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Biomedical subjects

L Alessio

Publications and source records attributed to L Alessio.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

[A pilot study on training and information of workers exposed to biomechanical overload of the upper limb].

Health education (HE) is very important in the prevention of occupational diseases, particularly when exposure to risk factors can be reduced through working procedures and hygienic behaviours. This pilot study refers to a HE program for prevention of work related muscle-skeletal disorders of upper limbs, carried out in two groups of 15 and 12 workers, respectively employed in trimming and assembling of plastic and metal parts. The first phase of the program consisted of worksite inspections and video recording of working procedures, characteristics of tools and machinery. This was followed by an informative meeting with the workers, which began with the administration of a multiple choice questionnaire, designed to evaluate the baseline knowledge about risk factors, work related muscle-skeletal disorders of upper limbs, working specific procedures and preventive actions. Questionnaires and video recording were repeated after two months in the second phase of the program, as subjective and objective methods of evaluation of HE effectiveness. In both groups, the questionnaire score was significantly increased after the program and a clear improvement was shown in the correct working procedures. This HE program contributed to increase the level of knowledge of the workers and fostered the adoption of working behaviours suitable to reduce the strain for the upper limbs.

Adult↗
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[Work capacity evaluation: the final step of health surveillance].

Job fitness evaluation for specific jobs is the conclusive step of workers health surveillance. This should include a physical examination and specific tests for the evaluation of organ functions which are the target for risk factors in the working environment. Occupational physicians must assess job fitness following a specific procedure: cooperation with the employer in the process of risk assessment, creating of a medical surveillance protocol related to the existing risks, implementation of medical surveillance, evaluate of etiological diagnosis of workers' illnesses and express the job fitness assessment. Possible patterns of assessment are: no job limitations, some specific temporary or permanent job limitations, temporary or permanent unfitness. The competence of the occupational physician is crucial when addressing specific problems of the workers, such as indvidual hypersusceptibility, particular tasks, illnesses, pregnancy. The occupational physician's competence is also required after fitness evaluation when transferring the worker to a more suitable job when he is deemed unfit for a job at risk and in selecting adequate personal protective equipment. In addition, the physician must perform other duties according to the existing regulations such as informing workers to obtain their consensus and the assurance of maintaining of professional secrecy as regards personal information. The occupational physician is expected to be independent and impartial towards both employer and employees, which is obtained by up-dating professional skills and by acting with care and honesty.

Humans↗
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[Skin disorders and job fitness assessment].

BACKGROUND: Assessment of fitness for employment represents the final phase of the risk evaluation and health surveillance carried out during pre-employment and periodical medical examination. Dermatoses are frequent diseases both in the general population and workers, therefore job fitness assessment for workers with skin problems will frequently fall within the occupational health area. The physician must verify whether or not the dermatosis is an occupational disease and must adopt preventive measures to avoid any worsening or relapse of the clinical situation due to occupational factors. OBJECTIVES: This article gives suggestions for correct management of occupational and non-occupational skin diseases in the workplace, with practical examples of job fitness assessment. METHODS: We first examined the role of the occupational physician in the evaluation of occupational risk factors that can induce work-related dermatoses or aggravate other dermatoses. We then discussed the factors that must be considered during assessment of fitness for employment when dermatoses are present. Finally, we examined practical examples of occupational or non-occupational dermatoses that can cause functional limitations, factors that can influence job fitness evaluation, and the possible role of allergological tests. RESULTS AND CONCLUSIONS: Several dermatoses can be aggravated or caused by occupational factors (e.g. atopic dermatitis, allergic contact dermatitis, irritant contact dermatitis, keratinization disorders, lichen planus, physical urticaria). Close cooperation between the dermatologist and the occupational physician is very important in order to make an etiological diagnosis that is necessary for the job fitness assessment. It is difficult to define definitive criteria for the assessment of fitness for employment; in this article only some suggestions are made and they can vary according to the different situations.

Humans↗
PubMedDate not supplied

[Introduction: scope and purpose of the multicenter project " Assessment of effects due to low doses in inorganic mercury following environmental and occupational exposure: human and in vitro studies on specific toxicity mechanisms"].

The principal aims of the project financed by the Italian Ministry of University and Scientific and Technological Research were: to verify if at the current limit values early biological effects can be demonstrated; to identify the levels of internal dose that can cause early effects; to evaluate the non-occupational factors that can contribute to the levels of internal dose. In particular, the mercury intake derived from dental amalgams and fish consumption was considered. The internal dose was measured with the traditional biological indicators (urinary and blood mercury) and with the speciation of a large percentage of biological samples by ICP-MS. The central nervous system, neuroendocrine function, kidney and the immune system were considered as target organs and were examined using previously standardized indicators of effects. Two groups of subjects were included in the study: workers with occupational exposure to inorganic mercury in different industrial settings and control subjects identified from the general population. The first group was characterized by an exposure level to inorganic mercury clearly below the current limit values; whereas the HgU levels of a relevant number of control subjects were similar to those measured in the exposed subjects. The in vitro studies covered several issues: the percutaneous absorption of mercury using skin derived from human post-mortem samples in a standardized model; the release of the metal from dental amalgams in different physiological conditions of the oral cavity; the effects of increasing doses of mercury chloride on tubular renal cells. The project was realized with the cooperation of seven Research Units from six Italian Universities. Researchers belonging to Departments of Occupational Medicine, Industrial Hygiene, General Pathology, Biochemistry, Odontology, and Biostatistics were involved to achieve a multidisciplinary approach. The results of this research project are described and discussed in the following papers.

Absorption↗
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[Evaluation of the dose of mercury in exposed and control subjects].

OBJECTIVES: The aim of this paper was to analyse the concentrations of HgU and HgB in three different groups: 122 workers exposed, 18 workers formerly exposed and 196 subjects not occupationally or environmentally exposed to mercury. METHODS: All the subjects filled out a questionnaire concerning personal data, lifestyle, occupational or non-occupational exposure to Hg and medical history. The amalgam fillings area was measured by a standardised method. RESULTS: Urinary mercury excretion was significantly greater in the group of the exposed workers respect to the group of subjects not occupationally exposed (Median value of 8.3 micrograms/g creatinine and the 5 degrees and 95 degrees percentile respectively of 2.66 e 23.50 micrograms/g creatinine against Median value of 1.2 micrograms/g creatinine and the 5 degrees and 95 degrees percentile respectively of 0.18 and 5.42 micrograms/g creatinine). U-Hg in formerly exposed workers were comparable to U-Hg in non-occupationally exposed subjects, with a median value of 1.6 micrograms/g creatinine. B-Hg values were similar in the three groups: the median value was 3.1 micrograms/l in the non-occupationally exposed, 4.0 micrograms/l in the exposed workers and 3.9 micrograms/l in the past exposed. These value were not significantly different. Among the considered variables (amalgam fillings, fish consumption, age, sex, alcohol intake, chewing-gum and smoking) dental amalgam and fish consumption were significantly related with the Hg urinary excretion and the B-Hg levels. This is particularly true considering the subjects altogether: for the exposed workers, indeed, the occupational exposure was the most relevant variable. CONCLUSIONS: The results of the present research confirmed that the U-Hg excretion in non-occupationally exposed subjects is influenced by amalgam dental fillings. Furthermore, in our study Hg urinary excretion was significantly related with fish consumption. This fact can be explained, according to several recent experimental human and animal trials, considering that methylmercury contained in fish is partially converted, through breakage of the carbon-Hg bond, into Hg inorganic forms, which accumulate in the kidney and have a urinary excretion pathway.

Absorption↗
PubMedDate not supplied

[Neurotoxic effect of exposure to low doses of mercury].

OBJECTIVES: To assess early effects on the Central Nervous System due to occupational exposure to low levels of inorganic mercury (Hg) in a multicenter nationwide cross-sectional study, including workers from chloro-alkali plants, chemical industry, thermometer and fluorescent lamp manufacturing. The contribution of non-occupational exposure to inorganic Hg from dental amalgams and to organic Hg from fish consumption was also considered. METHODS: Neuropsychological and neuroendocrine functions were examined in a population of 122 workers occupationally exposed to Hg, and 196 control subjects, not occupationally exposed to Hg. Neuropsychological functions were assessed with neurobehavioral testing including vigilance, motor and cognitive function, tremor measurements, and with symptoms concerning neuropsychological and mood assessment. Neuroendocrine functions were examined with the measurement of prolactin secretion. The target population was also characterized by the surface of dental amalgams and sea fish consumption. RESULTS: In the exposed workers the mean urinary Hg (HgU) was 10.4 +/- 6.9 (median 8.3, geometric mean 8.3, range 0.2-35.2) micrograms/g creatinine, whereas in the control group the mean HgU was 1.9 +/- 2.8 (median 1.2, geometric mean 1.2, range 0.1-33.2) micrograms/g creatinine. The results indicated homogeneous distribution of most neurobehavioral parameters among exposed and controls. On the contrary, finger tapping (p < 0.01) and the BAMT (Branches Alternate Movement Task) coordination test (p = 0.05) were associated with occupational exposure, indicating an impairment in the exposed subjects. Prolactin levels resulted significantly decreased among the exposed workers, and inversely related to HgU on an individual basis (p < 0.05). An inverse association was also observed between most neuropsychological symptoms and sea fish consumption, indicating a "beneficial effect" from eating sea fish. On the contrary, no effects were observed as a function of dental amalgams. CONCLUSIONS: In conclusion, this study supports the finding of early alterations of motor function and neuroendocrine secretion at very low exposure levels of inorganic Hg, below the current ACGIH BEI and below the most recent exposure levels reported in the literature.

Adult↗
PubMedDate not supplied

[Protein content of latex gloves used in hospitals].

In this study the total protein content and the latex allergenic protein content in different types of medical gloves commonly used in our hospital were evaluated. The correlation between these two parameters and the correctness of the data provided by the glove manufacturers have been also verified. The main purpose of this study was to acquire information useful for preventing latex allergy in our hospital personnel. 29 different types of medical gloves were examined. The total protein contents were evaluated with Lowry modified method and the allergenic latex protein contents were evaluated with RAST-inhibition assay, both on glove samples and glove extracts. The correlation between inhibition percentages found in glove samples and in glove extracts and the correlation between total protein content and inhibition percentages determined in samples of the same gloves was verified. The highest concentrations of total proteins and allergenic latex proteins were found in examination powdered latex gloves and in surgical powdered latex gloves. A good correlation was observed between the total protein content and the inhibition percentages determined in samples of the same gloves, and between inhibition percentages found in glove samples and glove extracts. A significant amount of latex proteins was found in some brands of nitryl gloves. The clear association between the total protein levels and the allergenic latex protein levels suggests that the gloves with highest total protein content have the greatest allergenic potential. We believe that the total protein content is relevant from a preventive point of view for a proper gloves selection in the workplaces. Therefore, manufacturing companies should provide package inserts including at least the total protein contents and possibly allergenic latex protein levels, with specific measurement methods. Since the highest total protein and allergenic latex protein contents were found in latex powdered gloves, powder-free gloves must be of first choice. RAST-inhibition assays directly on glove samples instead of glove extract seems to be a good reliable and faster alternative for the evaluation of the allergenic potential of latex gloves. For latex allergic subjects it is necessary to pay attention in choosing nitryl gloves, especially as an alternative to natural rubber gloves since some brands may contain significant amounts of allergenic latex proteins.

Allergens↗
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[Significance of biological indicators of mercury exposure].

BACKGROUND: It was considered appropriate to update of the significance and use of the different mercury exposure indicators. OBJECTIVE: The aim of the this paper was to correctly select biological media and sampling time and to understand the toxic kinetics of mercury for assessment of accurate biological monitoring. RESULTS: It was confirmed that mercury in blood (B-Hg) is a good indicator of recent exposure, while urinary mercury (U-Hg) indicates current exposure when mercury reaches the renal steady state. B-Hg values are greatly influenced by fish consumption, while the variables influencing U-Hg values are amalgam fillings, commercial gamma-globulin preparations, vaccines, topical remedies, environmental pollution and hobbies, occupational exposure and, partly, fish consumption. The speciation of mercury (Hg0, Hg++, methylmercury and ethylmercury) in biological media, should provide additional and important information in evaluating mercury toxicity. CONCLUSION: It was stressed that the appropriate choice of exposure indicators has to take account of the different variability factors and the characteristics of the toxic kinetics of mercury. The results of biological monitoring must be compared with references values, which are generally in the order of several micrograms/g creatinine, and limit values such as ACGIH BEI (U-Hg 35 micrograms/g creatinine and B-Hg 15 micrograms/l) or the DFG BAT (U-Hg 100 micrograms/l and B-Hg 25 micrograms/l).

Animals↗
PubMedDate not supplied

[Lead in the 90's: "new" rules for the "oldest" of environmental toxins?].

Present lead (Pb) exposures in working and general environments are undoubtedly lower than several decades ago so that mean blood lead levels (PbB) in the main industrial sectors using lead, such as ceramics and accumulator manufacturing, are now about 30 micrograms/100 ml and in the general population between 10 and 15 micrograms/100 ml and in some situations decidedly below 10 micrograms/100 ml. At the same time increasingly more accurate and sometimes original knowledge has been acquired on the effects of low-level Pb exposure, especially the effects on the nervous system, the cardiovascular system, the endocrine and immune systems, on heme-containing enzymes, and on the reproductive system. The question of a possible mutagenic and carcinogenic action of Pb is, however, still open. It is also clear that many of the above effects were observed for PbB levels considerably below the current limit levels. For certain effects, like those on heme, the central nervous system, and blood pressure, it has not been possible to establish a threshold below which they will not occur. With effects that are so different in nature and degree and with changed exposure conditions, a critical re-examination of the assumptions on which current knowledge and prevention models are based appeared appropriate. In particular, action models are proposed for discussion which, besides the priority aim of restricting use of Pb to those situations where there is no alternative and to those working environments which guarantee compliance with modern regulations and prevention procedures, have two differentiated objectives: the first is to eliminate the dose-dependent effects occurring at exposures higher than those in the general population; the second is to reduce to the lowest possible level the effects with no threshold or with as yet unestablished threshold, by means of actions in favour not only of occupationally exposed groups but also the general population.

Air Pollutants, Occupational↗
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[Biological monitoring of occupational exposure to aluminum].

The meaning and usefulness of biological indicators in the study of occupational exposure to aluminium (Al) was assessed on the basis of the most recently acquired knowledge on the toxicokinetics of aluminium absorbed by inhalation, results of environmental and biological investigations recently carried out in industrial sectors with low risk of aluminium absorption (refining, casting and pressure moulding covering a total of 8 plants and 119 workers) and the results of investigations on a group of welders exposed to Al concentrations between 5 and 10 mg/m3. It was confirmed that not only the environmental Al concentrations but also certain chemical and physical characteristics (particle size, allotropic state, solubility), simultaneous exposure to other dusts, and mode of exposure (existence of exposure peaks) play a significant role in lung absorption of Al. Urinary Al (AlU) may be considered as an indicator of "recent" exposure with biphase excretion kinetics influenced also by duration of exposure, whereas Al in serum (AlS) can probably furnish indications both on overall exposure and on body burden. In low-level Al exposure (below 0.5 mg/m3), these indicators (especially AlU) permit differentiation of the exposed groups from the general population without, however, any clear relationship with the various environmental Al concentrations. It was also seen that AlU increased with increasing work seniority and was more marked in certain processes, such as casting, and in the first few months or years of work.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Proposal of environmental and biological monitoring and health surveillance of the exposed to inhalation anesthetics. Consensus. A Study Group on Occupational Exposure to Inhalation Anesthetics].

The Study Group on Occupational Exposure to Inhalation Anaesthetics of the Lombardy Association of Occupational Health and Industrial Hygiene prepared a document that was discussed during the Congress "Occupational Risks due to Inhalation Anaesthetics", held in Brescia, Italy, on May 12, 1992. The same document was then approved by the Directory Council of the Lombardy Association of Occupational Health and Industrial Hygiene. Data on environmental concentrations of Nitrous Oxide collected from 1989 to 1991 in 269 operating rooms of 47 hospitals in Lombardy are reported. The measured levels are considerably lower than those collected from the same Study Group from 1985 to 1987 in 111 operating rooms. The methodologies for exposure control are discussed, regarding both environmental and biological monitoring. These two techniques are complementary and can be used with standardized methods. The review of the literature on the early effects showed, even with some uncertainty at the current exposure levels, effects on liver and Central Nervous System. Still controversial are the data regarding the reproductive toxicity. Health surveillance programs have been organized in the last 5 years in 18 Lombardy hospitals and they indicate no cases of pathologies due to inhalation anesthetics on 1498 subjects. Operative proposals are suggested on the methodology and the frequency of environmental/biological monitoring and health surveillance. The "technical limit values" reported in the document from the Italian Ministry of Health are also discussed. Finally, research topics are suggested in order to assess the early effects of exposure.

Anesthesia, Inhalation↗
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[Cooperation between the occupational health department and the technical assistance office to confront the problem of pollution by anesthetics].

In the past years the problem related to occupational exposure to anaesthetic gases in operating rooms has been dealt with in different ways by each hospital administration, and frequently with little cooperation between the health departments involved. At the Spedali Civili of Brescia in the five year period, 1987-1991, a monitoring activity of nitrous oxide (N2O) and halogenated anaesthetics was performed in 30 operating rooms. This lead to a noticeable reduction of environmental concentrations of these substances. Favourable results have been achieved principally by maintenance and/or substitution of anesthesiological machine parts. In order to organize and facilitate this program a close collaboration was accomplished between the Medical Direction of the Hospital and the Occupational Health Department, with the support of the Technical Assistance Department.

Air Pollutants, Occupational↗
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[Proposal of a health education program].

Since 1987 at the Spedali Civili of Brescia the problem of anaesthetic gases pollution in operating surgery rooms was managed by means of periodical environmental monitoring and maintenance of the anaesthesiological equipments. The mean nitrous oxide concentrations were generally reduced to values below the limits indicated by the Italian Ministry of Health. On the contrary, a low participation of the operating room personnel was observed in the health surveillance program and this phenomenon is clearly evidenced by the progressive decrease of the number of medical examinations. In order to clarify the usefulness of health surveillance programs and to promote the adoption of "less pollutant" behaviour, a Health Education Program was planned by the Medical Administration, in collaboration with the Occupational Health Service and the Department of Anesthesiology and Intensive Care. This program will be performed at different times, including the administration of a questionnaire, the participation at information meetings, the distribution of brochures and the evaluation of environmental and biological exposure data before and after the education program.

Anesthesia, Inhalation↗
PubMedDate not supplied

[Protocol for health surveillance of workers exposed to repetitive arm movements].

BACKGROUND: Repetitive movements of the upper limbs at work can cause the onset of musculo-skeletal disorders and therefore an adequate planning of health surveillance is needed. A Work Group on this problem was constituted in Brescia, Italy, following the great interest raised by recent scientific meetings on this topic. OBJECTIVES: The aim of the Group was to prepare a proposal for a health surveillance protocol for the use of Occupational Health Physicians. RESULTS: Health surveillance for the prevention of upper limb disorders must be based on the degree of risk. The risk assessment procedure should be based on the methodology currently available for ergonomic analysis and should also consider the frequency of upper limb disorders in the exposed workers. In case of moderate risk, it is necessary to identify hyper-susceptible individuals, in order to reduce exposure to repetitive movements by means of an adequate task fitness evaluation and suitable health education programmes. In situations of medium-to-high risk, a specific programme of health surveillance must be planned in order to identify early disorders and prevent the onset of more severe damage using task fitness evaluation and rehabilitation therapies. The appropriate diagnostic procedure is indicated for this purpose and a classification is proposed to divide the upper limb disorders into two stages, according to the clinical picture: a first acute-subacute stage, which is potentially reversible, and a chronic-subchronic stage, which is non-reversible. Legal reports are required according to the stage of the disease identified and must be supported by an adequate risk assessment.

Arm↗
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[Exposure to neurotoxic metals and prevalence of parkinsonian syndrome in the area of Brescia].

The prevalence of parkinsonian syndromes was studied in the province of Brescia (Northern Italy), in order to verify its possible increase in the surroundings of ferroalloy plants located in a valley of the pre-Alps. A case-list of subjects affected by these disturbances was identified using four different sources of information: a) registers from local medical clinics; b) admission charts from local hospitals; c) consumption of levodopa; d) NHS list of exemption from prescription payment, due to the illness. Exploratory data show a frequency of parkinsonian disturbances among the residents in the surroundings of the ferroalloy plants and downwind (crude prevalence = 358/100,000 population, standardized for age and sex = 438) significantly higher (s.m.r, = 1.58; C.I. = 1.41-1.76) than the entire Province (crude prevalence 246/100,000). This preliminary result could indicate the interaction of prolonged environmental exposure to heavy metals, such as manganese, and genetic factors, potentially relevant in this mountain population.

Adolescent↗