Mann-Whitney U test, p=0.0044), since it was positive in all exposed subjects. Only 75.1% of the exposed population was positive for asbestos bodies (AB). Subjects who had been exposed over a long time period had higher concentrations of fibres than subjects who had been exposed more recently probably because of higher exposure in the past.
The study confirms the results of a previous study on a limited number of subjects. Fibre concentrations in BALF can be considered as a reliable biomarker of past asbestos exposure even after many years after cessation of exposure.
La Medicina del lavoro 01/2004; 95(1):17-31. · 0.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Dermal risk assessment of exposure to chemicals is difficult due to the lack of standardisation of the methods used in exposure quantification; further limits concern the extent of skin contamination and especially dermal absorption of different substances. To solve these problems many authors proposed conceptual models founded on theoretical assumptions and experimental data, but their use in occupational settings revealed many difficulties. A possible alternative is the use of a check-list that permits evaluation of occupational dermal contamination hazards.
To propose a simplified method for dermal risk assessment.
Dermal contamination risk evaluation, chemical hazard quantification and duration of exposure are the basic features of the method. The first step assesses working conditions, use of protective devices, skin contamination directly observed, personal hygiene of workers: all information, collected by a trained observer, is scored according to literature data and/or to authors'personal experience. Chemical hazard quantfication is obtained from safety data sheet evaluation (R phrases classification and chemical-physical characteristics of the chemical in use). The method allows a preliminary dermal exposure assessment to be made, subdivided on hazard bands.
The method permits a rapid dermal exposure assessment to be made and suggests intervention measures to decrease dermal risk.
A check-list is proposed that can be a useful and easy method to assess dermal exposure to chemicals, particularly in small- and medium-sized enterprises.
La Medicina del lavoro 01/2004; 95(4):297-304. · 0.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The dermal risk assessment requires simplified methodologies to understand the role played by the skin. The conceptual models proposed to this aim are founded on theoretical assumptions and experimental data, but their use in occupational settings shows many difficulties. For this end we have drawn up a check-list that includes six sessions and allows to obtain a preliminary dermal exposure evaluation subdivided on hazard bands.
Giornale italiano di medicina del lavoro ed ergonomia 01/2003; 25(3):350-2.