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The first Italian annual monitoring study was carried out in Northern Italy to analyse the fate and removal of polycyclic musk fragrances (PMFs) in a wastewater treatment plant (WWTP) with conventional activated sludge (CAS) system. Water was sampled in four different stations along wastewater treatments to better understand the behaviour of PMFs along different steps of the plant. Galaxolide (HHCB) and galaxolidone (HHCB-lactone) were found in concentrations at μg L -1 level, 1 order of magnitude greater than tonalide (AHTN), whilst phantolide (AHDI) was never detected and celestolide (ADBI) was measured only at trace levels. Considering water concentrations, HHCB and AHTN evidenced a slight reduction, 20% and 50%, respectively, during wastewater treatments, thus resulting in a modest removal efficiency, mainly due to adsorption processes during the biological treatment. This was also confirmed by the high PMF concentrations measured in activated sludges which remained stable throughout the year. On the contrary, HHCB-lactone registered an increase up to 70% during wastewater treatments caused by the biotransformation of the parental compound HHCB during the biological treatment, as shown by the different HHCB-lactone/HHCB ratio measured before and after this step. No significant differences were recorded between seasons in terms of PMF input onto WWTP, in accordance with the common use of these chemicals in civil houses. Overall, this study suggests that current technologies employed in conventional WWTP are not enough efficient in removing these organic micropollutants from wastewaters and, therefore, WWTP effluents represent possible point sources of pollution for aquatic ecosystems. Additional treatments are necessary to enhance the removal of PMFs in order to increase the quality of the WWTP effluents., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

In order to formulate indications for work-related stress assessment established by Italian health and safety regulation (D.Lgs. 81/2008), the interregional technical committee has instituted a working group to define an operative guide. The guide indicates the elements that must be considered in the evaluation, criteria and methods for the assessment, the minimum requirements for the evaluation instruments, and the specific contents of the risk assessment document.The medical surveillance and the role of health and safety local authorities are also considered. The risk assessment must examine work organization indicators and the direct or indirect effects of work-related stress, like morbility, frequent accidents, changing job requests, legal actions, etc. Detecting subjective factors is a second step of the assessment, which must be carried out if the work organization indicators show considerable work-related stress problems, and only in the companies which employ more then ten workers.

Background: The necessity of a qualitative screening has arisen from the fact that good technical quality is of fundamental importance for evaluating initial pneumoconiosis, for reducing inter- and intra-reader variability, for effective secondary prevention and for forensic medicine purposes., Objectives: The authors report experience in use of a method to evaluate the quality of chest radiographs performed in health surveillance programs for workers at risk for development of pneumoconiosis., Methods: 747 postero-anterior chest radiographs concerning employees of 21 ceramic factories in the Province of Viterbo were examined. A standardized pattern was created for this evaluation. The pattern considers the main factors that can influence the quality of chest radiographs and assigns points for each of them. That factors are: 1) reproduced image of the lung's vascular structure, chiefly in the peripheral portions; 2) reproduced image of heart border, aorta, diaphragm; 3) deep inspiration; 4) symmetric image of the chest; 5) position of the scapulae; 6) visualization of the costal-phrenic angles; 7) technical impairments., Results: The application of the method revealed that half of the chest radiographs examined had poor image quality for a suitable reading, in conformity with the ILO 1980 guidelines. The critical points are poor visualization of the lung's vascular structure due to overexposure or underexposure, technical impairments, non-correct scapulae position., Conclusions: The authors believe that the suggested method can be a useful instrument for self-testing the quality of chest radiographs performed in radiology centers and for the National Health Service to test the quality of chest radiographs performed in health surveillance programs.

A quality control survey on spirometry assessments carried out in a number of factories in the province of Viterbo (Lazio Region) was made by the Local Health Unit in Viterbo, as required by law 626/94 on the promotion of workers health. The survey concerned 734 measurements concerning the same number of employees from 29 different factories. Each spirometry assessment was repeated in this study according to the quality standards defined in the literature and our own results were compared with the values which had been obtained over one year during the health surveillance program (ASP). A few main functional parameters were considered according to the following criteria: percentage of agreement (tolerance +/- 5%) between the two FVC, FEV1 and FEF25-75 measures or degree of discrepancy; for FEV1/FVC ratio, the occurrence of < 70 (suggestive of an obstructive lesion) and > 90 values (reflecting poor reliability in the measurement of the lung volumes) in the two sets of data. Further criteria concerned the comparison of the height of the individuals (tolerance range +/- 1 cm), and the comparison of the overall spirometry rating expressed as the number of tests rated normal or abnormal (during the first assessment as compared to the second). The results show poor agreement (11.4%) for FVC with as many as 85.8% underestimated values; 30.1% agreement and 64.2% underestimate for FEV1; 17% agreement and 53.5% overestimate for FEF25-75. There were 6.5% fewer < 70 FEV1/FVC ratios, and 18.3% more > 90 ratios in the tests carried out in the factories as compared to our own. There was 32.9% agreement on the height, with overestimation in 63.7% of the cases. There were 12.3% "false abnormal" and 2.6% "false normal" results in the overall rating of the spirometry (as carried out by the factories compared to our own). In conclusion, the survey revealed a trend in the measurements carried out by the factories to underestimate the volumes, overestimate the flows, improperly select the theoretical reference values because of a mistake in measuring the height, to overestimate restrictive abnormalities, and underestimate the obstructive ones.