Indoor exposure to particles emitted by biomass-burning heating systems and evaluation of dose and lung cancer risk received by population.

Homes represent a critical microenvironment in terms of air quality due to the proximity to main particle sources and the lack of proper ventilation systems. Biomass-fed heating systems are still extensively used worldwide, then likely emitting a significant amount of particles in indoor environments. Nonetheless, research on biomass emissions are limited to their effects on outdoor air quality then not properly investigating the emission in indoor environments. To this purpose, the present paper aims to evaluate the exposure to different airborne particle metrics (including both sub- and super-micron particles) and attached carcinogenic compounds in dwellings where three different heating systems were used: open fireplaces, closed fireplaces and pellet stoves. Measurements in terms of particle number, lung-deposited surface area, and PM fraction concentrations were measured during the biomass combustion activities, moreover, PM10 samples were collected and chemically analyzed to obtain mass fractions of carcinogenic compounds attached onto particles. Airborne particle doses received by people exposed in such environments were evaluated as well as their excess lung cancer risk. Most probable surface area extra-doses received by people exposed to open fireplaces on hourly basis (56 mm2 h-1) resulted one order of magnitude larger than those experienced for exposure to closed fireplaces and pellet stoves. Lifetime extra risk of Italian people exposed to the heating systems under investigation were larger than the acceptable lifetime risk (10-5): in particular, the risk due to the open fireplace (8.8 × 10-3) was non-negligible when compared to the overall lung cancer risk of typical Italian population.

Rehabilitation Utilization following a Work-Related Traumatic Brain Injury: A Sex-Based Examination of Workers' Compensation Claims in Victoria, Australia.

OBJECTIVES: To report on and examine differences in the use of four types of rehabilitation services (occupational therapy, physiotherapy, psychology, and speech therapy) by men and women following a work-related traumatic brain injury in Victoria, Australia; and to examine the importance of demographic, need, work-related and geographic factors in explaining these differences. METHODS: A retrospective cohort design was used to analyze 1786 work-related traumatic brain injury workers' compensation claims lodged between 2004 and 2012 in Victoria, Australia. ZINB regressions were conducted for each type of rehabilitation service to examine the relationship between sex and rehabilitation use. Covariates included demographic, need-related, work-related, and geographic factors. RESULTS: Out of all claims (63% male, 37% female), 13% used occupational therapy, 23% used physiotherapy, 9% used psychology, and 2% used speech therapy at least once during the first year of service utilization. After controlling for demographic, need-related, work-related, and geographic factors, women were more likely to use physiotherapy compared to men. Men and women were equally likely to use occupational therapy and psychology services. The number of visits in the first year for each type of service did not differ between male and female users. CONCLUSIONS: Our findings support a sex-based approach to studying rehabilitation utilization in work-related populations. Future research is needed to examine other factors associated with rehabilitation utilization and to determine the implications of different rehabilitation utilization patterns on health and return-to-work outcomes.

GPX4 and GPX7 over-expression in human hepatocellular carcinoma tissues.

Hepatocellular carcinoma (HCC) is the most common type of liver cancer and is still one of the most fatal cancers. Hence, it needs to identify always new putative markers to improve its diagnosis and prognosis. The selenium is an essential trace mineral implicated as a key factor in the early stage of cancer and exerts its biological function through the selenoproteins. In the last years our group has been studying the involvement of some selenoproteins in HCC. However, no many data are reported in literature about the correlation between HCC and the glutathione peroxidases (GPXs), both selenium and non selenium-containing GPXs. In this paper we have evaluated the GPX4 and GPX7 expression in some paraffin-embedded tissues from liver biopsy of patients with hepatitis C virus (HCV)-related cirrhosis and HCC by immunohistochemistry and RT-qPCR analysis. Our results evidenced that i) GPX4 and GPX7 had a statistically significant over-expression in HCC tissues compared to cirrhotic counterparts used as non tumor tissues, and ii) their expression was higher in grade III HCC tissues with respect to grade I-II samples. Therefore, we propose to use GPX4 and GPX7 as possible markers for improving HCC diagnosis/prognosis.

Epidemiology of work-related traumatic brain injury: a systematic review.

OBJECTIVE: This systematic review aimed to describe the burden and risk factors of work-related traumatic brain injury (wrTBI) and evaluate methodological quality of existing literature on wrTBI. METHODS: A search of electronic databases (MEDLINE, EMBASE, PsycINFO, and CINAHL) was conducted to identify articles published between 1980 and 2013 using a combination of terms for work, TBI, and epidemiology, without geographical limitations. RESULTS: Ninety-eight studies were included in this review, of which 24 specifically focused on wrTBI. In general, male workers, those in the youngest and oldest age groups, and those working in the primary (e.g., agriculture, forestry, mining) or construction industries were more likely to sustain wrTBI, with falls being the most common mechanism of injury. CONCLUSIONS: This review identified workers at highest risk of wrTBI, with implications for prevention efforts. Future research of better methodological quality is needed to provide a more complete picture of the epidemiology of wrTBI.

Assessment of the Selenoprotein M (SELM) over-expression on human hepatocellular carcinoma tissues by immunohistochemistry.

Selenium is an essential trace mineral of fundamental importance to human healthy and exerts its biological function through selenoproteins. In particular, Selenoprotein M (SELM) is located in the endoplasmic reticulum and contains the common redox motif of cysteine-X-X-selenocysteine type. It attracts great attention due to its high expression in brain and its potential roles as antioxidant, neuroprotective, and cytosolic calcium regulator. Recently, our group found SELM over-expression  in human hepatocellular carcinoma (HCC) cell lines. In this report some paraffin-embedded tissues from liver biopsy of patients with hepatitis C virus (HCV)-related cirrhosis and HCC were immunohistochemically stained and SELM expression scoring was evaluated. Our results evidence for the first time an increase of SELM expression in HCC liver tissues, and its gradual expression raise associated with an increased malignancy grade. Therefore, we propose to use i) SELM as putative marker for HCC as well as ii) simple immunohistochemistry technique to distinguish between the different grades of malignancy. 

Evaluation of the measurement uncertainty in automated long-term sampling of PCDD/PCDFs.

Since the publication of the first version of European standard EN-1948 in 1996, long-term sampling equipment has been improved to a high standard for the sampling and analysis of polychlorodibenzo-p-dioxin (PCDD)/polychlorodibenzofuran (PCDF) emissions from industrial sources. The current automated PCDD/PCDF sampling systems enable to extend the measurement time from 6-8 h to 15-30 days in order to have data values better representative of the real pollutant emission of the plant in the long period. EN-1948:2006 is still the European technical reference standard for the determination of PCDD/PCDF from stationary source emissions. In this paper, a methodology to estimate the measurement uncertainty of long-term automated sampling is presented. The methodology has been tested on a set of high concentration sampling data resulting from a specific experience; it is proposed with the intent that it is to be applied on further similar studies and generalized. A comparison between short-term sampling data resulting from manual and automated parallel measurements has been considered also in order to verify the feasibility and usefulness of automated systems and to establish correlations between results of the two methods to use a manual method for calibration of automatic long-term one. The uncertainty components of the manual method are analyzed, following the requirements of EN-1948-3:2006, allowing to have a preliminary evaluation of the corresponding uncertainty components of the automated system. Then, a comparison between experimental data coming from parallel sampling campaigns carried out in short- and long-term sampling periods is realized. Long-term sampling is more reliable to monitor PCDD/PCDF emissions than occasional short-term sampling. Automated sampling systems can assure very useful emission data both in short and long sampling periods. Despite this, due to the different application of the long-term sampling systems, the automated results could not be directly compared with manual results, not even in terms of measurement uncertainty. This investigation focuses on both uncertainty and repeatability of the automated sampling method. The standard 20988, developed by Internarional Organization of Standardization (ISO) can be used to estimate the measurement uncertainty. The results confirm that the uncertainties of manual and automated methods are comparable. At the same time, it is not appropriate to consider the manual method as a reference for the evaluation of the uncertainty of the automated sampling system, due to the high variability of both systems.

Biodegradation of α-, ß-, and γ-hexachlorocyclohexane by Arthrobacter fluorescens and Arthrobacter giacomelloi.

The organochlorine pesticide γ-hexachlorocyclohexane (γ-HCH, lindane) and its non-insecticidal isomers α-, ß-, and δ- continue to pose serious environmental and health concerns, although their use has been restricted or completely banned for decades. The present study reports the first results on the ability of two Arthrobacter strains, not directly isolated from a HCH-polluted site, to grow in a mineral salt medium containing α-, ß-, or γ-HCH (100 mgl(-1)) as sole source of carbon. Growth of cultures and HCHs degradation by Arthrobacter fluorescens and Arthrobacter giacomelloi were investigated after 1, 2, 3, 4, and 7 days of incubation by enumerating colony forming units and GC with ECD detection, respectively. Both bacteria are able to metabolize the HCHs: A. giacomelloi is the most effective one, as after 72 h of incubation it produces 88 % degradation of α-, 60 % of ß-, and 56 % of γ-HCH. The formation of possible persistent compounds was studied by GC/MS and by HPLC analysis. Pentachlorocyclohexenes and tetrachlorocyclohexenes have been detected as metabolites, which are almost completely eliminated after 72 h of incubation, while no phenolic compounds were found.

Long-term automated sampling of PCDD/PCDF flue gas: current status and critical issues.

After entry into force of the Stockholm Convention and Aarhus Protocol and in order to implement the upcoming European legal background, the European countries are asked to apply control measures to reduce the release of persistent organic pollutants (POPs) such as dioxins and furans (PCDD/PCDF) and polychlorinated biphenyls as well as to establish POPs release inventories. In this perspective, development of measuring techniques of emissions is a focal issue in acquiring useful information. In this paper, results of various measurement campaigns at different municipal waste incineration (MWI) plants using long-term automated sampling of PCDD/PCDF are presented. The samples collected from both manual and automated campaigns were analyzed following the European Standard EN-1948:2006 by high-resolution gas chromatograph/high-resolution mass spectrometer. Performances of two different commercial systems have been investigated. Anomalous values occurred during one long-term campaign (22.16 pg I-toxic equivalent (TEQ)/Nm(3)), compared to average values (4-5 pg I-TEQ/Nm(3)) of the MWI. At this maximum value, a main occurrence of abnormal and instable operating conditions has been found. Sampling based on long-term basis was found to be more reliable to monitor PCDD/PCDF emissions than occasional short-term sampling. Nevertheless, the results of long-term campaigns demonstrate that emission levels detected in 15-30 days campaigns, when unsteady operating conditions can occur, as start-up and shut down, are not immediately comparable to the typical levels in a 6-8 h, when operating conditions are generally stable. Moreover, there are often differences observed in the congener profiles between short- and long-term campaigns.

Concentration of organic micropollutants in the atmosphere of Trieste, Italy.

PURPOSE: PCDD/Fs, PCBs, and PAHs, ubiquitous environmental pollutants which are part of the POPs, are mainly produced by anthropogenic activities as well as by natural processes. Occurrences of these pollutants in different sites in Trieste are presented. PCDD/Fs distribution and their possible emission sources are discussed. METHODS: Air samples were collected in different sites near the industrial area, in the city center, and in a background area, using a high-volume sampler equipped with a quartz fiber filter and a PUF. Each sampling lasted a week. RESULTS: The concentrations of the organochlorinated pollutants are consistent with literature data (ΣPCDD/Fs and Σdl-PCBs were 5-38 fg TEQ/Nm(3) and 4-31 fg TEQ/Nm(3), respectively), and an apparent seasonal trend was found with slightly higher concentrations in the winter and lower levels in both summer campaigns. Moreover, the isomer profile of each sampling campaign was compared to the fingerprint of a sintering plant, a cement plant, and an incinerator, the main industrial activities in Trieste. CONCLUSIONS: The organic micropollutants were detected in levels consistent with literature data. The results show that the pollutants are uniformally distributed in the atmosphere of Trieste. PCDD/F fingerprints in each site remained almost identical during summer and winter, confirming the yearly prevalence of the emissions from the nearby sintering plant.

Characterization of metalloproteinases, oxidative status and inflammation levels in the different stages of fibrosis in HCV patients.

OBJECTIVES: This study was aimed at searching noninvasive markers of the transition from mild to severe fibrosis stage in HCV patients undergoing hepatic fibrosis. DESIGN AND METHODS: Thirty-three patients affected by chronic HCV vs. twenty healthy donors were evaluated for the serum levels of several circulating matrix metalloproteinases (MMPs), TRAIL and ß-NGF by multiplex biometric ELISA based immunoassay and anti- and pro-oxidant status (d-ROMs, BAP and NO) using a Diacron automated method. RESULTS: HCV patients displayed increased expression levels of MMP-8, MMP-9, TRAIL and ß-NGF, and an imbalance between pro- and antioxidant status, that contribute to liver fibrosis. CONCLUSIONS: Since the determination of these parameters represents a reliable and easily applicable method, these parameters are suggested as serum surrogate markers for HCV patients in the routine clinical practice.

An approach for understanding the inflammation and cancer relationship.

It is well known that persistent inflammatory conditions can induce the cancer formation. In fact, cytokines and chemokines play a crucial role in the promoting of angiogenesis, metastasis, and subversion of adaptive immunity. These proteins are involved in cancer-related inflammation and can represent a target for innovative diagnostic and therapeutic strategies useful to clinical studies.

Characterisation and evaluation of the emissions from the combustion of Orimulsion-400, coal and heavy fuel oil in a thermoelectric power plant.

An experimental campaign was carried out in a thermoelectric power plant in Southern Italy in order to evaluate the emissions released during the utilisation of three different fuels, Orimulsion-400, coal and heavy fuel oil (HFO) with high content of sulphur. Macropollutant concentrations in the exhaust gases were recorded by the continuous monitoring system and the Institute on Atmospheric Pollution of the Italian National Research Council (CNR) carried out samplings and analysis of Polycyclic Aromatic Hydrocarbons (PAHs), Polychlorodibenzo-p-dioxins (PCDD) and Polychlorodibenzofurans (PCDF), halogenidric acids and metals. The pollutant concentrations, mass flows and emission factors were compared. Each fuel met the air emission limits for all the pollutants. Coal showed the highest emission levels, whilst HFO and Orimulsion were fairly similar. NOx, SO2 and particulate matter showed constant concentration for all the fuels, while Orimulsion and HFO SO2 concentrations were critical at the highest operating power. Orimulsion showed the lowest PAHs values and PCDDs and PCDFs were much lower than the limits, for all the fuels. Particular attention must be paid with vanadium and nickel during Orimulsion utilisation. For these metals mass balances were carried out.

[Psychiatric services, social cooperation, voluntary activities. New relationships for new strategies]. / Servizi psichiatrici, cooperazione sociale, volontariato. Nuovi rapporti per nuove strategie.

OBJECTIVE: Eighteen years after the 1978 reform law no. 180, psychiatric services have to find new roles and goals in the social arena, in order to continue to effectively pursue the improvement of mental health in the community. The aim of the present paper is to show some theoretical and practical elements that could stimulate in the psychiatric services a deep consideration about the relationship between psychiatric services and "private social" bodies, particularly social co-operatives and voluntary organisations. METHOD: The elements shown in this study come from an analysis: a) of the literature about the crisis factors of the Italian welfare state, particularly in the Public Health Service and in the social assistance; b) of the literature about the development of the "private social" and about the relationship with the public services; c) of national and regional laws, particularly of Veneto region; d) of the present experiences in South Verona Psychiatric Service. RESULTS: The crisis of the traditional welfare state, the emergence in large sectors of general population of needs related to social fragmentation and relational impoverishment, the aspiration of a great number of individuals excluded from society to benefit of the right to full citizenship, all this urgently questions the traditional roles and responsibilities, the organisation, operational modalities, and the community orientation of existing health and human services. Within this framework, the relationship between psychiatric services (or, broadly speaking, public services in general) and "private social" bodies, particularly social co-operatives and voluntary organisations, has become part of a foreseeing, strategic new awareness of mental health workers. CONCLUSION: A shift from a relationship of mutual exploitation between organisations, to one of co-operation between them, each considering the other as an equal partner, may be a critical step forward a new model of welfare. This, in turn, would hopefully meet the needs for health of the population in terms of efficiency, quality, relevance and consideration of the users' resources and social competencies.