Biomedical subjects
Publications and source records attributed to S Tringali.
We report the statistical elaboration of some data pertinent to a population of workers professionally exposed to VDT. These first data also confirm that the length of the use of VDT doesn't influence the judgement of fitness to work.
We show the case of a worker affected with schizophrenia who was declared by the psychiatrist fit to work. The "Medico Competente" on the contrary decides that he is not fit to do that job and his judgement is also confirmed by the "ASL-Collegio Medico" according to the D.Lgs 626/94, item 17, which extends the judgement of the fitness to work given by the "Medico Competente" even to the psychic sphere of the worker.
We show the case of a worker affected with schizophrenia who was declared by the psychiatrist fit to work. The "Medico Competente" on the contrary, on the basis of his studies and in particular on his deep knowledge of the features of the office and the place where that worker works, decides that he is not fit to do that job. This judgement is confirmed by the "ASL-Collegio Medico". The case we described emphasizes in a very strong way what is written in the item 17, paragraph 1, letter a of the D.Lgs 626/94, which extends the judgement of the fitness to work given by the "Medico Competente" even to the psychic sphere of the worker.
Data on long-term biological monitoring in two groups of workers engaged in cleaning operations in a wool factory and exposed to methylchloroform are presented. The longitudinal survey lasted one year and brought about 19 random systematic sampling (once or twice a month for everyone of the 13 subjects monitored). The biological marker adopted was the urinary concentration of the solvent as such, according to a previously studied method. The collected data allowed to measure: the annual average level of exposure (estimated by the long term geometric mean); the day to day variation of the true daily exposure averages (estimated by the geometric standard deviation); the probability of overexposure (daily exposures exceeding the biological exposure limit) and the yearly number of work shifts of overexposure. The usefulness of performing long-term surveys of occupational exposure to the chemical substances by mean of longitudinal biological monitoring is discussed.
Practical applications and predictive values of a thermal comfort index (Fanger's PRV) were verified on a sample school population (1236 subjects) by studying the relationships between thermal sensations (subjective analysis), determined by means of an individual questionnaire, and the values of thermal comfort index (objective analysis) obtained by calculating the PMV index individually in the subjects under study. In homogeneous conditions of metabolic expenditure rate and thermal impedence from clothing, significant differences were found between the two kinds of analyses. At 22 degrees C mean radiant and operative temperature, the PMV values averaged 0 and the percentage of subjects who experienced thermal comfort did not exceed 60%. The high level of subjects who were dissatisfied with their environmental thermal conditions confirms the doubts regarding the use of the PMV index as a predictive indicator of thermal comfort, especially considering that the negative answers were not homogeneous nor attributable to the small thermal fluctuations (less than 0.5 degree C) measured in the classrooms.
In preventive occupational industrial medicine problems relevant to psycho-social factors always interfere in medical investigation by showing up as a not clearly organic symptomatology but as a phenomenon of somatization of anxiety or as working and social setting unfitness. CBA-2.0 Primary Scale Battery, a specific questionnaire for the investigation of some considerable clinical important traits, was administered to 414 white collar in order to facilitate a better discrimination between psychological and biological factors. Results show some areas (smoking habits, hurried eating, sedentary, Type A, conflicting social relationship on working setting) which are to be investigated thoroughly by both clinic and industrial psychologists for better defining distress causes in working organization and social environment.
The survey carried out in the large sample (2379 workers) of petrochemical industry in Lombardia region was intented to provide current estimates of prevalence of hypertension and cardiovascular risk factors in the industrial population. The prevalence of elevated blood pressure (borderline hypertension and definite hypertension) was 40% in men and 19% in women, the rate for definite hypertension were 17% in men and 7% in women. The relative impact of age and weight on blood pressure status appeared to be rather substantial. Estimated positive effects of the weight control program cold have reduced the prevalence of hypertension by about 45%. The survey data confirmed that subjects with hypertension were more often dyslipidemic, had higher blood glucose and serum uric acid levels than normotensive persons. It was rather intriguing to find very clear, however, not very strong effect of uric acid level on blood pressure also among normotensive workers. The importance of this factor may be strengthened by the fact that there was also statistically significant association between the changes in the optic fundi and serum uric acid level after controlling for age and blood pressure. The results of the study disclosed the positive effects of physical activity at leisure on blood pressure status and this was independent on weight and age. The high consumption of wine increased the relative risk of hypertension mainly in men. On the basis of the survey data collected it was not possible to confirm a definite relationship between smoking and hypertension.
Treatment options for acute leukemia relapsing after allogeneic BMT include conventional chemotherapy or a second transplant; however, results are rather discouraging, the first option being associated with poor survival and the second with a high mortality rate. More recently, donor leukocyte infusion (DLI) from the original donor has been used for relapsed patients in an attempt to induce a graft-versus-leukemia (GVL) effect. This procedure is partially devoid of the toxicity inherent to a second BMT. At our Institution, a 36-year-old patient with biphenotypic AML in second complete remission after relapse following allogeneic BMT was treated with peripheral blood stem cell (PBSC)-enriched donor leukocytes, obtained after in vivo priming with rhG-CSF. The patient experienced extensive cGVHD but developed a testicular relapse while in full hematologic remission. After irradiation of the sanctuary site he remains free of disease, still with chronic GVHD, 21 months after bone marrow relapse. This case suggests that immunologically privileged sites are inaccessible to GVHD/GVL effect. This should be considered when planning salvage transplants procedures in patients at risk for extramedullary involvement.
Two different groups of workers, involved in production or formulation of chlorotriazine herbicides during the last 10 years, have been retrospectively studied for occurrence of diseases related to the exposure to Atrazine, Simazine, Propazine, and Terbuthylazine. A control group has been selected between clerical workers of the same plants. Subjects exposed to the different compounds have been studied for inhalator and dermal exposure by active sampling, skin pads, and hand washings; samples have been further processed and specifically analysed. Urines have been studied for the presence and concentrations of mono and bidealkylated triazine metabolites. Exposure data have been collected during the last five years and extrapolations have performed for exposures in the preceding years. Clinical finding and laboratory data for all workers have been obtained from medical surveillance records. Data available for the last 10 years have been evaluated to highlight possible differences between the investigated groups.
Two different groups of workers involved, during the last 10 years, in the production or formulation of chlorotriazine herbicides have been retrospectively studied in order to verify the occurrence of diseases possibly related to Atrazine, Simazine, Propazine and Terbuthylazine exposure. A control group has been selected between clerical workers of the same plants. Exposure data have been collected during the last five years and some extrapolations have been performed to hypothesize the level of exposure in the preceeding years. Clinical findings and laboratory data obtained from ten year medical surveillance records have been evaluated to highlight possible differences between the investigated groups. A first close examination of the data concerning the anamnesis and clinical, hematochemical and functional reports of the three groups of investigated subjects does not show any pathological situation or symptoms specifically connected to chlorotriazine compounds exposure and/or significant differences between exposed and non exposed. A next series of statistical surveys involving some of the hematochemical indicators (RBC, WBC, Hb%, SGOT, SGPT, gamma GT) has been performed either on internal values of each group or on the average-values of the three groups differently exposed (production, formulation, control). The first survey was a longitudinal study, the second one was a cross sectional one. Both the investigations have excluded significant differences attributable to the occupational exposure.