[A case of occupational lung disease (welder lung) in a mechanical worker]. / Un caso di polmone del saldatore in un saldo-carpentiere forte fumatore.

A case of welder's lung is reported in a male hard smoker who had worked as welder-carpenter for almost 30 years. In order to establish an etiologic diagnosis, given the informed consent from the worker, open lung biopsy was performed that allowed to obtain sufficiently large specimens of affected lung to make histological, immunohistochemical and mineralogical examination. In such a way the pathologic features were accurately defined and a multidisciplinary approach was applied to differential diagnosis. The worker is recommended to undergo a strict health surveillance because of the reported association of welder's lung with lung cancer, especially in smokers.

[Air-dispersed asbestos fiber pollution in urban areas: current and previous levels]. / Inquinamento da fibre di amianto aerodisperse nelle aree urbane: livelli attuali e pregressi.

Over the last twelve years (since the Lombard Regional Law n 41 on asbestos came out in 1986) I have had the opportunity to actively take part into monitoring campaigns both in working environments and in several urban areas. At the beginning analysis were performed almost exclusevely using phase contrast optical microscope (MOCF). This technique, even with its well known limits, has lead to measurments of asbestos pollution never exceeding 4-5 fibers L(-1) in urban areas. The reported value had lowered to 1-2 fibers L(-1) by the beginning of the nineties and, in the following years it has become even lower. The introduction of scanning electronic microscope (SEM) has not only confirmed these data but also shown lowered values of asbestos fibers in air (< 0.05 fibers L(-1)). This is to be related with the use of artificial fibers (glass and synthetical fibers) in cars braking systems instead of natural mineralfibers (asbestos). Nowadays the concrete-asbestos roof coverages can be a potential environmental pollution source if their surfaces are not protected. The reported indoor levels of pollution are similar to the outdoor ones and to levels reported in areas nearby rock-caves. The levels of asbestos pollution reported in the previous years using MOCF have been nowadays confirmed using SEM, expecially as far as buildings reclaimed from asbestos are concerned.

Pneumoconiosis in a female worker exposed to a primer used in the production of non-stick pans: clinical case.

UNLABELLED: The primary prevention programmes carried out in the 1950's and 1960's in industrialized countries brought about a significant reduction in the incidence of pneumoconiosis. Nevertheless, it is still possible to diagnose new cases, perhaps in relatively unusual working activities. OBJECTIVE: To describe a case of q 2/2 pneumoconiosis associated with mixed powder containing less than 1% quartz that occurred in a 37 year-old female worker, who had been previously employed (1987-1994) in manually spraying a primer solution on the bottom of non-stick aluminium pans. METHODS: The manufacturing firm supplied details of the composition of the primer. The physiological, pathological and occupational history was obtained for the worker, who also underwent: respiratory functional exploration, chest radiographs and HRCT of the thorax, fibrobronchoscopy, with transbronchial biopsy and BAL collection. The lung tissue sample was examined via light microscopy and scanning electron microscope analysis. RESULTS: The primer contained 6.8% talc, free from asbestos or silica, 3.8% iron oxides and 0.6% bentonite which, in turn, contained less than 1% crystalline silica. The job was performed in a semi-confined environment, with an inefficient aspiration system. The worker had never complained of respiratory symptoms. Radiographs and HRCT showed widespread micronodulation. Light microscopy of pulmonary tissue showed multinucleate giant cell granulomas with intracytoplasmatic inclusions. Scanning electron microscope analysis revealed that these consisted of agglomerated particles, microanalysis of which showed the presence of a silicate. CONCLUSIONS: Particular jobs performed up to few years ago in Italy in a semi-confined environment can still involve exposure to doses of mineral dusts such as to cause pneumoconiosis. This is the first case of mixed powder pneumoconiosis described in a worker employed in the production of non-stick aluminium pans.

Immunocytological and mineralogical study of bronchoalveolar lavage in a group of subjects exposed to asbestos.

Twenty-five subjects (24 males and 1 female, mean age 57.4 years) who have been exposed to asbestos underwent chest radiography, high resolution computed tomography (HRCT) of the chest, lung function tests and bronchoalveolar lavage (BAL) for evaluation of cell components (total cell count, percentages of macrophages, lymphocytes, neutrophil and eosinophil granulocytes and the lymphocyte subpopulations CD3+, CD4+, CD8+, CD19+ and HLADR+), soluble factors (IL-8, IL-10, IL-12 and MCP-1 in the supernatant) and concentration of asbestos fibre. The subjects were subdivided according to the degree of their exposure, to the concentration of asbestos fibres in the BAL and to chest X-ray findings using the I.L.O. classification (0/0pl, 0/1 and 1/0 and above). According to the exposure index, we showed statistically significant (p < 0.05) higher lymphocytes percentage in the BAL of subjects with moderate exposure and significantly higher levels of IL-10 (p < 0.05) in the supernatant of subjects showing an absence of asbestos fibres in their BAL. In the group of subjects with a 0/0 and 0/1 radiological profile, the cellular component of the BAL was characterised by a higher percentage of lymphocytes (p < 0.02), whereas a trend toward an increase in the number of neutrophils was noted in subjects with obvious pulmonary fibrosis. The percentage of neutrophils was inversely correlated with some parameters of respiratory function such as vital capacity (p = 0.03) and the partial pressure of oxygen (p = 0.05) in the blood. Investigating the cytokines in the supernatant of the BAL, we found a trend toward lower concentration of IL-10 in the group showing the worst radiological picture (I.L.O. > or = 1/0), and a statistically significant negative correlation between this cytokine and pO2 (p = 0.048). Concerning the other cytokines and chemokines studied (MCP-1, IL-8 and IL-12), no significant differences were found to be associated with the radiological profiles. There were, however, positive correlations between the concentration of IL-8 and the percentage of neutrophils (p = 0.038) and between the concentration of MCP-1 and the percentage of lymphocytes (p = 0.006). A negative relationship between the concentrations of IL-12 and IL-10 has been also observed (p = 0.028). This research allows us to hypothesise that IL-10 may have a pathogenetic role in the evolution of asbestosis.

[Airborne asbestos fibers: law references, TLV, considerations]. / Fibre di amianto aerodisperse: riferimenti di legge, TLV, considerazioni.

The ACGIH proposal of 0.1 fibers/liter as TLV for airborne asbestos fibers isn't a properly parameter, because it is applicable in work environments and the Italian legislation has forbidden every work which employs asbestos from 1993 [Law 257/92 and Min.Dec. 6/9/94]. Actually in Italy the application of a TLV is only referred to two analytical results: A) 20 ff/liter by CPOM analysis, B) 2 ff/liter by SEM analysis. We think that a CPOM 4-5 ff/liter is a no trespassing limit and over this concentration alarm may be notified. Waste disposal of asbestos materials must be properly disposed in a restricted area.

Urinary thallium: critical problems, reference values and preliminary results of an investigation in workers with suspected industrial exposure.

Using a sensitive ETA ASS method, urinary thallium (Tl-U) has been measured in a group of non-exposed individuals and in two groups of workers with suspected industrial exposure. In non-exposed subjects (72 healthy males aged 41 +/- 11 years) the Tl-U mean value was 0.22 mu/l (range 0.05-0.61). Significantly higher values were found in two groups of workers (30 and 21 subjects) employed in two cement factories and two cast iron foundries (mean Tl-U value: 0.38 and 0.33 mu/l, respectively; range 0.06-1.2). Thallium has been determined in coal, raw materials and, in one factory, also in environmental samples, but no detectable levels were found. The analytical problems connected to urinary thallium determination and the preliminary results of biological monitoring in non-exposed individuals and in workers are discussed.

[Determination of metal dusts in aerosols using x-ray fluorescence. Comparison with other analytical methods]. / Determinazione dei metalli nelle polveri aerodisperse con l'impiego della fluorescenza-X. Confronto con altre tecniche analitiche.

Determination of metals in aerosol collected as thin layer on membran filters has made employing X-ray fluorescence. Standards are prepared in suitable chambers: dust collected on membran filter is weighted. The problems of methodology are discussed. Calibration curves have been prepared for Pb - Fe - Cd - Si; comparisons have been made with other methods employing atomic absorption spectroscopy.

[Calibration of selective samplers for respirable dust]. / Taratura dei campionatori selettivi per la polvere respirabile.

The AA., after a short introduction on the concepts of respirable dust consider the double stage selective samplers in the literature. They suggest three of them, which are all characterized by different suction flows; the features of separation of the dust in the air are documented by means of calibrated mixtures of aerosol. As to the penetration ACGIH curve, satisfactory results are obtainable fro the 12 mm sampler with a 10 l/min flow and for the 25.4 mm sampler with a 70 l/min flow. The tests achieved with the Dorr-Oliver 10 mm metal sampler do not agree with the above mentioned curve for a capacity included between 0.7 and 2.5 l/min.