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Nella letteratura scientifica recente ha acquisito sempre più importanza lo studio dell’esposizione occupazionale ed ambientale in relazione allo sviluppo della Sclerosi Laterale Amiotrofica (SLA), una patologia neurodegenerativa a prognosi infausta caratterizzata dalla degenerazione dei motoneuroni. Lo scopo del lavoro di revisione è stato quello di valutare lo stato delle conoscenze sul tema, focalizzando l’attenzione su alcune esposizioni occupazionali o ambientali ed in particolar modo sull’esposizione a metalli pesanti. Sono stati selezionati articoli di ricerca in base a parole-chiave ed anno di pubblicazione, includendo studi che lasciano ipotizzare un’associazione tra esposizione e meccanismi di danno neuronale connessi all’insorgenza di SLA. La revisione effettuata mostra che anche se la produzione scientifica ha incrementato sempre più l’interesse per la valutazione delle cause extragenetiche di insorgenza SLA, ancora pochi sono i lavori riguardanti lo studio accurato delle attività lavorative dei singoli pazienti, inoltre, ancora carenti sono le deduzioni che si possono ad oggi trarre circa l’eventuale connessione tra esposizione occupazionale a fattori di rischio ed insorgenza di degenerazione motoneuronale.

The evaluation of arterial hypertension in workplaces is an important prevention act and a public health priority; few epidemiological study, up to date, has been projected to detect correlation between workplaces and hypertension disease. We studied a cohort of industrial employees(mainly engineering area) to evaluate epidemiological disease data and to study particular aspects of disease; this work focalized to the role of blood pressure variability in workplace and its measurement by Ambulatory blood pressure in 24 hours (ABPM), useful instrument to predict and help to evaluate cardiovascular risk in workers exposed to several agents. In our study underwent ABPM 56 patients referred to an occupational physician; all of these patients were employed in industrial area (mainly engineering district). Identified risk factors: noise (85 dBA), handling of loads (Niosh Index > 1,6), inorganic powders. Job Content Questionnaire (JCQ)was administered to the entire study population, in order to identify the highest risk behavior profiles work related stress. The analysis performed showed no statistically significant correlation. The monitoring was carried out on patients with the indications provided by the ESH-ESC 2007 guidelines for the treatment of hypertension. The data analysis has highlighted the correlation between profile and BP circadian variability, in particular the SBP and MAP, calculated by evaluating the standard deviations; data also have shown that SBP and MAP variability within 24-hour and circadian profiles are two mutually independent variables and not correlated. The dipper group, which preserves a physiological circadian rhythm and is therefore considered a lower risk of cardio-cerebrovascular accidents, has a higher pressure variability compared to other groups, therefore an additional factor of cardiovascular risk. Exposure to noise, and high cardiometabolic request due to handling of loads (with a METs estimated to 3-4), may be contributing cause of these peculiar aspects of disease in our study cohort. Further studies are needed to confirm the observations made so far, in terms of examined population follow-up that we propose to make in the coming years. All these information should be considered in occupational medicine, especially in cardiometabolic risk management of industrial workers.

Tornato cultivation farms of Soutbern Italy were investigated in order to evaluate tbe generai working conditions and tbe levels of exposure of farm workers to pesticides, during tbe mixinglloading and tbe application of pesticides on fields. Information on working modalities, personal protective equipment, etc. was collected using a questionnaire. Inbaling and cutaneous exposure levels were measured, and tbe estimated pesticide total absorbed dose was compared witb Admissible Daily Intakes (ADIs). Field treatments were mainly carried out by using sprayers witb open cab tractors, and, in 57 ~9% of cases, tbe pesticide mixture was manually prepared by mixing pesticides in a paU, often witbout using gloves (59.5%). Tbe estimated pesticides absorbed doses varied in tbe range 0.56-2630.31 mg (mean value, 46.9 mg), and 20% of tbe measured absorbed doses exceeded ADIs. Tbe findings obtained in tbe 18 examined farms sbow a worrying situation, suggesting tbe investigation of many more farms, so tbat a statistically significant picture of tornato cultivations in Soutbern Italy could be formed. Besides, tbe planning of training courses aimed to increase workers consciousness about bealtb risks and bow tbey can be prevented is advisable.

The degree of permeability of different gloves towards doxorubicin and epirubicin was performed, considering different deposition times both at physiological and acid drug solution pH, to evaluate the gloves protection efficacy when used by sanitary staff and other professionals, as chemical laboratory technicians. Four types of gloves were tested, differing regarding materials and/or thickness: natural rubber gloves, 0.1mm, by two different producers and nitrile gloves, 0.1 and 0.3mm. Results of experiments at physiological pH evidenced the efficacy of all gloves tested: the two analytes were not present on gloves’ internal surfaces up to 8hrs contact time. Experiments performed at acid pH evidenced a different behaviour of the two materials tested: while natural rubber gloves still ensured complete impermeability, nitrile gloves’ performances were different depending on their thickness. Nitrile gloves of 0.3mm ensured complete impermeability, while 0.1mm ones showed a non-negligible permeability: after 8hrs 0.56% of doxorubicin and 2.4% epirubicin permeated the glove. Obtained results have important consequences in planning a correct Risk Management strategy, since evidenced the crucial role played by drug solution pH on gloves’ impermeability: for workers who have to handle acid solution of the two anthracyclines, natural rubber or nitrile gloves of high thickness must be adopted.

Results of an Environmental and Biological Monitoring (EM and BM, respectively) of Polycliclic Aromatic Hydrocarbons (PAHs) in a filling station are reported. EM was performed by measuring benzene, toluene, ethylbenzene, xylene, methylterbutylether and 16 PAHs suggested by EPA, performing both the area and the personal measurements in different operating conditions. In all cases obtained concentrations were below the TLV-TWA proposed by ACGIH and in line with levels reported in literature for urban areas in the same atmospheric conditions. BM was initially performed by measuring the benzene and trans,trans muconic acid levels in end-shift urine samples. Results highlighted in some cases concentrations greater than BEI proposed by ACGIH and reported in literature. To discriminate between occupational and extraprofessional exposition, analyses were repeated both on beginning- and end-shift urine samples. In line with EM, the obtained results confirmed the influence of extraprofessional exposition. In conclusion, the study highlight an acceptable exposure level, but also the need to perform a MA in climatic conditions which reflected the highest conceivable level of pollution and the BM of benzene by analyzing beginning- and end-shift urine samples. Thus, the representativeness of data is guaranteed and, at the same, costs of analyses, onerous for small and medium enterprises, are minimized.

Occupational exposure to antineoplastic drugs can represent a potential health risk for hospital staff. Considering that exposure assessment is the first step in providing a safe work environment, the present study reports results of a biological monitoring of nurses exposed to doxorubicin and epirubicin. A detailed questionnaire about workplace practices and work organization was administered to 56 nurses of oncological departments of two hospitals located in Southern Italy. End-shift urines were collected and analysed by solid phase extraction/liquid chromatography/fluorescence detection. Amounts of manipulated anthracyclines were registered. Questionnaire information evidenced that vertical laminar flow hoods were present in both hospitals, but surfaces were cleaned with inappropriate detergents, no anti-spilling devices were adopted, and gloves were not changed during the work shift. A lower percentage of positive samples was found in the hospital where higher amounts of anthracyclines were handled (3.4% compared to 14.8%), suggesting individual incorrect working/cleaning practices in the first case and overall hygienic standards to be improved in the second one. Results showed the crucial role of adopting effective safety precautions and handling practices to reduce exposure and highlighted the need to carry out both environmental and biological monitoring, in order to discriminate between incorrect personal working modalities and general hygienic standards.

It is universally recognized by the scientific community that asbestos, widely used in the past in many industrial sectors, is responsible for the onset of certain diseases of pleural and peritoneal serous membranes; in particular, Peritoneal Mesothelioma (PM) is an exceptional case, extremely rare malignancy of the abdominal cavity. In this work we describe a 62 years-old man, formerly exposed to asbestos, complains of dyspepsia associated with pain, abdominal swelling and mild difficulty during inspiration. After intraoperative biopsy of three masses found in abdomen, malignant peritoneal mesothelioma was diagnosed. The patient subsequently was subjected to cycles of chemotherapy and multiple palliative paracentesis, the patient died after about 12 months from diagnosis.

This project has received funding from the EU Horizon 2020 research and innovation program under the ORCHESTRA project Grant Agreement No. 101016167. The cohort from Verona is funded by the Regional Health Authority (Azienda Zero), Veneto Region, Italy., Collatuzzo G., Lodi V., Feola D., De Palma G., Sansone E., Sala E., Janke C., Castelletti N., Porru S., Spiteri G., Monaco M.G.L., Larese Filon F., Negro C., Cegolon L., Beresova J., Fabianova E., Carrasco-Ribelles L.A., Toràn-Monserrat P., Rodriguez-Suarez M.M., Fernandez-Tardon G., Asafo S.S., Ditano G., Abedini M., Boffetta P.

Objective: The development of a vaccine against hepatitis B virus (HBV) is one of the improvements in strategy prevention during the last decades. Aim: To evaluate HBV-related vaccine status in healthcare workers (HCW) exposed to biological risk. Methods: The serum markers for HBV were collected from HCWs in two tertiary care hospitals in Naples (Italy). Multivariate statistical analysis was then performed to identify associated factors linked to the long-term immunogenicity of the HCWs. Results: All HBV vaccinated individuals were screened for whole marker patterns; all were HBsAg/anti-HBc negative. Of individuals, 20% had an anti-HB antibody titre < 10 IU/L. Multivariate statistical analysis highlighted that women were more protected than men (73.6% vs. 26.4%, P < 0.05). Additionally, nurses seem to maintain a higher antibody titre than doctors and other staff, such as auxiliary technicians ( P < 0.05). Conclusions: Our data support the evidence of a strong immunogenicity against HBV, assessed through the circulating antibody titre, when prophylactic vaccination is conducted in non-infantile age, particularly for women. The outcome of the study supports the central role of occupational physicians within the hospital districts in terms of primary prevention and maximum protection of HCWs.

Manual patient handling (MPH) is a major occupational risk in healthcare settings. The aim of this study was to propose an MPH training model involving interdisciplinary aspects. A scheduled training program was performed with 60 healthcare workers (HCWs) from a hospital in Naples, Italy, providing training divided into three sections (occupational health&mdash, section one, physical therapy&mdash, section two, psychosocial section&mdash, section three) and lasting six hours. Fifty-two HCWs performed the training session. In section one, a questionnaire about risk perception related to specific working tasks was administered. Section two provided specific exercises for the postural discharge of the anatomical areas most involved in MPH. The last section provided teamwork consolidation through a role-playing exercise. The training program could also be useful for risk assessment itself, as they can examine the perceptions of the specific risk of the various workers and incorrect attitudes and therefore correct any incorrect procedures, reducing exposure to specific risks in the field. This pilot study proposes a training model that explores all aspects related to MPH risk exposure and also underlines the need for standardization of this formative model, which could represent a useful tool for studying the real effectiveness of training in workplaces.