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BACKGROUND: To assess the employment status, quality of life and work functionality in patients affected by Inflammatory Bowel Diseases (IBD). METHODS: Patients (n. 216) were enrolled between June 2020- October 2021. Personal, clinical and occupational features were investigated. The Short Inflammatory Bowel Disease Questionnaire and the Work Productivity and Activity Impairment questionnaire were administered. RESULTS: Among the enrolled patients, 114 (53%) were employed. Mean absenteeism and presenteeism percentages of 10% and 37% were determined, with 44% and 39% of daily and work activity impairment, respectively. A poor Health-Related Quality of Life (HRQoL) was retrieved (47 ± 12). Extra-intestinal manifestations, disease activity and HRQoL resulted associated with occupational outcomes. CONCLUSIONS: IBD can impact patients' work functionality. The association between clinical, psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease.
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BACKGROUND: The National Institute for Occupational Safety and Health (NIOSH), in 2011, developed the "Total Worker Health®" (TWH) as a holistic approach to protect and promote the workers' safety, health, and well-being. After over ten years from the TWH development, the aim of the present systematic review is to provide a comprehensive overview of the worldwide TWH initiatives. METHODS: PubMed, Scopus and ISI Web of Science were searched for TWH studies published up to the 31st of July 2023, and 43 investigations could be included. The review was registered on the International prospective register of systematic reviews PROSPERO with the reference number CRD42023416972. RESULTS: Issues that emerged as relevant for the TWH operationalization were the awareness about the TWH approach and fundamentals, the leadership commitment, and a participatory engagement of the workforce: these aspects all contributed to acceptable and effective setting oriented TWH plans, specifically tailored on the peculiarities of the workplace, including small enterprises and multiemployer worksites. Evaluation and continual improvement were reported as fundamental for the successful implementation of TWH initiatives. Limited resources for safety and health initiatives, in terms of time, people, and funds, together with difficulties in the identification of safety and health priorities and a poor participatory culture were recognized as obstacles to the TWH application. Training resulted the core component of the TWH leadership and workforce preparedness, with beneficial results in terms of safety culture and adoption of preventive measures. CONCLUSIONS: Although interesting aspects emerged from our review, future longitudinal investigations should confirm the effectiveness, easy integration, and long-term sustainability of TWH models in different workplaces, in order to effectively support safe and health-enhancing works able to improve innovation and productivity.
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Saúde Ocupacional , Humanos , Local de Trabalho/psicologia , Promoção da Saúde/métodos , LiderançaRESUMO
OBJECTIVES: This paper identifies approaches to the responsible development of emerging technologies to secure worker safety and health. METHODS: A retrospective analysis was used to describe the history of the responsible development of worker protection from engineered nanomaterials. Lessons from that history were extended and applied to emerging technologies and illustrated in three examples: advanced manufacturing, synthetic biology, and artificial intelligence. RESULTS: The same principles used to underpin responsible development of nanotechnology can be applied to emerging technologies. Five criterion actions were identified that embody these principles. CONCLUSION: Responsible development of emerging technologies requires anticipating hazards and risks and ethical issues attendant to them. Occupational and environment health specialists are often called upon to provide guidance on emerging technologies and the approach described here can serve as a basis for that guidance.
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Inteligência Artificial , Nanotecnologia , Saúde Ocupacional , Humanos , Exposição Ocupacional/prevenção & controle , Estudos Retrospectivos , Nanoestruturas , História do Século XXRESUMO
BACKGROUND: Severe asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters. METHODS: Fifty-two patients were enrolled between December 2022 and June 2023. Patients' personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee's productivity and perception of work ability, respectively. RESULTS: Among the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 ± 12 vs.87 ± 13%; 72 ± 14 vs. 86 ± 14%), FVC% (92 ± 11 vs. 101 ± 11%; 90 ± 13 vs. 98 ± 14%) and FEV1/FVC (62 ± 11 vs. 71 ± 8%; 64 ± 9 vs. 70 ± 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 ± 10.3 and 48.5 ± 8.5 to 46.8 ± 8.6 and 51.6 ± 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 ± 6 vs. 40 ± 6, P = 0.001). A significant reduction in the absenteeism (19 ± 15 vs. 3 ± 11%; P < 0.001) and presenteeism rate (53 ± 24 vs. 29 ± 26%; P < 0.001), and an improvement in daily (40 ± 27.5% vs. 28.9 ± 24.7%, P < 0.001, in the overall population) and work activities (57 ± 25 vs. 29 ± 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability. CONCLUSIONS: Our study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.
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OBJECTIVES: Work ability (WA) reflects a balance between work demands and an individual's ability to meet them. It is influenced by several occupational and health-related factors including the individual's physical fitness (PF). Therefore, the aim of the present study was to provide an overview of the possible relationship between PF measures and the individual's WA. METHODS: A systematic review of studies published up to December 1, 2022 and available in PubMed, Scopus, and ISI Web of Science databases, was performed. Results have been summarized according to the specific PF parameter explored. RESULTS: The 14 reviewed studies, enrolling 47 to 1005 workers, all showed a satisfactory methodological quality. Some positive evidence emerged for a possible association between changes in aerobic capacity, walking speed, balance, flexibility, muscle strength, and WA perception. However, the limited number of studies, their cross-sectional design, the different PF performance indicators, populations, and job tasks explored prevented definite conclusions. CONCLUSIONS: Future longitudinal studies should be planned to confirm such positive results and identify PF indicators better predictive for changes in the WA of employees engaged in specific job tasks, particularly in physically demanding activities. This may be helpful to include PF performance tests in occupational health practice as an integrated part of risk assessment and management strategies as well as in health and well-being promotion plans.
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Força Muscular , Aptidão Física , Humanos , Estudos Transversais , Bases de Dados Factuais , Comportamentos Relacionados com a SaúdeRESUMO
The study aims to reveal the exposure to perfluoroalkyl substances (PFAS) in workers in different industry sectors with exposures to hexavalent chromium (Cr(VI)). The PFAS exposure of in total 172 individuals from 4 countries was assessed by the determination of 8 perfluoroalkyl carboxylic acids and 4 perfluoroalkyl sulfonic acids in plasma samples. The participants were 52 chrome plating workers, 43 welders, 3 surface treating workers and 74 workers without any occupational Cr exposure as controls. Significant differences between workers with Cr exposure and controls were found for the perfluoroalkyl sulfonic acids, particularly for perfluorooctane sulfonic acid (PFOS). The median and maximum levels were, respectively, 4.83 and 789 µg/l for chrome plating workers, 4.97 and 1513 µg/l for welders, and 3.65 and 13.9 µg/l for controls. The considerably high PFOS exposure in Cr platers and welders can be explained by the former application of PFOS as mist suppressants in electroplating baths, which resulted in an exposure of the directly involved operators, but also of welders performing maintenance and repair service at these workplaces.
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Ácidos Alcanossulfônicos , Fluorocarbonos , Exposição Ocupacional , Humanos , Cromatos , Ferreiros , Ácidos SulfônicosRESUMO
Good mechanical properties and low costs have led to a global expansion of plastic production and use. Unfortunately, much of this material can be released into the environment as a waste product and cleaved into micro- and nanoplastics (NPs) whose impact on the environment and human health is still largely unknown. Considering the growing worldwide awareness on exposure to chemicals that can act as endocrine disruptors, a systematic review was performed to assess the impact of NPs on the endocrine function of in vitro and in vivo models. Although a limited number of investigations is currently available, retrieved findings showed that NPs may induce changes in endocrine system functionality, with evident alterations in reproductive and thyroid hormones and gene expression patterns, also with a trans-generational impact. Nanoplastic size, concentration, and the co-exposure to other endocrine disrupting pollutants may have an influencing role on these effects. Overall, although it is still too early to draw conclusions regarding the human health risks derived from NPs, these preliminary results support the need for further studies employing a wider range of plastic polymer types, concentrations, and time points as well as species and life stages to address a great variety of endocrine outcomes and to achieve a broader and shared consensus on the role of NPs as endocrine disruptors.
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Disruptores Endócrinos , Poluentes Ambientais , Humanos , Microplásticos/farmacologia , Disruptores Endócrinos/toxicidade , Reprodução , Sistema EndócrinoRESUMO
BACKGROUND: Seafood is a major source of vital nutrients for optimal fetal growth, but at the same time is the main source of exposure to methylmercury (MeHg), an established neurodevelopmental toxicant. Pregnant women must be provided with dietary advice so as to include safely fish in their diet for nutrition and mercury control. The aim of this work is to present the design of a multicentre randomized control trial (RCT), which combines human biomonitoring (HBM) with dietary interventions using seafood consumption advice to pregnant women for MeHg control, and to collect information about other possible sources of exposure to mercury. It also presents the materials developed for the implementation of the study and the characteristics of the study participants, which were self-reported in the first trimester of pregnancy. METHODS: The "HBM4EU-MOM" RCT was performed in the frame of the European Human Biomonitoring Initiative (HBM4EU) in five coastal, high fish-consuming European countries (Cyprus, Greece, Spain, Portugal and Iceland). According to the study design, pregnant women (≥120/country, ≤20 weeks gestational age) provided a hair sample for total mercury assessment (THg) and personal information relevant to the study (e.g., lifestyle, pregnancy status, diet before and during the pregnancy, information on seafood and factors related to possible non-dietary exposures to mercury) during the first trimester of pregnancy. After sampling, participants were randomly assigned to "control" (habitual practices) or "intervention" (received the harmonized HBM4EU-MOM dietary advice for fish consumption during the pregnancy and were encouraged to follow it). Around child delivery, participants provided a second hair sample and completed another tailored questionnaire. RESULTS: A total of 654 women aged 18-45 years were recruited in 2021 in the five countries, primarily through their health-care providers. The pre-pregnancy BMI of the participants ranged from underweight to obese, but was on average within the healthy range. For 73% of the women, the pregnancy was planned. 26% of the women were active smokers before the pregnancy and 8% continued to smoke during the pregnancy, while 33% were passive smokers before pregnancy and 23% remained passively exposed during the pregnancy. 53% of the women self-reported making dietary changes for their pregnancy, with 74% of these women reporting making the changes upon learning of their pregnancy. Of the 43% who did not change their diet for the pregnancy, 74% reported that their diet was already balanced, 6% found it difficult to make changes and 2% were unsure of what changes to make. Seafood consumption did not change significantly before and during the first trimester of pregnancy (overall average â¼8 times per month), with the highest frequency reported in Portugal (≥15 times per month), followed by Spain (≥7 times per month). During the first-trimester of pregnancy, 89% of the Portuguese women, 85% of the Spanish women and <50% of Greek, Cypriot and Icelandic women reported that they had consumed big oily fish. Relevant to non-dietary exposure sources, most participants (>90%) were unaware of safe procedures for handling spillage from broken thermometers and energy-saving lamps, though >22% experienced such an incident (>1 year ago). 26% of the women had dental amalgams. â¼1% had amalgams placed and â¼2% had amalgams removed during peri-pregnancy. 28% had their hair dyed in the past 3 months and 40% had body tattoos. 8% engaged with gardening involving fertilizers/pesticides and 19% with hobbies involving paints/pigments/dyes. CONCLUSIONS: The study design materials were fit for the purposes of harmonization and quality-assurance. The harmonized information collected from pregnant women suggests that it is important to raise the awareness of women of reproductive age and pregnant women about how to safely include fish in their diet and to empower them to make proper decisions for nutrition and control of MeHg, as well as other chemical exposures.
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Mercúrio , Compostos de Metilmercúrio , Animais , Feminino , Humanos , Gravidez , Dieta , Europa (Continente) , Contaminação de Alimentos/análise , Mercúrio/análise , Compostos de Metilmercúrio/análise , Estudos Multicêntricos como Assunto , Gestantes , Ensaios Clínicos Controlados Aleatórios como Assunto , Alimentos Marinhos/análise , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Occupational Physicians (OPs) are essential for health promotion (HP) at the workplace, although their HP knowledge and perception are still under-searched. METHODS: Between September and December 2022, the Italian Society of Occupational Medicine (SIML) - HP working group performed a cross-sectional survey on SIML-OPs aimed to address their approach, experience, strategies, and needs concerning HP plans. RESULTS: A total of 336 OPs completed the questionnaire. Regarding HP's OP perception, this was reported as a social investment (34.45%) and shared responsibility for all the company's preventive figures (30.18%). Over half of the enrolled OPs declared to have been involved as HP plans' organizers (57.30%) or collaborators (54.80%) in the previous 5 years. The greatest percentage of organizers were in the younger age groups (40-59 years; 50%). Additionally, following a more limited number of companies, prevalently of medium-high dimensions, and more than 500 workers were positively associated with greater OP participation in HP initiatives. Promoting healthy lifestyles was the main target of the HP plans (88.64%). Interdisciplinary collaboration, OP training on HP procedures and information on the targeted population have been reported as effective issues to support an active engagement of OPs in HP. CONCLUSIONS: A general interest of the Italian OPs with respect to HP was demonstrated, however, information on the potential benefits of HP in workplace aligned with OP perceptions and needs seem necessary to successfully implement HP interventions.
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Médicos do Trabalho , Medicina do Trabalho , Humanos , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Inquéritos e Questionários , Promoção da SaúdeRESUMO
Advances in nanotechnology have led to an increased use of engineered nanoparticles (ENPs) and the likelihood for occupational exposures. However, how to assess such exposure remains a challenge. In this study, a methodology for human biomonitoring, based on Single Particle Inductively Coupled Plasma Mass Spectrometry (SP-ICP-MS), was developed as a tool to assess the ENPs exposure of workers involved in nanomaterial activities in two Italian Companies. The method was validated for size and number concentration determination of Ag, Au, In2O3, Ir, Pd, Pt, and TiO2 NPs in urine and blood samples. The results showed the presence of In2O3 NPs in blood of exposed workers (mean, 38 nm and 10,371 particles/mL), but not in blood of controls. Silver, Au, and TiO2 NPs were found in urine (mean, Ag 29 nm and 16,568 particles/mL) or blood (mean, Au 15 nm and 126,635 particles/mL; TiO2 84 nm and 27,705 particles/mL) of workers, though these NPs were found also in controls. The presence of ENPs in both workers and controls suggested that the extra-professional exposure is a source of ENPs that cannot be disregarded. Iridium, Pd, and Pt NPs were not detected neither in blood nor in urine. Overall, the findings provided a rational basis to evaluate the exposure assessment to ENPs in cohorts of workers as part of risk assessment and risk management processes in workplaces.
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Within the EU human biomonitoring initiative (HBM4EU), a targeted, multi-national study on occupational exposure to hexavalent chromium (Cr(VI)) was performed. Cr(VI) is currently regulated in EU under REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) and under occupational safety and health (OSH) legislation. It has recently been subject to regulatory actions to improve its risk management in European workplaces. Analysis of the data obtained within the HBM4EU chromates study provides support both for the implementation of these regulatory actions and for national enforcement programs and may also contribute to the updating of occupational limit values (OELs) and biological limit values for Cr(VI). It also provides useful insights on the contribution of different risk management measures (RMMs) to further reduce the exposure to Cr(VI) and may support the evaluation of applications for authorisation under REACH. Findings on chrome platers' additional per- and polyfluoroalkyl substances (PFAS) exposure highlight the need to also pay attention to this substance group in the metals sector. A survey performed to evaluate the policy relevance of the HBM4EU chromates study findings supports the usefulness of the study results. According to the responses received from the survey, the HBM4EU chromates study was able to demonstrate the added value of the human biomonitoring (HBM) approach in assessment and management of occupational exposure to Cr(VI). For future occupational studies, we emphasise the need for engagement of policy makers and regulators throughout the whole research process to ensure awareness, relevance and uptake of the results in future policies.
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Exposição Ocupacional , Saúde Ocupacional , Humanos , Cromatos , Exposição Ocupacional/análise , Cromo/análise , PolíticasRESUMO
The aim of this study was to investigate the practicability of exhaled breath condensate (EBC) as a biological matrix to detect and measure hexavalent chromium (Cr(VI)) and trivalent chromium (Cr(III)) in workers occupationally exposed to Cr(VI). EBC samples were collected from workers in France, Finland, Italy, The Netherlands and the United Kingdom from three different target activities: chrome platers, stainless steel welders and surface treatment workers. Pre and post working week EBC samples were collected from 177 exposed workers and 98 unexposed workers (control group). Hyphenated chromatography systems with inductively coupled plasma - mass spectrometry (ICP-MS) were for the analysis. The results showed that the occupationally exposed workers had significantly higher levels of Cr(VI) and Cr(III) than the control group. Chrome platers exhibited the highest Cr(VI) levels in their EBC samples, with a significant increase from their pre to post samples for both Cr(VI) and Cr(III). A significant difference was also found between pre and post EBC samples for Cr(III) in welders. This study has shown that EBC has the potential to be a valid, non-invasive biological matrix to assess occupational exposure to Cr(VI) and Cr(III) for biological monitoring assessment, with the ability to detect low level inhalation exposures.
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Cromatos , Exposição Ocupacional , Humanos , Monitoramento Ambiental/métodos , Cromo , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Europa (Continente)RESUMO
In welding, there is a potential risk due to metal-oxide nanoparticles (MONPs) exposure of workers. To investigate this possibility, the diameter and number particles concentration of MONPs were evaluated in different biological matrices and in personal air samples collected from 18 stainless-steel welders and 15 unexposed administrative employees engaged in two Italian mechanical engineering Companies. Exhaled breath condensate (EBC) and urine were sampled at pre-shift on 1st day and post-shift on 5th day of the workweek, while plasma and inhalable particulate matter (IPM) at post-shift on 5th day and analysed using the Single Particle Mass Spectrometry (SP-ICP-MS) technique to assess possible exposure to Cr2O3, Mn3O4 and NiO nanoparticles (NPs) in welders. The NPs in IPM at both Companies presented a multi-oxide composition consisting of Cr2O3 (median, 871,574 particles/m3; 70 nm), Mn3O4 (median, 713,481 particles/m3; 92 nm) and NiO (median, 369,324 particles/m3; 55 nm). The EBC of welders at both Companies showed Cr2O3 NPs median concentration significantly higher at post-shift (64,645 particles/mL; 55 nm) than at pre-shift (15,836 particles/mL; 58 nm). Significantly lower Cr2O3 NPs median concentration and size (7762 particles/mL; 44 nm) were observed in plasma compared to EBC of welders. At one Company, NiO NPs median concentration in EBC (22,000 particles/mL; 65 nm) and plasma (8248 particles/mL; 37 nm) were detected only at post-shift. No particles of Cr2O3, Mn3O4 and NiO were detected in urine of welders at both Companies. The combined analyses of biological matrices and air samples were a valid approach to investigate both internal and external exposure of welding workers to MONPs. Overall, results may inform suitable risk assessment and management procedures in welding operations.
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Poluentes Ocupacionais do Ar , Nanopartículas , Exposição Ocupacional , Soldagem , Humanos , Aço Inoxidável/análise , Ferreiros , Monitoramento Biológico , Exposição Ocupacional/análise , Óxidos/análise , Soldagem/métodos , Material Particulado/análise , Compostos Orgânicos/análise , Poluentes Ocupacionais do Ar/análise , Monitoramento AmbientalRESUMO
BACKGROUND: Several studies showed important differences in the interpretation of spirometry based on different reference values, in particular by comparing European Respiratory Society (ERS) 1993 and Global Lung Function Initiative (GLI) 2012. The validation of new reference values in local populations is essential before they can be used in an appropriate manner. This study aimed to investigate the fit of GLI reference values in a healthy Italian working population. METHODS: Spirometry data were collected in 1355 workers during their health surveillance medical examination conducted for exposure to chemical and biological risk factors. A single portable spirometer that met the ATS/ERS recommendations for occupational testing was used and calibrated daily. RESULTS: Average z-score were -0.13 (with a median of -0.17), -0.25 (with a median of -0.24), and 0.18 (with a median of 0.17) for FEV1, FVC, and FEV1/FVC ratio, respectively. Considering only the normal-weighted workers, the average z-scores were -0.07 (with a median of -0.16), -0.15 (with a median of -0.16), and 0.07 (with a median of 0.02) for FEV1, FVC, and FEV1/FVC ratio, respectively. CONCLUSIONS: GLI 2012 reference values fit the Italian data satisfactorily, resulting as more accurate than ERS 1993, especially in women, normal-weighted subjects, aged 30-50 years, and for height < 165 cm.
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Pulmão , Feminino , Humanos , Valores de Referência , Volume Expiratório Forçado , Espirometria/métodos , ItáliaRESUMO
In the present study, surface contamination where antineoplastic drugs (ADs) are present was investigated, as occupational exposure risk is still an open debate. Despite recommendations and safety standard procedures being in place in health care settings, quantifiable levels of ADs are being reported in the recent literature. Thus, a survey monitoring program was conducted over five years (2016-2021) in nine Italian hospitals. The repeated surveys produced 8288 data points that have been grouped according to the main hospital settings, such as pharmacy areas and patient care units. Based on the most often prepared ADs, the investigated drugs were cyclophosphamide (CP), gemcitabine (GEM), 5-fluorouracil (5-FU), and platinum compounds (Pt). Patient care units had a frequency of positive wipe samples (59%) higher than pharmacies (44%). Conversely, pharmacies had a frequency of positive pad samples higher (24%) than patient care units (10%). Moreover, by statistical analysis, pad samples had a significantly higher risk of contamination in pharmacy areas than in patient care units. In this study, the 75th and the 90th percentiles of the contamination levels were obtained. The 90th percentile was chosen to describe a suitable benchmark that compares results obtained by the present research with those previously reported in the literature. Based upon surface contamination loads, our data showed that 5-FU had the highest concentration values, but the lowest frequency of positive samples. In pharmacy areas, the 90th percentile of 5-FU data distribution was less than 0.346 ng/cm2 and less than 0.443 ng/cm2 in patient care units. AD levels are higher than those reported for health care settings in other European countries yet trends of contamination in Italy have shown to decrease over time.
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Antineoplásicos , Exposição Ocupacional , Antineoplásicos/análise , Monitoramento Ambiental/métodos , Contaminação de Equipamentos , Fluoruracila/análise , Hospitais , Humanos , Exposição Ocupacional/análiseRESUMO
OBJECTIVE: This study aimed to investigate the impact of thyroid diseases (TDs) on patients' work ability (WA) and related influencing factors. METHODS: A total of 150 TD workers and matched healthy controls were enrolled from May 2020 to November 2021. The Work Ability Index was used to assess the workers' perception of WA. RESULTS: Overall, TD workers reported a good WA, although with a significantly lower mean score compared with controls (39 ± 6 vs 43 ± 4, P < 0.001). Subjects with Graves disease and follicular carcinoma showed the worst WA perception. Suffering from a TD ( ß = -0.396, P < 0.001) and job duration ( ß = -0.173, P < 0.001) were associated with poorer WA. CONCLUSIONS: Better understanding the impact that TD may have on work functioning can inform an interdisciplinary management of TD workers to support their personal, social, and professional lives.
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Doenças da Glândula Tireoide , Humanos , Ocupações , Projetos Piloto , Doenças da Glândula Tireoide/epidemiologiaRESUMO
Occupational exposures to hexavalent Chromium (Cr(VI)) can occur in welding, hot working stainless steel processing, chrome plating, spray painting and coating activities. Recently, within the human biomonitoring for Europe initiative (HBM4EU), a study was performed to assess the suitability of different biomarkers to assess the exposure to Cr(VI) in various job tasks. Blood-based biomarkers may prove useful when more specific information on systemic and intracellular bioavailability is necessary. To this aim, concentrations of Cr in red blood cells (RBC-Cr) and in plasma (P-Cr) were analyzed in 345 Cr(VI) exposed workers and 175 controls to understand how these biomarkers may be affected by variable levels of exposure and job procedures. Compared to controls, significantly higher RBC-Cr levels were observed in bath plating and paint application workers, but not in welders, while all the 3 groups had significantly greater P-Cr concentrations. RBC-Cr and P-Cr in chrome platers showed a high correlation with Cr(VI) in inhalable dust, outside respiratory protective equipment (RPE), while such correlation could not be determined in welders. In platers, the use of RPE had a significant impact on the relationship between blood biomarkers and Cr(VI) in inhalable and respirable dust. Low correlations between P-Cr and RBC-Cr may reflect a difference in kinetics. This study showed that Cr-blood-based biomarkers can provide information on how workplace exposure translates into systemic availability of Cr(III) (extracellular, P-Cr) and Cr(VI) (intracellular, RBC-Cr). Further studies are needed to fully appreciate their use in an occupational health and safety context.
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Poluentes Ocupacionais do Ar , Exposição Ocupacional , Biomarcadores , Cromatos , Cromo , Poeira , Monitoramento Ambiental , HumanosRESUMO
BACKGROUND: During the COVID-19 pandemic, working age individuals have been implicated in sustaining the resurgence of SARS-CoV-2 infections, and multiple outbreaks have been observed in several occupational settings. In this regard, Occupational Physicians play a crucial role in the management of infected workers, particularly in the safe return-to-work of subjects after clinical resolution. To this end, knowledge of the duration of the infective phase in the working age population is essential, taking into account previous evidence suggesting that PCR positivity does not coincide with virus viability. METHODS: A systematic review and meta-analysis, searching major scientific databases, including PubMed/MEDLINE, Scopus and Web of Science, were performed in order to synthesize the available evidence regarding the mean and maximal duration of infectivity compared to the mean and maximal duration of viral RNA shedding. A subgroup analysis of the studies was performed according to the immunocompetent or immunocompromised immune status of the majority of the enrolled individuals. RESULTS: Twenty studies were included in the final qualitative and quantitative analysis (866 individuals). Overall, a mean duration of RT-PCR positivity after symptom onset was found equal to 27.9 days (95%CI 23.3-32.5), while the mean duration of replicant competent virus isolation was 7.3 days (95%CI 5.7-8.8). The mean duration of SARS-CoV-2 shedding resulted equal to 26.5 days (95%CI 21.4-31.6) and 36.3 days (95%CI 21.9-50.6), and the mean duration of SARS-CoV-2 infectivity was 6.3 days (95%CI 4.9-7.8) and 29.5 days (95%CI 12.5-46.5), respectively considering immunocompetent and immunocompromised individuals. The maximum duration of infectivity among immunocompetent subjects was reported after 18 days from symptom onset, while in immunocompromised individuals it lasted up to 112 days. CONCLUSIONS: These findings suggest that the test-based strategy before return-to-work might not be warranted after 21 days among immunocompetent working age individuals, and could keep many workers out of occupation, reducing their livelihood and productivity.
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COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , Humanos , PandemiasRESUMO
Work-related exposures in industrial processing of chromate (chrome plating, surface treatment and welding) raise concern regarding the health risk of hexavalent chromium (Cr(VI)). In this study, performed under the HBM4EU project, we focused on better understanding the determinants of exposure and recognising how risk management measures (RMMs) contribute to a reduction in exposure. HBM and occupational hygiene data were collected from 399 workers and 203 controls recruited in nine European countries. Urinary total chromium (U-Cr), personal inhalable and respirable dust of Cr and Cr(VI) and Cr from hand wipes were collected. Data on the RMMs were collected by questionnaires. We studied the association between different exposure parameters and the use of RMMs. The relationship between exposure by inhalation and U-Cr in different worker groups was analysed using regression analysis and found a strong association. Automatisation of Cr electroplating dipping explained lower exposure levels in platers. The use of personal protective equipment resulted in lower U-Cr levels in welding, bath plating and painting. An effect of wearing gloves was observed in machining. An effect of local exhaust ventilation and training was observed in welding. Regression analyses showed that in platers, exposure to air level of 5 µg/m3 corresponds to U-Cr level of 7 µg/g creatinine. In welders, the same inhalation exposure resulted in lower U-Cr levels reflecting toxicokinetic differences of different chromium species.
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Poluentes Ocupacionais do Ar , Exposição Ocupacional , Soldagem , Poluentes Ocupacionais do Ar/análise , Cromatos/análise , Cromo/análise , Monitoramento Ambiental , Humanos , Exposição Ocupacional/análiseRESUMO
The high toxicity of antineoplastic drugs (ADs) makes them dangerous not only for patients, but also for exposed workers. Therefore, the aim of this review was to provide an updated overview of the biological monitoring of occupational AD exposure in order to extrapolate information useful to improve risk assessment and management strategies in workplaces. Several studies demonstrated that remarkable portions of healthcare workers may have traces of these substances or their metabolites in biological fluids, although with some conflicting results. Nurses, directly engaged in AD handling, were the occupational category at higher risk of contamination, although, in some cases, personnel not involved in AD-related tasks also showed quantifiable internal doses. Overall, further research carried out on greater sample sizes appears necessary to gain deeper insight into the variability retrieved in the reported results. This may be important to understand the impact of the extent of ADs use, different handling, procedures, and cleaning practices, spill occurrence, training of the workforce, as well as the adoption of adequate collective and personal protective equipment in affecting the occupational exposure levels. This may support the achievement of the greatest clinical efficiency of such therapies while assuring the health and safety of involved workers.