[Asbestos exposure assessment in the first case of intrasplenic mesothelioma]. / Accertamento dell'esposizione ad amianto nel primo caso di mesothelioma splenico.

BACKGROUND: In 2013 the International Journal of Surgical Pathology published a case report of intrasplenic malignant mesothelioma (MM) in a 48-year-old man: it was the first report in literature describing a case of primitive intra-splenic MM, described without  a history of asbestos exposure. OBJECTIVE: To verify the possible past exposure to asbestos, ignored by the patient himself, by studying in depth his environmental and occupational history. METHODS: Information about the occupational and non-occupational history of the subject was collected by Experts of the Operational Unit of Occupational Health and Safety Control (UOC PSAL) of the Local Health Unit Umbria 1 - Perugia, using the Italian National Mesothelioma Register (ReNaM) questionnaire and guide lines; an inspection was  carried out at the past canning industry where the patient worked in the period 1982-1990 and material was taken to be analysed by MOCF and SEM. RESULTS: Samples showed the presence of asbestos  fibres belonging to the amphibole class (amosite and crocidolite) and to the serpentine class (chrysotile). CONCLUSIONS: The survey described the past occupational exposure to asbestos in a canning industry, where  the subject worked in the period 1982-1990,  unknown to the patient himself. The authors strongly confirm the  usefulness of standardized methods, such as the ReNaM Questionnaire, and the importance of technical expertise of the investigator to find and analyse the suspect materials and to demonstrate  possible past occupational exposure to asbestos.

[Levels of exposure to respirable fibres at worksites for abatement of compact and friable asbestos]. / Livelli di esposizione a fibre regolamentate in cantieri di bonifica di materiali contenenti amianto in matrice compatta e friabile.

BACKGROUND: Starting from a project aimed at assessing the carcinogenic risk in some industrial sectors covered by Local Health Authority No.1 (LHA) in Perugia (USL Umbria1, Italian acronym), worksites for abatement of materials containing asbestos (MCA) were examined in order to estimate respirable fibres exposure levels in workers. Abatement work is, indeed, a fast developing sector, but is not free from asbestos risks in the long-term, particularly carcinogenic risks; this kind of work therefore requires maximum effort in respecting prevention standards prescribed in the relative legislation. OBJECTIVES: The aim of the research was to define the personal levels of exposure to respirable fibres and to create a reliable database for the interpretation of possible asbestos-related cases of neoplasms that may occur in the future in workers of this important occupational sector. METHODS: The authors took in consideration operations both on compact MCA and on friable MCA. In the case of compact MCA, exposure values measured by the LHA via their own sampling were compared to those measured by the companies involved in the project. In the case of friable MCA, however, sampling was only performed by the LHA and the assessment covered not only workers' exposure levels but also the pollution levels in the areas in the vicinity of the work site. RESULTS: In the case of compact MCA, results showed moderate average values of personal fibre exposure, and always considerably lower than the limit values (100 fibres/litre) prescribed by law (Legislative Decree 81/08); however, the average values detected by the LHA (15,8 fibres/litre) were significantly higher (p < 0.001) than those detected by companies (4,9 fibres/litre). In the case of friable MCA, however, average personal exposure values of workers (106,8 fibres/litre) were even higher than the limit values prescribed by current regulations, while in areas near the work sites, average fibre pollution levels (1,04 fibres/litre) were always very low and lacked significant variations (p > 0.05) during the different phases of work. CONCLUSIONS: According to the authors, the data collected show how in MCA abatement operations a carcinogenic risk in the long-term is in any case present, and this both in compact MCA work, where not all the prevention measures were accurately observed, and even more so, in friable MCA work, where average exposure levels of workers showed a heavy trend to exceed the above mentioned limit values. Considering the different evolution of the results of sampling carried out by the LHA and by the companies, the authors also highlight the need to provide mandatory technical guidelines for industrial hygiene laboratories so that sampling and analysis methods are as homogeneous as possible, thus making the results of research easily comparable.

[A survey on workers' individual exposure to crystalline silica in the building industry]. / Indagine conoscitiva sull'esposizione personale dei lavoratori a silice libera cristallina in edilizia.

BACKGROUND: The wide-spread presence of silica in nature and the variety of materials containing it cause crystalline silica exposure of workers in various industrial activities. Moreover crystalline silica is classified as carcinogenic to humans (Group 1) by IARC, in relation to its possible lung carcinogenicity. OBJECTIVES AND METHODS: The purpose of this paper was to assess respirable particles and crystalline silica exposure of workers in a number of some building sites located in the area of a Local Health Unit in the Umbria region. The study examined differences in four types of building sites: "construction of new buildings", "renovation of old buildings", "road construction" and "transport of aggregates by loaders in crushing plants". According to the strategy suggested by European Standard EN 689/1997, personal air samples were collected during work in jobs characterized by elevated amounts of widespread dust. RESULTS AND CONCLUSIONS: Analysis of data showed that levels of exposure to crystalline silica were lower than the limits recommended by ACGIH/2010 in almost all samples except one. The percentages of crystalline silica in respirable particles were in the range 0.4%-21%. Crystalline silica exposure levels were different in the various jobs and comparison between the mean values of exposure levels in each one showed statistically significant differences (p < 0.01, variance analysis). Work with the highest exposure to crystalline silica were: brick cutting, plaster brushing, "Serena stone" cutting, as they use tools operating at high speed and often in dry conditions (grinder, power drill, pneumatic hammer), producing low-size airborne particles (respirable fraction). During work in these jobs levels of worker exposure to crystalline silica showed high variability, so that it was impossible to establish if in the medium-long term, they were lower than the Threshold Limit Values with a set probabilistic certainty (OTL test, confidence level 95%). In the remaining jobs the assessment of occupational exposures to crystalline silica showed a low probability of exceeding the Threshold Limit Values.

Induced sputum, exhaled breath condensate and nasal lavage fluid in electroplating workers exposed to chromium.

Occupational exposure to chromium may cause airway inflammation and bronchial asthma. In this study we investigated the effect of chromium on the respiratory tract of exposed and non-exposed electroplating workers using spirometry and analysis of induced sputum (IS), exhaled breath condensate (EBC) and nasal lavage fluid (NLF). In both groups spirometry was normal; chromium in induced sputum was higher in exposed workers (7.90 +/- 0.855 microg/L, vs 1.78 +/- 0.075 microg/L; p<0.001); no significant difference was found in induced sputum cellularity. Median nitrite concentration in EBC was significantly higher in exposed subjects (4.35 micromol/L, 5 degrees -95 degrees percentile: 1.88-10.13 vs 0.11 micromol/L, 5-95 percentile: 0-0.72) (p<0.001). IL-6 and TNF-alpha were not detectable in EBC. Median IL-6 concentration in nasal lavage fluid was higher in exposed workers (5.72 pg/ml, 5-95 percentile: 0-65.25 pg/ml vs 0.28 pg/ml, 5-95 percentile: 0-1.7 pg/ml) (p<0.01). No differences in Eosinophil Cationic Protein concentration were found. TNF-alpha was not detectable in NLF. Chromium in induced sputum correlated with nitrites in EBC. For the first time three non-invasive methods were used to assess changes in respiratory tract in workers exposed to chromium. The results suggest chromium exerts an inflammatory/irritative action on airways.

[Health promotion in the occupational setting: what are the prospects in the Italian situation?]. / La promozione della salute in ambiente di lavoro: quali prospettive nella situazione italiana?

Over the past decades advances in sciences and medicine have improved living and health conditions and lengthened life expectancy. These benefits are associated with an increase in prevalence of chronic degenerative diseases. With their multi-factorial aetiology these diseases are influenced by life styles and personal habits and require prolonged medical care and high social costs. Now days health is no longer considered as the absence of disease but a state of mental, physical and social well-being. The World Health Organization has defined health promotion as "the process of enabling people to increase control over and to improve health". Since the 70s in the USA many health promotion programmes have been proposed, especially by large corporations, in order to ensure a more efficient, productive and motivated work-force, to reduce health insurance costs and to provide a better company image. Workplaces,--particularly when the working population is relatively stable--are excellent areas for health promotion programmes because workers can be monitored over a long period of time. The most successful programmes are aimed at modifying behaviour in risk patterns (smoking, alcohol abuse, eating disorders, etc.) through information, active participation, screening, follow-up, personalized programmes, changes in the working environment, physical exercise programmes. These health promotion programmes are extremely hard to develop for Italian workers. Most firms are small or very small and much still remains to be done to eliminate well-known occupational risk factors. The current flexibility of modern work patterns could constitute a further obstacle.