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Within the EU human biomonitoring initiative (HBM4EU), a targeted, multi-national study on occupational exposure to hexavalent chromium (Cr(VI)) was performed. Cr(VI) is currently regulated in EU under REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) and under occupational safety and health (OSH) legislation. It has recently been subject to regulatory actions to improve its risk management in European workplaces. Analysis of the data obtained within the HBM4EU chromates study provides support both for the implementation of these regulatory actions and for national enforcement programs and may also contribute to the updating of occupational limit values (OELs) and biological limit values for Cr(VI). It also provides useful insights on the contribution of different risk management measures (RMMs) to further reduce the exposure to Cr(VI) and may support the evaluation of applications for authorisation under REACH. Findings on chrome platers’ additional per- and polyfluoroalkyl substances (PFAS) exposure highlight the need to also pay attention to this substance group in the metals sector. A survey performed to evaluate the policy relevance of the HBM4EU chromates study findings supports the usefulness of the study results. According to the responses received from the survey, the HBM4EU chromates study was able to demonstrate the added value of the human biomonitoring (HBM) approach in assessment and management of occupational exposure to Cr(VI). For future occupational studies, we emphasise the need for engagement of policy makers and regulators throughout the whole research process to ensure awareness, relevance and uptake of the results in future policies. Highlights: Potential policy impact of the HBM4EU chromates study is presented and discussed; Surveyed policy makers confirmed policy relevance of biomonitoring results; Study considered to support national enforcement and further lowering of OELs; Added value of HBM in the management of occupational exposure to Cr(VI) was demonstrated; Close co-operation with regulators to support policy uptake is emphasised. Funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 733032 and received co-funding from the author's organizations and/or Ministries. info:eu-repo/semantics/publishedVersion

Background: Several studies showed important differences in the interpretation of spirometry based on different reference values, in particular by comparing European Respiratory Society (ERS) 1993 and Global Lung Function Initiative (GLI) 2012. The validation of new reference values in local populations is essential before they can be used in an appropriate manner. This study aimed to investigate the fit of GLI reference values in a healthy Italian working population. Methods: Spirometry data were collected in 1355 workers during their health surveillance medical examination conducted for exposure to chemical and biological risk factors. A single portable spirometer that met the ATS/ERS recommendations for occupational testing was used and calibrated daily. Results: Average z-score were −0.13 (with a median of −0.17), −0.25 (with a median of −0.24), and 0.18 (with a median of 0.17) for FEV1, FVC, and FEV1/FVC ratio, respectively. Considering only the normal-weighted workers, the average z-scores were −0.07 (with a median of −0.16), −0.15 (with a median of −0.16), and 0.07 (with a median of 0.02) for FEV1, FVC, and FEV1/FVC ratio, respectively. Conclusions: GLI 2012 reference values fit the Italian data satisfactorily, resulting as more accurate than ERS 1993, especially in women, normal-weighted subjects, aged 30−50 years, and for height < 165 cm.

In the present study, surface contamination where antineoplastic drugs (ADs) are present was investigated, as occupational exposure risk is still an open debate. Despite recommendations and safety standard procedures being in place in health care settings, quantifiable levels of ADs are being reported in the recent literature. Thus, a survey monitoring program was conducted over five years (2016–2021) in nine Italian hospitals. The repeated surveys produced 8288 data points that have been grouped according to the main hospital settings, such as pharmacy areas and patient care units. Based on the most often prepared ADs, the investigated drugs were cyclophosphamide (CP), gemcitabine (GEM), 5-fluorouracil (5–FU), and platinum compounds (Pt). Patient care units had a frequency of positive wipe samples (59%) higher than pharmacies (44%). Conversely, pharmacies had a frequency of positive pad samples higher (24%) than patient care units (10%). Moreover, by statistical analysis, pad samples had a significantly higher risk of contamination in pharmacy areas than in patient care units. In this study, the 75th and the 90th percentiles of the contamination levels were obtained. The 90th percentile was chosen to describe a suitable benchmark that compares results obtained by the present research with those previously reported in the literature. Based upon surface contamination loads, our data showed that 5–FU had the highest concentration values, but the lowest frequency of positive samples. In pharmacy areas, the 90th percentile of 5–FU data distribution was less than 0.346 ng/cm2 and less than 0.443 ng/cm2 in patient care units. AD levels are higher than those reported for health care settings in other European countries yet trends of contamination in Italy have shown to decrease over time.

The widespread application of additive manufacturing (AM) technologies, commonly known as three-dimensional (3D) printing, in industrial and home-business sectors, and the expected increase in the number of workers and consumers that use these devices, have raised concerns regarding the possible health implications of 3D printing emissions. To inform the risk assessment and management processes, this review evaluates available data concerning exposure assessment in AM workplaces and possible effects of 3D printing emissions on humans identified through in vivo and in vitro models in order to inform risk assessment and management processes. Peer-reviewed literature was identified in Pubmed, Scopus, and ISI Web of Science databases. The literature demonstrated that a significant fraction of the particles released during 3D printing could be in the ultrafine size range. Depending upon the additive material composition, increased levels of metals and volatile organic compounds could be detected during AM operations, compared with background levels. AM phases, specific job tasks performed, and preventive measures adopted may all affect exposure levels. Regarding possible health effects, printer emissions were preliminary reported to affect the respiratory system of involved workers. The limited number of workplace studies, together with the great variety of AM techniques and additive materials employed, limit generalizability of exposure features. Therefore, greater scientific efforts should be focused at understanding sources, magnitudes, and possible health effects of exposures to develop suitable processes for occupational risk assessment and management of AM technologies.

The high toxicity of antineoplastic drugs (ADs) makes them dangerous not only for patients, but also for exposed workers. Therefore, the aim of this review was to provide an updated overview of the biological monitoring of occupational AD exposure in order to extrapolate information useful to improve risk assessment and management strategies in workplaces. Several studies demonstrated that remarkable portions of healthcare workers may have traces of these substances or their metabolites in biological fluids, although with some conflicting results. Nurses, directly engaged in AD handling, were the occupational category at higher risk of contamination, although, in some cases, personnel not involved in AD-related tasks also showed quantifiable internal doses. Overall, further research carried out on greater sample sizes appears necessary to gain deeper insight into the variability retrieved in the reported results. This may be important to understand the impact of the extent of ADs use, different handling, procedures, and cleaning practices, spill occurrence, training of the workforce, as well as the adoption of adequate collective and personal protective equipment in affecting the occupational exposure levels. This may support the achievement of the greatest clinical efficiency of such therapies while assuring the health and safety of involved workers.

Improvements in the survival and clinical outcomes of cystic fibrosis (CF) patients raised questions about their workforce participation and capacity to work. One hundred and ninety-six outpatients, attending the Adult CF Center of an Italian University Hospital, were enrolled between May 2020 and March 2021. The patients’ personal and clinical characteristics, employment status, and profession were assessed. The Cystic Fibrosis Questionnaire—Revised and the work ability index (WAI) were employed to assess CF health-related quality of life and the employee’s perception of their ability to work, respectively. Among the enrolled patients, 98 (50%) were employed. The non-working subjects were significantly younger (mean age ± standard deviation: 30 ± 10 vs. 37 ± 10 years) and were diagnosed with CF significantly earlier (9 ± 13 vs. 17 ± 18 years) than the employed subjects. The vast majority of CF workers (82.6%) were employed in tertiary professions. A general good work ability perception was determined in the employed population. Aging and being employed for &gt, 15 years could significantly predict a reduction in work ability, while a better quality of life was a positive predictor for its enhancement. Although further research is necessary, these results may introduce interdisciplinary CF healthcare management that includes a work function assessment, formal career counseling, and job guidance to support the personal, social and professional lives of CF patients.

Background: The aim of the present study was to evaluate the psychological well-being (PWB) during the coronavirus disease (COVID-19) pandemic in workers of a multinational company. Methods: Employees (aged ≥ 18 years) were recruited from Latin American, North American, New Zealand and European sites of a multinational company operative during all the pandemic period. The self-reported Psychological General Well Being Index (PGWBI) was employed to assess the global PWB and the effects on 6 sub-domains: anxiety, depressed mood, positive well-being, self-control, general health and vitality. The influencing role of age, gender, geographical location, COVID-19 epidemiology, and restrictive measures adopted to control the pandemic was explored. Results: A total of 1335 workers completed the survey. The aggregate median PWB global score was in a positive range, with significantly better outcomes detected in the Mexican and Colombian Latin American sites compared to the other worldwide countries (p

In the current coronavirus (COVID-19) pandemic, the definition of risk factors for susceptibility to adverse outcomes seems essential to support public and occupational health policies. Some specific issues need to be addressed to understand vulnerability in occupational settings. Among these, individual factors, e.g., age, sex, and preexisting comorbidities (hypertension, cardiovascular diseases, diabetes, obesity, cancer), that can predispose individuals to more severe outcomes and post-COVID-19 symptoms that may represent conditions of acquired susceptibility, possibly impacting the return to—and fitness for—work. Additionally, the risk of contracting COVID-19 through work should be addressed, considering the probability of being in contact with infected people, physical proximity to others, and social aggregation during work. Occupational health settings may represent appropriate scenarios for the early identification of vulnerable subjects, with the final aim to guide risk assessment and management procedures. These should include the systematic surveillance of work-related risk factors, collective preventive policies, stringent actions for specific groups of workers, decisions on occupational placement of employees, and health promotion activities. Concerted actions of general practitioners, hospital specialists, occupational physicians, and all the stakeholders involved in the occupational health and safety management should be focused on planning suitable preventive measures for susceptible subjects.

Hypertensive disorders in pregnancy (HDP), including gestational hypertension (GH) and preeclampsia (PE), characterize a major cause of maternal and prenatal morbidity and mortality. In this systematic review, we tested the hypothesis that occupational factors would impact the risk for HDP in pregnant workers. MEDLINE, Scopus, and Web of Knowledge databases were searched for studies published between database inception and 1 April 2021. All observational studies enrolling > 10 pregnant workers and published in English were included. Un-experimental, non-occupational human studies were excluded. Evidence was synthesized according to the risk for HDP development in employed women, eventually exposed to chemical, physical, biological and organizational risk factors. The evidence quality was assessed through the Newcastle–Ottawa scale. Out of 745 records identified, 27 were eligible. No definite conclusions could be extrapolated for the majority of the examined risk factors, while more homogenous data supported positive associations between job-strain and HDP risk. Limitations due to the lack of suitable characterizations of workplace exposure (i.e., doses, length, co-exposures) and possible interplay with personal issues should be deeply addressed. This may be helpful to better assess occupational risks for pregnant women and plan adequate measures of control to protect their health and that of their children.

Multicenter Study The EU human biomonitoring initiative, HBM4EU, aims to co-ordinate and advance human biomonitoring (HBM) across Europe. As part of HBM4EU, we presented a protocol for a multicentre study to characterize occupational exposure to hexavalent chromium (Cr(VI)) in nine European countries (HBM4EU chromates study). This study intended to collect data on current occupational exposure and to test new indicators for chromium (Cr) biomonitoring (Cr(VI) in exhaled breath condensate and Cr in red blood cells), in addition to traditional urinary total Cr analyses. Also, data from occupational hygiene samples and biomarkers of early biological effects, including genetic and epigenetic effects, was obtained, complementing the biomonitoring information. Data collection and analysis was completed, with the project findings being made separately available. As HBM4EU prepares to embark on further European wide biomonitoring studies, we considered it important to reflect on the experiences gained through our harmonised approach. Several practical aspects are highlighted for improvement in future studies, e.g., more thorough/earlier training on the implementation of standard operating procedures for field researchers, training on the use of the data entry template, as well as improved company communications. The HBM4EU chromates study team considered that the study had successfully demonstrated the feasibility of conducting a harmonised multicentre investigation able to achieve the research aims and objectives. This was largely attributable to the engaged multidisciplinary network, committed to deliver clearly understood goals. Such networks take time and investment to develop, but are priceless in terms of their ability to deliver and facilitate knowledge sharing and collaboration. Highlights: Feasibility of conducting harmonised Pan-European biomonitoring study on occupational exposure demonstrated; Developing a successful network and implementation of systematic methodology takes significant dedication from all involved; Methodological improvements were identified which will benefit future large-scale occupational biomonitoring campaigns; Developed multicentre network allows and promotes further opportunities for future research, knowledge sharing and collaboration; Data produced supports science to policy interface in the scope of REACH and occupational safety and health regulations. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 733032 and received co-funding from the author’s organizations and/or Ministries. info:eu-repo/semantics/publishedVersion

Various decontamination methods that may be used to extend respirator inventories have been examined for over a decade. In light of the ongoing coronavirus disease 2019 pandemic, many health-care settings are now implementing these techniques amid respirator shortages. We sought to perform a critical review of the available literature regarding decontamination methods to determine which strategies are effective at inactivating the target organism, preserve performance (filter efficiency and fit) of the respirator, leave no residual toxicity from the treatment, and are fast-acting, inexpensive, and readily available. We also identified areas for future research. We found that ultraviolet germicidal irradiation (UVGI) is the most widely studied method, and treatments are effective at inactivating SARS-CoV-2 without diminishing filtration efficiency or fit. These treatments were found to leave no residual toxicity for the wearer, have a relatively short cycle time of less than 1 h, and existing systems can likely be retrofitted to accommodate this method. Further, UVGI (among other treatment methods) has been recommended by the Centers for Disease Control and Prevention (CDC), Occupational Safety and Health Administration (OSHA), and respirator manufacturers. Methods involving microwave-generated steam also show potential in that they are likely effective against SARS-CoV-2, preserve performance, have no residual toxicity, require a short duration treatment cycle (often less than 10 min), and microwave ovens are inexpensive and readily available. Steam methods are currently recommended by the CDC, OSHA, and manufacturers. These respirator decontamination methods are likely also useful against other viruses or pathogens. © The Author(s) 2020.

Thyroid diseases are characterized by a wide range of physical and mental symptoms that can affect biological function, emotional and social life of patients. However, their impact on work functioning is not yet fully understood. Therefore, this review aims to address the way in which thyroid diseases can affect occupational outcomes, i.e., the employment rate, sick leave, working capacity and work income of patients. A systematic review of Pubmed, Scopus and ISI Web of Knowledge databases has been performed. Although it is not possible to extrapolate precise data for benign pathologies, about a third of the survivors of thyroid cancer could be unemployed. Hyperthyroid and hypothyroid patients presented a greater risk of long-term sick leave than controls, depending on the severity of the disease. Hyperthyroidism impaired working ability in about a third of affected patients, particularly in cases complicated by orbitopathy with diplopia. A possible influence of thyroid diseases on various occupational outcomes emerged from our review, however further research seems necessary to understand the relationship between work problems, specific pathological characteristics over time and risk factors in the workplace. This may support a comprehensive, interdisciplinary management of thyroid disorders, with benefits for patients’ personal, social and professional life.

Introduction: Spirometry is the main pulmonary function test routinely employed in the occupational medicine practice. Its interpretation depends on the choice of the theoretical reference values. Therefore, our objective was to retrospectively evaluate the differences in the spirometric interpretation according to the reference values used. Methods: A total of 2462 spirometries performed during health surveillance programs were analyzed. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio were compared according to three different reference values: the European Coal and Steel Community (ECSC) 1971, the European Respiratory Society (ERS) 1993, and the Global Lung Initiative (GLI) 2012. Results: The GLI 2012 provided significantly higher predicted mean FVC and FEV1 values compared to the ERS 1993 and significantly lower compared to the ECSC 1971. The GLI 2012 were able to detect all the obstructive deficits and mixed patterns diagnosed with ECSC 1971 and ERS 1993, in addition to others not diagnosed by these two latter reference values. The number of restrictive patterns identified through the GLI 2012 was significantly reduced and increased compared to those diagnosed using the ECSC 1971 and the ERS 1993, respectively. Discussion: In comparison to the GLI 2012, the ERS 1993 values significantly underestimated obstructive and restrictive alterations. Conversely, the ECSC 1971 significantly underestimated obstructive changes, while overestimated restrictive patterns, compared to GLI. Although the GLI reference values may provide a correct spirometric interpretation, their validation in an Italian worker population is necessary to confirm their possible use in routine occupational health programs.

Objectives Migraine is a chronic neurological disorder characterized by recurrent attacks of headache, mainly affecting the working age population with a great socioeconomic impact. The etiology of migraine is still uncertain, and various individual and/or environmental risk factors have been suggested as triggers of the attacks, including irregularities in the sleep‐wake rhythm. In this perspective, it is possible that shift and night work, affecting circadian rhythms, may play a key function in the disease pathogenesis. Therefore, aim of this review was to provide an overview on the possible association between shift works and migraine development or clinical outcomes. Methods A systematic review of literature studies available in Pubmed, Scopus, and ISI Web of Science databases, addressing the possible shift work‐migraine relationship was performed. Results Conflicting data emerged from the revised studies. Some results supported a positive association between migraine prevalence and shift works, according to peculiar job tasks, seniority in shift works, specific work schedules, and number of night shifts performed in a month. However, other investigations failed to confirm such findings. Conclusions The limited number of available studies, their cross‐sectional nature, the different criteria employed for migraine diagnosis, and the various shift work schedules analyzed, together with exposure to other confounding factors on workplace do not allow to extrapolate definite conclusions on shift work‐migraine relationship. From an occupational health perspective, further studies appear necessary to better understand such exposure‐disease association and possibly define risk assessment and management strategies to protect the health of susceptible and/or migraine affected workers.

The widespread industrial application of nanotechnology has increased the number of workers exposed to engineered nanomaterials (ENMs), but it is not clear to what extent prevention guidance is practiced. Our aim was to explore the extent that companies manufacturing and/or using ENMs apply risk assessment and management measures. Thirty-four companies were surveyed with an international 35-item questionnaire investigating company and workforce features, types of ENM handled, and risk evaluation and preventive measures adopted. Among participating companies, 62% had a maximum of 10 employees. Metal-based nanomaterials were most frequently identified (73%). Environmental monitoring was performed by 41% of the companies, while engineering exposure controls were approximately reported by 50%. Information and training programs were indicated by 85% of the sample, only 9% performed specific health surveillance for ENM workers. Personal protective equipment primarily included gloves (100%) and eye/face protection (94%). This small-scale assessment can contribute to the limited amount of published literature on the topic. Future investigations should include a greater number of companies to better represent ENM workplaces and a direct access to industrial settings to collect information on site. Finally, deeper attention should be paid to define standardized frameworks for ENM risk assessment that may guide nano-specific preventive actions.

Epigenetics are heritable changes in gene expression not coded in the DNA sequence, which stand at the interface between the genome, environmental exposure and development. From an occupational health perspective, epigenetic variants may link workplace exposures and health effects. Therefore, this review aimed to overview possible epigenetic effects induced by welding fumes on exposed workers and health implications. A systematic search was performed on Pubmed, Scopus, and ISI Web of Knowledge databases. DNA methylation changes have been reported in genes responsible for the cardiac autonomic function and coagulation, i.e., LINE-1, GPR133 and F2RL3, in mitochondrial-DNA-sequences involved in the regulation of energy-generation/redox-signaling, as well as in inflammatory activated genes, i.e., iNOS. However, the limited number of retrieved articles, their cross-sectional nature, the lack of a suitable qualitative-quantitative exposure assessment, and the heterogeneity of biological-outcomes investigated, prevent the extrapolation of a definite causal relationship between welding fumes and epigenetic phenomena. Future studies should clarify the function of such epigenetic alterations as possible markers of occupational exposure and early effect, dose-response relationships, and underlying molecular mechanisms. Overall, this may be helpful to guide suitable risk assessment and management strategies to protect the health of workers exposed to welding fumes.

Silicosis is a progressive fibrotic lung disease that is caused by the inhalation of respirable crystalline silica. Due to its high silica content, artificial stone (AS) can become a possible source of hazardous dust exposure for workers that are employed in the manufacturing, finishing, and installing of AS countertops. Therefore, the aim of this review was to verify the association between AS derived silica exposure and silicosis development, and also then define the pathological characteristics of the disease in relation to specific work practices and preventive and protective measures that were adopted in the workplace. A systematic review of articles available on Pubmed, Scopus, and Isi Web of Knowledge databases was performed. Although the characteristics of AS-associated silicosis were comparable to those that were reported for the disease in traditional silica exposure settings, some critical issues emerged concerning the general lack of suitable strategies for assessing/managing silica risks in these innovative occupational fields. Further research that is designed to assess the hazardous properties of AS dusts, levels of exposure in workplaces, and the effectiveness of protective equipment appears to be needed to increase awareness concerning AS risks and induce employers, employees, and all factory figures that are engaged in prevention to take action to define/adopt proper measures to protect the health of exposed workers.

Our systematic review on artificial stone (AS)-associated silicosis and the related comment by Edwards underline the urgency to define effective strategies to assess and manage the risk of exposure to silica in workers involved in AS job tasks. Case screening programs may be important to fully understand the extent of the silicosis epidemic associated with AS and point out critical issues in workplace settings/practices that, by contributing to higher respirable crystalline exposure, favor the disease manifestation. This information may guide the identification of the most appropriate preventive measures in workplaces, especially regarding the administration of updated training and information courses, the definition of good working practices, and the application of targeted health surveillance programs. However, considering the recent epidemiological data and the severity of AS-associated silicosis, it would be appropriate (according to the hierarchy of control strategy) to also consider the application of more stringent prevention measures, such as a safety-by-design approach to the chemical formulation of the AS. Overall, the implementation of the aforementioned preventive measures should ensure an effective control of the current silicosis epidemic and, at the same time, prevent the development of new disease cases in the near future.

The technologically interesting properties of palladium nanoparticles (Pd-NPs) allowed their widespread industrial application, although concerns emerged on increasing general and occupational levels of exposure. In this context, to assess the toxicological behavior of Pd-NPs, and particularly their endocrine disruptive potential, has become a public health priority. Therefore, we evaluated Pd-NP impact on the female endocrine reproductive system of Wistar rats sub-chronically treated for 90 days with increasing doses of this xenobiotic (0.12, 1.2, and 12 µg/kg, administered at days 1, 30, and 60 for cumulative doses of 0.36, 3.6, and 36 µg/kg) via the intravenous route. In this regard, we investigated potential alterations in different sex hormone, for example, estradiol, follicle-stimulating hormone (FSH), luteinizing hormone, progesterone, and testosterone, serum concentrations. All treated groups showed significantly greater levels of FSH compared to controls, suggesting a possible impact of Pd-NPs on the regulatory system that controls the normal physiology of female reproductive function. Although relevant, since obtained under sub-chronic, low-dose conditions of exposure resembling those encountered in real-world scenarios, the present results are preliminary and require confirmation as well as identification of the possible underlining molecular mechanisms. From a public and occupational health perspective, implications for the reproductive health of exposed subjects and the next generations of women exposed during their childbearing age or pregnancy should be elucidated. This information is essential to elaborate adequate preventive strategies for assessing and controlling possible Pd-NPs adverse effects on the endocrine system.

Particular working conditions and/or organization of working time may cause important sleep disturbances that have been proposed to be predictive of cognitive decline. In this regard, circadian rhythm misalignment induced by exposure to night work or long working hours would be responsible for cognitive impairment. Nevertheless, evidence supporting this correlation is limited and several issues still need to be elucidated. In this regard, we conducted a systematic review to evaluate the association between shift/night work and cognitive impairment and address its main determinants. Information provided by the reviewed studies suggested that night work might have serious immediate negative effects especially on cognitive domains related to attention, memory and response inhibition. Furthermore, cognitive performance would progressively worsen over consecutive night shifts or following exposure to very long work shifts. Otherwise, conflicting results emerged regarding the possible etiological role that night work chronic exposure would have on cognitive impairment. Therefore, circadian rhythm desynchronization, lack of sleep and fatigue resulting from night work may negatively impact worker’s cognitive efficiency. However, in light of the considerable methodological variability of the reviewed studies, we proposed to develop a standardized research and evaluation strategy in order to obtain a better and comprehensive understanding of this topic.

INTRODUCTION: Phthalates, a group of ubiquitous industrial chemicals, have been widely used in occupational settings, mainly as plasticizers in a variety of applications. Occupational exposure to different phthalates has been studied in several occupational settings using human biomonitoring (HBM). AIM: To provide a comprehensive review of the available literature on occupational exposure to phthalates assessed using HBM and to determine future data needs on the topic as part of the HBM4EU project. METHODS: A systematic search was carried out in the databases of Pubmed, Scopus, and Web of Science for articles published between 2000 and September 4, 2019 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 22 studies on the occupational HBM of phthalates was considered suitable for review. RESULTS AND DISCUSSION: Among the reviewed studies, 19 (86%) focused on DEHP, an old phthalate that is now subject to authorization and planned to be restricted in the EU. Concentrations of MEHHP, one of its metabolites, varied up to 13-fold between studies and across sectors when comparing extreme geometric means, ranging from 11.6 (similar to the general populations) to 151 μg/g creatinine. Only 2 studies focused on newer phthalates such as DiNP and DPHP. Concerning the geographical distribution, 10 studies were performed in Europe (including 6 in Slovakia), 8 in Asia, and 4 in North America, but this distribution is not a good reflection of phthalate production and usage levels worldwide. Most HBM studies were performed in the context of PVC product manufacturing. Future studies should focus on: i) a more uniform approach to sampling timing to facilitate comparisons between studies; ii) newer phthalates; and iii) old phthalates in waste management or recycling. CONCLUSION: Our findings highlight the lack of recent occupational HBM studies on both old and new phthalate exposure in European countries and the need for a harmonized approach. Considering the important policy actions taken in Europe regarding phthalates, it seems relevant to evaluate the impact of these actions on exposure levels and health risks for workers. ispartof: INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH vol:229 ispartof: location:Germany status: published

Thyroid hormones are regulated by the pituitary thyroid stimulating hormone (TSH), whose secretion presents a circadian rhythmicity. Indeed, it is conceivable that shift- and night shift-work, affecting sleep-wake rhythms, may impact thyroid functionality. Therefore, the aim of the present review was to provide an overview on the association between shift- and night shift-work and thyroid hormonal changes and disease development. A systematic review of studies available in PubMed, Scopus, and ISI Web of Science databases was performed. A positive association between night shift-work and increased TSH concentrations was reported by most of the reviewed investigations. Inconclusive evidence was available on thyroid diseases. However, the limited number of studies, the noticeable heterogeneity in the shift-work scheduling, in terms of amount, duration, type of shift- or night shift-work, prevents easily integrating findings and extrapolating definite conclusions. Further investigation seems necessary to better define the relationship between shift schedules and different thyroid outcomes, and possible long-term implications of early functional changes. Overall, this may support the adoption of advanced risk assessment and management strategies aimed to achieve a safer workplace organization and a timely, responsible realization of all the benefits of a 24-h economy.

Diabetes mellitus (DM) is a group of metabolic diseases that may originate from an interaction between genetic and lifestyle risk factors. However, the possible role of occupational chemical exposures in the disease development and progression remains unclear. Therefore, this review aimed to provide a comprehensive evaluation of the relationship between occupational exposure to specific chemical substances or industrial activities and DM morbidity and mortality outcomes. Although some positive findings may support the diabetogenic role of certain pesticides and dioxins in different workplaces, the variable conditions of exposure, the lack of quantitative environmental or biological monitoring data and the different outcomes evaluated do not allow defining a specific exposure-disease causality. Therefore, further epidemiological studies will be necessary to adequately assess modes of action for different substances, dose–response relationships as well as individual susceptibility factors potentially affecting the exposure-disease continuum. Overall, this appears important to adequately assess, communicate and manage risks in occupational chemical exposure settings with the aim to protect workers and build healthier job conditions for diabetic employees.

In recent years, the increased use of rhodium (Rh) as an active catalyst material in modern three-way automobile catalytic converters has led to a parallel rise in environmental levels of this metal. In spite of this, the literature contains few studies of the effects of Rh on human health. The aim of this study is to assess the effects of Rh on the renal function of female Wistar rats. Our findings show that sub-acute exposure to six increasing concentrations, ranging from 0.001 to 1 mg L(-1), of Rh (III) chloride hydrate in drinking water does not induce alterations in urinary albumin levels, while, at concentrations from 0.1 to 1 mg L(-1), a significant rise in urinary levels of Retinol Binding Protein is evident and an increasing trend in urinary β2-microglobulin, which becomes significant at 1 mg L(-1), is observed. These results therefore demonstrate a nephrotoxic action of Rh at tubular level in a wide range of doses. Interestingly, because of the recent increase in environmental Rh levels, these findings may have relevant implications both for occupationally exposed subjects and for the general population, especially children.

In a world of finite resources and ecosystem capacity, the prevailing model of economic growth, founded on ever-increasing consumption of resources and emission pollutants, cannot be sustained any longer. In this context, the “green economy” concept has offered the opportunity to change the way that society manages the interaction of the environmental and economic domains. To enable society to build and sustain a green economy, the associated concept of “green nanotechnology” aims to exploit nano-innovations in materials science and engineering to generate products and processes that are energy efficient as well as economically and environmentally sustainable. These applications are expected to impact a large range of economic sectors, such as energy production and storage, clean up-technologies, as well as construction and related infrastructure industries. These solutions may offer the opportunities to reduce pressure on raw materials trading on renewable energy, to improve power delivery systems to be more reliable, efficient and safe as well as to use unconventional water sources or nano-enabled construction products therefore providing better ecosystem and livelihood conditions. However, the benefits of incorporating nanomaterials in green products and processes may bring challenges with them for environmental, health and safety risks, ethical and social issues, as well as uncertainty concerning market and consumer acceptance. Therefore, our aim is to examine the relationships among guiding principles for a green economy and opportunities for introducing nano-applications in this field as well as to critically analyze their practical challenges, especially related to the impact that they may have on the health and safety of workers involved in this innovative sector. These are principally due to the not fully known nanomaterial hazardous properties, as well as to the difficulties in characterizing exposure and defining emerging risks for the workforce. Interestingly, this review proposes action strategies for the assessment, management and communication of risks aimed to precautionary adopt preventive measures including formation and training of employees, collective and personal protective equipment, health surveillance programs to protect the health and safety of nano-workers. It finally underlines the importance that occupational health considerations will have on achieving an effectively sustainable development of nanotechnology. Electronic supplementary material The online version of this article (doi:10.1186/1476-069X-13-78) contains supplementary material, which is available to authorized users.