[Investigation on health status of silica exposed workers in "cotto Fiorentino" companies]. / Indagine sullo stato di salute degli esposti a silice nelle aziende del cotto Fiorentino.

The manufactured in "cotto" is typical of Chianti Fiorentino with about 400 employees. In 2005. the UF PISLL encountered an exposure to silica more than TLV, particularly for some tasks; were prescribed interventions of prevention and was undertaken an investigation of the occupational health status with occupational health physician. We observed 227 workers, 208 males and 19 females, with average age of 43 years and average age working of 15 years. The habit of smoking tobacco was higher than for the general population. The assessment of exposure to silica has been detected for 59 workers (mean 0.05 mg / mc); at pulmonary function testing resulted: 10 with airway obstruction and 4 airflow limitation; by 140 chest X - ray acquired 1 was interstitial pulmonary disease and 1 was bronchopneumonia. Among the diseases not related to exposure to silica, emerging 42 cases of low back pain, 28 hearing loss, 7 with hypertension. Non uniformity in health surveillance and diagnostic criteria highlights the need to cooperate between occupational doctor in public prevention and control service and qualified occupational doctor to ensure a standard of quality in the prevention of disease in exposed to silica.

[A case of methemoglobinemia due to 4-nitrobenzonitrile exposure]. / Un caso di metaemoglobinemia da esposizione a 4-nitrobenzonitrile.

The paper describes a singular case of acute intoxication by 4-nitrobenzonitrile, a rare intermediate compound produced by pharmaceutical synthesis. The patients subsequently showed an increase in triglycerides and fatty alterations of the liver.

[Evaluation of risk and acoustic damage in a department of metallic carpentry]. / Valutazione del rischio e del danno acustico in un reparto di carpenteria metallica.

A study was performed in a ten-years period (1980-1990) inside a metallic carpentry department. We carried out noise level measurements: equivalent continuous A-weighted sound pressure level (Leq), personal dosimetry, reverberation time. During the studied period, operation schedule and noise therefore did not change. According our results it appeared a high noisy level (mean Leq 88.3; 89.7) by a fluctuating noise within a building structure with high reverberation time (5 sec.). All employees were young (mean age = 32 years old) and equipped with suitable acoustic protection means: protecting covers with a good lowering of noise level in octave band included between 1 KHz-8 KHz. Audiometry showed a slight worsening among the exposed workers with more seniority and the aged.

Functional evaluation in stage I pulmonary sarcoidosis.

A functional evaluation was performed in 9 non-smoking patients suffering from sarcoidosis characterized, on chest roentgenograms, by hilar adenopathies (stage I). Frequency dependence of compliance (5 cases) and decreased conductance of the upstream segment (3 cases) were the major findings. From this it is concluded that, even at stage I, small-airway impairment may be documented in some patients, suggesting the existence of peribronchiolar granulomatous infiltration.

Effects of steroid therapy on pulmonary involvement in sarcoidosis.

In eleven patients with stage II-III pulmonary sarcoidosis as assessed by mediastinoscopy or open lung biopsy, we carried out a functional study by evaluating static and dynamic pulmonary volumes, diffusing lung properties (TLCO, KCO), and mechanical properties: resistance of the airway, flow-volume curve, pressure-volume curve, flow-pressure curve, and dynamic compliance. In 7 of 11 patients a clinical and functional follow-up during steroid treatment over a period of 5 months to 3 years was also performed. Before treatment diffusing properties were in the normal range in 6 of 11 subjects, reduced in 4, and increased in 1. Elastic properties studied in 8 patients were in the normal range, whereas peripheral airway involvement was noted in 4 nonsmokers. During the follow-up the changes noted in diffusing lung properties on the whole parallelled the clinical and radiologic improvement or relapses after cessation of therapy. In contrast, no changes in elastic properties or lung volume were noted. We concluded that steroid treatment seems to improve parenchymal lung involvement in most cases as shown by the increase in diffusing lung properties.