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Objectives: Guideline values have been defined by the ad hoc S.I.M.L.I.I. Working Group as "the level of a risk factor, previously established for an environmental or biological context, to which the levels actually measured for/in the workers should be compared, in order to assess their degree of exposure"., Methods: Guideline values include limit values, action levels and reference values, and may refer to an environmental or biological matrix., Results: The present paper aims to discuss the methodologies currently used for the definition of the most relevant guideline and limit values at the national and international level, with a particular attention to those used in the European Union (OEL)., Conclusions: It is concluded that a correct use of guideline values represents a fundamental tool for both the assessment and the management of chemical risk in workers exposed to toxic and/or carcinogenic substances., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by Aracne Editrice, Roma, Italy.)

Objectives: A literature review was performed to highlight which work-related diseases express sex/gender differences in health outcomes and focus the main limits of studies in this field., Methods: The research, carried out on PubMed by specific search string, identified 4828 articles (1997-2017 period) of which 381 are eligible for review (4-22%, depending on the disease)., Results: Among them, 68% reported sex/gender differences in health outcomes, which in most cases appear to be due to different exposure and/or work segregation rather than to biological differences. However, few studies place this assessment among the research goals and results are almost never discussed and hypothesis are seldom formulated about any observed differences., Conclusions: It seems necessary to use research methodologies and study design that can detect and explain the described complexity and useful in defining appropriate preventive strategies., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by Aracne Editrice, Roma, Italy.)

Objectives: A thorough and fully application of the principles of gender mainstreaming, in accordance with the European Community guidelines, to the health and safety at work, implies the systematic review of the whole prevention from the gendered point of view. This means that both biology- and gender-based differences between male and female workers should be conceived not only as determinants of health but also as factors affecting either positively or negatively the health and safety risk prevention. In this evolutionary cultural step the role of the occupational physician is particularly important., Methods: In this paper we propose some operative tools that can concretely implement gender perspective in all the various areas of prevention, where the occupational physician has a leading, if not even exclusive, role such as risk assessment, training and health medical surveillance., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by Aracne Editrice, Roma, Italy.)

Occupational exposure limits and guideline values for the general population proposed for benzene by several international bodies are discussed and compared with the Italian and EU occupational limit values, taking also into account the criteria used for their derivation. Benzene is an environmental pollutant, and the EU guideline value for ambient air is 5 microg/m3, based on carcinogenic risk. Presently, occupational exposures are greatly reduced, and in many instances close to those of the general population. Consequently, it does not seem to be appropriate to maintain the Italian and the EU occupational exposure limits of 1 ppm (3.2 mg/m3), which are inconsistent with the ALARA principle and not justified by technological constraints. It should be pointed out that, in any case, preventive interventions should be carried out, beyond the compliance with the established limit values, in order to ensure the lowest exposure and by carrying out biological monitoring as a tool to verify the appropriateness of risk management measures.

The presence of chemical agents in construction is certainly relevant in terms of quality, quantity and toxicity. Their manipulation can result in potential exposure as inhaled and/or through the skin. It is therefore possible and necessary to identify a list of substances to be considered relevant for the risk assessment and the possible environmental monitoring to verify the adequacy of the estimate made. The many variables inherent in construction make it extremely difficult to apply the usual methods of the industrial hygiene because it would not very significant conclusions in terms of space-time representation. SIMLII in one of its guidelines have proposed a "indexes" method that can provide useful information to the figures of prevention for the actions of their competence. The subsequent introduction of the REACH Regulation and exposure scenarios may help to further sharpening the assessment of chemical hazards in construction.

The application of air quality guidelines and limits for occupational exposure in the workplace are the main tools for risk reduction and prevention of the effects of pollutants on health of the general population and workers respectively. The Biological Reference Values (BRVs), determined in situations of non-occupational exposure, and the Biological Limit Values (BLVs) contribute to the interpretation of biological monitoring data. In the occupational field the comparison with the BRVs should be informative about the existence of exposures greater than the general population and are particularly important for substances without VLBs or whose effects include chronic diseases.

The definition and compliance with occupational limit values for pollutants in the workplace are the main tool for risk reduction and prevention of possible adverse health effects. There is no doubt that the decisions on the limit values are now closely linked to what produced in the European Community, if not at the international level. However, we believe that Scientific Associations should play a role in proposing and updating the limit values adopted by law in Italy. Become prominent interlocutors of lawmakers and institutional bodies is equally important.

Particulate matter (PM) exposures are correlated in several studies with short-term increases of morbidity and mortality for cardiovascular diseases. Some of these effects are believed to be exacerbated by dysregulation of cardiac rhythm. We studied patients with antecedent myocardial infarction showing that a reduction of heart rate variability (HRV) correlates with the intensity of exposures to quasi-ultrafine particles (PM0.25). However, this correlation was not found in patients taking beta-blockers. These data suggest that the effects of PM could be mediated through a rapid imbalance of the autonomic regulation of the heart. Current mechanistic hypotheses are discussed leading to the conclusion that the most studied one, i.e. pulmonary inflammation, may trigger reflexes or, more likely PM interact with bronchial receptors directly, and inflammation may be simply bystander.

In order to validate specific personal selectors for the collection of fine particles, 65 double measurements of PM10 and PM2.5 were carried out at the same collection site; thus allowing a comparison between two different methods of sampling. The first method was that normally used by ARPAV in order to sample the above-mentioned granulometric fractions in outdoor environment. The second method was chosen by us for personal sampling (PEM working at 2 l/min and at 4 l/min). In both cases the filters gravimetric analysis conformed to the expectations of D.M. 60 of 2/4/2002. The comparison between the two methods showed a good correlation in both the granulometric fractions: correlation coefficients r for the PM2.5 are equal to 0.96 and 0.99 for the PEM working at 2 l/min and at 4 l/min respectively; r for the PM10 are equal to 0.98 and 0.99 for the PEM working at 2 l/min and at 4 l/min respectively. The analysis of results in terms of fine particles concentration and difference between methods against their mean, shows a slight overestimate of the particles concentration with PEM working at 2 l/min, compared to those working at 4 l/min. Nevertheless, considering the good results obtained even with a flow of 2 l/min, we believe that using PEM working at 2 l/min to monitoring 24 hours-personal exposure assures an improved capacity in the battery-operated pumps.

The total tannin concentration was determined, using two different SPF methods, in 35 dust powdered wood species, both hard and softwood. Using direct reading-method (280 nm) the concentration varied from 2485 mg/g for Swedish pine to 35,843 mg/g for European oak (quercus robur, hardwood). The data obtained with the second method (Folin-Chocalteau) were well correlated (y = 0.9885x + 4.3373; r = 0.84; n=35) with the data obtained with the first method. The measured concentrations are usually higher in hardwood than softwood tested. Finally, a simple HPLC-DAD method was tested for gallic acid (GA), recently proposed as a marker for oak dust.

In this paper we have defined the new biomarkers of exposure (NBE) as those biomarkers discovered in the last five years and, among previously validated biomarkers, also those applied in different ranges of doses or those determined in biological matrices which differ from matrices originally considered. We examined the results from the surveys carried out by the main Italian research units involved in biological monitoring, i.e. those from the Universities of Brescia, Milan, Naples, Padua, Parma, Pavia, Turin and Verona. The data were collected using a standardized model and included the following: type of element or organic compound, type of biomarker, analytical technique and method, their relationship with environmental monitoring data, their relationship with effect indicators or effects in general, improvement with respect to old biomarkers, reference values. Twenty two NBEs were identified: 14 elements and chemical compounds as such or as metabolites, 4 examples of mixtures, 3 of new matrices, one of speciation. Among the others, aspects such as interest in requiring NBE, quality assurance, availability, cost-benefit ratio were discussed. We conclude that development of this specific field of research appears to be a crucial point for future improvement in risk assessment and health surveillance procedures.

We considered data of environmental monitoring during three working days in a dentist's office who habitually employs nitrous oxide (N2O): conscious sedation is used to alleviate anxiety and to diminish or eliminate dental pain. Three different nose masks were tested to determine influence on environmental pollution by N2O. The study shows that the levels of N2O always remains low with the use of proper dental procedures, although the chose of the type of nose mask can further diminish air pollution and the exposure of dental personnel.

An assessment of the electromagnetic fields emitted from short and ultrashort wave diathermy sources and from magneto therapy operating at a frequency of 50 Hz was made to evaluate the occupational exposure to the operators. Operators were exposed to electromagnetic fields which rarely exceed the recommended limits of International Commission on Non-Ionizing Radiation Protection (ICNIRP) and American Conference of Governmental Industrial Hygienists (ACGIH). Only a measurement of electromagnetic fields near short wave diathermy equipment operating at a frequency of 27.12 MHz exposed operators to levels above those recommended by ICNIRP at a distance of 1 metre. Magnetic fields of magneto therapy exceeded residential exposition of 1 microtesla, at a distance of 4 metres.

We considered data of samples collected in the period 1994-2001 in 83 operating rooms of 13 different public and private hospitals in Veneto Region. The anaestetic gases more used in operating rooms were nitrous oxide, isoflurane and, more recently, sevflurane. The mostly polluted positions were those in proximity of anaesthesiologic devices; the gases average concentrations were low in all hospitals examined, although some operating rooms demonstrated concentrations of anasthetic gases exceeding limit values. Lastly, the professional figures had different exposure to the various anaesthetic gases.

Occupational diseases and labour accidents in health care workers (Azienda Ospedaliera di Padova) were evaluated from 1990 to 2000; the information collected is compared with the same data of Regione Veneto and INAIL. 262 occupational diseases were found; nurses are more affected than other health care workers. In both reports (Azienda Ospedaliera di Padova and Osservatorio epidemiologico della Regione Veneto) half of the occupational diseases and injuries are represented by allergic disease. Low back pain is also equally represented in Azienda Ospedaliera and in Osservatorio epidemiologico results (5.3% and 6.6% respectively). Among the labour accidents reported to INAIL from 1994 to 2000, 25% of them were represented by falls and slips, 23% by car accidents, 17% were caused by tools, 17% by movement of goods and persons, 8% by contact with splinters, liquids, dusts, 5% by assaults and 5% by contact with blood or body fluid. The latter result is widely underestimated in the INAIL report, because these events usually produce a temporary inability of less than 3 days; in fact, they represent more than half of the labour accidents treated at the Azienda Ospedaliera di Padova. Medical surveillance (in exposure to aldehydes, anaesthetic gases, chemioterapic drugs) has shown many other occupational health problems that often need specific structural intervention (restructuration and restoration of workplaces in health care environments), and work organization changes.