Search

To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-trasmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools. Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10°C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: $$ \text{dose} = \sum a_i^m t_i$$ , where a i is the acceleration magnitude on tool i, t i is the lifetime exposure duration for tool i, and m = 0, 1, 2 or 4. Among the HTV workers, the initial prevalence and the 1-year incidence of VWF were 18.1 and 1.7%, respectively. At the first examination, the HTV workers with moderate or severe score for VWF showed a significantly increased cold reaction in the fingers when compared with the controls and the HTV workers with no vascular symptoms. At the follow-up, the controls, the asymptomatic HTV workers, and the prevalent cases of VWF did not show significant changes in the cold response of digital arteries. A deterioration of cold-induced digital vasoconstriction was found in the incident cases of VWF. In the HTV workers, vibration doses with high powers of acceleration (i.e., $$ \text{dose} = \sum a_i^m t_i$$ with m > 1) were major predictors of the vasoconstrictor response to cold at the follow-up examination. The measurement of FSBP after local cooling may be a helpful objective test to monitor prospectively the change in vibration-induced vascular symptoms. The findings of this longitudinal study suggest a dose–effect relationship between cold-induced digital arterial hyperresponsiveness over time and measures of cumulative vibration exposure. In the controls, the cold response of the digital arteries was stable over 1-year follow-up period.

The prevalence of low back pain (LBP) was investigated in 598 Italian professional drivers exposed to whole-body vibration (WBV) and ergonomic risk factors (drivers of earth moving machines, fork-lift truck drivers, truck drivers, bus drivers). The control group consisted of a small sample of 30 fire inspectors not exposed to WBV. Personal, occupational and health histories were collected by means of a structured questionnaire. Vibration measurements were performed on representative samples of the machines and vehicles used by the driver groups. From the vibration magnitudes and exposure durations, alternative measures of vibration dose were estimated for each subject. Daily vibration exposure, expressed in terms of 8-h energy-equivalent frequency-weighted acceleration, A (8), averaged 0.28–0.61 (range 0.10–1.18) m s −2 rms in the driver groups. Duration of exposure to WBV ranged between 1 and 41 years. The 7-day and 12-month prevalence of LBP was greater in the driver groups than in the controls. In the professional drivers, the occurrence of 12-month LBP, high intensity of LBP (Von Korff pain scale score ⩾5), and LBP disability (Roland & Morris disability scale score ⩾12) significantly increased with increasing cumulative vibration exposure. Even though several alternative measures of vibration exposure were associated with LBP outcomes, nevertheless a more regular trend of association with LBP was found for vibration dose expressed as ∑ a vi t i (m s −2 h), in which the frequency-weighted acceleration, a v , and lifetime exposure duration, t , were given equal weight. In multivariate data analysis, individual characteristics (e.g. age, body mass index) and a physical load index (derived from combining manual materials handling and awkward postures) were significantly associated with LBP outcomes, while psychosocial work factors (e.g. job decision, job support) showed a marginal relation to LBP. This study tends to confirm that professional driving in industry is associated with an increased risk of work-related LBP. Exposure to WBV and physical loading factors at work are important components of the multifactorial origin of LBP in professional drivers.

Aims: To follow up vibration induced white finger (VWF) in a selected group of 73 vibration exposed workers who claimed unsuccessfully for VWF compensation at a first examination. Methods: The VWF claimants were sent to our unit by the National Insurance Institute. The basic compensatory criteria included a positive history of VWF and abnormal cold response of the digital arteries. Following the first unsuccessful examination, over a mean time period of 4.1 (range 1–11) years the National Insurance Institute requested a second examination for all 73 claimants and a third examination for 29. During the follow up period, all subjects continued to work with vibratory tools. Results: There were 14 new cases who reported white finger during the follow up period. In the new VWF cases, finger blanching attacks became visible after about 3.5 years since the first examination. All incident cases of anamnestic VWF showed an abnormal cold response in the digital arteries and obtained compensation according to the basic compensatory criteria. In the entire sample of VWF claimants, there was a discrepancy between positive history of VWF symptoms at medical interview (55%) and abnormal cold provocation outcomes (19%). Digital arterial hyperresponsiveness to cold was associated with both VWF symptoms and the duration of vibration exposure since the first examination. Over the follow up period, a significant increase in the vasoconstrictor response to cold was observed in the vibration exposed workers with no symptoms of finger whiteness. Abnormal cold response was not associated with either age or smoking habit. Conclusions: Cold test measuring finger systolic blood pressure may be considered a useful laboratory method to confirm objectively VWF symptoms and to disclose abnormal cold induced vasoconstrictor response in vibration exposed workers with a negative history of VWF. Medical interview outcomes should be interpreted with caution in medicolegal situations involving VWF claimants.

Background: Natural rubber latex has become an important occupational health concern, particularly among health care workers, who for protection are required to wear latex gloves when at work. This study evaluated the prevalence of latex-related symptoms and sensitisation among a large group of health care workers in Trieste hospitals. Methods: We evaluated the prevalence of latex-related symptoms in 1,165 health care workers, by means of a questionnaire, a medical examination, skin prick tests and IgE-specific evaluation. We determined atopy and latex sensitivity by skin prick tests using a battery of common inhalant allergens, a commercial latex extract (Lofarma Allergeni, Milan) and individual skin puncture tests for each of the vegetables immunologically related to latex (potato, tomato, chestnut, banana, kiwi fruit). Associations between potential risk factors for latex allergy were assessed. Results: Glove-related symptoms were noticed on 17.2% of the nurses (200) the majority of symptoms being mild dermatitis with itching and erythema (120 subjects, 11.1%). Symptoms suggestive of IgE-mediated latex allergy were found in 51 subjects: 35 (3%) complained of contact urticaria and 16 (2.2%) complained of asthma and/or rhinitis. The resulting symptoms were significantly related to skin prick tests that were positive to latex (odds ratio (OR)=11.89; 6.40–22.2), to personal atopy (OR=2.15; 1.47–3.12), to familiar atopy (OR=2.12; 1.48–3.03), to skin prick test positivity to related fruit (OR=2.01; 1.16–3.46) but not to prick test positivity to common inhalant allergens (OR=1.00; 0.71–1.39). Symptoms increased as a direct function of the time-usage of latex gloves and were more prevalent in operating room staff. Conclusion: In this large cross-sectional study, glove-related symptoms and latex skin sensitisation appear to be substantial among health care workers, and are related to common signs of atopy. We stress the need of preventive measures to avoid latex exposure when health care workers are at risk of developing allergy symptoms.

Objective: The aim of this study was to eval- uate the outcome of the specific inhalation challenge test (SIC) in 160 subjects with suspected baker's asthma and to assess its relation to total flour dust levels and to personal characteristics such as specific skin sensitisa- tion, non-specific bronchial hyper-responsiveness (NSBH) and atopy. Methods: We investigated the out- come of SIC tests performed with wheat flour in six Italian laboratories. For each subject, data was available regarding skin sensitisation to wheat flour, NSBH, ato- py, forced expiratory volume at 1 s (FEV1) monitoring and airborne flour dust in the challenge chamber mea- sured by the gravimetric method (total dust in mg/m 3 ). Results: The SIC test was positive for early asthma in 42 subjects (26%) and for late/dual asthma in 18 (11%). Positive outcome to SIC was significantly associated with NBSH (odds ratio, OR: 3.5, 95% CI: 1.6-7.7) and skin sensitisation to wheat flour (OR: 3.1, 95% CI: 1.3- 7.0). Exposure level to wheat flour was less than or equal to 10 mg/m 3 in 12% of individuals, ranged between 11 and 30 mg/m 3 in 43% and exceeded 30 mg/m 3 in 45%. The outcome of SIC was always negative among workers not skin sensitised to wheat flour and without NSBH and atopy. An increasing prevalence of positive SIC was observed among workers with one or more of the above-mentioned personal characteristics whose challenge exposure was greater than 10 mg/m 3 (P < 0.001). Conclusion: Procedures currently adopted for wheat flour dust exposure during SIC need to be better standardised in order to avoid excessive airborne dust exposure. Over-exposure seems to be of no use for the diagnosis and risks making the asthmatic reaction worse, particularly in patients who are both sensitised to wheat allergens and have NSBH and/or atopy.

Background Occupational respiratory allergy to green coffee beans (GCB) and to castor beans (CB) was studied in 112 workers in a modern coffee manufacturing plant of Trieste (Italy), where the process is completely automatic, the environmental conditions are good and where exposure to CB can be considered absent because since 1970, only new sacks have been used for coffee transportation. Methods All subjects were interviewed by a trained doctor using a questionnaire to investigate allergic symptoms and predisposing factors. Sensitization to GCB and to common allergens (pollens, molds, house dust mites) were evaluated by the skin-prick test. The serum of subjects with a positive skin-prick test to CGB or who had symptoms at work was tested for specific IgE (RAST) for GCB and CB. Lung function was evaluated by a Ponigraph spirometer. Results Sensitization to GCB was found in 25.8% of green coffee workers (31 cases), in 2.7% of roasted coffee workers (37 cases) and in 4.5% of the clerks (44 cases), p < 0.01. The evaluation of IgE specific for CB gave positive results only in 3 of 10 subjects sensitized to GCB. A total of 20% of GCB workers (6 cases) complained of work-related respiratory symptoms (asthma and/or rhinitis) compared with only one subject in the roasted coffee group and one in the control group (p < 0.01). Asthma was reported by 2/31 of the green coffee workers and by 1/44 of roasted coffee workers. Conclusions There was a significant correlation between sensitization to GCB and work related symptoms (p < 0.01), common allergic symptoms (p < 0.05) and atopy by prick test (

A survey was carried out on respiratory symptoms and skin prick test response to common allergens (atopy), storage mites, and occupational allergens among 226 bakers and pastry makers from 105 small businesses in northern Italy. Atopy was present in 54 workers (23.4%); 40 workers (17.7%) were skin positive to at least one storage mite, 27 (11.9%) to wheat flour and 17 (7.5%) to alpha-amylase. Work related asthma was reported by 11 (4.9%) workers and rhinoconjunctivitis by 31 (17.7%); 22 workers (10.2%) complained of chronic bronchitis. The distribution of skin prick test results among bakers and among 119 white collar workers did not indicate (by logistic analysis) an increased risk for bakers to skin sensitisation to common allergens, storage mite, or to a group of five flours. Sensitisation to wheat flour, on the other hand, was present only among exposed workers. Skin sensitisation to occupational allergens was significantly associated with atopy (p < 0.001), smoking habit (p = 0.015), and work seniority (p = 0.027). The risk of work related symptoms was associated with sensitisation to wheat or alpha-amylase, and with atopy, but not with sensitisation to storage mites, work seniority, or smoking habit. The results of the study indicate that there is still a significant risk of allergic respiratory disease among Italian bakers. Not only wheat allergens, but also alpha-amylase must be considered as causative agents, although sensitisation to storage mites is not important in the occupational allergic response. Atopy must be regarded as an important predisposing factor for skin sensitisation to occupational allergens and for the onset of symptoms at work. The data confirm that for effective prevention, greater care should be taken not only in limiting environmental exposure, but also in identifying susceptible people.

Based on the hypothesis that the development of cancer is actively inhibited during embryonic life, the effects on tumor growth of homogenates of different tissues (embryos, uteri at ninth day of pregnancy, non-pregnant uteri and normal liver) were investigated in syngeneic C57BL/6 female mice. Primary tumor growth and spontaneous pulmonary metastasis formation were completely suppressed in the group of mice treated with pregnant uteri homogenates. Embryos, non-pregnant uteri and normal liver homogenates were ineffective.

The authors report on pollution measures in some operating theatres and consider biological data for the hepatic and hemopoietic functions in operating room personnel and in control groups. Waste gas concentrations range from 17.3 to 22.6 ppm for enfluorane and from 500 to 1275 for N2O in theatres not equipped with antipollution systems. Pollution is 3-8 times lower when a scavenging system is present, while with horizontal laminar air flow exhaust in function, the gas concentration in the air is insignificant. Tests for the hepatic and hematological functions, done on 61 operating room personnel, 87 ward nurses, and 69 technicians and physicians of radiology services, do not show any significant difference between those exposed to anesthetic gases and controls.

Platelet aggregation and blood clotting parameters were studied in 22 workers (84 %) using pneumatic riveting and grinding hand tools and in 20 workers (90 %) not exposed to vibration but comparable with respect to age, anthropometric data, smoking and drinking habits, and atherogenic risk factors. The weighted acceleration levels of the vibrating tools are reported. According to Taylor's grading system for vibration-induced white fingers, 15 exposed workers (57 %) were in stage OT, 9 (34 %) in stage 0N, and 1 (4 %) in stage 1. Between the reference and the vibration-exposed groups no differences in the platelet aggregation indices both "in vitro" (adenosine-diphosphate, epinephrine, threshold adenosine-diphosphate concentration) and "in vivo" (platelet factor four, beta-thromboglobulin) were found. In addition the clotting parameters (prothrombin index, activated partial thromboplastin time, fibrinogen, antithrombin III) and the immunoglobulins G, A, and M were normal in the two groups. The measurement of skin temperature of the third right finger before and after the cold provocation test showed that the vibration exposed workers experienced a stronger vasoconstriction of the digital vessels than the referents. It is concluded that, in the early stages of vasospastic disorders, segmental vibration can induce peripheral vascular hyperreactivity without changes in the platelet function and clotting parameters.

La tragica vicenda di Giulio Regeni ha avuto l’effetto di porre, in modo forse inedito, all’attenzione dei media italiani ed europei la realtà dei ricercatori che conducono i propri studi in società instabili dal punto di vista politico, sociale o antropologico. Più in generale, si può affermare che la precarizzazione della condizione dei ricercatori è una conseguenza fin ad oggi poco evidenziata del processo di destabilizzazione dei sistemi politici mediorientali e arabo-musulmani comunemente definito come “primavera araba”. Al di là della drammaticità di queste vicende, va tuttavia sottolineato che la condizione degli studiosi occidentali che conducono le proprie ricerche nei paesi dell’Asia, dell’Africa e del Medio Oriente porta con sé indissolubilmente una serie di ostacoli che sono in parte riconducibili alle crisi politiche del momento, ma che sono in generale legate ai caratteri specifici di quelle società. Il saggio fa riferimento a un campo di studi e a un’area geografica specifici: la ricerca storico-politica e l’Asia meridionale, ovvero la regione del continente asiatico che comprende gli Stati dell’Afghanistan, del Pakistan e dell’India, oltre al Bangladesh e una serie di entità politiche meno estese non trattate in questa sede.