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A product class characterization was requested on some plastic granular waste samples, already reduced in fine form with particles < 20 mm, derived from waste electrical wires and PC cables. The product class discrimination was worked out by visual characterization with the aid of optical stereomicroscopy and confirmation by electron scanning microscopy (SEM) and microanalysis. Characterization at a micro-scale level evidenced predominance of plastic materials with presence of metal wires, paper, textile and glass fibres at residual levels in the main fraction (0.5–4 mm). The fractions < 0.5 mm, when present, cannot easily be distinguished at sight and only approximate qualitative information can be extracted by SEM analysis. The described approach has been carried out effectively due to major shape and material differences between plastic particles and metal wires and other materials. However, this approach may not work in every case, or it may not lead to usable results with every type of waste. [ABSTRACT FROM AUTHOR]

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Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A new simple cumulative index, named Critical Index (CI), linearly dependent on traffic load and outdoor222Rn levels (as related to the air mixing condition) was introduced in order to determine the cumulative effect of traffic and atmospheric dilution on PM10(particles with aerodynamic diameter < 10 μm) and Benzene concentrations in Milan (Italy) air in the years 2000 and 2001. Benzene, PM10data were obtained from the public air quality monitoring stations. The traffic load was evaluated by the number of vehicles circulating in a street in the centre of Milan. Outdoor222Rn measurements were carried out by the authors. Traffic data and mixing layer height (estimated through the outdoor222Rn air activity) combined in a cumulative index, allowed to demonstrate the correlation of traffic load with high Benzene and PM10pollution levels without exception. [ABSTRACT FROM AUTHOR]

Aims Methods and Results Conclusion Giant cell interstitial pneumonia (GIP) is a fibrosing lung disease histologically characterized by centrilobular pulmonary fibrosis and cannibalistic intra‐alveolar multinucleated giant cells. It is considered a form of pneumoconiosis caused particularly by secondary exposure to hard metals (cemented carbide or tungsten carbide). Hard metals are commonly used in various industrial applications, such as cutting tools, drilling tools, machine inserts, and other wear‐resistant components. However, cases with unknown exposure that recurred in transplanted lungs have been described. This has led to the hypothesis of a complex etiopathogenesis, likely multifactorial, involving the coparticipation of immune mechanisms. We aimed to identify all the elements present in a series of GIP lung samples to better understand the pathogenic mechanisms of the disease.We describe five cases of histologically diagnosed GIP in patients with occupational exposure to metallic dust using ultrastructural characterization to identify metal dust and to quantify asbestos fibres. We found that tungsten was present in three cases, albeit in trace amounts in two of them. Numerous elements were identified in all samples, including asbestos fibres in patients with endstage pulmonary fibrosis. Furthermore, in one of the described cases the recurrence of the disease was also observed in transplanted lungs.These findings support the hypothesis that GIP may be due to elements other than hard metals, with asbestos possibly representing a contributory factor in the expression of a more severe fibrotic disease. The recurrence of GIP observed in transplanted organs strengthens the hypothesis of the existence of a not yet fully understood etiopathogenic immune mechanism. [ABSTRACT FROM AUTHOR]

Summary: Worldwide studies have been published on the mortality of workers employed in asbestos-based materials for the production of clutches and brakes. However no one of these studies is related to Italian cases. Furthermore, not even surveys have been conducted in Italy to characterize the correlation between asbestos exposures and the possible occurring of asbestos-related disease. Our objectives are the following: i) to assess and quantify the asbestos exposure cases, ii) to describe the nature and the frequency of asbestos-related diseases among blue collar employees of an important factory producing brakes and clutches with chrysotile asbestos content from 1971 to 1993 and iii) to provide preliminary data on cumulative asbestos exposure estimated using lung fibre burden analysis. Critical appraisal of airborne asbestos fibre measurements and identification of cases of asbestos-related diseases between the blue collar employees, either notified to the local health authority or recovered from the Italian national Mesothelioma registry was investigated. Lung fibre burden analysis using the lung tissue samples from two deceased blue collar employees was also performed. Airborne asbestos fibre measurements (carried out in 1982) suggested asbestos fibres average concentrations of about 0.3 f/ml, while all 1992 measurements showed results below 0.1 f/ml. Furthermore, since 1988, we identified four cases of pleural plaques, three cases of asbestosis and seven cases of lung cancer. No case of malignant mesothelioma was found. In both lung cancer cases, analysed to measure the lung fibre burden, commercial amphiboles were absent or in limited concentration but chrysotile and, especially, tremolite asbestos were present in noticeable amount. In conclusion, since 1971 and up to early 1980s, exposure to chrysotile asbestos and talc, likely contaminated by tremolite, had been significant and comparable to levels causing asbestosis long-term risk. No case of malignant mesothelioma was found, that is consistent with the absence of amphiboles and with the lower risk of mesothelioma associated with the chrysotile asbestos. However a subset of the blue collar employees, the ones employed later on, could still have not reached the full risk condition, and so being still at risk of developing malignant mesothelioma. In the two lung cancer cases studied, the lung fibre burden was essentially made of chrysotile and tremolite. Lastly, lung cancer occurrence in the population of blue collar employees has been likely underestimated and the correct determination of lung cancer risk should be done through the mortality analysis of this population., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by GIMLE.)

Background: Severe silicosis from occupational exposure to calcined diatomaceous earth has been observed in the past, due to the high-temperature transformation of amorphous silica in crystalline phases, mainly cristobalite. In dental alginate production and use a silica exposure may be underestimated., Objectives: To describe the clinical picture, the scenario and pattern of occupational exposure to silica and the corresponding necroscopic findings of a case of silicosis in a worker engaged in the production of alginates for dental use., Methods: A commercial sample of calcinated diatomaceous earth and necroscopic lung samples were analysed by scanning electron microscopy (SEM-EDS) and X-ray diffraction (XRD) for the quali-quantitative determination of crystalline silica. Material safety data sheets (MSDSs) of diatomaceous earth produced in 2002 and 2018 were examined to assess the information content on silicosis risk. Clinical findings and post-mortem examinations of the worker are evaluated., Results: A cristobalite concentration of 36% (wt/wt) was determined in the diatomaceous earth sample and a large amount of diatom fragments were observed in lung samples. The DRX spectra indicated the presence of cristobalite either in the bulk sample or in the lung tissues. The MSDS dated 2002 reported the presence of SLC up to 63% with cristobalite concentrations minor of 60%, and the resulting risk of silicosis, while the MSDS dated 2018 and referred to a commercial product currently on the market indicated a concentration of cristobalite minor of 1% and no risk of silicosis. The worker was suffering from a severe silicosis, histologically confirmed by necropsy., Conclusion: The present case-study revealed that the risk of silicosis from calcined diatomaceous earths used to produce dental alginates has been ignored. The lack of engineering controls and personal protection measures led to a high cristobalite lung burden, consistent with the development of a severe silicosis that were a contributing factor of death. A MSDS of a commercial product currently on the market does not report this serious hazard.

Background: The relationship between pleural plaques and cumulative asbestos exposure is controversial., Objectives: To evaluate the relationship between lung asbestos bodies (AB) and fibres (AF) and plaques presence and extension., Methods: In a necropsy series of shipyard workers with asbestos-related diseases, we measured counts (per g of dry lung tissue) of AB (thousands) and AF>1 µm (millions). Pleural plaques were classified into three extension grades. We fitted univariate and multivariable linear (dependent variables: AB and AF, log10 transformed) and multinomial (dependent variable: plaques grade) regression models., Results: We analysed 124 subjects, 13 without plaques 20 with grade 1, 69 with grade 2, and 22 with grade 3 plaques. Geometric means (GM) of AB were 10.6, 23.3, 126, and 140 in the four groups respectively (P=0.0001). GMs for AF (mostly amphiboles) were 1.2, 1.4, 7.3, and 12.9 (P=0.0001). AB and AF were strongly correlated (r=0.81). The likelihood of no plaques and grade 1 plaques decreased with increasing AB and AF doses, with a corresponding increase of grade 2 and 3 plaques. Plaque presence and extension was also associated with histologically verified asbestosis (P<0.001)., Conclusions: Our study showed a strong positive relationship between pleural plaque presence and extension and both lung asbestos burden and asbestosis.

Background: The occurrence of malignant mesothelioma is almost always causally associated to asbestos exposure but, considering women occurrences, this association is often difficult to demonstrate and consequently the asbestos exposure is defined as 'unknown'., Objectives: To describe the working activity and to give occupational asbestos exposure probability estimation related to an uncommon and poorly investigated productive sector: doll manufacture., Methods: From the Province of Brescia Mesothelioma Registry, established in 1993 on population-based criteria, we have extracted the certified mesothelioma diagnosis cases, related to patients who were employed for some time in doll manufacture., Results: Among the 757 total cases of malignant mesothelioma registered and studied up to 2016, we found 3 cases of pleural epithelial mesothelioma histologically diagnosed in young women who had worked in two doll manufacturing companies and whose asbestos exposure had been initially defined as 'unknown', because an environmental, family or extra-professional asbestos exposure was considered unlikely. However, the judicial autopsy performed on one of the 3 women had allowed examining lung tissue samples with Scanning Electron Microscopy. This technique showed a concentration of amphiboles fibers of about 12,000,000 per gram of dry lung tissue, with a consequent re-classification of asbestos exposure from 'unknown' to 'occupational certified'., Discussion: Mesotheliomas in women with no apparent occupational asbestos exposure are normally referred to life or family environmental exposure. Moreover, it is known that occupational asbestos exposure in women is difficult to recognize. Previously, only one publication had reported two cases of mesothelioma in cloth doll manufacture. The occurrence of two mesothelioma cases in the same company out of the three here presented was suggesting an occupational exposure. The finding of a high amphibole fibers lung concentration confirmed the previous hypothesis, despite the impossibility to determine the circumstances with good evidence., Conclusion: The three cases of mesothelioma in doll production workers suggest that also in this restricted manufacturing sector had occurred an occupational asbestos exposure, which is up to now unknown and isn't due only to the use of sewing or ironing machines. The lung asbestos fibers burden analysis is confirmed to be a decisive factor in the assessment of mesothelioma cases with 'unknown' exposure.

Background: Malignant mesothelioma cases among primary school teachers are usually linked with asbestos exposure due to the mineral contained in the building structure. Among the approximately 12,000 cases of mesothelioma described in the fourth report of the National Mesothelioma Register, 11 cases of primary school teachers are reported, in spite of the fact that the "catalogue of asbestos use" does not describe circumstances of asbestos exposure other than or different to that due to asbestos contained in the buildings. Four cases in the Brescia Provincial Mesothelioma Register are identified as teachers, without this circumstance of exposure., Objectives: To characterize the asbestos concentration and fibre type retained in the lungs of a teacher reported as a new mesothelioma case and preliminarily classified as of unknown asbestos exposure., Methods: The mesothelioma case presented here was diagnosed at age 78 and malignant mesothelioma was confirmed at autopsy; the patient was interviewed directly for occupational history. Samples of lung parenchyma from necropsies were collected, stored and analyzed by scanning electron microscope (SEM) and samples of DAS paste were analyzed by SEM to detect asbestos fibre content., Results: It was possible to confirm past exposure to DAS paste in forming and finishing dry items and toys during school recreational activity almost every day from the mid-60s to about the mid-70s. Subsequent SEM analysis showed: i) chrysotile fibres were found in an old and unused pack of DAS paste; ii) a lung burden of 1,400 asbestos bodies, 310.000 total asbestos fibres (33% chrysotile, 67% amphibole) and 210.000 talc fibre per gr/dry lung tissue was detected from necropsies performed on the subject. These results seem to be in agreement with an occupational exposure to asbestos due to past use of DAS paste. After the investigation, this case was reclassified from "unknowun" to " sure" occupational asbestos exposure. The occupational origin of the tumour was recognized by the Italian Workers' Compensation Authority (INAIL)., Conclusion: This case suggests i) the need to carry out any possible detailed studies of the circumstances and exposure sources whenever any mesothelioma case is classified as "asbestos exposure unknown", according to the guidelines of the National Mesothelioma Register, ii) handling of DAS paste can be considered as sure asbestos exposure and iii) it should be borne in mind that mesothelioma cases can occur even after cumulative low, occupational exposure, even only to chrysotile.

Background: Lung burden of amphibole fibres is a good biological index of occupational cumulative asbestos exposure. Malignant mesothelioma (MM) has been amply documented in textile industry workers, dealing either with mineral fibres or with vegetable and animal fibres. So far the concentration of asbestos fibres in lung tissue among textile workers has not been reported in Italy. We analysed asbestos burden in the lung tissue of eleven textile-workers with malignant mesothelioma, mainly employed in industries near Brescia, in the North of Italy., Objectives: To characterize lung asbestos concentration and fibre type retained in the lung of asbestos and non-asbestos textile workers., Methods: Sample of lung parenchyma from necropsies and extrapleural pneumonectomy were collected, stored and analysed by scanning electron microscope, according to the methods recommended in the current scientific literature. Nine patients were interviewed directly for occupational history., Results: Eleven cases of MM (10 primary pleural, 1 primary peritoneal) were collected, 9 women and 2 men, aged between 51 and 87 years, 4 asbestos-textile workers and 7 non-asbestos textile workers. The highest values of asbestos fibres were detected in all the workers of the former group and in 3 non-asbestos workers (jute recycling employees), with concentrations between 9.1 and 397 million/g of dried lung tissue. The total fibre concentration in the other 4 non-asbestos textile workers (silk and cotton production workers) ranged from 0.33 to 1.2 million/g of dried lung tissue. In only one of these subjects, did lung amphibole burden exceed 1,000,000 amphibole fibres longer than 1 microm per g of dried tissue. Eight cases out of eleven, showed a higher concentration of amphiboles than chrysotile. We detected amphibole fibres in all the "non-asbestos" textile workers and for two of them a higher concentration of tremolite., Conclusion: i) Among textile workers using asbestos or jute recycling, the asbestos fibre burden is as high as that found in other high risk jobs (e.g. asbestos-cement workers); ii) among non-asbestos textile workers, employed in cotton and silk production, the fibre content in lung tissue was much lower and it was nonetheless above the occupational cut-off for one of them; iii) tremolite found in lung tissue of non-asbestos textile workers with MM could be a contaminant of chrysotile friction materials or originate, with other amphiboles, from some other source as yet to be investigated.

Background: Work in the construction industry is causing the highest number of mesotheliomas among the residents of the Veneto Region (north-east Italy, 4,5 million inhabitants)., Objectives: To sum up the results on occurrence, asbestos exposure, lung fibre content analyses, and compensation for occupational disease., Methods: Case identification and asbestos exposure classification: active search of mesotheliomas that were diagnosed via histological or cytological examinations occurring between 1987 and 2006; a probability of asbestos exposure was attributed to each case, following interviews with the subjects or their relatives and collection of data on the jobs held over their lifetime. Risk estimate among construction workers: the ratio between cases and person-years, the latter derived from the number of construction workers reported by censuses. Lung content of asbestos fibres: examination of lung specimens by Scanning Electron Microscope to determine number and type of fibres. Claims for compensation and compensation awarded: data obtained from the National Institute for Insurance against Occupational Diseases available for the period 1999-2006., Results: of 952 mesothelioma cases classified as due to asbestos exposure, 251 were assigned to work in the construction industry (21 of which due to domestic of environmental exposures), which gives a rate of 4.1 (95% CI 3.6-4.8) x 10(5) x year among construction workers. The asbestos fibre content detected in the lungs of 11 construction workers showed a mean of 1.7 x 10(6) fibres/g dry tissue (range 350,000-3 million) for fibres > 1 micro, almost exclusively due to amphibole fibres. 62% of the claims for compensation were granted but the percentage fell to less than 40% when claims were submitted by a relative, after the death of the subject., Conclusion: The prevalence of mesothelioma occurring among construction workers is high and is associated with asbestos exposure; the risk is underestimated by the subjects and their relatives. All mesotheliomas occurring among construction workers should be granted compensation for occupational disease.

Background: In many previous studies, the asbestos fibres retained in the lung were regarded as a good index of cumulative occupational asbestos exposure. Twelve workers suffering from asbestos-related diseases and had been employed in an asbestos-cement factory operating from 1961 to 1994 underwent post mortem investigations in the course of a criminal law suit., Objectives: Samples of lung tissues were collected for electron microscopy analysis to measure the asbestos fibre burden of the lungs in workers with high exposure, and assess the possible correlation between asbestos fibre lung burden and the estimated levels of cumulative exposure., Methods: Samples of lung parenchyma obtained from a consecutive series of 12 post-mortem examinations that were performed between 1994 and 2007and included 5 cases of malignant pleural mesothelioma, 4 lung cancers, 1 case of asbestosis and2 ofpleuralplagues, were collected, stored and analysed by SEM electron microscopy, according to the methods suggested by the current scientific literature. For each worker, all males, a detailed occupational history was reconstructed by means ofpersonal interviews; both the measurements of airborne asbestos fibresperformed by the factory in the 1970's and the duration of each single job in the plant were taken into account to estimate an individual cumulative exposure index., Results: A wide variation of total asbestos fibre concentrations in the lung (1,320-118 million) was observed; in all 12 workers, the lung amphibole fibre burden exceeded 1,000,000 fibres per g/dry tissue, The highest values were detected in the mesothelioma cases, in which the mean fibre concentrations differed statistically (t=2.29, p=0.045) from the mean calculated for the other asbestos-related diseases; in 9 subjects only amphibole fibres were detected. There was a good correlation between total asbestos fibre concentration and cumulative exposure index (r=0.91, p<0.0001)., Conclusion: This study, which was numerically the biggest ever performed in Italy for this category of workers, confirms a wide range of total asbestos fibre burden in heavily occupationally exposed workers and showed that of the asbestos-related diseases, the highest lung concentrations of asbestos fibres were reached in cases of mesothelioma. It was also observed that almost the entire lung burden consists of only amphibole fibres, all exceeding 1 million per gramme of dry tissue. This study tested a synthetic cumulative occupational exposure index, which appears to be well correlated to the level of exposure established by biological analysis.

Background: Due to poor information collected through patient interviews, a considerable number of malignant mesothelioma (MM) cases still remain classified as "unknown" asbestos exposure in the Italian Mesotelioma Registry (Re.Na.M). At the same time, some occupational asbestos exposures, which were previously unknown, have been demonstrated in certain types of work, i.e., in agriculture and in the textile industry., Objectives: The aim of this research was to investigate the possible past occupational exposure to asbestos in clothing workers using sewing-machines., Methods: The MM cases were collected from the Mesothelioma Registry of Brescia. Work histories were obtained via a standardized questionnaire. Investigations were conducted in sewing-machine maintenance workshop in order to collect information regarding the possible use of asbestos parts. In addition, the use of asbestos friction materials and the use of insulated asbestos materials was checked in the clothing divisions by interviewing the management and maintenance workers of two companies where cases of MM were observed., Results: The Mesothelioma Registry of Brescia identified and collected 10 MM cases with past work in the clothing industry: 6 used sewing-machines and 4 were self-employed tailors. The search for asbestos materials gave positive results as the use of friction materials had been widespread since the 1950's in all types of sewing-machines; in addition, asbestos materials were used to insulate some parts of the ironing equipment and the steam pipelines., Conclusion: The results of this investigation suggest assigning at least "possible occupational asbestos exposure" to those cases employed in clothing manufacture since the 1950's, who used sewing-machines or pressing machines, according to the Re.Na.M guidelines. Other possible occupational exposures to asbestos in this working sector cannot be excluded; when the simple interview of patients does not reveal such exposures further investigations are needed in order to demonstrate all the possible circumstances of exposure.

Starting from an hospital observation of the mesotheliomas cluster in women living in a lakeside area (Iseo lake, Northern Italy), an epidemiological surveillance of this tumour was performed by the local occupational health service. This cluster wasn't notified, in spite of the relevant number of factories producing asbestos textile materials in this area. From 1977 to august 2006, 45 cases of mesothelioma were detected among the workers of 3 textile industries located in 3 little villages: 14 cases occurred working crocidolite and chrysotile rope and gasket; 20 cases in a textile factory producing cotton garments, that was adjacent to and polluted by the farmer and were asbestos insulation and blankets used for fireproofing are present; 11 cases occurred among women working in silk factories. The mesothelioma cases occurred in the same period in this area, which constituted the recruitment area of the people working in the 3 textile plants (11 villages, about 43,000 inhabitants), are 55.93% of which had been occupationally exposed to asbestos. Out of the dockyard and the asbestos-cement industries, this frequency of occupational exposed workers is the highest never observed in Italy. The majority of the cases (66%) occurred among women working in the textile factories. In a women, producing asbestos textile materials and suffered form peritoneal mesothelioma and pleural plaques, the analysis (by SEM) of asbestos fibre lung burden show 286 million fibres x gr. of dry tissue. Between the 42 mesothelioma cases occurring in the population of the 3 villages where the textile plants was located, we observed only one case with possible environmental exposure to asbestos: a gardener of the village where the manufacturing asbestos ropes and gasket plant is present. In the silk factories, asbestos exposure was probable because of the presence of asbestos insulated pipes. The female pleural mesothelioma standard incidence observed in this area (6.8 x 100,000, 1977-2005) is the highest never estimate in Italy. The epidemiological surveillance of the mesothelioma appear essential to identify cases unreported and allow the collection of information useful to understand clearly the asbestos exposure effects on health's workers and to estimate the tumour incidence in the population.