Exposure to emissions from municipal solid waste incinerators and miscarriages: a multisite study of the MONITER Project.

BACKGROUND: Miscarriages are an important indicator of reproductive health but only few studies have analyzed their association with exposure to emissions from municipal solid waste incinerators. This study analyzed the occurrence of miscarriages in women aged 15-49years residing near seven incinerators of the Emilia-Romagna Region (Northern Italy) in the period 2002-2006. METHODS: We considered all pregnancies occurring in women residing during the first trimester of pregnancy within a 4km radius of each incinerator. Addresses were geocoded and exposures were characterized by a dispersion model (ADMS Urban model) producing pollution maps for incinerators based on PM10 stack measurements and for other pollution sources based on NOx ground measurements. Information on pregnancies and their outcomes was obtained from the Hospital Discharge Database. Simplified True Abortion Risks (STAR)×100 estimated pregnancies were calculated. We ran logistic regressions adjusting for maternal characteristics, exposure to other sources of pollution, and sites, considering the whole population and stratifying by miscarriage history. RESULTS: The study analyzed 11,875 pregnancies with 1375 miscarriages. After adjusting for confounders, an increase of PM10 due to incinerator emissions was associated with an increased risk of miscarriage (test for trend, p=0.042). The odds ratio for the highest quartile of exposed versus not exposed women was 1.29, 95% CI 0.97-1.72. The effect was present only for women without previous miscarriages (highest quartile of exposed versus not exposed women 1.44, 95% CI 1.06-1.96; test for trend, p=0.009). CONCLUSION: Exposure to incinerator emissions is associated with an increased risk of miscarriage. This result should be interpreted with those of a previous study on reproductive health conducted in the same area that observed an association between incinerator exposure and preterm births.

[Sensitivity and accuracy of health databases in determining incidence of lymphoid malignancies in an Italian population]. / Sensibilità ed accuratezza diagnostica dei flussi informativi del Servizio Sanitario Nazionale nella rilevazione dell'incidenza delle patologie linfoproliferative in una popolazione italiana.

We examined the sensitivity and the accuracy of three health databases (hospital discharge data, death certificates and pathologic records) between 1997 and 2001 in an Italian community, to evaluate their accuracy for the diagnosis of lymphoid malignancies and their ability to detect newly diagnosed patients affected by these diseases. Hospital discharge data showed the best sensitivity among the examined databases, though they exhibited an unexpectedly high number of diagnostic errors, even when limiting the analysis to patients with repeated hospital admissions over time. Overall, the pathologic registry and the death certificate file showed a higher diagnostic accuracy, though their sensitivity was considerably lower than hospital discharge data.

Mortality among male farmers licensed to use pesticides.

The mortality experience of 4,580 male farmers licensed to buy and use pesticides in Northern Italy was examined from 1974 to 1987. The historical cohort was determined from the registers of the agricultural inspectorate offices. The vital status at the end of the study period was ascertained by municipality records and only 4 subjects were lost to follow-up. Death certificates were obtained for 100% of the 565 identified deaths. External comparison on to the Italian male population was supplemented by regional comparison. Mortality deficits were observed for all causes, all neoplasms and most specific malignancies. A non-significant mortality excess due to brain cancer, compared both to national and regional populations, was found (11 cases, Standardized Mortality Ratio 169 and 139, respectively). The excess of brain cancer became statistically significant in the age group 65-75 years. Caution must be used in the interpretation of our findings. Nevertheless, it seems reasonable to hypothesize an association of the observed excess of brain cancer with the occupational and/or environmental exposure of the cohort.

[Temporary myopia and subjective symptoms in video display terminal operators]. / Miopizzazione temporanea e sintomatologia soggettiva in operatori al videoterminale.

The study covered a group of female VDT operators assigned to data entry and data acquisition. Subjective VDT-related symptoms of asthenopia were assessed by means of a questionnaire. All operators were examined by an ophthalmologist. Visual acuity was measured using vision tables with optotypes. In order to achieve an objective assessment of VDT-induced visual fatigue, refractive power was measured at the beginning and at the end of the shift, using an infra-red autorefractometer. Changes in refractive power were then related to VDT work and asthenopia symptoms. Visual acuity defects were observed in 63.5% of the operators; in 36% of the cases the subjects were either unaware of the defects or the defects were not adequately corrected. 62.5% of the operators complained of subjective asthenopia symptoms. Asthenopia was not related to the number of hours at the VDT. The results suggest that ametropic subjects are likely to be more susceptible to visual fatigue than emmetropic subjects, since there was a tendency for the prevalence of asthenopia to increase in the former group. A significant decrease in refractive power (temporary myopization) was observed in 20% of the operators at the end of the shift at the VDT: all these subjects also complained of asthenopia, compared to 50% of the workers without end-of-shift myopization. The difference between the groups was highly significant (p less than 0.01); contrarywise, none of the subjects without asthenopia developed myopization. On the basis of these results, it can be concluded that end-of-shift myopization, as measured by an automatic refractometer, may be used as a reliable objective measurement of VDT-related visual fatigue.

Serum type III procollagen peptide in asbestos workers: an early indicator of pulmonary fibrosis.

Serum type III procollagen peptide (PIIIP) concentrations were determined in 36 male workers exposed to asbestos fibres in the production of asbestos cement items and in 13 healthy male controls. Mean (SD) PIIIP serum concentrations were 9.3 (1.5) ng/ml (range 7-12) in the controls and 13.7 (3.5)ng/ml (range 7.5-20) in the asbestos workers; the difference was statistically significant (p less than 0.01). The exposed workers were subdivided according to presence or absence of radiological signs of asbestosis and intensity and duration of exposure. PIIIP serum values of workers with asbestos related interstitial fibrosis were the highest of the groups at 14.6 (2.3) ng/ml. In workers with heavy exposure the PIIIP values were significantly related to duration of exposure (r = 0.95; p less than 0.01). PIIIP serum values may be a useful index for the early diagnosis of asbestos induced pulmonary fibrosis and its use should be considered as part of the biological monitoring of exposed workers.

Visual fatigue in video display terminal operators: objective measure and relation to environmental conditions.

The lighting conditions, luminance, contrast, and design of the workplace were studied in video display terminal (VDT) work stations operated by a group of female VDT data-acquisition clerks. VDT-induced symptoms were assessed by means of subject answers to a questionnaire. To measure VDT-induced ocular fatigue objectively, refraction power was determined before and at the end of workshift by an infrared autorefractometer. Job-induced refraction changes were then related to visual complaints and conditions in the workplace. The results confirmed that VDT data-acquisition work can lead to temporary myopia (myopization) in a remarkable percentage of operators; a significant correlation between eye discomfort, ocular asthenopia, and myopization was also found. Illumination levels, luminance, and contrast seem to be of paramount importance regarding visual symptoms: neither asthenopia nor myopization was observed when all of these conditions were adequate. If the ergonomic design of the workplace and the viewing distance are adequate, there are also usually fewer musculoskeletal symptoms. Our results suggest that changes in the ocular refraction status before and at the end of the work-shift, as determined by an automatic refractometer, provide a good objective index of VDT-induced "ocular fatigue", which in our study proved to be significantly related to workplace conditions.

[The McCollough effect and visual fatigue induced by the use of green phosphorus monochromatic video terminals]. / Effetto McCollough ed affaticamento visivo indotti dall'uso di videoterminali monocromatici a fosfori verdi.

We examined 101 students (40 men, 61 women) aged 16-19 years, working 1-3 hours daily with video display terminals (VDT) with luminous green characters on dark background. McCollough visual aftereffect (ME) was reported, almost occasionally, in 80.2% of the examined group. 68% of the students referred daily ME appearance. Usually the effect appeared after 1 hour or less of VDT work and might persist for 1 hour or more. ME prevalence and persistence were significantly greater in women than in men. Apparently no relations were observed between ME prevalence and VDT work hours of visual defects. ME prevalence and persistence were significantly related to VDT induced visual asthenopia symptoms, but not with ocular asthenopia. According to our results, ME appearance may represent an early index of individual susceptibility to visual asthenopia induced by green characters VDT and/or be itself a precocious visual asthenopia symptom.