[Meta-analysis: cardiovascular effects in workers occupationally exposed to urban pollution]. / Metanalisi: effetti sull'apparato cardiovascolare in lavoratori esposti a inquinamento urbano.

BACKGROUND: Many studies showed a connection between exposition to high levels of urban pollution (especially to particulate and traffic noise) and the onset of even deadly cardiovascular diseases. DESIGN: Meta-analysis of case-control design. OBJECTIVES: The aim of this study is to estimate the association between cardiovascular effects and occupational exposition to atmospheric pollution in urban environment. DATA SOURCES: Biomedcentral, MEDLINE/ PubMed, MEDLINE/ National Library of Medicine (NLM), MEDLINE Plus, Nioshtic-2, Scopus, TOXNET/Toxline, unpublished studies known by the authors and acts of national and international conferences between 1988 and May 2010 included. There has not been any kind of language or typological restriction. CRITERIA OF ELEGIBILITY: The research on cardiovascular effects includes control cases of workers exposed to urban pollution, compared with non-exposed subjects. PARTICIPANTS AND INTERVENTIONS: The selected studies present outdoor workers exposed to urban pollution (drivers and petrol pump attendants) and a control group of indoor workers (managers, university students and other selected subjects). STUDY APPRAISAL AND SYNTHESIS METHODS: The evidences (independently token from two different authors) have been grouped in two classes, the first one formed by continuous variables (systolic blood pressure, diastolic blood pressure, heart rate, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and the second one by discontinuous variables (electrocardiographic abnormalities prevalence, hypertension prevalence, hypercholesterolemia prevalence). The studies related to both classes and presenting more than one variable for each class have been included and used, in order to elaborate the results. We calculated heterogeneity in each variable (ES calculation for continuous variables and OR calculation for discontinuous variables). RESULTS: On 378 publications, we have selected and included 16 articles. The variables show statistically irrelevant differences between exposed group and control group, except regarding the triglycerides. LIMITATIONS: The controlled studies are limited and characterized by a non-homogeneous evaluation of both expositional times of workers to urban pollution and of professional expositional values. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Considering the heterogeneity and the lack of studies, it is impossible at the moment to document effects on the cardiovascular system in workers exposed to urban pollution. The results of this meta-analysis only suggest the association of urban pollution with alteration of triglycerides blood levels (referring to just three studies). As reported in scientific literature on this subject, it is necessary to conduct a future professional investigation on this subject with more qualified and homogeneous studies.

Occupational exposure to noise and the cardiovascular system: a meta-analysis.

The aim of our meta-analysis is to evaluate the association between the modifications of the cardiovascular system and chronic exposure to noise in occupationally exposed subjects. We considered the articles published from 1950 to May 2008. Only 15 papers were conforming to the inclusion criteria identified for this meta-analysis. A total of 18,658 workers were divided in three groups according to the level of noise exposure as measured in the original studies (High Exposure, HE, Intermediate Exposure, IE, Low Exposure, LE). A preliminary evaluation of the type of data allowed for a classification of the type of performed measurements. Two classes of variables were identified: Class I, composed by continuous variables (systolic blood pressure, SBP, diastolic blood pressure, DBP, and heart rate, HR) and Class II, composed by not continuous variables (prevalence of hypertension and prevalence of ECG abnormalities). For each variable the calculation of heterogeneity was performed. For continuous variables the calculation of ES and its significance were performed while Odds Ratio (OR) and its significance were calculated for not continuous variables. The results show a statistically significant increase of SBP and DBP in HE workers compared to LE and IE workers while HR is statistically higher in HE participants compared to LE participants. The prevalence of both hypertension and ECG abnormalities is statistically higher in HE workers compared to LE and IE workers. Taking into account both the extremely high heterogeneity among studies and the ES/OR values we suggest a particular attention to the measurement and evaluation of SBP, DBP and HR in workers with chronic exposure to noise. Also ECG for workers with chronic exposure to noise is suggested in order to identify and evaluate possible abnormalities noise could be a concurrent cause of.

[Food service workers and cooks: occupational risk assessment]. / Mense e personale addetto alle cucine: valutazione dei rischi occupazionali.

The aim of the study is to evaluate the occupational risks among food service workers and cooks. During the occupational risks assessment the following risk factors must be evaluated: musculoskeletal disorders, chemical risk (cleaning kitchen work surface, dishes, utensils ecc.) biological risk (contact with foods or biological agents) cancerogenic risk (by baking smoke inhalation), and psycho-social stress. In this study the preventive measures and protective equipment to prevent health hazards for these workers have been evaluated (i.e. aspiration hood, adapted ventilation, chosen of less harmful methods of baking, ecc.). In particular the performance of rigid behavioural norms and hygienic procedures is very important for cooks and food service workers to reduce the risk of occupational infections.

Urban stressors and plasmatic 17-beta-estradiol (E2) in male exposed workers.

The aim of the study is to evaluate if the occupational exposure to urban stressors could cause alterations in 17-beta-estradiol (E2) plasma levels and related disorders in male traffic police compared with a control group. After excluding from the study, the subjects with the principal confounding factors, traffic police and controls were matched by age, working life, Body Mass Index (BMI), smoking and drinking habit. A total of 171 male traffic police and 171 controls were included in the study. In traffic police, mean E2 values were significantly lower versus controls (P < 0.001). The distribution of E2 values in traffic police and controls was significant (P < 0.001). No significant differences were found in percentage of traffic police versus controls concerning the following questionnaire items: fertility and mental health diseases. Our results suggest that the occupational exposure to chemical urban stressor, interacting with and adding to the psychosocial ones, could alter plasma E2 concentrations in male traffic police compared with a control group. According to our previous researches on other neuro-immune-endocrine parameters, E2 could be used as an early biological marker, valuable for the group, to be used in occupational set even before the onset of the pathologies.