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Biomedical subjects

A Baldasseroni

Publications and source records attributed to A Baldasseroni.

At least 19 recordsLinked to original sources

Carpal tunnel syndrome and ulnar neuropathy at the elbow in floor cleaners.

OBJECTIVE: To determine the occurrence of carpal tunnel syndrome (CTS) and ulnar neuropathy at the elbow (UNE) in a cohort of floor cleaners and to check differences between workers with and without CTS. METHODS: All female floor cleaners of three major hospitals in Tuscany (Italy) were contacted. Clinical and electrophysiological severity of CTS and UNE were evaluated with standardized scales and symptoms were assessed with the self-administered Boston Questionnaire (BQ); demographic and non-occupational factors and durations of current and previous occupations were recorded. Univariate analysis of risk factors was performed in workers with and without CTS. Logistic regression was used to evaluate the capacity of independent variables to predict CTS. RESULTS: Out of a total of 179 cleaners, 145 (81%)-mean age 39.6 years (20-64 years)-were enrolled in the study; 70 (48%) had CTS (diagnosis based on clinical and electrophysiological findings). BQ symptom and hand function scores were anomalous in 108 (74%) and 84 (58%) subjects, respectively. UNE was detected in 7/103 women. Univariate analysis showed that cleaners with CTS were older, had greater BMI and longer exposure to cleaning with previous employers than those without CTS. In the logistic regression, the only predictor of CTS was cleaning with previous employers (O.R. 12.1, 95% CI 3-49.9). CONCLUSIONS: These results indicate a high occurrence of CTS in floor cleaners; UNE is less frequent than CTS, presumably due to repetitive movements that stress wrists more than elbows. The only predictive factor of CTS was cleaning as an occupation with previous employers. Therefore, the actual risk factor for CTS could not be cleaning per se, but how this job is performed.

Adult↗

Prevention of work related eye injuries: long term assessment of the effectiveness of a multicomponent intervention among metal workers.

BACKGROUND: Systematic assessments of the effectiveness of interventions to prevent work related eye injuries are needed. AIM: To investigate the long term effectiveness of a multicomponent prevention campaign. METHODS: The campaign (conducted in collaboration with the local Employers' Association and Trade Unions) targeted all 237 metal-ware factories in the district of Imola, Italy. Based on preliminary inspections, the main intervention included distribution to all factories of specific educational brochures and broadcasting/publication of television/radio programmes and local newspaper articles containing expert advice on the subject. This was followed by a four year "post-intervention reinforcement" period of unannounced official inspections. Main outcome measures analysed were eye injury rates (versus non-eye injury rates) among metal workers during "pre-intervention" (1988-90), "peri-intervention" (1991-92), "post-intervention reinforcement" (1993-96), "late post-intervention" (1997-2000), and "very late post-intervention" (2001-03) periods with respect to two comparison sectors (construction and wood/ceramics). RESULTS: A Poisson regression in which the eye injury rates were modelled for each sector, period, and interaction, adjusting for non-eye injury rates, was chosen. The periods did not by themselves determine an overall reduction in eye injuries. The period/sector interaction terms were related to significant reductions for the metal sector when crossed with the "post-intervention reinforcement" (IRR = 0.77, 95% CI 0.61 to 0.97; % decline = 23.4), the "late post-intervention" (IRR = 0.63, 95% CI 0.50 to 0.79; % decline = 37.4), and the "very late post-intervention" (IRR = 0.58, 95% CI 0.43 to 0.77; % decline = 42.4) periods, suggesting a sustained reduction in eye injury risk following the main intervention. CONCLUSION: Results suggest that a carefully coordinated, extensive, multicomponent intervention can lead to lasting reductions in the burden of eye injuries.

Accidents, Occupational↗

Occupational exposure to n-hexane in Italy--analysis of a registry of biological monitoring.

OBJECTIVE: This study assesses 2,5-hexanedione (2,5-HD) in the urine of subjects exposed to n-hexane solvent between 1991 and 1998, from details obtained from the Registry of Biological Monitoring (BM) at the Florence Local Health Unit, and its development over time. METHODS: The Registry contains 15,925 samples from 6,650 subjects occupationally exposed to n-hexane, especially in leather (9,099 samples; 3,607 subjects) and shoe (3,865 samples; 1,938 subjects) production. RESULTS: Over the time span studied there was a total reduction of 31.9% in urinary 2,5-HD level. The yearly decrease over the entire period was 5.4%. Dividing the 8 years into three periods: before the introduction of the new legislation for health protection in the workplace (1991-1993), during its transition (1994-1996) and after its complete enforcement (1997-1998), respectively, we observed a marked decrease in the last period. Women and young people (under 30 years) experienced significantly higher absorption levels (respectively, 7.1% and 24.4%). CONCLUSION: The data suggest that monitoring was more frequent in subjects with higher starting values, and the greatest decrease was reported in this group. Reduction may be due to less n-hexane in the products used, better structural conditions in the factories, and the effectiveness of inspections carried out by the authority for hygiene and safety in the workplace. The results confirm the usefulness of the reporting of risk levels of exposure to industrial toxicants by routine biological monitoring.

Adolescent↗

Occupational exposure to cadmium and lung function.

A total of 69 male subjects occupationally exposed to cadmium fumes in a factory producing silver-cadmium-copper alloys for brazing, were subjected to lung function tests, including ventilation (FVC and FEV1), residual volume (RV) and alveolar-capillary diffusion capacity (TLCO and KCO). For each subject, the cumulative exposure to cadmium was calculated as the product of the number of years in the job and the average atmospheric concentration of cadmium (expressed in micrograms/m3) encountered each year. Cadmium-exposed subjects had moderately higher mean values of RV (+ 8%) as compared with the control group; the increase was greater (+ 10%) in the subgroup of workers with greater cumulative exposure to cadmium. No significant differences were observed in FVC, FEV1, TLCO and KCO.

Adult↗

[Survival in respiratory tract tumors: Italian population-based data and international comparisons].

Population survival studies are usually carried out within population-based cancer registries and are useful mainly for geographical and temporal survival comparisons. Survival studies based on clinical series of patients are traditionally executed to evaluate the efficacy of a given treatment or to analyze the prognostic role of clinical factors. Subjects from a case-control study on incidence of larynx and hypopharynx cancers in Turin, for the period 1979-82, were followed-up in order to study their survival. The analysis was based on 347 cases of larynx cancer (319 males and 28 females) and 48 cases of hypopharynx cancer (47 males and 1 female). For larynx cancer, observed five-years survival was 59% in males and 64% in females. Hypopharynx cancer had a worse prognosis (21%). In males suffering from larynx cancer, older age, extent of spread, birth in Northern Italy, and being unmarried proved to be statistically significant negative prognostic factors. The same variables were also predictive of survival for hypopharynx cancer. The one- and three-year relative survival for larynx cancer in Turin was higher than that reported by other cancer registries. For males, relative five-year survival figures range from 47% to 65%. Survival for hypopharynx cancer is considerably lower, five-year figures ranging from 13% to 35%. The survival study on lung cancer was based on all the incident cases recorded by the Lombardy Cancer Registry (L.C.R.) from 1976 to 1981; during this period there were 2042 cases of primary lung cancers occurred in males and 217 in females. Observed survival at one, three and five years from diagnosis was 29%, 8% and 5%, respectively. Survival decreased with increasing age; no important differences between sexes are evident. Information on tumor stage was available in 1904 cases and histotype was known in 1605. Three-year survival was 17% for localized tumors, 8% for tumors with regional metastasis, and 1% for tumours with distant metastasis. Epidermoid carcinomas had a better prognosis than non-epidermoid carcinomas in the first year of follow-up, survival being 38% and 29%, respectively; among non-epidermoid carcinomas the worst prognosis was for small-cell carcinomas. Comparisons between the LCR relative survival and that reported by other cancer registries did not show important differences, five-year figures ranging from 5% to 10% in males.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Carrots, green vegetables and lung cancer: a case-control study.

A total of 417 lung cancer cases and 849 controls were interviewed on their life-long tobacco usage and their current intake of four food items rich in retinol or carotene. The study was a hospital-based case control where 'cases' were lung cancer patients diagnosed during the period 1979/80 at seven hospitals in the Lombardy region (90% pathologically confirmed) and controls were patients admitted to the same hospitals for causes unrelated to tobacco smoking (epithelial cancers being excluded from present analysis). Odds ratios (OR) have been computed for increasing frequencies of consumption of liver, cheese, carrots and leafy green vegetables, having controlled for the confounding effects of tobacco usage, residence and birthplace. Current smokers who did not consume carrots showed a three-fold risk of developing lung cancer compared with those who ate them more than once a week (OR = 2.9 less than p less than 0.01); the ORs for consumers in the categories of 1-2 and 3-4 times per month were 1.8 and 2.0 respectively, with a significant test for linear trend (p less than 0.01). Among ex-smokers or non-smokers, no decrease of lung cancer risk is evident associated with carrot consumption. An excess risk was also associated with low intake of green vegetables although it was not significant, while no excess risk was evident for non-consumers of liver and cheese. The effect of carrots is independent of histological type of lung cancer while the effect of green vegetables was confined to epidermoid carcinomas: low versus high intake group OR = 1.3.

Diet↗

On the causal association between exposure to leather dust and nasal cancer: further evidence from a case-control study.

A case-control study was performed on the incident cases of nasal cavity tumours which occurred between 1968 and 1982 among the residents of Vigevano (Lombardy region, northern Italy). This area is characterised by a high prevalence of shoemakers (especially in leather); the activity has predominated in Vigevano since the beginning of this century. Twenty one cases were identified (16 men and five women); 20 were histologically confirmed as nasal epithelial tumours; 17 had already died at the time of interview and the occupational history was obtained from the next of kin. Two controls per case were selected from the general population and matched by vital status, age, sex, and residence. The overall odds ratio for the subjects exposed to leather dust was 47.1 for men and 3.5 for women. The odds ratio was higher for adenocarcinoma and among the workers exposed to the worst working conditions. A significant trend for the level of exposure to leather dust was found. Nevertheless, even the jobs characterised by a relatively low exposure were found to have a significantly higher risk (OR = 7.5). Smoking habits and exposure to solvents are unlikely to confound the relation between exposure to leather and nasal tumours.

Adenocarcinoma↗

[Changes of hemoglobinemia during chelating therapy in lead poisoning].

The modifications of the Hb level of 32 subjects in which a lead poisoning occurred were studied during chelation therapy. 27 subjects showed a subclinical lead poisoning picture; 5 subjects suffered for a mild anemia. At the end of therapy, the mean Hb value of the whole group increased from 14.5 g/100 ml to 15.8 g/100 ml; the 5 subjects with anemia showed a remission and their mean Hb level increased from 12.3 to 15.1 g/100 ml. A group of 12 subjects with Hb values at the lower normal limits and 10 subjects with "apparently normal" values of Hb showed a significant increase in the Hb level following the treatment. The results obtained confirm the inhibitory activity exerted by lead on the heme synthesis also during preclinic lead poisoning and suggesting the opportunity of a constant evaluation of the Hb levels in order to decide the doses and the lengths of the chelation therapy and to lead the decision about the readmission to the working activity.

Adult↗

Respiratory risks in tunnel construction workers.

Respiratory diseases are frequent in tunnel construction workers. A group of 144 subjects randomly selected from the population of 2516 workers engaged in the construction of the railway tunnel under the Appennine Mountains, from Bologna to Firenze was investigated. A group of 69 males comparable for age, living area and habits was studied as a control group. Assessment of air pollutants (NO, NO2, SO2, total dust, silica %) was carried out by means of fixed monitoring stations as well as personal monitors. All the subjects included in the study were examined with a standardised protocol which included physical examination, lung function tests (before and after shift work) and a questionnaire to college respiratory symptoms. Low concentrations of environmental pollutants were evidenced. Significantly lower values of FEV1 and PEF were determined in the worker group pared to controls. A significant decrease in respiratory parameters was shown after shift work. Variables capable of influencing the decrease in parameters include smoking habits, work activity, presence of cough and expectoration, period of the year (spirometries resulted worse in the winter time). Significantly lower values of FEV1 and PEF were evidenced in the workers compared to controls. In spite of the present low work environmental exposure conditions, some physiologic parameters appear altered in tunnel construction workers. This may depend on a variety of noxious agents present in the working environment.

Adult↗

[Occupational experience, epidemiologic observations, and scientific evidence in an illustrative case: adverse effects of the production and use of aromatic amines in Italy].

Economical, social and technical interrelations between synthetic dyes' production and bladder cancer in workmen engaged in the manufacture are reviewed. International situation is the background of Italian situation, mainly of the Lombardy region and Turin area. For decades social actors, individuals and institutions, acted as separate bodies, contributed to delay and omit the protection of workers' health. The situation changed when scientific knowledge, technical developments and workers' commitment prioritized workers' health as a main goal. The epidemic of bladder cancers among dyestuff workers was a cornerstone in the development of a different scenario in the production responsibility, workers' participation and eventually scientific community. The authors hypothesise that in our country these events stimulated the growth of epidemiology and epidemiologists; furthermore since then institutions promulgated a new and up-to-date wave of protective legislation in the workers' H&S field.

2-Naphthylamine↗

[Fatal occupational accidents: estimates based on more data sources].

The data reported by INAIL (Istituto Nazionale Assicurazione Infortuni sul Lavoro) on fatal occupational injuries have always been considered complete and reliable. The authors of this article verified the completeness of this information source crossing it with data bases existing in different registration systems (Regional Mortality Registry of Tuscany--RMR; registers and data of the Operative Units of Prevention, Hygiene and Safety in the Workplace--UOPISLL) for the period between 1992 and 1996. In the five years concerned, a total of 458 cases were reported. These cases could be considered fatal injuries at work without taking into account traffic accidents, which were not included in the present study. The results show that the most complete information source was RMR, reporting 80% of the total data, while INAIL reports only 62.2% of the total cases. On the contrary, the UOPISLL source is the least reliable. Using the capture/recapture method, the estimate of events in the period concerned (1992-1996) amounts to nearly 500 (499.8 LC 475.9-523.7), while the three sources systematically explored for the whole period (INAIL, RMR, UOSPILL) report 458 cases. An additional information source, the daily press, which could be systematically tested only two months for each of the five years, reports 10 additional cases, which were ignored by the 3 other sources, indirectly confirming in this way how reliable the performed estimate was. The main cases among the 157 fatal accidents reported by RMR, but not by INAIL, occurred among farmers (70), most of them already retired, but there were several fatal accidents reported in the construction sector (30). Other categories were included only in the RMR data because, in the period concerned, they were not covered by INAIL insurance (18 cases in the Army and Police, 7 on the railways). The survey that was carried out confirms the essential importance of INAIL data for the surveillance system applied to this phenomenon. This also confirms the need--which has been already stressed in the scientific literature--to combine INAIL's registration system at least with the mortality registries. In this way the knowledge and comprehension of the phenomenon could be integrated and completed especially for marginal work areas, where obligatory insurance may be evaded; and for groups of workers not covered by insurance. The relevance of an integrated system of registration of occupational fatal accidents is discussed.

Accidents, Occupational↗

[Progress of studies promoted by the MODS collaborative group].

In industrialised countries, carpal tunnel syndrome (CTS) is considered an epidemic work-related disease. We have set up the MODS (Malattie Occupazionali Da Sovraccarico biomeccanico, biomechanical overload-related occupational diseases) collaborative group, formed by epidemiologists, ergonomists and occupational physicians to investigate CTS in Italy, applying the methods that epidemiologists commonly use to understand epidemics. Several studies are already ongoing. Two different descriptive studies based on current hospitalisation data are in the reporting phase. A pilot case-control multicentre study (260 cases and 520 controls in 13 centres) is in the final phase of data collection. A longitudinal study on a cohort of 3000 subjects exposed to different risk factors has reached the third year of follow-up. Moreover, a surveillance system has been set up to cover selected districts of the Emilia Romagna region. These studies will generate new information about the prevalence and incidence of CTS in Italy, along with identification of regional, high-risk job titles and work sectors, and the relative influence of non-occupational factors.

Adolescent↗

[Longitudinal study for assessing the efficacy of preventive measures in a population of health workers exposed to the risk of patient lifting].

Preliminary data of a follow-up study on effectiveness of mechanical devices for patients handling are shown. Main study results highlight a statistical significant decrease for subjective referred episodes of acute low back pain during the previous 12 months, a decrease in perceived effort and Borg scale score in the subgroup who received any sort of mechanical devices. However no difference was found regarding to proportion of subjects positive at symptom questionnaire for low back pain and mean length of absenteeism for disease was similar even after the introduction of mechanical devices.

Adult↗

A long-lasting pandemic: diseases caused by dust containing silica: Italy within the international context.

Diseases caused by dust containing silica represent an exemplary case study in the field of work-related diseases and in the history of the discovery of chronic industrial disease and its relationship to industrial society. Both dust and steam are indissolubly linked to the Industrial Revolution which everywhere was expected to replace slaves with masses of proletarians alike lesser gods. The identification of different nosological entities of dust-related diseases, the discovery that the most harmful dust particles in gold mines were invisible, insurance compensation and the development of the silicosis threshold limit value were all subjects of intense political negotiation that accompanied, with the connivance of doctors and scientists, a compromise between the health of workers and the economic health of industry. The preference for damage compensation (insurance system) over risk prevention (industrial hygienic measures) was also asserted and maintained in post-war Italy. Decline and modification of silicosis in Italy proceeded at the same rate as the introduction and subsequent application of more effective preventative legislation, especially with the protest movements of the working class at the end of the 1960s, together with the elimination of entire sectors of industrial activities, first those specialising in extraction and then the metallurgy.

Cultural Evolution↗