[Heat stroke in the workplace: description of a case with fatal outcome]. / Colpo di calore in ambito lavorativo: descrizione di un caso con esito fatale.

BACKGROUND: Heat exposure represents an occupational risk factor in various work settings. Adverse effects may range from mild symptoms, like muscular cramps, to life threatening conditions, like heat stroke. Data on the occurrence of work-related adverse effects of heat exposure in Italy are lacking. OBJECTIVES: To highlight the risk of heat stroke in a common working activity. METHODS: The case of a fatal heat stroke in a 19-year-old worker, in apparently good health, employed in maintenance of open park spaces is presented. After working 7 hours outdoors on a sunny day he was found unconscious. He was immediately taken to the local Emergency Department, where he arrived in hyperthermic and comatose conditions, and died due to multiple organ failure after 36 hours. After excluding other main causes of hyperthermia, heatstroke was identified as the initial cause of death. RESULTS: The case presented describes the possible extreme consequences of an underestimation of the risk related to occupational heat exposure, even in young and apparently healthy workers. Heat-related adverse effects may occur in a number of common activities, not necessarily involving heavy workload or extreme temperatures. Different methods, including simplified methods, are available for heat stress risk evaluation. The main preventive measures include adequate acclimatization, periodic interruption of exposure, sufficient fluid intake, adequate clothing and appropriate Personal Protective Equipment. Adequate training and workers' health surveillance are also essential. CONCLUSIONS: Heat exposure may be a significant occupational risk, potentially inducing life-threatening conditions, in a number of common activities but is frequently underestimated. An example of undervaluation of the risk and of the possible consequences, are presented and discussed in this case report.

[Occupational exposure to 50 Hz magnetic fields in workers employed in various jobs]. / Esposizione professionale a campi magnetici a 50 Hz in lavoratori addetti a varie mansioni.

BACKGROUND: Information on occupational exposure to ELF magnetic fields (MF) in workers is largely insufficient, and is mostly based on results obtained in Scandinavian countries and North America. Accordingly, the collection of further data is needed, especially in workers exposed in other countries, including in Italy. METHODS: One hundred and fifty workers (84 males and 66 females) employed in 28 different jobs in the Emilia-Romagna Region of Italy were examined. Individual exposure was measured using personal monitors worn on the hip in a belted pouch during three whole work-shifts (8 hours each) of a normal working week. A sampling interval of 10 seconds was adopted, resulting in the collection of more than 8600 measurements for each worker. The individual Time-Weighted Average (TWA) occupational exposure of workers was calculated as the arithmetic mean of all measurements during each work-shift. Environmental non-occupational exposure was also measured. RESULTS: The 50 degrees percentile of individual TWA in the whole group was 0.15 microT, and the 5 degrees - 95 degrees percentile was respectively 0.02-1.45 microT. Job-related exposure (expressed as the mean of the TWA measured in all workers engaged in that job) was highest in substation electric power plant workers (1.12 microT) and in sewing machine workers (0.84 microT), but was lower than 0.2 microT in more than the 70% of the examined jobs. Considering the geometric mean of individual TWA are 27 out of 28 the jobs inducing an exposure lower than 0.2 microT. The lowest exposure was observed in infant school teachers. A high variability was observed among different workers engaged in the same occupation, mainly in substation electric power plant workers, machine testers and grinders in the engineering industry and in sewing machine workers and quality control in garment production. A marked variability of the pattern of exposure during the work-shift was also observed The overall environmental (non-occupational) exposure was 0.044 microT, and individual exposure was lower than 0.2 microT in about 97% of the examined subjects. Occupational exposure was usually higher and was not correlated with environmental exposure. CONCLUSIONS: The results show that the occupational component of overall exposure must be considered in studies on the biological effects of ELF-MF in populations. The high variability observed among workers engaged in the same occupation and the variability of the pattern of exposure certainly constitute major problems and could be a cause of the scarce coherence of the results of epidemiological studies on biological effects of ELF-MF to date. An improvement in protocols for the evaluation of exposure in workers, including the use of personal monitoring, is certainly needed.

[Sister chromatid exchange (SCE)and high-frequency cells in workers professionally exposed to extremely low-frequency magnetic fields (ELF)]. / Scambi tra cromatidi fratelli (SCE) e high-frequency cells in lavoratori professionalmente esposti a campi magnetici a frequenza estremamente bassa (ELF).

BACKGROUND: Up now no firm conclusions can be drawn on the genotoxicity of Extremely Low Frequency (ELF) Magnetic Fields (MF) in exposed workers: both an increase in chromosomal aberrations (CA) and micronuclei (MN) or no effects were observed in substation workers, while a slight increase in CA, but not in sister chromatid exchanges (SCE) or MN was reported in linesman; an increase in CA was observed in cable splicers and, more recently, in train engine drivers, but results have not been replicated. OBJECTIVES: Objective of the study was an evaluation of possible genotoxicity of occupational exposure to ELF-MF. METHODS: SCE, high-frequency cells (HFC) and SCE in HFC were measured in peripheral blood lymphocytes from 70 workers exposed to various levels of ELF-MF in different occupations, not involving exposure to known mutagens or carcinogens. In all participants, individual ELF-MF exposure was measured throughout the whole work-shift for 3 consecutive days by personal monitoring. RESULTS: Time Weighted Average (TWA) values of ELF-MF in the whole group ranged from 0.01 to 3.48 microT; the geometric mean was 0.19 mT, and only 3 subjects exceeded 2 microT. According to the individual TWA exposure, subjects were divided into two groups: low exposed (< or = 0.2 microT) and highly exposed (> 0.2 microT). The mean values of SCE, HFC and SCE in HFC were compared between low and highly exposed: no significant differences were observed. The result was further tested by selection and comparison of workers exposed up to 0.1 microT vs. exposed > 0.4 microT only, i.e. excluding intermediate exposures: again no difference in genotoxicity indices was observed. Also multivariate analysis did not show any correlation between individual ELF-MF exposure and genotoxicity indices. CONCLUSIONS: The results of our study do not give any support to the hypothesis that occupational exposure to ELF-MF up to about 2 microT, i.e. at the levels currently found in most workplaces, can exert a genotoxic effect in workers.

[Levels of occupational exposure to extremely low frequency magnetic fields among workers in different jobs]. / Livelli di esposizione occupazionale a campi magnetici a frequenza estremamente bassa (ELF) in lavoratori addetti varie mansioni.

Using personal dosimeters, occupational exposure to ELF-MF was measured in 150 workers employed in 28 different occupations. The main results are presented. The overall arithmetical mean in the whole sample was 0.36 microT, the overall geometric mean 0.21 microT. A high variability among workers engaged in the same occupation, and among different days in the same worker, was observed. The results suggest a relatively low exposure to ELF-MF in the large part of workers. Nevertheless, the higher levels measured in some workers, and the high variability, show the need of adequate measurements of ELF-MF exposure in workers.