[Register of exposed to carcinogens]. / Registro di esposizione a cancerogeni.

Law Decree 626/94 already provided for the "register of exposed subjects" to be implemented by employer once the presence of cancerogenic agents falling into the definition of the norm itself have been assessed in working activities. The lack of an effective decree identifying the models and modalities of register keeping has led so far to an exposure under-evaluation. Of course the coming into force of Ministerial Decree 155/2007, almost at the same time as the new body of regulations made up by Law Decree 81/2008, stimulated the addressees to proceed with setting an exposure register to be forwarded to the National Institute for Occupational Safety and Prevention (ISPESL) and to the competent inspection authority. Starting for the regulations, the authors will go through the register forms and information flow management.

[Integration of biological and workplace monitoring as an efficient control of chemical exposure]. / Integrazione dei piani di monitoraggio degli indicatori biologici di esposizione e dei piani di monitoraggio ambientale/espositivo.

Evaluation of professional exposure by means of biological monitoring is nowadays a consolidated method in the practice of Occupational Health. Generally biological monitoring is used simultaneously to ambient monitoring as a complementary method to obtain a mutual validation of exposure assessment. Experience gathered in the last years allowed us to verify that at low exposure levels, the values of biological indicators of dose are always markedly below their limits. Consequently, under standard conditions, it appears useful to alternate the two different exposure assessments (either biological or ambient monitoring), in order to obtain an efficient control of chemical exposure. Moreover, this methodological approach allows a better integration of all the professionals, who manage directly or indirectly the activities concerning Occupational Health and Industrial Hygiene, having as their first goal the health protection of employees and job environment.

[Implementation of parliamentary act D. Lgs 25/02 and definition of "moderate risk"]. / Applicazione del D.Lgs 25/02 e definizione di "rischio moderato".

This paper describes the position of the Joint Working Group of the Italian Association of Industrial Hygienists (AIDII), the Italian Society of Occupational Health and Industrial Hygiene (SIMLII) and the Italian Society of Toxicology (SITOX) on "Analysis of Parliamentary Act D.Lgs 25/02 and role of the Scientific Societies in the definition of Limit Values". The positive aspects of the new law which implements the European Directive 98/24 are discussed, including the abolition of the rigid periodicity of medical examinations as stated by the old rule D.P.R. 303/56. The Authors also address various parts of the law which appear to be unclear and controversial and highlight the expected difficulties arising for the employers and the safety and health professionals during the application of this new piece of legislation. Moreover, a number of discrepancies are noted between the new Italian law and the original Directive or other current Italian rules such as i. the translation of the term "slight risk", as from the original Directive, into "moderate risk", and the resulting non compulsoriness of health surveillance and biological monitoring of the workers in presence of a "moderate risk", ii. the concurrent exclusion, under the same circumstances, of the occupational physician from risk assessment procedures and iii. the upward modification of the previously established (D.Lgs 277/91) occupational exposure limits for lead. Moreover, the Authors examine and criticize--both in semantic and in toxicological terms--a recent proposal for the definition of "moderate risk" made by an ad hoc Consulting Committee of the Labour Ministry, in which the term "moderate" has been interpreted either as "low" or as "irrelevant for health effects", clearly two very different meanings. Besides, it would be inappropriate to define the conditions of a moderate risk based only on the level of exposure to the chemical (expressed as a fraction of the corresponding limit value), without considering the two other components of risk assessment for that chemical (hazard and susceptibility). Even worse would be the use of simplified models based on "algorithms", which might be useful in a preliminary phase of risk assessment, but easily could lead to an under- or over-estimation of risk, particularly when used by non professionals. In conclusion, the Working Group recommend that the new law be amended in order to clarify its most controversial aspects, whose misinterpretation could severely jeopardize the protection of the workers' safety and health at work.

[Management of combined exposure to chemical agents: an operative proposal]. / Gestione dell'esposizione combinata ad agenti chimici: una proposta operativa.

The Decree 25/2002 introduces the duty, in case of activities involving exposure to several chemical agents, to evaluate the risk "on the basis of the risk presented by all such chemical agents in combination". Yet, in the Decree, no principles or formal methods are defined to perform such evaluation. Waiting for specific technical instructions, we propose a scheme for the management of the "combined risk", inspired to the formal criteria and suggestions of the American Agencies ACGIH and OSHA. Advantages and limits of the proposed scheme are discussed.

Hemoglobin adducts as biomarkers of 1,3-butadiene in occupationally low exposed Italian workers and a few diesel-exposed miners.

Hemoglobin adducts were determined as biomarkers of 1,3-butadiene (BD) in 30 workers and 10 controls from an Italian BD plant and in 14 diesel-exposed miners. N-(2,3,4-trihydroxybutyl)valine (THBVal), an N-terminal valine globin adduct of reactive butadiene metabolites, was analyzed by gas chromatography/high resolution mass spectrometry after a modified Edman degradation and further acetylation. The BD exposure for the plant workers was 31 microg/m(3) (personal sampling). Whereas there was no detectable difference in hemoglobin adduct levels (range 17.7-61.4 pmol/g globin) between the total group of exposed and controls, slight but significant differences could be found between two subgroups of workers from different production units as well as one subgroup and controls (P<0.05), between smoking (n=13) and non-smoking exposed workers (n=17; P=0.066) as well as between smoking exposed workers and controls (P=0.055). Adduct levels of the miners (all non-smokers) were in the same range as those of the Italian BD-workers and controls. The internal exposure and strain measured by THBVal levels resulting from a very low occupational BD exposure was in the range of the contribution of moderate smoking.