[Shoe factory workers, solvents and health]. / Attività calzaturiera, solventi ed effetti sulla salute.

Exposure to organic solvents in footwear manufacturing industry came from the glues used adhering the shoe parts to each other. Benzene was the first solvent used in shoe factories until the evidence of its capacity to cause leukaemia. Then, the demonstration that exposure to n-hexane was related to distal polyneuropathy limited the use of this substance. After that, results of neurotoxicological studies conducted on workers exposed to different mixtures of organic solvents make necessary prevention measure directed to a progressive reduction of air dispersion of these chemicals. Today exposure to solvents in workplaces is regulated by health based exposure limit values that should warranty absence of central nervous system effects. One of the most important rules of occupational medicine is verify that these exposure levels are really health protective also for workers with increased susceptibility.

Dermal exposure to polycyclic aromatic hydrocarbons in asphalt workers.

OBJECTIVES: To assess dermal exposure to 16 polycyclic aromatic hydrocarbons (PAHs) in asphalt workers by applying polypropylene pads to six body sites (neck, shoulder, upper arm, wrist, groin, ankle), to identify the compounds and exposure sites most representative, and to integrate dermal exposure results with environmental and biological data. METHODS: Twenty-four asphalt workers were recruited. Dermal exposure was assessed during a single work shift. Sixteen PAHs (from naphthalene to indeno[1,2,3-cd]pyrene) were quantified via gas chromatography-mass spectrometry. Airborne exposure, urinary PAHs and monohydroxy metabolites were also investigated. RESULTS: Phenanthrene (PHE), present in all samples, was the most abundant compound (median 0.805-1.825 ng/cm(2)). Benzo[a]pyrene (BaP) was present in 75% of the samples (0.046-0.101 ng/cm(2)). Wrist had the highest contamination, with median PHE, pyrene (PYR), and BaP concentrations of 1.825, 0.527, and 0.063 ng/cm(2). PHE and PYR on wrist correlated with almost all 3- to 4-ring PAHs (0.405< or =r< or =0.856), but not with BaP; BaP correlated with almost all 4- to 6- ring PAHs (0.584< or =r< or =0.633). Significant correlations were observed between PHE level, airborne exposure, and the corresponding urinary PHE and monohydroxy metabolites. For PYR, significant correlations existed only between urinary PYR and monohydroxy metabolites. Multiple linear regression analysis revealed that 42% of the end-of-shift monohydroxy metabolites were the result of airborne exposure, dermal exposure, and baseline levels of biomarkers. CONCLUSIONS: Dermal exposure to PAHs was in the low ng/cm(2) range. PHE or PYR and BaP were the most representative compounds and the wrist was the best location to perform dermal exposure assessments. Both dermal and airborne exposure contributed to the total body burden of PAHs, though the relative contribution was analyte-dependent.

Influence of some detoxification enzyme polymorphisms on cytogenetic biomarkers between individuals exposed to very low doses of 1,3-butadiene.

OBJECTIVE: To evaluate the variation of some biomarkers related to the level of enzymatic activity dependent on the different polymorphisms. METHODS: We studied 27 butadiene-exposed workers and 37 controls using different biomarkers of the genotoxic effect. The genotypes were determined using polymerase chain reaction and restriction fragment length polymorphism-polymerase chain reaction techniques; the subjects were assigned to a specific group based on the microsomal epoxide hydrolase (mEH) activity predicted by their genotype (low, intermediate, high). RESULTS: The studied biomarkers were not able to discriminate between exposed and control individuals, but sister chromatid exchange (SCE) and high frequency cells were influenced by smoking habits. Smokers having fast microsomal epoxide hydrolase activity showed higher SCE frequency (7.61) respect to those presenting intermediate (5.86) or slow (6.65) enzymatic activity. CONCLUSIONS: On the basis of these results, can we suppose the existence of an "intermediate genotype" advantage (at least for induction of SCE)?

Application of ultraviolet spectrophotometry to estimate occupational exposure to airborne polyaromatic compounds in asphalt pavers.

An ultraviolet (UV) spectrophotometric procedure was devised for the determination of polycyclic aromatic compound-oriented organic soluble matter in vapors and particulate collected from emissions of hot asphalt mix. Ultrasonic extraction was carried out with acetonitrile, followed by UV measurements at 254 nm. Polycyclic aromatic compounds (PACs) in volatile and particulate fraction were quantified as phenanthrene or benzo[k]fluoranthene equivalents. A comparison between UV and high-pressure liquid chromatography with fluorescence detection showed that PACs were one to three orders of magnitude higher than the sum of 15 priority polycyclic aromatic hydrocarbons (PAHs); still, significant correlations were found between volatile or particulate PACs and, respectively, total volatile or particulate PAHs. Moreover, in the particulate phase, PACs correlated with total particulate matter quantified by gravimetry. The proposed procedure was employed in a field study for monitoring personal exposure to asphalt emissions of workers engaged in road construction. Observed levels of acetonitrile-soluble PACs in air samples were very low (2-20 microg/m3); however, asphalt pavers were exposed to significantly higher concentrations of volatile PACs than construction workers (geometric mean, 5.9 microg/m3 vs. 4.1 microg/m3). This method for estimating the global content of volatile or particulate PACs in air samples satisfies our requirements of simplicity and is suitable for conducting an initial screening to assess exposure to airborne polyaromatic organics in asphalt pavers.

Determination of low level methyl tert-butyl ether, ethyl tert-butyl ether and methyl tert-amyl ether in human urine by HS-SPME gas chromatography/mass spectrometry.

Methyl tert-butyl ether (MTBE), ethyl tert-butyl ether (ETBE) and tert-amyl methyl ether (TAME) are oxygenated compounds added to gasoline to enhance octane rating and to improve combustion. They may be found as pollutants of living and working environments. In this work a robotized method for the quantification of low level MTBE, ETBE and TAME in human urine was developed and validated. The analytes were sampled in the headspace of urine by SPME in the presence of MTBE-d12 as internal standard. Different fibers were compared for their linearity and extraction efficiency: carboxen/polydimethylsiloxane, polydimethylsiloxane/divinylbenzene, and polydimethylsiloxane. The first, although highly efficient, was discarded due to deviation of linearity for competitive displacement, and the polydimethylsiloxane/divinylbenzene fiber was chosen instead. The analysis was performed by GC/MS operating in the electron impact mode. The method is very specific, with range of linearity 30-4600 ng L(-1), within- and between-run precision, as coefficient of variation, <22 and <16%, accuracy within 20% the theoretical level, and limit of detection of 6 ng L(-1) for all the analytes. The influence of the matrix on the quantification of these ethers was evaluated analysing the specimens of seven traffic policemen exposed to autovehicular emissions: using the calibration curve and the method of standard additions comparable levels of MTBE (68-528 ng L(-1)), ETBE (<6 ng L(-1)), and TAME (<6 ng L(-1)) were obtained.

Comparison between urinary o-cresol and toluene as biomarkers of toluene exposure.

The characteristics of urinary o-cresol (o-C) and urinary toluene (TOL-U) as biomarkers of occupational exposure to toluene were comparatively evaluated. One hundred healthy male rotogravure printing workers and 161 male and female control subjects were studied. Personal exposure to airborne toluene (TOL-A) during the shift was determined as a time-weighted average. Simple analytical procedures based on solid phase microextraction followed by gas chromatography/mass spectometry analysis were applied to the determination of end-shift o-C and TOL-U. Median TOL-A was 48 (6.0-162.0) mg/m3 in printers and 0.021 (<0.003-0.137) mg/m3 in controls. o-C was 0.185 (0.032-0.948) mg/g creatinine in printers and 0.027 (<0.006-0.330) mg/g creatinine in the controls. TOL-U was 7.6 (1.8-23.9) microg/L in printers and 0.140 (0.094-0.593) microg/L in the controls. According to all indices, exposure to toluene was higher in printers than in the controls. Nevertheless, the distribution of o-C in the two groups partially overlapped, whereas such behavior was not found in TOL-U. Both o-C and TOL-U in printers were correlated with TOL-A (Pearson's on log10-transformed variables r = 0.704 and 0.844, respectively) and with each other (r = 0.683). Smoking habits significantly increased the excretion of o-C but not of TOL-U. From the point of view of sampling conditions and analytical requirements, TOL-U and o-C showed similar properties, but comparison of their intrinsic characteristics showed that TOL-U had higher specificity and sensitivity, lower background values, was better correlated with airborne exposure, and was not influenced by cigarette smoking. Therefore TOL-U may be considered superior to o-C as a biomarker of occupational exposure to toluene.

Evaluation of exposure to PAHs in asphalt workers by environmental and biological monitoring.

In the present article we assessed exposure to polycyclic aromatic hydrocarbons (PAHs) in Italian asphalt workers (AW, n = 100), exposed to bitumen fumes and diesel exhausts, and in roadside construction workers (CW, n = 47), exposed to diesel exhausts, by means of environmental and biological monitoring. 1-hydroxypyrene (OH-Py) was determined in urine spot samples collected, respectively, after 2 days of vacation (baseline), before, and at the end of the monitored work shift, in the second part of the workweek. Median airborne levels during the work shift of 15 PAHs (both vapor and particulate phases), from naphthalene (NAP) to indeno(1,2,3-cd)pyrene, ranged from below 0.03 to 426 ng/m(3). Median excretion values of OH-Py in baseline, before- and end-shift samples were 228, 402, and 690 ng/L for AW and 260, 304, and 378 ng/L for CW. Lower values were found in nonsmokers compared to smokers (e.g., in AW 565 and 781 versus 252 and 506 ng/L in before-shift and end-shift samples, respectively). In all subjects a weak correlation between personal exposure to the sum of airborne 15 PAHs and OH-Py was observed (r = 0.30). The results of this article show that AW experienced a moderate occupational exposure to airborne PAHs, resulting in a significant increase of urinary OH-Py during the workday and the workweek. The contribution of working activities to internal dose was in the same order of magnitude of the contribution of cigarette smoking.

Toxicological comments to the discussion about REACH.

It is the ultimate goal of the intended REACH process (Registration, Evaluation and Authorization of Chemicals) of the European Union to identify substances of hazardous properties and to evaluate the risks of human and environmental exposure. During the last few months there has been a controversial discussion as to what extent in vitro studies and consideration of structure activity relationship provide sufficient information to waive repeated exposure studies. Industry as well as certain regulatory agencies or NGOs support this approach and propose that repeated dose studies may only be required beyond 100 t/a. From a toxicological point of view it has to be stressed that this discussion primarily considers the cost reduction and protection of animals, whereas protection of human health and the environment are secondary. In vitro studies only allow identification of specific hazardous properties which can be detected by the specific test system. Moreover, appropriate information on the dose response of adverse effects, identification of thresholds and NOELs that are essential for risk characterization cannot be obtained from these studies. Consequently, identification of all relevant hazardous properties and endpoints of adverse effects can only be determined in the intact animal by repeated dose studies such as 28-day or 90-day studies. In the absence of such information the hazard identification is incomplete and there is no basis for appropriate risk assessment of human exposure. Thus, any waiving of repeated dose studies in animals bears the probability of unforeseen effects in case of acute or continuous human exposure. From this the undersigning European Toxicologists conclude: 1. The intention of REACH is to identify hazardous properties in order that a reliable risk assessment can be made and measures taken to deal with chemicals posing a significant risk. 2. The recent debate has centered on ways in which the well established in vivo methods for risk assessment can be bypassed. 3. The evidence that the available alternatives would support such replacement is weak. Progress to improve their value for risk assessment purposes is bound to be slow because the issues are very complex. As a group of European Toxicologists we strongly support the need for more research support in these areas, but we believe that over claims for progress is damaging their development. 4. Under the circumstances only two options are available: to reduce very substantially the estimation of hazard and risk with inevitable adverse consequences for human health and environmental protection, or to continue the existing methods until properly validated new methods are available.

Biological monitoring of exposure to polycyclic aromatic hydrocarbons by determination of unmetabolized compounds in urine.

In this paper we evaluated the possibility to assess occupational exposure to polycyclic aromatic hydrocarbons (PAHs) measuring unmetabolized PAHs in urine. With this aim, 24 road paving (RP) workers, exposed to bitumen fumes, and 6 road construction workers (CW), exposed to diesel exhausts, were investigated. Median personal exposure to low boiling PAHs (from naphthalene to pyrene) during the work shift ranged from 0.5 to 369 ng/m(3), with naphthalene as the most abundant compound. Three urine samples were collected for each worker: baseline (after 2 days of vacation), before- and end-shift samples (in the second part of the work week). The following urinary compounds were measured by headspace-solid phase microextraction GC/MS: naphthalene (U-NAP), acenaphthylene (U-ACY), acenaphthene (U-ACE), fluorene (U-FLE), phenanthrene (U-PHE), anthracene (U-ANT), fluoranthene (U-FLU), pyrene (U-PYR). Urinary PAHs were detected in almost all samples. Median levels for U-NAP, U-PHE, U-PYR and U-FLE in end-shift samples were 82, 48, 54 and 21 ng/L in RP and 69, 14, 24 and 15 ng/L in CW, respectively. Significant differences in the levels of U-PHE, U-FLU and U-PYR were found between RP and CW (p<0.05). Moreover in RP samples the urinary excretion of most analytes increased during the work shift (p<0.05). These results suggest that urinary PAHs may be useful biomarkers of occupational exposure.

Lack of genotoxic effect in workers exposed to very low doses of 1,3-butadiene.

1,3-Butadiene (BD), a probable carcinogen to humans, has been shown to have an ill-defined genotoxicity in occupationally exposed workers. In the present study, the influence of exposure to very low doses of BD and to cigarette smoking was investigated on some cytogenetic endpoints, namely, sister chromatid exchanges (SCE), chromosomal aberrations (CA) and cells with a high frequency of SCE (HFC), in peripheral blood lymphocytes. Twenty-seven male workers employed in a petrochemical plant and 26 matched controls were included in the study. As regards the airborne BD values, there was a significant difference between exposed (median BD value 1.5, min-max 0.2-69.0 microg/m3) and non-exposed workers (median BD value 0.4, min-max <0.1-3.8 microg/m3). Genotoxic biomarkers were not able to distinguish between the two groups. The frequency of SCE was higher in smokers than in non-smokers (p=0.001), with a positive correlation between the number of cigarettes smoked per day and both SCE (r=0.4; p=0.004) and HFC frequency (r=0.3; p=0.04). Multiple regression analysis confirmed the influence of cigarette smoking on the level of SCE and HFC, while these parameters were not affected by personal exposure to BD. Overall, the biomarkers of genotoxic effect investigated in our study were not able to discriminate between workers with a very low exposure to BD and controls, while it was possible to distinguish between smokers and non-smokers on the basis of SCE.

Monitoring low benzene exposure: comparative evaluation of urinary biomarkers, influence of cigarette smoking, and genetic polymorphisms.

Benzene is a human carcinogen and an ubiquitous environmental pollutant. Identification of specific and sensitive biological markers is critical for the definition of exposure to low benzene level and the evaluation of the health risk posed by this exposure. This investigation compared urinary trans,trans-muconic acid (t,t-MA), S-phenylmercapturic acid, and benzene (U-benzene) as biomarkers to assess benzene exposure and evaluated the influence of smoking and the genetic polymorphisms CYP2E1 (RsaI and DraI) and NADPH quinone oxidoreductase-1 on these indices. Gas station attendants, urban policemen, bus drivers, and two groups of controls were studied (415 subjects). Median benzene exposure was 61, 22, 21, 9 and 6 microg/m(3), respectively, with higher levels in workers than in controls. U-benzene, but not t,t-MA and S-phenylmercapturic acid, showed an exposure-related increase. All the biomarkers were strongly influenced by cigarette smoking, with values up to 8-fold higher in smokers compared with nonsmokers. Significant correlations of the biomarkers with each other and with urinary cotinine were found. A possible influence of genetic polymorphism of CYP2E1 (RsaI and/or DraI) on t,t-MA and U-benzene in subjects with a variant allele was found. Multiple linear regression analysis correlated the urinary markers with exposure, smoking status, and CYP2E1 (RsaI; R(2) up to 0.55 for U-benzene). In conclusion, in the range of investigated benzene levels (<478 micro/m(3) or <0.15 ppm), smoking may be regarded as the major source of benzene intake; among the study indices, U-benzene is the marker of choice for biomonitoring low-level occupational and environmental benzene exposure.

The first century of the "clinica del lavoro" in Milan.

The Clinica del Lavoro was created in Milan at the beginning of the 20th century by Luigi Devotto, who deemed it essential for physicians and health researchers to get involved in the life and health problems of working populations. The main roles of the Clinica del Lavoro were to educate medical students and train physicians; study actual workplaces, examine health and safety hazards and their noxious effects; and create initiatives and services to protect and promote workers' health. Important scientific contributions were made in several fields, including chemical carcinogenesis, effects of mineral and biologicalfibers, mechanism of action of silica dust, methods for the detection and measurements of toxic substances in both the work environment and workers' biological media.

Determination of urinary ortho- and meta-cresol in humans by headspace SPME gas chromatography/mass spectrometry.

ortho-Cresol (o-C) and meta-cresol (m-C) are minor urinary metabolites of toluene, a widely used chemical with neurotoxicological properties. A new assay for their determination in human urine is here proposed. Urinary cresol sulphates and glucuronates are submitted to acid hydrolysis, urine is neutralized, added with o-cresols-d8, and analytes are sampled in the headspace of urine by SPME using a polydimethylsiloxane fiber. Analysis is performed by GC/MS using, for separation, either a SupelcoWax10 (for o-C) or a chiral CP Cresol (for o-C and m-C) column. The method is very specific, with a range of linearity 0-5.0 mg/l, within- and between-run precision, as coefficient of variation, <15% and <19%, limit of detection of 0.006 mg/l for o-C and 0.007 mg/l for m-C. The procedure is applied to the quantification of cresols in urine from workers exposed to toluene and from subjects belonging to the general population.

Application of gas chromatography-mass spectrometry for the determination of urinary ethylenethiourea in humans.

Ethylenethiourea (ETU) is a major metabolite of ethylenebisdithiocarbamate pesticides: a sensitive and specific assay for its determination in human urine is proposed below. ETU is extracted on a diatomaceous earth column using dichloromethane and derivatized with the mixture of N-(tert-butyldimethylsilyl)-N-methyltrifluoroacetamide and tert-butyldimethyilsilyl chloride. The derivative is analyzed using GC/MS in the EI/SIM mode. The whole procedure is carried out in the presence of ethylenethiourea-d(4) as internal standard. The analytical features of the method are: high specificity, >90% recovery, range of linearity 0-200 microg/L, within- and between-run precision as coefficient of variation, <17 and <20%, respectively, limit of quantification 2 microg/L. In specimens stored in the dark at -20 degrees C ETU is stable for at least 6 months. The procedure was successfully applied to the biological monitoring of vineyard workers exposed to EBDTC and of a matched group of subjects from the general population.