[Alkylphenols in the environment: a risk for human health?]. / Presenza di alchilfenoli nell'ambiente: un possibile rischio per la salute umana?

Endocrine Disrupting Chemicals (ECD) are a class of chemical compounds widely utilized for many industrial and civil applications and, consequently, widely diffused in the environment. Due to their chemical-physical characteristics, ECD may interfere with several endocrine functions in humans. Alkylphenols (APs), mainly produced by biodegradation of alkylphenols polyethoxylates surfactants, are a relevant group of ECD, both for their environmental diffusion and demonstrated estrogenic activity. Aim of this paper is to assess the potential risk of exposure to APs for humans, on the basis of the available data in literature concerning APs: environmental levels, accumulation in sediments and biota, toxicological effects on experimental animals.

Predictors of preoperative anxiety in children.

This study aimed to identify factors contributing to anxiety at induction of anaesthesia in children. One hundred and twenty children aged five to twelve years and scheduled for surgery requiring general anaesthesia were included. Children were interviewed and assessed prior to surgery. Parents completed anxiety measures prior to surgery and were interviewed after the induction of anaesthesia. The level of children's anxiety was determined at the time of induction of anaesthesia by the modified Yale Preoperative Anxiety Scale. Factors associated with increased levels of anxiety in the children included increased number of people in the room at induction of anaesthesia; longer waiting time between admission at the hospital and induction of anaesthesia; negative memories of previous hospital experiences; and having a mother who does not practise a religion. Suggestions for implementation of the findings and for future research are provided.

[Low birth weight, life style of mothers during pregnancy and chlorinated drinking water]. / Basso peso alla nascita, abitudini di vita delle madri in gravidanza e consumo di acque sottoposte a clorazione.

Numerous environmental factors such as smoking habits, alcohol intake, economic and social status, and by-product chlorination present in drinking water can determine adverse pregnancy outcomes like a low weight birth, small for gestational age or preterm delivery. In 1998 the Italian Ministry of University and Scientific Technological Research (MURST) has financed a multicentric study in order to evaluate the association between exposure to by-products chlorination in drinking water during pregnancy and adverse pregnancy outcomes at birth such as preterm delivery and low birth weight. We describe the socio demographics characteristics, personal habits and the health status during pregnancy and exposure to the VOX of 171 women recruited from the Research Unit of Rome and L'Aquila. A case control study with incident cases was performed. Exposure to Chlorination By Products (CBP) and confounding factors for studied outcomes, were assessed by a validated questionnaire. At the same time, collection and analysis of 124 tap water samples were carried out directly at women's home. No association was found between CBPs level and low birth weight or preterm delivery. We found an excess risk statistically significantly between preterm delivery and hypertension (OR = 5.06; IC 95% = 1.70-15.44) an excess risk statistically significantly between low birth weight and smokers (OR = 3.43, IC 95% = 1.15-10.26). The CBPs levels were rather low (range cases = 0.09-6.28 microg/L; range controls = 0.01-6.44 microg/L). The results confirm the literature data and the validity of the epidemiological method adopted. The low CBPs levels, under the Law level, are probably imputable to the good quality of sorgive waters. Considering the CBPs level temporal variability in chlorinated waters, is to be hoped a careful and continues surveillance of the CBPs spike levels for better exposure assessment.

Cytogenetic biomonitoring of workers from laboratories of clinical analyses occupationally exposed to chemicals.

A cytogenetic monitoring study was carried out on a group of workers in clinical analysis laboratories to investigate the risk of occupational exposure to chronic low levels of chemicals.Thirty-four clinical laboratories have been involved in the study. In these laboratories, toxicants and analytical procedures utilized have been characterized. The individual occupational exposure of workers was assessed by use of a questionnaire concerning the chemical substances utilized. About 300 different chemicals have been identified. Cytogenetic analyses (chromosomal aberration and micronucleus tests) were carried out on a strictly selected group of 50 workers enrolled from these laboratories and compared to 53 controls (healthy blood donors) matched for gender and age. The exposed group shows a significantly higher frequency of genetic damage than the control group. Both chromatid and chromosome aberration frequencies in workers appear significantly higher than in controls. Similarly, comparison between micronucleated cells rates of exposed and unexposed groups show significantly higher frequencies of binucleated cells with micronucleus (BNMN) and of total micronuclei (MN tot) in workers than in controls.

[Hospital hygiene and disinfectants: experience in a teaching hospital]. / Igiene ospedialiera e disinfettanti: esperienza in un policlinico universitario.

A survey was conducted during March-July 1999 to assess and identify the disinfectants and chemical sterilants employed in a teaching hospital of Roma. The purposes were studying the problems of safety in the use also, and the treatment like waste of disinfectants and chemical sterilants. Were collected the data from 61% of 39 Department/Institutes of the whole hospital. A total of 635 records were examined, and 40 different active ingredients of 110 commercial forms were identified. This study was conducted by a survey chart. Data collected outline that to minimize the risk for nursing staff, workers and the patients a modern hospital staff should prepare a handbook that can explain the concentrations and correct use for various disinfectants and chemical sterilants that was choose and employed.

[Survey of disinfectant usage in a polyclinic in Rome: preliminary results]. / Indagine sull'impiego dei disinfettanti in un policlinico Romano: risultati preliminari.

The authors describe the survey that was conducted in the largest hospital in Rome. The aim was to estimate the disinfectants and chemical sterilizers employed and asses possible hazards for patients and workers arising from the use of disinfectants, together with the problem of waste disposal. The study was conducted by means of a survey form that was distributed to 39 departments/institute in the whole hospital of which 24 (61%) responded. Overall 635 charts were collected listing 886 usage procedures and 110 formulations with 40 different active ingredients. The disinfection fields of use were: skin(52.4%) environment (28.8%) and hospital equipment (20.8%) This study shows that a modern hospital should select very few disinfectants and prepare a handbook that can explain disinfectant usage procedures and concentrations. In the guidelines the problem of waste disposal and employee safety should also be considered.

Anger, depression, and coping interactions in headache activity and adjustment: a controlled study.

OBJECTIVE: To determine if individuals in the general community with chronic headache or migraine differ in terms of anger, depression, and coping strategies and from headache-free individuals in terms of anger and depression. METHOD: A community sample comprising 16 chronic tension-type headache (CTH), 28 migraine headache (MH), and 38 headache-free control subjects (CNT) were compared on measures of anger, depression, and use of various coping strategies. Affective and coping measures, recorded during a headache-free period, were regressed on headache activity measured in a daily diary over the following 2 weeks. Relationships between anger, depression, and coping were also examined in each of the headache groups. RESULTS: The MH subjects were found to use less effective coping strategies than controls and CTH, while the CTH group had higher levels on depression and various anger scales compared to controls and MH. Direct positive relationships were observed between suppressed anger and depression in the MH group, and between trait anger and depression in the CTH group. Anger and coping were predictive of headache activity in the following 2 weeks for both MH and CTH groups, while depression and coping, compared to coping only, were predictive of lifestyle interference from head pain in MH and CTH, respectively. CONCLUSION: The results support a relationship between affective and coping factors in headache activity and adjustment.

[Laboratory diagnosis: correlated health and environmental risks]. / La diagnostica di laboratorio: rischi sanitari e ambientali correlati.

Method description and initial results of a study to assess risks to health sector workers and environment due to chemical agents used and waste products generated in diagnostic clinical chemical laboratories, and image diagnostic testing. A survey was conducted of the methods and agents used and their toxicological classification, the number of workers exposed and an analytical profile of the waste produced. The assessment of risk to workers was based on cytogenetic tests (chromosome aberrations and micronuclei); the assessment of environmental risk from waste disposal was based on tests on plant systems.

Headache interference as a function of affect and coping: an artificial neural network analysis.

Artificial neural networks present a technique for modeling relationships between variables in complex systems. The negative effects of headache are determined by many "biopsychosocial" elements that represent a complex system. Artificial neural networks may therefore be useful for examining psychological factors in headache. To test this hypothesis, we trained an artificial neural network to predict life-style interference attributed to headache from psychological measures of anger, depression, and coping appraisal and strategies. The artificial neural network demonstrated a better fit of the data than that obtained by multiple regression, and predicted interference levels to within 10% error for 80% of novel cases. Artificial neural networks may be a useful technique for examining psychological correlates of headache.