End users "Feedback" to improve ergonomic design of machinery.

This paper describes the Feedback method designed to collect the contribution of users for the reconstruction and comprehension of the actual work and real activity for the improvement of the technical standards, design, manufacturing and use of machinery. The Feedback method has since now been applied successfully - in collaboration with public authorities, market surveillance bodies, social partners organization and technical institutes - to five different types of machines: woodworking machinery, forklift trucks, angle grinder and combine harvester. After ten years of experimentation in seven European countries Feedback has proved to be trans-nationally comparable and has attracted the interest of as much as 250 expert users - mostly workers, but also employers and technicians - who have shared their knowledge and experience by taking part in almost 30 working groups. The information collected with the Feedback method can be used by: -CEN and ISO standardization committees and working groups to become aware of the problems relating to the real use of specific machines in different work contexts, and thus to be able to draw up new or to revise existing standards accordingly; - Designers and manufacturers to produce better, more comfortable and safer machines and to provide precise instructions for use; - Employers, users and workers for training purposes and for defining appropriate work procedures; - Inspection bodies to enhance their knowledge and improve the efficiency of their interventions and advice.

A shelf procedure at a follow-up of 75 years.

Developmental dysplasia of the hip predisposes to premature degenerative hip disease. A number of operations have been described to improve acetabular cover and have achieved varying degrees of success. We present the case of an 84-year-old woman, who underwent a shelf procedure to reconstruct a dysplastic hip 75 years ago. To date, the shelf remains intact and the hip is asymptomatic. We believe this represents the longest documented outcome of any procedure to stabilise the hip.

[The risk of lead and health conditions of exposed workers in the Siena region]. / Il rischio da piombo e le condizioni di salute dei lavoratori esposti nel territorio senese.

A number of studies on the health of occupational exposure to lead of workers from various industrial sectors are summarized. These studies document the disappearance of severe cases of saturnism, as seen in the past, and the occurrence nowadays, mainly of sub-clinical manifestations, such as alterations of blood levels of lead and protoporphyrin IX, in the large majority of cases. For the period 1984-95, a statistical analysis of the results obtained for these parameters is reported, together with other clinical data, for seven industrial sectors: crystal, ceramics, chemistry, metallurgy and mechanics, iron and steel, printing and painting. These results show a drop of the mean concentrations of blood lead levels in all sectors but the ceramic industry, especially since 1991, when the law, Decreto Legislativo 277/91--in accomplishment of European directives on protection of workers, including the directive 82/605/EEC--has been put into force.

Biological monitoring of exposure to chlorpyrifos-methyl by assay of urinary alkylphosphates and 3,5,6-trichloro-2-pyridinol.

The results of biological monitoring by assay of urinary 3,5,6-trichloro-2-pyridinol and alkylphosphates (DMP, DMTP) in groups of 9 and 2 workers exposed to chlorpyrifos-methyl during vine spraying and manual leaf thinning 5-11 d after spraying, respectively, are reported. The results are compared with those of a control group of 46 subjects not occupationally exposed to organophosphate insecticides. Significantly higher urinary excretion of metabolites (Mann-Whitney U-test) was found in both groups than in controls. Levels of 3,5,6-trichloro-2-pyridinol (mean +/- SD) were 15.9 + 10.6 nmol/g creatinine (n = 33) for controls, 92.4 + 162.5 nmol/g creatinine (n = 20) for manual workers, and 675.5 + 1110.8 nmol/g creatinine (n = 48) for workers spraying and mixing the insecticide. Levels of DMP (mean +/- SD) were 63.8 + 100.1 nmol/g creatinine (n = 42), 123.0 + 79.0 nmol/g creatinine (n = 20), and 577.2 + 1003.2 nmol/g creatinine (n = 61), respectively, for the same 3 groups. Levels of DMTP (mean +/- SD) were 153.4 + 164.4 nmol/g creatinine (n = 43), 489.3 + 288.3 nmol/g creatinine (n = 20), and 297.6 + 215.4 nmol/g creatinine (n = 61), respectively, for the same 3 groups. Good correlations were found between urinary excretion of 3,5,6-trichloro-2-pyridinol and DMP (r = .776 for manual workers; r = .775 for workers mixing and spraying the insecticide) or DMTP (r = .558 and r = .746, respectively for the same 2 groups). The peak of excretion of the three metabolites was found in urine samples collected the night after the spraying or leaf thinning operations.

Solubilization of lead from crystal dust in protein solution (pseudointerstitial fluid) and gastric juice.

Since several workers engaged in polishing and engraving crystal articles were found to have higher than average blood levels of lead (560 micrograms/liter, range 80-560 micrograms/liter), we investigated the hypothesis that crystal dust releases lead in the human body. To test the hypothesis, two types of crystal polishing dusts, having different lead contents, were mixed with human serum diluted 1:3 (pseudointerstitial fluid), gastric juice, and phosphate buffer at pH 9. After 14 days of contact, the diluted serum had extracted 0.620% of the lead in the crystal dust (particle size < 20 microns) containing 25.2% lead and 0.425% of that containing 19.9% lead. After 48 hr in gastric juice, 0.235 and 0.556% of the lead was extracted from crystal dusts (unsieved crystal dusts) containing 25.2 and 19.9% lead, respectively. After 28 days in alkaline solution, 0.358 and 0.304% of the lead was extracted respectively from the same two crystal dusts (unsieved crystal dusts).

Mortality among pyrite miners with low-level exposure to radon daughters.

Mortality among pyrite miners with low-level exposure to radon daughters. Scand J Work Environ Health 14 (1988) 280-285. A cohort mortality study was conducted with regard to a pyrite mine located in central Italy. Exposure to radon ranged from 0.12 to 0.36 working levels (WL) in the work areas; most measurements were around 0.2 WL. The concentration of free silica in the dust was less than 2%. The cohort was determined from company files and included 1,899 subjects. Mortality was studied for the years 1965-1983. The loss to follow-up was less than 2%. The standardized mortality ratio for all causes and all neoplasms was 97 and 107, respectively. That for lung cancer and for nonmalignant respiratory diseases was 131 (95% confidence interval 97-175) and 173 (95% confidence interval 135-231), respectively. It was estimated that the extra cases of lung cancer attributable to radon daughters numbered 13 per 10(6) person-years and working level month in the whole cohort and 21.3 per 10(6) person-years in the subcohort with 10-25 years of exposure.

Prevalence of vibration-induced white finger and assessment of vibration exposure among travertine workers in Italy.

Among 76 stonedrillers and stonecutters/chippers working in the Rapolano travertine quarries (Tuscany, Italy), 27 subjects (35.5%) were affected with vibration-induced white finger (VWF). The median latent period for VWF was ten years (range 0.1-26 years). A VWF prevalence of 8% was found among 60 comparable controls (P less than 0.0001). Vibration measurements showed that the frequency-weighted accelerations for two rock-drills and two small chipping hammers ranged from 19.7 to 36.4 m/s2. Weighted accelerations between 2.4 and 4.1 m/s2 were measured on the handles of a vertical grinder and a hand cutter. Vibration data, daily exposure time and total duration of exposure period were used to calculate two indicators of vibration dose such as the four-hour, energy-equivalent, frequency-weighted acceleration (m/s2) and the vibration exposure level (dB). A significant association between the vibration exposure level and the severity of VWF stages was observed among the travertine operators. The dose-effect relationship proposed by ISO 5349 was not suitable for the data of the present study because it overestimates the risk due to hand-transmitted vibration in the travertine workers. Finally, the results of a cold test indicated that the rewarming time of fingertips to room temperature was more prolonged in the operators with VWF than in those without VWF and in the controls.