Subjective Symptoms in Magnetic Resonance Imaging Personnel: A Multi-Center Study in Italy.

Introduction: Magnetic Resonance Imaging (MRI) personnel have significant exposure to static and low-frequency time-varying magnetic fields. In these workers an increased prevalence of different subjective symptoms has been observed. The aim of our study was to investigate the prevalence of non-specific subjective symptoms and of "core symptoms" in a group of MRI personnel working in different centers in Italy, and of possible relationships with personal and occupational characteristics. Methods: The occurrence of 11 subjective symptoms was evaluated using a specific questionnaire with 240 subjects working in 6 different Italian hospitals and research centers, 177 MRI health care and research personnel and 63 unexposed subjects employed in the same departments. Exposure was subjectively investigated according to the type of MRI scanner (≤1.5 vs. ≥3 T) and to the number of MRI procedures attended and/or performed by the personnel, even if no information on how frequently the personnel entered the scanner room was collected. The possible associations among symptoms and estimated EMF exposure, the main characteristics of the population, and job stress perception were analyzed. Results: Eighty-six percent of the personnel reported at least one symptom; drowsiness, headache, and sleep disorders were the most frequent. The total number of symptoms did not differ between exposed persons and controls. Considering the total number of annual MRI procedures reported by the personnel, no significant associations were found nor with the total number of symptoms, nor with "core symptoms." Only subjects complaining of drowsiness also reported a significantly higher mean annual number of MRI procedures with ≤ 1.5 T scanners when compared with exposed subjects without drowsiness. In a multivariate model, subjects with a high level of perceived stress complained of more symptoms (p = 0.0002). Conclusions: Our study did not show any association between the occurrence of reversible subjective symptoms, including the more specific "core symptoms," and the occupational exposure of MRI personnel to static and low-frequency time-varying magnetic fields. On the other hand, the role played by occupational stress appears to be not negligible. In further research in this field, measurements of EMF exposure should be considered.

[The new AIRM guidelines for workers exposed to electromagnetic fields: health surveillance and fit for work judgment]. / Le nuove linee guida AIRM per gli esposti a campi elettromagnetici: sorveglianza sanitaria e giudizio di idoneità.

SUMMARY: This report illustrates some points relating to the health surveillance of workers exposed to electromagnetic fields (EMF) contained in the new Guidelines on EMFs. A working group from AIRM (Italian Association of Medical Radiation Protection) is currently implementing these guidelines. The report focus in particular on two specific aspects, critical to set up and carry out a correct Health Surveillance (HS): 1. Identification of the exposed workers (who will undergo Health Surveillance). 2. Health Surveillance contents. Considering the peculiar characteristic of the agents at risk, the identification of workers to undergo health surveillance (not specified in the legislation), should involve an assessment of the exposure levels as well as the specific health condition of each "worker at particular risk". Health surveillance programs, to be applied in case of greater exposure, will be focus on identifying sensitive risk groups who should undergo more frequent health checks.

[Preliminary results of a cognitive survey among the members of the Italian Medical Radiation Protection Society(AIRM): from characterization of the professional activity to identification of training needs]. / Risultati preliminari di un'indagine conoscitiva tra i soci dell'Associazione italiana radioprotezione medica (AIRM): dalla caratterizzazione dell'attività professionale all'individuazione del fabbisogno formativo.

OBJECTIVES: For several decades, the Italian Association of Medical Radioprotection (AIRM) is engaged in the promotion of scientific, technical, and methodological knowledge in the field of medical radioprotection. METHODS: Starting from the results of the previous study conducted in 2013, AIRM has carried out a new survey among its members. This survey was carried out through a self-administered questionnaire to be completed online on a platform set up on the association's website. RESULTS: The preliminary data collected by the survey provide both the personal/professional description of the AIRM members and an in-depth analysis regarding the need for training updates in the field of radioprotection. CONCLUSIONS: The results obtained will be used by the AIRM to support its commitment, now over a decade, in the offer of current and effective radioprotection update programs.

[AIRM recommendations for the application of probability of causation method.] / Indirizzi AIRM per l'utilizzo della Probabilità di Causa.

OBJECTIVES: L'applicazione del metodo della Probability of Causation (PC) è certamente ampio poiché è oggi lo strumento riconosciuto per la individuazione del nesso di causa non solo nelle richieste di indennizzo in ambito assicurativo (per il quale è stata utilizzato inizialmente) ma anche per dirimere contenziosi giuridici in ambito civilistico e penalistico. METHODS: Thanks to the Italian Association of Medical Radiation Protection (AIRM), PC method has been recently proposed as an aid for the radiation protection occupational physician in medical assessments involving both the mandatory actions that, in case of suspicion of occupational disease, the physician needs to perform (report / complaint / reporting) and the expression of the fitness evaluation in case of return to work after cancer and clinical recovery. RESULTS: For all these uses PC value, calculated through the method, should be used in a flexible manner, and thus lead to different decisions, "modulated" on the basis of purposes and listed contexts; and this not only within the legal framework, but also in the strictly professional one. CONCLUSIONS: According to different purposes, different PC values are proposed as a reference for the decisions to be taken.

Proteomic approach for the analysis of acrylamide-hemoglobin adducts. Perspectives for biological monitoring.

The formation of adducts between acrylamide and hemoglobin in vitro was investigated by using mass spectrometric methodologies to identify the amino acid residues sensitive to alkylation. Liquid chromatography-electrospray ionisation mass spectrometry analysis of either intact or trypsin-digested alpha- and beta-globin chains isolated from hemolysate samples incubated in vitro with acrylamide at different molecular ratios allowed us to identify Cys93 of beta-globin as the most reactive site in hemoglobin, according to a Michael-type addition reaction between acrylamide and the sulphydryl group of cysteine. The only other reactive sites were Cys104 of alpha-globin and the N-terminal amino groups of both chains. The method developed, based on electrospray ionisation quadrupole time-of-flight tandem mass spectrometry analysis of intact globin chains was able to specifically detect low levels of adducts. In this way, rapid identification of alkylated portion of Hb was achieved to be potentially used as a biomarker for high-sensitivity biological monitoring.

Chromosomal aberrations in long-haul air crew members.

The increasing use of air travel suggests the need for risk assessment and cytogenetic analysis of flight personnel, to check for the risk of developing cancer. Taking into consideration occupational risk and possible confounding factors, we used traditional cytogenetics, the micronucleus test and fluorescent in situ hybridization (FISH) analysis to study 48 male crew members working on long-haul flights and a control group of 48 ground staff. Compared to controls, we detected a significant increase in the relative risk of gaps and breaks (adjusted odds ratio (OR(adj))--7.8; 95% confidence interval (CI) - 2.4-24.9) and of translocations (OR(adj)--5.1; 95% CI 1.5-17.3) in crew members, with a non-significant difference in the other chromosomal aberrations. The possibility of a correlation between translocations and cancer risk highlights the need for preventive measures for aircraft personnel.