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Fertility among workers exposed to metal fumes and solvents in the Italian mint (stampers, founders, and other technical workers) was compared to the reproductive experience of the administrative staff. Data on the reproductive history and time to pregnancy were collected by interview. For workers with children, data on the time to pregnancy (TTP) for the first pregnancy was assessed in relation to occupational risk factors. The groups with the highest prevalence of pregnancy delay beyond 6 months were stampers (21%) and those exposed to solvents (21.5%). Logistic regression did not show a significant association of these job exposures with pregnancy delay, but the power of the study to show an important difference was low. The data are not inconsistent with the hypothesis that male exposure to solvents and metal fumes is associated with an increase in the TTP.

Background: Asthma is frequently found in athletes, often associated with rhinitis and allergy. Aim: To study the predictive value of allergy and pulmonary function tests for the diagnosis of asthma in athletes. Subjects and methods: Ninety-eight national preOlympic athletes underwent an accurate medical examination including a validated questionnaire for asthma and rhinitis, spirometric recordings and skin prick testing with a panel of the most frequent inhalant allergens. Bronchodilator and/or exercise challenge were also performed in asthmatic subjects. Results: Clinical asthma was present in 20.4% of athletes, rhinitis in 35.3% (in 21.4% of cases alone and in 13.9% associated with asthma). Positive prick tests were recorded in 44.4% of athletes (in 60.5% of asthmatics, in 95.2% of rhinitics and in 21.0% of nonasthmatic – nonrhinitic subjects). Mean spirometric values and distribution of abnormal values were not different among asthmatics, rhinitics and nonasthmatics – nonrhinitic patients. Skin-tests positivity was not related to the abnormal spirometric data found in individual cases. Provocation tests with bronchodilators or exercise did not appear sensitive enough to diagnose mild forms of asthma in subjects with normal basal spirometric values. Conclusions: Allergy testing and spirometry should be performed routinely in athletes because of the high prevalence of allergy, rhinitis and asthma in this population. However, the predictive value of these tests and of the bronchial provocation tests performed in this study seems too low to document mild or subclinical asthma in athletes.

The paper examines the possible interference of pesticide exposure on male fertility, by studying the time to pregnancy (TTP) in the first pregnancy of 127 greenhouse workers and 173 controls. The TTP of exposed and control population, analysed by logistic regression model, has shown an increase in the risk of conception delay among the greenhouse workers with high exposure (OR:2.4; 95% CI: 1.2-5.1).

Several environmental substances and pesticides exert a direct, cytotoxic effect on male germ cells. However, an increasing concern has been raised by compounds that may act through more subtle mechanisms, for example, specific pesticides that are potentially capable of modulating or disrupting the endocrine system. Overall, exposure to pesticides with endocrine-disrupting potential raise a particular concern for male fertility because of the possible occurrence of both effects at low concentrations and additive interactions with other environmental risk factors. Delayed reproductive problems deserve special attention, since experimental data consistently indicate a high vulnerability in the developing male reproductive system. Epidemiologic studies have confirmed an increased risk of conception delay associated with occupational exposure to pesticides. Moreover, an increased risk of spontaneous abortion has been noted among wives of exposed workers.

Many antineoplastic drugs have shown to be carcinogenic, teratogenic and mutagenic to humans and exposure and absorption have been showed to occur during the preparation and administration in health care practise. More recently, in many countries, national health authorities concern has been focused on promoting actions aimed to protect health of the personnel handling these drugs. The present study reports the results of a survey carried out through a questionnaire among the pharmacists and nurses working in the health care settings located in the province of Rome (Italy), with the aim to survey: occupational risk perception of health care workers; their confidence in the safety measures adopted in the work practice; their knowledge of risk factor and the kind of training received regarding these specific agents. Among the respondents, most of the pharmacists (80%) and nurses (90.4%) show a high concern about antineoplastic drugs dangerousness. At the same time, they state not to have a satisfactory level of knowledge regarding the risk factor and, also that their main information source on occupational risk connected to antineoplastic drugs exposure is not the health care structure, where they are employed. Besides, they do not show a high level of confidence in the safety measures adopted in the health care structures with the aim to protect workers' health. The study results suggest the necessity to promote the development of preventive actions aimed to minimise occupational exposure to these substances through the implementation of procedures and controls in the hospitals, as well as the use of work practice and protective equipment, reinforced by workers education and training.

It was believed that occupational exposure to several toxic agents could negatively affect male fertility. This paper reports the results of a study on the fertility of couples in whom the man was occupationally exposed to three different toxics: metals, solvents and pesticides, having effects on reproduction. Fertility was evaluated during the time that elapsed between attempting and achieving the first pregnancy of the couple (time to pregnancy--TTP). Exposure to occupational risks during the period preceding conception was defined on the basis of data collected from 153 workers of a mint (exposed to metal and solvents), 322 agricultural workers licensed to handle pesticides and 127 greenhouse workers. Comparing the groups exposed during the conception period with comparable non-exposed groups, we found a slight delay in conception among couples with male exposure to metals (OR = 1.3; 95% CI 0.5-3.6), to solvents (OR = 1.7; 95% CI 0.6-4.6) and to pesticides among greenhouse workers (OR = 1.6; 95% CI 0.8-3.1 for the moderately exposed and OR = 2.4; 95% CI 1.2-5.1 for the heavily exposed). No increase in the risk of conception delay was observed in agricultural workers with generic exposure to pesticides. The results of this study suggest that the workers exposed to metals and solvents and greenhouse workers exposed to pesticides experienced a delay in conception at the time of their wives' first pregnancy.

Excessive pneumatization of the maxillary sinus subsequent to the loss of teeth frequently interferes with the placement of osseointegrated implants. Many techniques have been developed and tested to reduce the size and alter the anatomy of the sinus to augment the quantity of bone available for an adequate number of prosthetically well-placed implants of a satisfactory length. Most of these describe extensive one- or two-stage sinus grafting procedures that are usually performed through a lateral approach. A technique of localized elevation of the maxillary sinus floor through a less-invasive crestal approach is presented here. Ninety-seven implants were placed with this technique between 1991 and 1998. The healing was always uneventful, without any sign of pathologic reaction in the maxillary sinus. Eighty-six implants were successfully loaded for a period between 6 and 90 months (mean 35 months). Eight implants failed to integrate, and three were lost after different periods of function, for a cumulative success rate of 88.6%.

We attempt to study fertility problems among workers exposed to pesticides, comparing the reproductive experience of greenhouse workers and administrative staff working in the Health Local Units of the same geographical area (reference population). Data on reproductive history and time to pregnancy (TTP) at first pregnancy were collected by personal interview. For workers with children, we collected data on TTP in relation to the occupational risk factors. The analysis of TTP was conducted among 127 greenhouse and 173 administrative workers married and aged 20-55. The greenhouse workers reported 232 pregnancies and a mean number of 1.8 children; the controls 270 and 1.6 respectively. For greenhouse workers the mean TTP in months (5.4 with SD 5.6) resulted longer than for controls (3.9 with SD 5.6). The risk for conception delay (beyond 3 months) by exposure category of the man adjusted for age of woman, smoking of man and woman at first pregnancy resulted 2.4 higher for a subgroup of greenhouse workers with higher exposition (CI 95% 1.2-5.1).

This study was conducted among 32 pesticide applicators occupationally exposed to pesticides to determine whether paternal exposure is associated with an increased risk of spontaneous abortion. The ratio of abortion was compared between applicators and a group of 51 food retailers (control population). The ratio of abortions/pregnancies for applicators was 0.27 and for retailers 0.07. OR for spontaneous abortion adjusted for age of wife and smoking of parents is 3.8 times greater than for the control population in the multiple logistic regression model and 7.6 times with interaction effects model.

Environmental pollution is a great cause of concern, in particular, growing attention is being paid to the potential of many chemicals to affect the reproductive system in humans. The key role of prevention and control of reproductive hazards is recognized world-wide. Many chemicals have been shown to impair fertility and/or prenatal and perinatal development in experimental studies. However, a sufficient evidence of an effect on human reproduction is available for some compounds only. The use of biological markers may improve the assessment of exposure to chemicals, contribute to identify mechanisms of action and put into evidence early, reversible, biological effects. Valid biological markers are also needed in epidemiological studies: without reliable data on the level of current and past exposures it is difficult to establish a causal relationship between a pollutant and the occurrence of adverse health effects. A multidisciplinary approach to risk assessment is required. Priorities for interdisciplinary research on environmental chemicals and reproduction include the identification of susceptible population subgroups and risk assessment of exposure to multiple chemicals.

BACKGROUND AND STUDY AIMS: It is difficult to measure the prevalence of hereditary non-polyposis colorectal cancer (HNPCC) in geographical areas that do not have tumor registers, as is the case in the present study, and it was therefore decided to assess the prevalence in Italy using different methods. PATIENTS AND METHODS: The pedigree was established for 485 of 501 colorectal cancer patients diagnosed with colorectal carcinomas. Patients were included consecutively in 13 gastroenterology centers; they had not taken part in prevention examinations. Information was collected regarding the neoplastic pathology observed in the families, confirmed in 90% of cases among 3515 first-degree relatives and in 79.5% of cases among 7068 second-degree relatives. RESULTS: In the 3515 first-degree relatives (1002 parents, 1560 siblings and 953 children), 61 colorectal carcinomas, 29 carcinomas in the digestive tract outside the colon, and 99 carcinomas in other locations were reported. Only five of the 485 patients (1%) satisfied the Amsterdam criteria (three cancers, two of which were in first-degree relatives in different generations and one in a relative younger than 50). When broadening the criteria that we are proposing (satisfying only two of the three Amsterdam criteria), the prevalence would increase to 3% (15 cases). CONCLUSIONS: Modifying the criteria makes it easier to identify new mutations or confirm the existence of those already known, as well as allowing preventative treatment in relatives who are apparently healthy.

During the last ten years, interest has been focussed on occupational exposure in thermoelectric power plants (i.e., coal dust, polycyclic aromatic hydrocarbons, dioxin, dielectric liquids, PCB's, asbestos, etc.), although available evidence on its effects on the health status of the occupational population are far from being definitive. A retrospective cohort study was carried out to investigate the association between exposure to risk factors and mortality for cancer in three thermoelectric power plants located in the north-east of Italy. The three plants studied started with oil and coal but since 1968 they utilized mostly coal as fuel. In spite of the different fuel used at the beginning, the production process has been fairly constant since the main conversion from oil to coal with a substantial increase in power production. A total of 1,772 male workers were included in the total study cohort and followed-up from 1968 to 1987, with a total of 22,090 person-years of exposure. Eighty percent of the cohort began to work in the plant before 30 years of age, and had a mean period of employment of 9.5 years. The cohort was completely traced to the end of the follow-up period by using an original computer system based on personal fiscal codes. Causes of death were ascertained in the municipalities where the deaths occurred and coded according to the International Classification of Disease, IX Revision. During the study period 68 deaths were observed with an SMR for all causes of death equal to 0.79.(ABSTRACT TRUNCATED AT 250 WORDS)

WIDESPREAD head louse infestation (Pediculus humanus capitis De Geer) among schoolchildren has been recorded in Italy. An investigation was carried out to evaluate the prevalence and to identify the factors which contribute to the spread of the ediculosis. In this study (March 23 to April 21,1978) 1,988 pupils grouped proportionally to the numerical division in three types of schools were examined. The prevalence of pediculosis in the school population stüdied was 9.6%; no significant differences were detected among the three types of schools examined. Distribution of cases by degree of infestation and hair length was also studied. Distribution of para sitosis seems not to depend on the number of pupils in a class, while it was influenced by the size of the family. In the Elementary and Primary schools prevalence among females was twice that of males, while no relationship was detected between infestation and sex in the Nursery schools.

Relationships between arterial pressure, age, sex, anthropometric measurements, body fat, and urinary excretion of electrolytes were examined in a group of 120 adolescents from 11 to 14 years of age. Body weight and triceps skinfold thickness are two variables that have the highest correlation with arterial pressure levels, especially among girls. Only a slight correlation was found between urinary excretion of sodium and arterial hypertension. The apparent contradiction between positive correlation of fat percent and arterial pressure and the negative correlation between urinary excretion of sodium and arterial pressure can possibly be explained by the low sodium content of the diet of the subjects studied. Their typical Mediterranean diet was abundant in fresh food, mainly based on carbohydrates (macaroni, bread, vegetables), rather than conserved foods in which salt plays an important role in the conservation process (butter, bacon, salad, etc.), typical of the continental diet.

An analysis of cancer mortality over a 10-year period in Italy is presented. Data are from the Italian part of the Seven Countries Study, an international investigation into the epidemiology of coronary heart disease. The analysis confirms that coronary risk factors provide a useful guide to the prediction of cancer mortality, particularly in association with factors related to age, smoking habits, body weight, and diabetes. (summary in ENG)

An epidemiological study was conducted in the city of Rome and the incidence of malignant melanoma was determined retrospectively for the years 1970-9. All patients had legal residence in Rome and a histological diagnosis of melanoma during that period; only cases of malignant melanoma of the skin (ICD 172, 8th revision) were considered. A total of 17 public and 82 private hospitals were involved in the study with 11 081 and 6127 hospital beds respectively. All the hospitals in the study had one of the following therapeutic and diagnostic facilities: internal medicine, dermatology, oncology, radiology, surgery, plastic surgery, histopathology. Analyses of incidence are based on 500 cases, 237 males and 263 females, collected in the period 1970-9. The data indicate a positive time trend in incidence; the average annual increase is 0.27 cases/year per 100 000. The data show that in a Mediterranean and Latin country such as Italy the incidence of melanoma presents the same ascending trend as that of other Caucasian countries, whether European or not, the slope of the curves is similar for both sexes. The distribution of the primary site for both sexes is closely parallel to that described for all Caucasian populations, the lower limbs being more affected in females and the trunk in males.

Laboratory studies have been carried out on two species of ticks, I. ricinus and H. marginatum, showing different seasonal activity and different geographical distribution in nature. The purpose of the present study has been to investigate the effect of different combinations of temperature and humidity on the oviposition of I. ricinus and H. marginatum. An index of reproduction efficiency (no. eggs/wt female), established to relate the capacity of the females to produce eggs to their body weight, has been calculated; for I. ricinus 5 temperatures (18-20-25-27 and 30 degrees C) have been studied (Fig. 1), for H. marginatum 3 (25-30 and 32 degrees C) (Fig. 2) and for both species 2 R.H. (75-95%). An optimal range of temperature, within which the value of such an index doesn't change, has been demonstrated for both species by statistical testing (Table 1). A critical weight value as the minimum engorged female weight required for egg deposition has been identified with the weight of first female which has laid eggs. This weight, different in each species, is influenced by temperature and humidity.

BackgroundRepeatability and reproducibility are essential for clinicians for several purposes. Although discouraged, use of the Coefficient of Variation (CV) for assessing repeatability and reproducibility, rather than the Intraclass Correlation Coefficient (ICC), is still widespread. The aim of the present study was to highlight how using inappropriate indices may lead to misleading results, and this is done by simulation study and using real data on Anterior Active Rhinomanometry (AAR) in both healthy children and ones with rhinitis.MethodsA simulation study was carried out to highlight how using inappropriate indices could be misleading. Then a comparison was made between CV and ICC to assess repeatability and reproducibility of AAR, for which previous studies have given underestimated results. AAR is recommended as the gold standard tool for measuring nasal resistance in clinical practice.ResultsA simulation study showed that the ICCs estimated from data generated assuming a true CV yielded results in agreement with estimated CVs; by contrast, if data were generated assuming a true ICC, CVs yielded conflicting results. For AAR, ICCs showed good repeatability, whereas CVs showed unacceptable repeatability. AUC and 95% CI for AAR showed good performance in predicting current symptoms of rhinitis in the overall study population.ConclusionsThe present study focused on the importance of the choice of appropriate indices of repeatability and reproducibility, demonstrating the repeatability of AAR in both healthy children and ones with rhinitis.Trial registrationClinicalTrials.gov(ID:NCT03286049; Registration Date: September 15, 2017; Actual Study Start Date: January 10, 2018).