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Biomedical subjects

G B Raffi

Publications and source records attributed to G B Raffi.

At least 19 recordsLinked to original sources

Failure of urinary trans,trans-muconic acid as a biomarker for indoor environmental benzene exposure at PPB levels.

Benzene is a widespread pollutant whose main source in the environment is automotive emission. There is increasing interest in the exposure of the population to this pollutant as benzene is present also in the indoor environment due to cigarette smoke, drinking water, and food. The aim of this study was to evaluate, in an adult nonsmoking population not occupationally exposed to benzene, whether it is possible to detect differences in the urinary concentration of trans,trans-muconic acid (t,t-MA) between low and high environmental exposure to benzene. A study sample of 31 employees working in pharmacies in a large town in Italy with low environmental exposure to benzene (4.8 microg/m3) was compared to a high (8.1 microg/m3) benzene exposure group. Analysis of urinary t,t-MA was carried out by high-performance liquid chromatography (HPLC; photodiode array detector); analysis of environmental benzene samples was by gas chromatography/mass spectroscopy (GC-MS). The statistical analysis revealed no significant differences in urinary levels of t,t-MA of subjects with high (mean concentration: 157.9 microg/g creatinine) versus low exposure (mean concentration: 114.2 microg/g creatinine). Data show that it is difficult to correlate urinary t,t-MA with benzene exposure at parts per billion levels.

Adult↗

Biomonitoring of exposure to nitrous oxide, sevoflurane, isoflurane and halothane by automated GC/MS headspace urinalysis.

OBJECTIVES: The goal of the present study was to develop an automated method to assess by biological monitoring, the volatile-anaesthetic exposure (nitrous oxide, sevoflurane, isoflurane and halothane) in operating theatre personnel. METHODS: Post-shift urine samples were analysed by gas chromatography-mass spectrometry coupled with static headspace sampling (GC-MS/ HSS); intra-assay %-RSD (n= 10) was less than 5% for nitrous oxide and less than 7% for each halogenated vapour. The biomonitoring method was validated with air monitoring data, obtained by personal samplers and a similar GC-MS method. The sensitivity achieved by single ion monitoring (SIM) was sufficient to reveal low biological and environmental exposure averages down to 1 microg/l(urine) and 0.5 ppm for nitrous oxide and 0.1 microg/l(urine) and 50 ppb for halogenated compounds, respectively. RESULTS: In 1998 we collected and analysed 714 post-shift urine samples for the biological monitoring of volatile anaesthetics in the urine of the operating-theatre personnel of Sant'Orsola-Malpighi Hospital (Bologna, Italy). Our data showed that nitrous oxide (N20), the anaesthetic most largely used in general anaesthesia, is still the decisive factor in operating-theatre pollution. Moreover, on the basis of our results, working in close contact with anaesthetics seems to be the main determinant of risk: surgical nurses and anaesthesiologists are the most-exposed professional categories (mean post-shift urinary N2O approximately 65 microg/l(urine)) while general theatre staff, surgeons, and auxiliary personnel have significantly lower exposure. CONCLUSIONS: The biological monitoring of post-shift unmodified urinary volatile anaesthetics was confirmed to be a useful tool for evaluating individual exposure to these chemicals. The urinary concentrations of N2O and of halogenated vapours might reflect, to a certain extent, the external exposure to these compounds, and respiratory air-monitoring data support the validity of biological monitoring. Furthermore, the good relationship between air and urinary concentration of anaesthetics in people working in closer contact with these chemicals may be a good indirect means of revealing the bad air conditions of operating rooms, and may contribute to the highlighting and correction of service defects in anaesthesiology equipment and of human errors.

Air Pollution, Indoor↗

Screening of health care workers for hepatitis B virus and hepatitis C virus: criteria for fitness for work.

The aim of this study was to propose a protocol for assessment of markers of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) in exposed health care professionals and to define criteria for evaluation of fitness for the job of the infected personnel. The study comprised 800 persons involved in operative procedures, including 414 surgeons, 275 nurses, and 111 anaesthetists. A graduated protocol was created for monitoring markers of HBV and HCV infection. A well-defined combination of markers of antigen-antibody systems enabled identification of four groups of persons with HBV infection differing in fitness for work: 1) HBsAg-positive, HBeAg-positive, HBV DNA-positive; 2) HBsAg-positive, anti-HBe-positive, HBV DNA-positive; 3) HBsAg-positive, anti-HBe-positive, HBV DNA-negative; and 4) anti-HBs-positive, anti-HBc-positive, anti-HBe-positive group. For HCV infection, two groups with different job fitness were identified: 1) anti-HCV-positive, HCV RNA-negative and 2) anti-HCV-positive, HCV RNA-positive. Screening of hospital personnel at risk to HBV and HCV infection requires a well-defined protocol which may help to evaluate the fitness of the infected personnel for a specific job.

Hepatitis B↗

Gardening work and heavy metals in urban environment.

Urban soil may be a source of occupational exposure to various pollutants in gardening and land cultivation. This paper presents data of a one-year follow-up of lead, cadmium, nickel, chromium, and vanadium in the environment of the city of Bologna. Samples of soil and leaves were collected at three locations; gardens from the inner-city high-traffic area, parks in moderate-traffic area, and parks in suburban, low-traffic area. The top and deeper layers of soil and leaves were mainly polluted by lead at all locations, which corresponded to the traffic density. Personal samplers recorded greater concentrations of airborne metals than did the area samplers but the values kept below the threshold limit established by the American Conference of Governmental Industrial Hygienists for the working environment. Due to cumulative nature and interactive effects of toxic metals with other toxic and essential elements, long-term exposure to metals in the urban environment may be a health risk for occupationally exposed gardeners.

Cadmium↗

Ocular hypertonia and crystalline lens opacities in healthcare workers exposed to ionising radiation.

Some activities performed by healthcare workers may still involve total or partial exposure to ionising radiation exceeding the limit values. In addition to the appearance of crystalline lens opacities which may lead to rays-cataract, recent studies have indicated possible induction of ocular hypertonia in occupationally exposed subjects. The aim of this study was to establish the actual prevalence of ocular hypertonia and crystalline lens opacities in a group of healthcare workers exposed to ionising radiation. The collected data failed to show significant risk of ocular hypertonia and suggested that crystalline lens opacity was not an important indicator of exposure. Notwithstanding, preventive and periodic (every 5 years) ophthalmologic control may prove helpful for medicolegal purposes. Namely, such control would record congenital crystalline lens opacities in many individuals and would thus rule out unjustified claims of occupational disease due to exposure to ionising radiation. Additionally, ophthalmologic control should focus on different and probably more important ocular risks for the radiologists such as the ocular fatigue resulting from a prolonged use of a video display terminal or other diagnostic screens or electrodiaphanoscopes.

Adult↗

Use of ultrasound in occupational risk assessment of low-back pain.

The aim of the study was to evaluate ultrasound technique in preemployment medical assessment of the risk for low-back pain. Volunteers for the study were recruited among agricultural workers employed in the "Agraria Department" of the University of Bologna, Italy. The group consisted of 90 subjects, 52 male and 38 female, aged 25 to 58 years. The subjects filled in a questionnaire on medical history of low-back pain and were examined using an ultrasonograph equipped with a high linear frequency probe (3.5 MHz). The oblique parasagittal diameter of the lumbar spinal canal was measured by transabdominal ultrasonic imaging in the lumbar (L4-L5) and lumbosacral (L5-S1) region. Individuals with significantly narrower canals (< 14 mm) had an increased risk of low-back pain. The paper concludes that ultrasound imaging could become a valuable screening tool in industry, permitting selective job placement for workers at high risk for disorders of the back.

Adult↗

Short-term neurobehavioural effects in anaesthetists with low exposure to nitrous oxide.

The aim of this study was to assess whether a sample of 37 anaesthetists occupationally exposed only to N2O showed any deterioration in vigilance and/or mood. The anaesthetists were examined with three neurobehavioural tests (Simple Reaction Time and Colour Word Vigilance to measure the vigilance and Mood Rating Scale to evaluate the level of stress and arousal) and underwent N2O biological monitoring (to correlate the test results with the N2O exposure) on the first and on the last day of the work week, before and after work in the operating room. No significant relationship was found between the biological monitoring and the test results. The only significant statistical difference was found between the beginning and the end of each workday in the arousal level, regardless of the result of the biological monitoring.

Adult↗

Evaluation of the impingement of the pronator muscle in occupational carpal tunnel syndrome by electromyographic and ultrasonographic techniques.

Normal flexion of the fingers involves an involuntary contraction of the pronator and lumbrical muscle. In individuals whose profession involves constant flexing of the fingers those muscles become hypertrophied, impinging on the carpal tunnel. The narrowing of the carpal tunnel yields well to ultrasonography. The objective of this investigation was to find an ultrasonographic index of occupational carpal tunnel syndrome. Thus "Index M" denotes the variation obtained in the "M Space" before and after flexion-extension of the fingers. The study included 45 subjects performing tasks which involved the risk of cumulative trauma disorders. The subjects were tested using the electromyography and ultrasonography. The method was based on relation between the decrease in conduction of the median nerve measured by electromyography and the ultrasonographically measured variation of "M Space" in terms of sensitivity and specificity. The sensitivity of ultrasonography was 85%, as it confirmed the pathologic findings determined by electromyography ("M Index" positive) in twenty-two out of 26 hands, but the specificity was not statistically significant. Ultrasonography seems to have found very important application as a screening technique in occupational medicine. It is non-invasive, sensitive, easily repeated, and costs little.

Adult↗

Use of ultrasonography in monitoring work-related carpal tunnel syndrome: a case report.

Carpal tunnel syndrome (CTS) is a syndrome whose diagnosis is well established. One cause could be occupational factors, while others have no relation to work or the work environment. We present in this article a case report regarding a worker affected by CTS, which is of interest concerning the sensitivity of ultrasonography and electroneurography, applied as diagnostic methods, related in our protocol to the variations in occupational exposures. The case reports an agricultural worker, whose tasks required repetitive and high frequency movements of the hand-arm. Diagnosis of CTS used ultrasonography and electroneurography techniques. In our opinion, the clinical evolution of CTS encompasses three "work-related" phases (preclinical phase; phase of nerve compression; phase of irreversible damage). Ultrasonography provides greater information about the evolution of CTS, as well as other cumulative trauma disorders, and is able to discern tendinitis of flexors causing a compression on the median nerve in the carpal tunnel.

Carpal Tunnel Syndrome↗

Cohort mortality study of rubber and plastics product makers in Italy.

A retrospective cohort mortality study was carried out in 20 industrial factories in the Local Health Unit Bologna Sud (Emilia Romagna, Italy), where different rubber and plastics products were manufactured. The cohort consisted of 925 subjects (578 males and 347 females) employed for at least six months continuously; follow-up was between the beginning of operation of each factory, ranging between mid fifties and mid seventies, and 31 December 1989. For those exposed more than one year cause specific Standardized Mortality Ratios (SMRs) were computed using regional rates for comparison, 90% confidence intervals (CI) were calculated assuming the Poisson distribution. Among the 748 subjects employed for more than one year (457 males and 291 females) there were no lost to follow-up, 54 individuals were dead (41 males and 13 females) and for three subjects the cause of death was unknown. The results showed that all causes mortality was above expectancy in the total cohort (SMR = 123; 54 Obs; 90% CI = 97-154), among males (SMR = 117; 41 Obs; 90% CI = 89-152) and females (SMR = 143; 13 Obs; 90% CI = 85-228). Increased mortality for all malignant tumours was observed in the total cohort (SMR = 150; 25 Obs; 90% CI = 104-209) and for both genders. All nine lung cancer cases were observed among males, the SMR was equal to 218 and was statistically significant; seven cases occurred at duration of exposure less than 10 years and six at latency up to 20 years. The interpretation in terms of causality of the present investigation is limited by the small number of observations and by exposure definition solely in terms of employment in the study factories; nonetheless the results are indicating the existence, in this group of rubber and plastics product makers, of an adverse health effect which deserve further investigation.

Adult↗

Airborne contact dermatitis from 2-amino-2-methyl-1-propanol in a cosmetic company.

The authors described two cases of airborne contact dermatitis caused by 2-amino-2-methyl-1-propanol (AMP 100) in two subjects with periorbital erythema and itching skin. The AMP 100 has been used to replace ammonia as a hair dye component in the cosmetic industry with the purpose to eliminate its smell. Patch tests proved positive only to dilutions of 10% and 20% in the two described patients, as well as in other six asymptomatic subjects operating in the same working environment. The authors have diagnosed an irritative airborne contact dermatitis by AMP 100.

Air Pollutants, Occupational↗

A new risk of occupational disease: allergic asthma and rhinoconjunctivitis in persons working with beneficial arthropods.

Allergic asthma and rhinoconjunctivitis have been reported in workers who are constantly in close contact with arthropods during the course of breeding and research. We investigated a group of ten people working with beneficial arthropods in a "bio-factory." The following tests were carried out: skin prick test with allergens present in the workplace, baseline pulmonary function test, aspecific bronchial provocation test with ultrasonically nebulized distilled water, and pulmonary function test after workplace exposure in two subjects. The results demonstrated a good correlation between skin prick test, previous RAST positive reactions, clinical symptoms, and exposure. Pulmonary function test after workplace exposure proved positive in one asthmatic subject and in one subject with rhinoconjunctivitis. It is concluded that the evidence supports the occupational nature of these allergic diseases and that there is a need for careful surveillance and environmental monitoring within the workplace.

Adult↗

Cumulative trauma disorders of the upper limbs in workers on an agricultural farm.

The work associated with repetitive efforts and inadequate resting periods, strong physical exertion, awkward postures or static positioning exposes workers to the risk of cumulative trauma disorders of the upper limbs. These risk factors are present in many agricultural activities. A study was carried out among workers on an agricultural farm. The workers' histories were taken and they were given periodical medical check-ups. The presence of upper limb disorders was shown in a group of workers. A sample of 42 people was selected for the study by means of specific tests: electromyography, ultrasonography and laser-doppler flowmetry. The tests showed a high incidence of carpal tunnel syndrome and microcirculation disorders. The study confirmed that electromyography, ultrasonography and/or laser-doppler flowmetry are highly useful tools for identifying cumulative trauma disorders.

Adult↗

Assessment of human exposure to pesticides in greenhouses and effectiveness of personal protective devices.

The exposure to pesticides in a group of workers growing vegetables in greenhouses in farms near Rimini in Italy was evaluated. The pesticides used were organophosphorus compounds, organochlorine compounds, carbamates, pyrethroids, amide and anilide derivatives. Measurements were carried out in seven greenhouses randomly selected. The environment was free of atmospheric agents which could have influenced the pesticide concentrations in the indoor air. Two types of chemical sampling were performed: environmental and personal. The latter was done in the liquid for washing hands and by means of pads applied directly to the worker's skin and to the clothes. The aim of the determination of airborne pesticide concentrations was to evaluate mean environmental exposure to pesticides in the sprayed areas. The sampling went on from a fixed point during the entire spraying period. The aim of individual sampling was to determine the active ingredients as contaminants. The values obtained showed a risk of exposure for the greenhouse personnel working without using personal protective devices (masks, gloves and waterproof clothes), considering that pesticides could be absorbed through the skin in between the spraying intervals.

Agricultural Workers' Diseases↗

A new risk of occupational disease: allergic asthma and rhinoconjunctivitis in persons working with beneficial arthropods. Preliminary data.

For some years, biological pest control has been re-evaluated as an alternative to the indiscriminate use of pesticides. The number of "bio-factories" in Europe has been constantly increasing and today more than 100 technicians work in mass rearing of arthropods. Seven cases of asthma and allergic rhinitis are reported in 13 workers engaged in the production of beneficial arthropods. The subjects suffered from attacks of asthma and rhinitis when they came into contact with eggs and scales or waste of Chrysoperla carnea, Leptinotarsa decemlineata, Ostrinia nubilalis and Ephestia kuehniella. These attacks occurred after an average exposure period of 18 months. A RAST test, prepared by Lofarma, was carried out on subjects' serum against the above-mentioned allergens and was positive in all symptomatic subjects (7 of 13) and negative in the others. This demonstrates IgE direct sensitization mediated by complete antigens.

Adult↗

gamma-Glutamyltransferase isoenzyme pattern in workers exposed to tetrachloroethylene.

In compliance with the mandatory medical surveillance of workers exposed to tetrachloroethylene (PCE) in Italy, isoenzyme fractioning of serum gamma-glutamyltransferase (GGT) was performed on 141 workers of both sexes and on 130 control subjects. None of the workers showed any clinical symptoms of liver disease and their enzymatic profiles, including AST, ALT, 5'-NU, ALP, and GGT, were within the normal reference limits. A statistically significant increase in total GGT serum level was found in the exposed subjects, which was associated with an increase in one of the two fractions normally present in healthy individuals (GGT-2), as well as with the appearance and progressive increase of the level of a fraction (GGT-4) considered to be an expression of hepato-biliary impairment. Further research is ongoing among these workers, which will clarify whether or not electrophoretic GGT tests may be useful in detecting liver function changes due to occupational exposure to PCE.

Adult↗

Indoor climate and air quality in new offices: effects of a reduced air-exchange rate.

In response to a request from the personnel of a credit bank that had been moved into a new building, an evaluation was made of employee health complaints. The prevalence of symptoms was determined using a self-administered questionnaire. Ventilation effectiveness, contaminant concentrations (which included chemicals and bioaerosols) and microclimate were studied to establish their relationship to environmental discomfort and to the health problems mentioned by the employees. Indoor air quality--which was assessed in different seasons--revealed relatively high levels of carbon dioxide and bioaerosols in areas occupied by employees as compared with other places. Temperature and humidity were considered to be satisfactory. Although a causative agent was not isolated, the authors conclude that an ineffective rate of room air exchange, possibly in interaction with chemical contaminants, may be responsible for the discomfort and, perhaps, for the health symptoms experienced by workers in fully enclosed rooms.

Air Microbiology↗

[Electromyography of those exposed to vibration].

Electrophysiological findings in the median and ulnar nerves of a group of ten workers who operate hand-held vibrating power tools are described. Motor conduction velocities, motor latencies and amplitude of evoked compound muscle action potentials were measured. We have observed statistically significant changes in the distal latencies and in the amplitude of evoked compound muscle action potentials of median nerves in all the subjects examined, whereas the motor conduction velocities were normal in both median and ulnar nerve. These findings are compatible with functional changes without a clinically manifest neuropathy and they are suggestive of a compression damage such as carpal tunnel syndrome: the possible pathogenic mechanism of these damages are discussed. It's necessary to emphasize the importance of further studies in order to estimate the type and entity of the exposure to vibrations to show a cause-effect relationship.

Adult↗