ABSTRACT
BACKGROUND AND OBJECTIVES: The aim of this study was to investigate mortality of a cohort of 1,767 male workers employed in a sugar refinery plant located in the Province of Arezzo, Italy, where asbestos had been used from the 1960's for the insulation of thermohydraulic systems and for furnaces. In 1987-88 workers removed the asbestos-cement insulation from the plant. METHODS: The cohort was composed by male workers who were employed in the plant between 1 March 1962 and 1 February 1996, and had worked for at least 2 months. Follow-up started on 1 March 1962, and ended on 31 May, 2003. The population mortality for Tuscany Region was used as the reference. The relative risk was estimated by Standardized Mortality Ratio (SMR) and the confidence intervals were calculated at a 95% level (95% CI). RESULTS: The majority of workers were employed during the summer only. Significant decreases in mortality were observed for overall mortality (SMR = 78; 95% CI = 69-88), all cancers (SMR = 80; 95% CI = 65-97), cardiovascular diseases (SMR = 64; 95% CI = 50-81), lung cancer (SMR = 66; 95% CI = 43-98), and gastrointestinal diseases (SMR = 53; 95% CI = 26-98). Non-significant increases were observed for kidney cancer (SMR = 229; 95% CI = 92-472), and diseases of the nervous system (SMR = 155; 95% CI = 71-294). Kidney cancer mortality for workers employed for > = 5 years was significantly higher (SMR = 508; 95% CI = 105-1485). CONCLUSIONS: Mortality for asbestos-related diseases did not show any increase. The higher kidney cancer mortality for workers employed for > = 5 years could be due to exposures to various carcinogens, that occurred not only in the sugar refinery plant, given that the workers were seasonal and did other jobs during the rest of the year. Asbestos-related deaths could occur in the future among some workers who in 1987-88 were employed on the removal of asbestos-cement insulation from the plant.
Subject(s)
Food Industry , Occupational Diseases/mortality , Adolescent , Adult , Cause of Death , Follow-Up Studies , Humans , Italy/epidemiology , Male , Middle AgedABSTRACT
Strict guidelines for selection, monitoring and treatment of Potential Organ Donors (POD) in Neurosurgical Intensive Care Units (ICUs) are mandatory since patients with Acute Brain Injuries (ABI) are more frequently admitted on these specialized ICUs. We report the guidelines accepted in the Neurosurgical ICU of Treviso City Hospital (TVH) and the results obtained in the last three years (1988-1990). All patients with unfavourable neurological outcome were considered POD if absolute or relative contraindications to organ procurement were absent. They were treated with a multisystemic approach, according to standard protocols, including: ECG monitoring, water and electrolyte balance restoration, pharmacological cardiocirculatory support, prophylaxis and treatment of infections, control of hormonal disturbances. Our data demonstrate an increase of POD from TVH due to the centralization of patients with ABI in the Neurosurgical ICU and show an increase of the rate of POD from Neurosurgical ICU vs General ICU of TVH. The increase of POD in the Neurosurgical ICUs involves medical, legal, organizing and psychological problems, related to this clinical condition. The attention to severe protocols, that must be periodically reviewed, makes more easy the management of POD and ameliorates the outcome of these patients.
Subject(s)
Critical Care , Neurosurgery , Tissue Donors/statistics & numerical data , Humans , Monitoring, Physiologic , Treatment OutcomeABSTRACT
The extensive blood loss during the surgical correction of craniosynostosis in infancy needs usually homologous transfusion. The Authors report a program of preoperative and intraoperative hemodilution and their experience in six infants, the very first in pediatric neurosurgery. Prevention of homologous blood transfusion achieved in 4 out 6 cases can be considered a success that could be further improved introducing minor changes in our protocol.
