After attending this presentation, attendees will appreciate the importance and under-valuation of workplace violence in the health care setting. This presentation will impact the forensic science community by demonstrating that violence occurring in a health care workplace environment is a serious, but unevaluated, problem that needs to be adequately addressed. Recommendations on how to confront this problem are suggested. “Workplace violence” is defined by the National Institute of Occupational Safety and Health (NIOSH) as “violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty.” Over the past years, the scientific community and the media have given significant attention to this phenomenon. It is estimated that about one-quarter of such violence takes place in the health care sector. Several studies are available in the literature that primarily concern aggression toward nurses, particularly emergency room nurses. This appears to be the most at-risk health care category. However, the exact extent of this phenomenon is difficult to define, given the tendency to not report these incidents. Often they are considered to be “part of the job” and “inevitable.” Violence against health care workers is present all over the world, in developing countries as well as industrialized ones. In one study that examined several countries (Brazil, Bulgaria, Lebanon, Portugal, South Africa, Thailand, and Australia), it was revealed that more than 50% of workers experienced at least one episode of physical or psychological violence in the 12 months preceding the survey. Psychological violence is much more prevalent than physical violence, particularly “verbal abuse.” The European Agency for Safety and Health at Work (EU-OSHA) reports that 15% of European health care workers experienced aggression over the course of 2010. In one American study involving 3,465 emergency room nurses, results showed that in the three years prior to the investigation, approximately 25% of the analyzed sample were victims of physical aggression more than 20 times, and almost 20% were the victims of 200 incidents of verbal abuse. In Italy, there are still very few studies concerning violence directed at health care workers. Only in the last few years has there been more attention paid to this issue: in one investigation performed every two years in a local Italian health unit between 2005 and 2011, 9% of the 1,411 study participants affirmed that they had been the victims of stalking. Moreover, estimates regarding the frequency of physical aggression over a one-year period vary between 3% and more than 7%. It is even more difficult to evaluate the frequency of non-physical aggression that, according to several studies, is reported to involve between 38% and 90% of hospital workers. For this reason, it is essential to monitor the issue of aggression, even through the use of incident-reporting forms. Not only violence perpetrated by patients but violence between workers must also be monitored using a standardized “reporting system” because such aggression represents a considerable source of work-related stress for hospital employees. Objectives: Examine the problem of aggression and harassment in the context of community health according to the professional category and workplace. The goal is to identify the subjects and the work environments that are most at risk and to formulate prevention and coping strategies to address the problem (e.g., best practice, mitigation action, and listening centers). Method: From one of the biggest hospitals in southern Italy, 107 workers (doctors, psychologists, nurses, auxiliary social workers, and social assistants) were recruited and 88 workers who have the same professional qualifications were recruited from local social-health care service centers. Instruments: After having obtained consent from

Purpose: To assess the predictive power of the comet assay in the context of occupational exposure to pesticides. Materials and methods: The recruited subjects completed a structured questionnaire and gave a blood sample. Exposure to pesticides was measured by means of an algorithm based on Dosemeci’s work (Agricultural Health Study). Approximately 50 images were analyzed for each sample via fluores- cence microscopy. The extent of DNA damage was estimated by tail moment (TM) and is the product of tail DNA (%) and tail Length. Results: Crude significant risks (odds ratios, ORs) for values higher than the 75th percentile of TM were observed among the exposed subjects (score>1). The frequency of some confounding factors (sex, age and smoking) was significantly higher among the exposed workers. A significant dose–effect relationship was observed between TM and exposure score. Significant high-risk estimates (ORs), adjusted by the studied confounding factors, among exposure to pesticides and TM, % tail DNA and tail length were confirmed using unconditional logistic regression models. Conclusions: The adjusted associations (ORs) between the comet parameters and exposure to pesti- cides were significant. The sensitivity of the comet test was low (41%), the specificity (89%) and the predictive positive value (0.77) were found acceptable.

BACKGROUND The Italian meat supply chain is a large-scale industry typically characterized linked to circuit of DOP (Protected Designation of Origin) products. In this reality all workers are exposed to a wide range of biological agents that have developed antibiotic resistance and, therefore, represent a public and occupational health issue. METHODS An anamnestic semi-structured interview was performed to the study participants, in order to better define the risk exposure, which was followed by physical examination of the skin and skin appendages. Samples of nasal swabs were sown, within 24 hours, in Mannitol Salt Agar growth medium, specific for the detection of Staphylococcus Aureus. After an incubation period, we selected positive colonies for S. aureus in order to undergo genetic tests to detect the presence of MRSA. MRSA positive samples were analyzed, at last, with a specific PCR for the ST398, swine specific sequence type. RESULTS 162 workers joined the study, which was performed a physical examination of hand skin, a nasal swab and then given an anamnestic semi-structured interview. The sample was composed of 139 males and 23 females, mean age 45 years, with average seniority of 10 years. From 162 nasal swabs championships, a first analysis of culture media for Staphylococcus Aureus showed 35 positive (21.6%). The molecular analysis revealed only one MRSA sample, belonging to a butcher's meat processing company. (0.6%). The molecular analysis did not confirm the positivity for genotype 398, which characterizes the infection in pigs. CONCLUSION Recontamination with Staphylococcus Aureus occurs via surface treating machinery, as a result of fecal contamination at evisceration, or via increased human handling during meat processing. Our study revealed a low risk for MRSA, because of superficial heat treatments such as scalding and flaming that reduce significantly the burden of MRSA on the carcasses.

Soluble mesothelin-related peptide (SMRP) is a biomarker that has been proposed for differential diagnosis from pleural metastatic cancer, as well as prognosis and treatment monitoring of malignant pleural mesothelioma (MM). The aim of this study was to evaluate the role of SMRP in clinic management of MM. We assayed the SMRP concentrations in 354 subjects: 109 healthy volunteers with no history of exposure to asbestos, 26 patients with previous occupational asbestos exposure but who were free from pleural or parenchymal disease, 48 patients with asbestosis, 110 patients with pleural plaques, 25 patients with lung cancer, and 36 patients with MM. We also tested SMRP titers in 2 patients with MM at 5 different times of the disease, to evaluate the trend of the biomarker in the course of therapy. Our data confirm previous experiences with the use of SMRP as a diagnostic marker of MM. Low SMRP levels at diagnosis seem to have a positive prognostic significance.

Background: Polycyclic aromatic hydrocarbons (PAHs) exposure in the coke industry poses a risk for workers’ health as well as for subjects living in the plant vicinity.Objectives: To assess PAHs exposure in coke-oven workers (CW) at the Taranto plant, Apulia, and in subjects from the general population living near (NC) and far away (FC) from the plant. Methods: Exposure was assessed by personal air sampling and urinary 1-hydroxypyrene (1-OHP) measured in 100 CW, 18 NC and 15 FC. Results:Median airborne benzo[a]pyrene (BaP) levels were 152, 1.5, and 3.6 ng/m3 in CW, NC, and FC, respectively. In CW, median 1-OHP increased from 1.45 to 1.96 μg/g creatinine (crt) during the work shift (p>0.05); in NC and FC, 1-OHP levels were 0.56 and 0.53 μg/g crt. No significant differences between NC and FC for both air and urinary indices were found. BaP exposure in CW exceeded the recently proposed German acceptable (70 ng/m3) and tolerable (700 ng/m3) risk-based limit values in 82 and 11% of subjects, respectively. In NC and FC, BaP exposure exceeded the European target value for ambient air (1 ng/m3) in 67 and 60% of subjects, respectively. Biomonitoring showed that 21% of CW had 1-OHP levels higher than the proposed biological limit value for the coke-oven industry (4.4 μg/g crt), while 93% of FC, and 88% of NC, had 1-OHP levels exceeding the Italian reference value (0.3 μg/g crt). Among non-smokers, a linear regression between 1-OHP and BaP (Pearson value r=0.65, p<0.05) allowed us to estimate levels of 1.2 and 1.9 μg/g crt for 1-OHP end-of-shift corresponding to acceptable and tolerable limit values. Conclusions: Although lower than in the past, PAHs exposure in the coke plant still poses a health risk for workers and the general population and requires further efforts to improve workplace conditions.

Outcrops of ophiolites containing tremolite asbestos were found at the Basilicata-Calabria border, Italy. A previous study mapped the outcrops and assessed the exposure through environmental sampling of airborne asbestos fibers nearby towns, showing doses up to 22 ff/L. Our study assesses the presence and level of personal exposure to inhalable asbestiform fibers in residents employed in occupational activities involving earthmoving and soil disturbance and other activities. We recruited 20 workers employed in construction and agriculture and 10 people employed in other activities not involving movement of soil; in addition, were recruited 5 relatives of residents who died from malignant mesothelioma in areas with these outcrops. Personal sampling was performed during two summer days using portable suction pumps. Each sampling covered almost the whole work shift, however never less than 400 minutes; filters were analyzed with SEM/EDS. We observed personal values of tremolite fibers ranged 0.8 - 23.06 ff/L. In 50% of all samples exceeded the environmental level of 2 ff/L. 60% of farmers and 100% of construction workers reported a personal exposure exceeding 2 ff/L (range: 2.07 - 23.06 ff/L). The relatives exceeded also the limit values (range: 3,05 - 6,07 ff/L), suggesting an unconventional type exposure to tremolite asbestos suffered by relatives died from malignant mesothelioma. These results are in accordance with the data of regional mesothelioma register that counts, in these naturally-polluted areas, 19 cases of malignant mesothelioma in farmers and 9 in construction workers. There were no value above the limit in workers employed in activities not involving soil disturbance.

Abstract Background: Exposure to formaldehyde (FA) causes irritative effects and induces nasopharyngeal cancer; the International Agency for Research on Cancer (IARC, Lyon) classified FA as carcinogenic to humans, Group 1. Many studies have been published so far concerning the occupational exposure of industrial workers, embalmers, pathologists and anatomists to FA but very few data regarding medical examiners are available. Methods: To assess the extent to which subjects were exposed to FA, airborne concentrations of this chemical were measured by High Performance Liquid Chromatography (HPLC). In September-October 2006 we examined the personnel, which worked in an autopsy room (medical examiners) and in three laboratories of pathologic anatomy of the University Medical School of Bari, Policlinico Hospital, Southern Italy. Irritative effects were also investigated. Results: All the personal exposure data obtained exceeded the National Institute for Occupational Safety and Health Threshold Limit Value-Time Weighted Average (NIOSH TLV-TWA: 0.02 mg/m3) and, in a few cases, even the American Conference of Industrial Hygienists Threshold Limit Value-Ceiling level (ACGIH TLV-C: 0.37 mg/m3). Conclusion: Irritative effects in more than 50% of the workers enrolled, increasing the risk of injuries.

Lo studio italiano ‘Interazione geni-ambiente nell’eziologia dei linfomi’ è nato con l’intento di riunire i gruppi italiani che hanno finora partecipato separatamente al Consorzio Internazionale Interlymph, promosso dal National Cancer Institute degli Stati Uniti allo scopo di raccogliere tutti i maggiori studi sui linfomi condotti a livello internazionale ed esplorare nuove ipotesi patogenetiche. Lo studio è attualmente in corso. La nostra Unità Operativa ha reclutato 109 casi di linfoma e 43 controlli presso l’Azienda Ospedaliera Policlinico di Bari e presso la ASL Taranto. I casi e i controlli sono stati sottoposti a un prelievo ematologico per lo studio di polimorfismi genetici (SNPs) e per il dosaggio sierologico di sostanze tossiche e ad entrambi i gruppi è stato somministrato un questionario. Non essendo ancora disponibili né i dati ematochimici né quelli relativi agli SNPs, in questa fase abbiamo effettuato un’analisi statistica per classificare i diversi sottotipi di linfomi in base a un preliminare indicatore di esposizione a cancerogeni. Abbiamo nella fattispecie ottenuto un assessment dell’esposizione occupazionale a diversi fattori utilizzando il modello CAREX (CAR-cinogen EXposure). Dal nostro studio è emerso che il sottotipo di linfoma più diffuso tra gli operai è il linfoma a grandi cellule B (DLCB), seguito dal Linfoma Follicolare (FL), classificati secondo i criteri forniti dall’OMS nel 2008. L’analisi multivariata ha registrato un’aumentata incidenza di linfoma tra gli operai [OR=4,06 (1,03-15.96)]. Inoltre l’esposizione a solventi cancerogeni (benzene, tetracloruro di carbone, dicromato di etilene, dibromoetano), aggiustato per le diverse variabili un modello di regressione logistica non condizionale, è risultata associata ad un aumentato rischio di linfoma [OR=3,29 (1,36-7,94)]. Purtroppo in letteratura queste associazioni sono ancora deboli ed è per questo auspicabile un’ implementazione degli studi eziologici sui linfomi.

RIASSUNTO. Lo studio italiano ‘Interazione geni-ambiente nell’eziologia dei linfomi’ è nato con l’intento di riunire i gruppi italiani che hanno finora partecipato separatamente al Consorzio Internazionale Interlymph, promosso dal National Cancer Institute degli Stati Uniti allo scopo di raccogliere tutti i maggiori studi sui linfomi condotti a livello internazionale ed esplorare nuove ipotesi patogenetiche. Lo studio è attualmente in corso. La nostra Unità Operativa ha reclutato 109 casi di linfoma e 43 controlli presso l’Azienda Ospedaliera Policlinico di Bari e presso la ASL Taranto. I casi e i controlli sono stati sottoposti a un prelievo ematologico per lo studio di polimorfismi genetici (SNPs) e per il dosaggio sierologico di sostanze tossiche e ad entrambi i gruppi è stato somministrato un questionario. Non essendo ancora disponibili né i dati ematochimici né quelli relativi agli SNPs, in questa fase abbiamo effettuato un’analisi statistica per classificare i diversi sottotipi di linfomi in base a un preliminare indicatore di esposizione a cancerogeni. Abbiamo nella fattispecie ottenuto un assessment dell’esposizione occupazionale a diversi fattori utilizzando il modello CAREX (CAR-cinogen EXposure). Dal nostro studio è emerso che il sottotipo di linfoma più diffuso tra gli operai è il linfoma a grandi cellule B (DLCB), seguito dal Linfoma Follicolare (FL), classificati secondo i criteri forniti dall’OMS nel 2008. L’analisi multivariata ha registrato un’aumentata incidenza di linfoma tra gli operai [OR=4,06 (1,03-15.96)]. Inoltre l’esposizione a solventi cancerogeni (benzene, tetracloruro di carbone, dicromato di etilene, dibromoetano), aggiustato per le diverse variabili un modello di regressione logistica non condizionale, è risultata associata ad un aumentato rischio di linfoma [OR=3,29 (1,36-7,94)]. Purtroppo in letteratura queste associazioni sono ancora deboli ed è per questo auspicabile un’implementazione degli studi eziologici sui linfomi

Background: There is a high prevalence of musculoskeletal disorders among healthcare professional students. Although recent studies show musculoskeletal disorders are a common problem among X-ray technologists, there are no data on these disorders among students of this healthcare profession. We have therefore estimated the prevalence of musculoskeletal complaints among a group of X-ray technology students. Methods: The students (n = 109) currently attending the 3-year X-ray technologist school at a large University in the Apulia region of Southern Italy were recruited for the study, with a 100% participation rate. A questionnaire collected data concerning personal characteristics, physical exposure during training activities, and the presence of musculoskeletal symptoms in the neck, shoulders, low back, hand/wrist and legs. Results: The prevalence of complaints in any body site over the previous 12 months was 37%. Low back pain was the most frequently reported symptom (27%), followed by neck (16%), shoulder (11%), leg (8%) and hand/wrist (5%) pain. Poor physical activity was associated with the complaints. Conclusions: Our study showed prevalence rates of musculoskeletal complaints among X-ray technology students to be somewhat high, representing about half of those found in Italian technologists. The most common musculoskeletal problem was low back pain, which had also been found in research conducted among nursing students. Our research also showed a significant association between poor physical activity and the presence of musculoskeletal disorders in young university students.

Introduction The association between NHL (Non Hodgkin Lymphoma), solvents and occupation are reported in several studies. Our italian national case-control study was inserted within the INTERLYMPH consortium for the GWAS protocol and to examine new etiological hypothesis of NHL, studying the role of genetic polymorphisms (SNPs), occupational and personal factors such as diet, location of house, smoke. The study is ongoing. Methods 109 cases of lymphoma and 43 healthy controls were recruited in a research unit of Bari and Taranto within an, since 2007. Cases and controls were invited to blood sample drowning for serum measurement of xenobiotic and DNA analysis of SNPs and to administration of a questionnaire. In this phase we only produce a description of different subtypes of lymphoma recruited in our research unit and to carry out a preliminary assessment of the role of occupational factors using CAREX job exposure matrix, for the lack of haematic and genetics data Results The found subtypes of lymphoma, according the fifth level WHO 2008 classification, among blue collars, showed an higher proportion of NHL, mainly represented by Diffuse Large B- subtype (DLBCL) and Follicular lymphoma (FL). In the multivariate analysis an higher risk of lymphoma was reported among the blue collars [OR=4,06 (1,03-15.96)]. Moreover, the exposure to some carcinogenic solvents (Benzene, carbone tetrachloride, ethylene dichromate, dibromoethane), adjusted by several variables in a multiple unconditional regression model, resulted associated to lymphoma [OR=3,29 (1,36-7,94)]. Discussion Benzene is a carcinogenic to humans (group 1, IARC); trichloroethylene is classified as probably carcinogenic to humans (group 2b); carbon tetrachloride, used as a solvent, is related to an excess risk for NHL for women; dibromoethane is considered as a carcinogen by the IARC (Class 2). In scientific literature the associations between these carcinogenic solvents and NHL are still weak and unknown, because of the different subtypes distribution.

Exposure to air pollution is associated with increased morbidity from cardiovascular diseases, lung cancer, respiratory and allergic diseases. The aim of this study was to investigate allergic diseases in 111 traffic wardens compared to a control group of 101 administrative employees. All participating subjects underwent a physical examination, in which a complete medical history was taken and a dedicated allergological questionnaire administered. Spirometry, Specific IgE dosage (RAST) and skin prick tests (SPT) were done. Diagnostic investigations such as the nasal cytology, a specific nasal provocation test and rhinomanometry were also performed. Statistical analyses were performed using STATA version 11. The percentage of subjects with a diagnosis of allergy was higher in the exposed workers than in the controls. As regards the clinical tests, the positivity was higher for thegroup of exposed subjects. Among the exposed workers, those who worked on foot or motorcycle had a higher positivity in clinical trials compared to the traffic wardens who used the car. Our study showed a higher percentage of allergic subjects in the group of workers exposed to outdoor pollutants than in the controls. These results suggest that allergological tests should be included in the health surveillance protocols for workers exposed to outdoor pollutants.

Methicillin-resistant S. aureus (MRSA) is a pathogen spread not only in the hospital environment but also in the community and amongst livestock (LA-MRSA). LA-MRSA can be transmitted to humans that live in close contact with MRSA-colonized animals, and human colonization and/or infection has been reported worldwide, particularly among those involved with livestock farming. In this study the authors evaluated the prevalence of S. aureus and MRSA among healthy carriers who worked in the food industry in Apulia, Southern Italy.

High prevalences of musculoskeletal disorders have been described among nursing students. Although recent studies show musculoskeletal disorders to be a common problem among X-ray technologists, no data have been so far reported concerning such disorders among students of this health profession. The aim of the study was to estimate the prevalence of musculoskeletal complaints among a sample of X-ray technologist students. A cross-sectional study was carried out among 166 X-ray technologist students attending the schools of two large universities in Apulia region (Southern Italy). A questionnaire was used to collect data concerning personal characteristics, physical exposure during training activities, and the presence of musculoskeletal symptoms in the neck, shoulders, low back, hand/wrist and legs. The prevalence of complaints at any body site in the previous 12 months was 38%. Low back pain was the most commonly reported symptom (28%), followed by neck (16%), shoulder (10%), leg (8%) and hand/wrist pain (6%). Poor physical activity was associated with the complaints. Our study showed prevalence rates of musculoskeletal complaints among X-ray technologist students to be somewhat high, representing about half of those found in Italian technologists. The most common musculoskeletal problem was low back pain, as indeed found in researches conducted among nursing students. Our research also showed an important role of regular physical activity in reducing the risk of musculoskeletal disorders in young university students.

Introduzione La filiera della carne è una grande realtà industriale in Italia, caratterizzata dal circuito Denominazione di Origine Protetta (DOP).Tutti i lavoratori sono esposti a una vasta gamma di agenti biologici che hanno sviluppato antibiotico resistenza e, di conseguenza, rappresentano un problema di salute pubblica ed occupazionale. Obiettivi Valutare il rischio biologico da MRSA in lavoratori della filiera delle carni. Metodi Sono stati reclutati, previo consenso, 162 lavoratori della filiera delle carni del Sud Italia.Tutti i partecipanti hanno risposto ad una intervista semi-strutturata , sono stati sottoposti ad esame obiettivo della cute ed a prelievo di un tampone nasale.Il questionario ha indagato la storia clinica e professionale, storia residenziale, la presenza di animali domestici, il contatto extra-professionale con animali d’allevamento e sul consumo di carne cruda o poco cotta.Eventuali infezioni respiratorie e/o cutanee, dissenteria, malattie infettive, stato immunodepressivo, recenti interventi chirurgici e ricoveri ospedalieri, infortuni, assunzione di antibiotici, sono stati considerati criteri di esclusione ai fini della valutazione del tampone nasale.I campioni di tamponi nasali sono stati seminati, entro 24 ore, in terreno di crescita Mannitol Salt Agar, specifica per il rilevamento di Staphylococcus Aureus. Dopo un periodo di incubazione, sono state selezionate colonie positive per S. Aureus sulle quali sono stati ricercati i geni 447bp NUC, che codifica per la nucleasi, e il gene mecA, che codifica per la sequenza della meticillino-resistenza, utilizzando la procedura Multiplex Polymerase Chain Reaction (MPCR).I campioni positivi per MRSA sono stati analizzati, infine, con una PCR specifica per la ST398, sequenza specifica per la specie suina. Risultati Sono stati reclutati 139 maschi e 23 femmine, con età media di 45 anni ed anzianità lavorativa media di 10 anni. Dalla semina dei 162 tamponi nasali, una prima analisi ha mostrato positività per lo Staphylococcus Aureus in 35 campioni (21,6%).L'analisi molecolare ha rivelato un solo campione positivo per MRSA (0,6%), in un lavoratore addetto alla trasformazione della carne..L'analisi molecolare non ha confermato la positività per il genotipo ST398, caratteristico dell'infezione nei suini. Conclusioni Il nostro studio ha rivelato un basso rischio per MRSA, condizionato dall’uso di antibiotici in ambito veterinario e dai trattamenti termici superficiali effettuati sulle carcasse, come scottature e flambature, che riducono significativamente la presenza di MRSA. La ricontaminazione con S. Aureus, tuttavia, potrebbe verificarsi a seguito di contaminazione fecale durante l’eviscerazione, tramite una maggiore manipolazione delle carni da parte degli operatori durante la lavorazioni ed, infine, attraverso il contatto con le superfici potenzialmente infette dei macchinari. Bibliografia 1. Colosio C. et al. Linee Guida per la Sorveglianza Sanitaria in agricoltura. 2012 SIMLII 2. Il rischio biologico nei luoghi di lavoro (2011) INAIL 3. Livermore, Antibiotic resistance in staphylococci, International Journal of Antimicrobial Agent 16 (2000) S3 – S10

Background: Occupational exposure is known to play a role in the aetiology of lymphomas. The aim of the present work was to explore the occupational risk of the major B-cell lymphoma subtypes using a case–control study design. Methods: From 2009 to 2014, we recruited 158 lymphoma cases and 76 controls in the provinces of Bari and Taranto (Apulia, Southern Italy). A retrospective assessment of occupational exposure based on complete work histories and the Carcinogen Exposure (CAREX) job-exposure matrix was performed. Results: After adjusting for major confounding factors, farmers showed an increased risk of diffuse large B-cell lymphoma (DLBCL) [odds ratio (OR) = 10.9 (2.3–51.6)] and multiple myeloma (MM) [OR = 16.5 (1.4–195.7)]; exposure to the fungicide Captafol was significantly associated with risk of non-Hodgkin lymphoma (NHL) [OR = 2.6 (1.1–8.2)], particularly with the risk of DLBCL [OR = 5.3 (1.6–17.3)]. Conclusions: Agricultural activity seems to be a risk factor for developing lymphoma subtypes, particularly DLBCL, in the provinces of Bari and Taranto (Apulia Region, Southern Italy). Exposure to the pesticides Captafol, Paraquat and Radon might be implicated. Trial registration: Protocol number UNIBA 2207WEJLZB_004 registered 22/09/2008. Keywords: Lymphomas, Occupational exposure, CAREX matrix, Pesticides, B-cell lymphoma subtypes, Case–control study

È stata valutata la salute respiratoria di lavoratori addetti alla gestione dei rifiuti urbani rispetto ad un gruppo di non esposti costituito da impiegati, con riscontro di una prevalenza di deficit respiratori nei soggetti esposti ad inquinanti outdoor.

Background Rural areas on the Calabro-Lucano border, Southern Italy, are characterized by the presence of ophiolites outcrops containing tremolite. A study mapped the outcrops and assessed the exposure through environmental sampling of airborne asbestos fibers nearby towns, showing doses up to 22 ff/L. Our study assesses the presence and level of personal exposure to inhalable asbestiform fibers in residents employed in occupational activities involving earthmoving and soil disturbance and other activities. Methods We recruited 30 volunteers including 20 employed in construction and agriculture and 10 employees working in other sectors not involving disturbance of the soil, and also five relatives of patients who died of pleural mesothelioma residents in areas with ophiolites outcrops. Sampling was conducted over two days later in the summer. The content and type of asbestos fibers were determined by technique of scanning electron microscopy (SEM) equipped with EDS (Energy Dispersive Spectrometer). Results The SEM analysis showed the presence of asbestos fibers serpentine type tremolite in 20 above 30 filters obtained by personal sampling. EDS microanalysis allowed to exclude titanium and organic material. The doses of tremolite fibers observed were between 0.8 and 23.06 ff/L. The environmental fund limit of 2 gg/L was exceeded in 50% of samples. 60% of farmers reported a personal exposure than 2 ff/L (from 2.07 to 23.06 ff/L) and 100% of construction workers (from 4.02 to 12.02 ff/L). The five relatives reported exposure values from 0.8 to 6.07 ff/L, exceeding in three cases the limit of 2 ff/L. Conclusion 90% of residents not employed in agriculture and construction has been exposed to doses of tremolite lower than the value of the fund. The information campaign, aimed at a proper risk management, was useful. Health surveillance of resident population is needed.

The increase of risk for hematopoietic cancer among pesticides operators particularly associated with specific compounds was reported by several case-controls studies. The retrospective semiquantitative estimates of the intensity of pesticides exposure allow the assessment of the trends of relative risks associated to the its variation. The aims of the present study are finalized to evaluate a modified version of a questionnaire used for the collection of data related to pesticides use modality in agriculture; to Apply the Dosemeci algorithm for the assessment of pesticides exposure intensity; to evaluate if the information of the specific questionnaire for the agriculture used in the Italian study on the haetiology of lymphoma are congruent with validated questionnaires and are useful to estimate the intensity of exposure to pesticides. The Alburkle questionnaire was previously validated on a sample of 40 pesticides users. The questionnaire reported data related to the different methods of pesticides use were codified and inserted in a data base of Microsoft Access® to obtain an exposure intensity score. A comparison of the items of the Arbukle questionnaire and the specific questionnaire for the agriculture was carried out. The results showed that only the use of back pesticides sprayers is associated with the exposure to levels higher than the median score (F= 8,58 p <= 0,006). This finding was confirmed in the multivariate analisys. The questionnaire comparison showed a not complete correspondence (60%) of the data of the specific questionnaire for the agriculture used in the Italian study on the haetiology of lymphoma, regarding the methods of pesticides spraying useful for the Dosemeci algorithm score assessment. In conclusion, the questionnaire used in the case-control study of HCC was suitable to the collection of data useful to the estimate of pesticides exposure in agriculture. The Dosemeci algorithm is able to properly quantify the exposure intensity. We need to increase the items of the specific questionnaire for the agriculture used in the Italian study on the haetiology of lymphoma to reach the right quantity of information useful for the assessment of the intensity score. The collection of data could be carried out by means of phone interviews.

Taranto area is among the highest environmental risk ones, giving the vast presence of plants in it. On this basis, we carried out a biological monitoring programme on Taranto resident population, not occupational exposed to heavy metals. Particularly, we investigated Arsenic (As), Chrome (Cr), Manganese (Mn), Mercury (Hg) and Lead (Pb) due to the ubiquitous characteristics of these metals, widely diffuse in nature, and from the potential carcinogenic effects. We measured iAs+MMA+DMA, Cr, Hg, Mg and Pb in 84 urinary samples of subjects living in Taranto area. We also administrated a questionnaire, in order to investigate the influence of occupational and non-occupational factors on urinary metals excretion. The mean values of urinary excretion of Pb and Cr were above the reference values observed by the Italian Association for Reference Values in the general population not occupational exposed to metals. In addiction, in order to Hg, Pb and Cr, a significant difference was observed in relation with gender and place of residence.