[Assessment of exposure to fluorine and health effects in the production of aluminum]. / Valutazione dell'esposizione a fluoro ed effetti sulla salute nella produzione di alluminio.

To check the current levels of exposure to fluorine and possible implications for health, 429 workers of a plant for aluminum production were involved in this study. The protocol included a medical examination with standardized questionnaire and dosage of urinary fluorine at the beginning and end of the shift. Workers with an urinary value greater than 5 mg F/L (66% of the limit SCOEL) were examined also by X-ray of the pelvis (AP); they were classified for the presence of fluorosis by a semiquantitative scale. Workers directly exposed showed a statistically significant difference compared to non/indirectly exposed ones (mean at the end of shift 3.11 vs 0.59/0.29 mg F/L respectively). No worker showed actual clinical signs or symptoms uniquely related to fluorosis. According to the adopted criteria it was found "possible fluorosis" or "initial fluorosis" in 4.81% of the workers (all with duration of exposure more than 20 years), no case of confirmed fluorosis.

[Occupational exposure to chemical carcinogens between estimates and reality: an Italian multicentric study in Lombardy]. / Esposizione professionale ad agenti chimici cancerogeni tra stima e realtà: studio multicentrico lombardo.

Exposure to carcinogenic chemicals at work is again debated owing to continuous technological developments. The observed decrease in cancer mortality in North America and in Western Europe after the 1980s can be attributed to several factors including a reduction of exposure to carcinogens at work. A multicentric study was conducted in Lombardy (PPTP-Study) in order to assess the actual presence and possible exposure to chemical carcinogens, with the aim of mapping the work areas at greatest risk at present. The results showed that an integrated use of databases to map the exposed workers may provide a useful starting point to set priorities for preventive action, but it must be underlined the need of a constant updating about the evolution of the technological innovations of enterprises.

[The ICOH International Code of Ethics for Occupational Health Professionals]. / Il codice etico dell'LCOH per gli operatori di Medicina del Lavoro.

In the paper all the steps are described which are followed by ICOH to finalize the International Code of Ethics for Occupational Health Professionals (OHP). The Code is composed by a "Preface" in which is explained why the Occupational Health Professionals need a specific Code different from other Codes built up for general practitioners or other specializations, followed by an "Introduction" where the targets of Occupational Health are underlined and which professionals contribute to achieve the defined target. These two parts are followed by a more substantial description of the tasks and duties of the OHP. In the last part of the Code it is illustrated how to carry out the above mentioned duties. The principles inserted in the ICOH Code of Ethics have been worldwide accepted by the OHP and particularly in Italy where they have been included in the Legislative Decree 81/08.

An integrated approach to biomonitoring exposure to styrene and styrene-(7,8)-oxide using a repeated measurements sampling design.

The aim of this work was to investigate urinary analytes and haemoglobin and albumin adducts as biomarkers of exposure to airborne styrene (Sty) and styrene-(7,8)-oxide (StyOX) and to evaluate the influence of smoking habit and genetic polymorphism of metabolic enzymes GSTM1 and GSTT1 on these biomarkers. We obtained three or four air and urine samples from each exposed worker (eight reinforced plastics workers and 13 varnish workers), one air and urine samples from 22 control workers (automobile mechanics) and one blood sample from all subjects. Median levels of exposure to Sty and StyOX, respectively, were 18.2 mg m(-3) and 133 microg m(-3) for reinforced plastics workers, 3.4 mg m(-3) and 12 microg m(-3) for varnish workers, and <0.3 mg m(-3) and <5 microg m(-3) for controls. Urinary levels of styrene, mandelic acid, phenylglyoxylic acid, phenylglycine (PHG), 4-vinylphenol (VP) and mercapturic acids (M1+M2), as well as cysteinyl adducts of serum albumin (but not those of haemoglobin) were significantly associated with exposure status (controls

Indicadores biológicos para la valoración de la exposición humana a compuestos químicos industriales : Mercurio

Traducción de la obra en inglés \"Biological indicators for the assessment of human exposure to industrial chemicals\" (EUR 10704 EN) publicada por la Oficina para las Publicaciones Oficiales de las Comunidades Europeas. Contiene: propiedades químicas y físicas del mercurio, efectos en los humanos, mutagesis, metabolismo, control biológico...

Urinary hydroxylated metabolites of polycyclic aromatic hydrocarbons as biomarkers of exposure in asphalt workers.

BACKGROUND: Fumes and vapours released during laying of hot asphalt mix have been recognised as a major source of exposure for asphalt workers. OBJECTIVES: We investigated the relationships between inhalation exposure to asphalt emissions and urinary biomarkers of polycyclic aromatic hydrocarbons (PAHs) in asphalt workers (AW, n=75) and in ground construction workers (CW, n=37). METHODS: Total polyaromatic compounds (PAC) and 15 priority PAHs in inhaled air were measured by personal sampling. Hydroxylated PAH metabolites (OH-PAHs) (2-naphthol, 2-hydroxyfluorene, 3-hydroxyphenanthrene, 1-hydroxypyrene, 6-hydroxychrysene and 3-hydroxybenzo[a]pyrene) were determined in urine spot samples collected in three different times during the work week. RESULTS: Median vapour-phase PAC (5.5 microg m(-3)), PAHs (

[Biological monitoring in the molding of plastics and rubbers]. / Monitoraggio biologico nello stampaggio di plastiche e gomme.

This survey was carried out in the molding of plastics and rubbers, in the "Professional Cancer Prevention Project" sponsored by the Lombardy region with the objective of developing and implementing protocols for evaluating exposure to carcinogens through the biological monitoring. The realities of molding the thermoplastic polymer ABS, rubber, and thermosetting plastics containing formaldehyde were examined. The carcinogenic substances identified in these processes were: 1,3-butadiene, acrylonitrile and styrene in molding ABS, polycyclic aromatic hydrocarbons (PAH) in molding rubber, and formaldehyde in molding the thermosetting plastics. Only for some of these substances biological indicators are available. The limited exposure to airborne chemicals in molding ABS and the intrinsic characteristics of biological indicators available for 1-3 butadiene have determined the non applicability of biological monitoring to this situation. The absence of a biological indicator of exposure to formaldehyde has made this situation not investigable. Exposure in the rubber molding was studied in 19 subjects applying the determination not metabolized PAH in urine. The levels of these indicators were similar to those measured in other groups of subjects without occupational exposure to PAH, confirming a low airborne contamination in this workplace.

[Exposure to polycyclic aromatic hydrocarbons (PAH) in rubber forming industry]. / Esposizione ad idrocarburi policiclici aromatici nello stampaggio della gomma.

Among various chemical agents present at the workplaces in the rubber industry, a particular attention was adressed to the Polycyclic Aromatic Hydrocarbons (PAH) contained in oil and carbon black, but some questions regarding level of exposure are also controversially discussed. The literature reports that PAH may have irritant effects; moreover some of these have been recognized as probably or possibly carcinogenic to human by the International Agency for Research on Cancer, the European Union, and other institutions. In Lombardy, a study aimed to evaluate the occupational exposure in Benzo[b]fluorantene the rubber forming industry was planned during last two years. The results of environmental air monitoring (the 16 most relevant, according to the American Environmental Protection Agency, EPA) and biological monitoring (urinary 1-hydroxypyrene excretion) show that PAH exposure in these workers is not higher than that observed in other study regarding low level and acceptable exposure.

[Rubber industry and exposure to carcinogenic chemical agents: an Italian Multicentric Study in Lombardy]. / Stampaggio della gomma ed agenti chimici cancerogeni: l'esperienza dello Studio PPTP-Gomma.

Evaluating the chemical risks at the workplaces, the potential carcinogenic risk is a primary interest. Particularly, in the rubber forming industry the main attention was directed to the hot processing as a possible source of exposure to chemical agents, several of which were classified as carcinogens by the International Agency for Research on Cancer (IARC) and/or the European Union (EU). A study on occupational exposure to chemical carcinogens in the rubber forming industry was planned during last two years, involving a representative sample of firms. In the first step the occupational exposure and the use of preventive measures were evaluated by an investigation at workplace supported with standardized questionnaires. The presence of above 100 chemical agents was registered; 15 agents were classified to carcinogenic or probably carcinogenic to human. The evaluation of exposure by air sampling and monitoring of most substances of interest (acrylonitrile, 1,3-butadiene, styrene, Polycyclic Aromatic Hydrocarbons), demonstrated a low level of occupational exposure, the common hygienic prevention measure being applied.

[Plastic industry and exposure to carcinogenic chemical agents: an Italian Multicentric Study in Lombardy]. / Stampaggio della plastica ed agenti chimici cancerogeni: l'esperienza dello studio PPTP-Plastica.

The potential carcinogenic risk at the workplaces is a primary interest of occupational health, but some questions are also controversially discussed. Particularly, in the plastic forming industry a great attention was directed to the hot processing and their possible exposure to monomers, some of which were classified as carcinogen by the International Agency for Research on Cancer (IARC) and/or the European Union (EU). In Lombardy, a study on occupational exposure to chemical carcinogens in the plastic forming industry was planned during last years. The aim was to recognize and promote preventive technical and medical solutions, basing on efficacy. By an investigation at workplace supported with standardized questionnaires, the presence of chemical carcinogens was registered in 59% of a representative sample of firms; but an effective possibility of exposure was found only for 34% of cases. The evaluation of exposure to monomers by air monitoring (acrylonitrile, 1,3-butadiene, styrene, formaldehyde), involving a representative sample of factory with ABS and formaldehydic resins processing, showed low level exposure, because the common hygienic prevention measures were applied; some particular occupation shoved greater exposure to formaldehyde.

[Nanoparticles and health effects: an evidence based approach]. / Nanoparticelle ed effetti sulla salute: approccio basato sull'evidenza.

The possibility of health effects related to nanoparticles (less than 100 nanometers diameter) exposure may be considered as an emerging problem. Current approaches are usually partial and do not consider the multidisciplinary available data. The purpose of this work is to define the problem using an evidence-based approach: we characterized the possible nanoparticles-human interactions by collection of all pertinent scientific data available in the literature and by their critical evaluation. The distinction between non-intentional nanoparticles ("ultrafine particles", UFP) and intentional nanoparticles ("intentionally produced nanomaterials" or simply "nanomaterials", IPN) is a critical item. Each single type of nanoparticle is more relevant than isolated metric characteristics. Globally, the experimental studies suggest a possible inflammatory acute effect. The available data regard mainly the UFP. Regarding IPN, the studies about attaints on human health are actually few and limited: no cardiovascular. respiratory and coagulation effect were showed as consistent with exposure. No human study about IPN chronic effect is available, and any human data is not showed relating carcinogenic and sensitizing effects.

Indicadores biológicos para la valoración de la exposición humana a compuestos químicos industriales : Arsénico

Traducción de la obra en inglés \"Biological indicators for the assessment of human exposure to industrial chemicals\" (EUR 11135 EN) publicada por la Oficina para las Publicaciones Oficiales de las Comunidades Europeas. Contiene: propiedades químicas y físicas del arsénico, exposición humana a arsénico, metabolismo, efectos en los humanos, indicadores biológicos, indicadores de efectos...

[Assessment of exposure to organic aromatic compounds and PAH in asphalt industry: the PPTP-POPA Study results]. / Valutazione dell'esposizione a composti organici aromatici e IPA nelle opere di asfaltatura: i risultati dello Studio PPTP-POPA.

Asphalt is a mixture of mineral matter and bitumen, its fumes contain about 1% of Polycyclic Aromatic Hydrocarbons (PAH), some of which are carcinogens. In the PPTP-POPA Study of Lombardy Region, a group of 100 asphalt workers (exposed to bitumen fumes and diesel exhausts) and a group of 47 ground construction operators (exposed only to diesel exhausts) were investigated to assess PAH exposure in Italy, by means of environmental-air monitoring (the 16 most relevant, according to the American Environmental Protection Agency, EPA) and biological monitoring (urinary 1-hydroxypyrene excretion). Our results show that PAH exposure in these workers is not higher than that observed in traffic policemen working in urban areas. Since dermal exposure has been suggested as a major determinant of the total PAH dose absorbed by road pavers from bitumen fumes, we assessed skin contamination by organic aromatic compounds and by sixteen PAH: in both groups, six pads were applied to each subject in different parts of the body, during the workshift. The results show that the dermal contamination in road pavers is higher than in ground construction operators and that cutaneous dose rate is higher than respiratory dose rate, whereas the amount of absorption the ratio is inverted.

[Urinary MTBE as biological marker of exposure to traffic exhaust fumes]. / Valutazione di MTBE urinario come indicatore biologico di esposizione a traffico autoveicolare.

Methyl tert-butyl ether (MTBE) is an oxygenated compound added to Italian fuel in quantity of about 3% v/v. In the present study the excretion of urinary MTBE (U-MTBE) was evaluated as biomarker of exposure to traffic exhaust fumes. With this aim 127 Milan urban policemen, working as traffic wardens, were investigated. Spot urine samples were obtained prior to and at the end of the work shift, in different seasons. Median U-MTBE varied from 74 to 164 ng/L (range 60-657 ng/L). Comparing the pre-shift and end-shift samples an increase of about 14% in the U-MTBE level during the workshift was observed. An influence of the different seasons was observed, with lower values in spring and higher values in winter. Smoking did not affect the excretion of U-MTBE. The results of this study suggest that U-MTBE is a sensitive and specific marker for the assessment of exposure to traffic exhaust fumes.

[Questionnaire for the mobbing risk: CDL2.0]. / Uno strumento per la valutazione del rischio mobbing: CDL2.0.

The aim of the study is to develop and validate a questionnaire able to evaluate the risk of mobbing at the workplace. A multiple-choice questionnaire has been developed which contains, among the different items, only one revealing a mobbing situation. The questionnaire has been administered to two groups (group A--243 subjects in a mobbing situation and group B--63 subjects without exposure to mobbing) and the differences in the scores obtained have been analysed. The questionnaire has proved to be valid and reliable. The results show that the presence of five mobbing actions is sufficient to define the workplace situation as potentially at risk for mobbing. The study reveals some limits in the selection of the two samples thus needing some adjustment. However, the questionnaire, also in the present form, can be considered a tool able to detect the mobbing situations.

[New biomarkers of exposure]. / Nuovi indicatori di esposizione.

In this paper we have defined the new biomarkers of exposure (NBE) as those biomarkers discovered in the last five years and, among previously validated biomarkers, also those applied in different ranges of doses or those determined in biological matrices which differ from matrices originally considered. We examined the results from the surveys carried out by the main Italian research units involved in biological monitoring, i.e. those from the Universities of Brescia, Milan, Naples, Padua, Parma, Pavia, Turin and Verona. The data were collected using a standardized model and included the following: type of element or organic compound, type of biomarker, analytical technique and method, their relationship with environmental monitoring data, their relationship with effect indicators or effects in general, improvement with respect to old biomarkers, reference values. Twenty two NBEs were identified: 14 elements and chemical compounds as such or as metabolites, 4 examples of mixtures, 3 of new matrices, one of speciation. Among the others, aspects such as interest in requiring NBE, quality assurance, availability, cost-benefit ratio were discussed. We conclude that development of this specific field of research appears to be a crucial point for future improvement in risk assessment and health surveillance procedures.

Biological monitoring in occupational exposure to low levels of 1,3-butadiene.

Exposure to 1,3-butadiene (BD), a probable carcinogen to humans, was investigated in two groups of subjects working in a petrochemical plant where BD is produced and used to prepare polymers: 42 occupationally exposed workers and 43 internal non-occupationally exposed controls. BD personal exposure was very low but significantly different in the two groups (median airborne BD 1.5 and 0.4 microg/m(3) in exposed and controls, respectively). Similarly, BD in blood and urine, but not in exhaled air, was higher in the exposed workers than in controls (blood BD 3.7 ng/l versus <1.8 ng/l, urinary BD 2.4 ng/l versus <1.0 ng/l). These three biomarkers correlated significantly with personal exposure ( 0.283 < or = Pearson's r < or = 0.383) and between them (0.780 < or = r < or = 0.896). Excretion of urinary mercapturic acids N-acetyl-S-(3,4-hydroxybutyl)-l-cysteine (MI), N-acetyl-S-(1-hydroxymethyl-2-propenyl)-l-cysteine and N-acetyl-S-(2-hydroxy-3-butenyl)-l-cysteine (MII), chromosomal aberrations (CA), and sister chromatid exchanges (SCE) in peripheral blood lymphocytes were not influenced by occupational exposure. Our results show that unmetabolised BD in biological fluids, and particularly urinary BD, represents the biomarker of choice for assessing occupational exposure to low airborne concentrations of BD.

[The precautionary principle: is it applicable to occupational medicine?]. / Il principio di precauzione: è applicabile in medicina del lavoro?

Precautionary Principle (PP) and its application to environmental and health policy appear in the 70's and from that time is introduced more and more frequently in different international treaties and conferences on environment and health. PP is a risk management policy applied to scientifically uncertain circumstances where it is necessary to act against a potentially harmful risk factor without waiting for more accurate information. When this situation takes place at the workplace, the risk management is an Employer's task. The employer can use different instruments, including the occupational physician's advise, to reach their target. After identification of possible health and safety risk factors and after characterisation of a non-admissible risk for worker's health, the Employer must chose which precautionary actions to take, also in function of economic, technical and judicial needs and restrictions. This action can be the application of measures of "prudent avoidance" through steps such as health surveillance, until more radical measures are taken by using P.P. The Occupational health specialist that is already operating of the work place with characterised and well known risk factors should introduce the instruments, in the health surveillance activities, that may detect possibly adverse effects related to risk factors characterised by scientific uncertainty. This is very important whenever the employers don't have the possibilities or are not sensitive enough to take other kinds of precautionary measures. Moreover, the occupational physician should play an active role also in the risk assessment phase by defining those chemicals or physical agents still characterized by scientific uncertainty.