[On 2 cases of acute pulmonary edema with unusual etiology: hydrochloric acid and commercial bleaches (sodium hypochlorite)].
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Adult↗
Biomedical subjects
V Foà
Publications and source records attributed to V Foà.
[Determination of 2 aromatic amines (benzidine, o-tolidine) in the work environment: description of a method].
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Amines↗
Immunomodulatory effects of occupational exposure to mancozeb.
The effects of occupational exposure to ethylene-bis-dithiocarbamate of manganese and zinc on the immune system were evaluated in a group of mancozeb-exposed manufacturers and controls. The immune system tests revealed the following: (a) lymphocyte proliferative responses triggered by different activators and mitogen-induced IL-2 production were higher in exposed subjects than in controls; (b) production of monocyte/macrophage-derived IL-1 and polyclonal IgG and IgM, by beta-lymphocytes, did not differ between exposed subjects and controls; (c) percentages and absolute numbers of total T-cells, T-helper cells, T-suppressor/cytotoxic cells, activated T-cells, total beta-cells, and natural killer cells were similar in exposed subjects and controls; (d) serum immunoglobulin classes and complement fractions were within the range of normality; and (e) rheumatoid factor and non-organ-specific serum autoantibodies were absent in exposed and control subjects. An increase in T-cell functional response was found in the exposed group, suggesting a slight immunomodulator effect of mancozeb in conditions of low-level, prolonged occupational exposure.
Air Pollutants, Occupational↗
[Etiology of polyneuritides due to glues : experimental studies on the neurotoxicity of n-hexane].
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Alkanes↗
[Lead arsenate as an underestimated cause of polyneuropathy in rural environment: description of two cases].
Two cases of lead arsenate polyneuropathy are described in two farmers from the same rural area; the etiology of the neurologic al disorder was ascertained only after repeated hospital admissions. It was a neuropathy of the radial nerve associated with signs of peripheral impairment of the lower limbs with pains and paresthesias. Abdominal colies, arterial hipertension, anaemia and signs of renal impairment were also present. Specific therapy was undertaken which was soon followed by nearly full recovery. Lead and arsenic toxicology are discussed with particular focusing on the necessity emphasis on commun occupational hazards both in terms of diagnostic and therapeutic procedures. The differential diagnosis is considered between the observed clinical picture and other polyneuropathies of different etiology i.e. dysmetabolic (porphyria) or toxic (insecticides, T.O.C.P., etc).
Adult↗
[Chemical and physical characteristics and toxicology of man-made mineral fibers].
The evidence for the adverse health effects following exposure to asbestos (i.e. fibrogenic and carcinogenic effect) has prompted widespread removal of asbestos-containing materials and led to banning of asbestos internationally (in Italy, DPR 257/1992), resulting in the increased use of substitutes composed of both naturally occurring and synthetic materials, including man made mineral fibres (MMMFs) and man made organic fibres (MMOF). MMMFs represent a family of synthetic, inorganic vitreous substances derived primarily from glass, rock, slag, or clay. MMMFs are further divided into two categories: 1) man made vitreous fibres (MMVFs), further divided as follows: a) fibrous glass, including mainly continuous filament, special purpose fibres; and microfibres. The materials are typically composed of oxides of silicon, calcium, sodium, potassium, aluminum, and boron. b) Mineral wool, including glass wool, rock wool (derived from magma rock) and slag wool (made from molten slag produced in metallurgical processes such as the production of iron, steel, or copper). The main components of rock wool and slag wool are oxides of silicon, calcium, magnesium, aluminum, and iron. 2) Refractory/ceramic fibres, amorphous or partially crystalline materials made from kaolin clay or oxides of aluminum, silicon or other metal oxides (i.e. oxides of zirconium and yttrium). Less commonly, refractory fibres are also made from non-oxide refractory materials such as silicon carbide, silicon nitride, or boron nitride. Industrial production of MMVFs began in the second half of the 19th century, while ceramic fibres production began more recently, in the early 1970s. Major uses of MMMFs include thermal, acoustic and aerospace insulation, fire proofing, reinforcing material in plastics, cement and textile, optic fibres, air and liquid filtration, friction products, refractory coatings. Serious questions have been raised about health implications of MMMFs. Suspicion about the possible occurrence of adverse effects following exposure to MMMFs arises mainly from some similarities of MMMFs with asbestos (fibrous aspects, inhalability, chemical composition, free radical formation). The fibre characteristics that have been identified as crucial in influencing the pathogenesis of fibre-related adverse respiratory effects can be mainly divided into two groups: fibre dimension, and chemical composition and structure. Fibre dimension plays a determining role in conditioning penetration in the lung. In a broad sense, the term "respirable" means "capable of being carried by breath into the respiratory system". For regulatory purposes, "respirable fibres" (i.e. RFP) are defined in most countries following WHO criteria: length > 5 microns, diameter < 3 microns, length/diameter > 3. MMMFs are generally produced as fibres of diameter higher than asbestos, and too large in diameter to be respirable. Moreover, due to the production process, they are structurally amorphous. Since MMMFs have no crystalline domains, they also have no clearly defined structural faults and they fracture transversely, and randomly. Fragments that are too large to be taken up by macrophages can be resolved in the lung by a leaching--or dissolution--process which leads to a progressive reduction of particle length. In contrast, when abraded, asbestos tends to split longitudinally into new, fine, straight fibres: these fibrils are of much smaller diameter, more respirable, and consequently more hazardous than parent fibres. Fibre chemical composition plays a determining role in conditioning the higher or lower biological activity, durability, biopersistence, and biodegradability. The term "biological activity" means reactivity or ability to interact (possibly due to formation of active oxygen species, identified as a crucial step in the mechanism of action) with biological structures and tissues. Fibre "durability" is strictly related to its solubility. It can be defined as the ability to resist
Animals↗
[The preparation and characterization of fine dusts carried out in the Clinica del Lavoro di Milano in support of experimental studies].
This paper aims to illustrate the conditions selected at the Clinica del Lavoro of the University of Milan to prepare and analyze a large number of fine dust samples produced over a period of about 50 years, that were initially used for studies within the Clinic performed in its own facilities, and since 1956 were sent to other Italian and overseas laboratories (Luxembourg, UK, Germany, Norway, Sweden, South Korea, USA). The total quantity of material distributed (with maximum size 7-10 microns) was about 2 kg and consisted of the following mineral and artificial compounds: quartz, HF-treated quartz, tridymite, HF-treated tridymite, cristobalite, chromite, anthracite, quartz sand for foundry moulds, sand from the Lybian desert, vitreous silica, pumice, cement, as well small quantities of metallic oxides, organic resins, chrysotile, crocidolite, fibres (vitreous, cotton and polyamidic). About half of the entire quantity of dusts produced consisted of partially HF-treated tridymite. Initially, research on the etiology of silicosis used quartz dust samples, simply sieved or ventilated (consisting of classes finer than 0.04 mm, containing a 15-20% respirable fraction). From 1956 to 1960 the dusts were produced by manual grinding in an agate mortar, below about 10 microns, starting from quartz from Quincinetto (near Ivrea, Province of Turin), containing about 99.5% quartz: particle size and composition were checked using an optical-petrographic technique, with identification of the free and total silica content. Subsequently, the dusts used for biological research were obtained by grinding coarse material with a cast iron pestle and planetary mills, agate and corundum jars. The grinding products were sized by means of centrifugal classification, using the selector developed by N. Zurlo, ensuring control of dust size both optically and by means of wet levigators and hydraulic classifiers (in cooperation with the Institute of Mines of Turin Polytechnic School). After 1990 pestles and rotating drum mills with autogenic grinding load were used for grinding: the size of the treated samples was reduced to 0.05 mm and an extremely fine fraction was extracted, smaller than 7-10 microns, which was used for pneumoconioses research. The characterization of the dust produced was in any case achieved by means of preliminary examination under the optical microscope (polarized light, sometimes supplemented with phase contrast), followed by quantitative analysis using chemical/petrographic, chemical diffraction or, more commonly, petrographic/diffraction techniques. Microscopic examination, if necessary supplemented with photo-micrography, was also used for particle size control, for numerical counting and subsequent reference to weight proportion. For all operational procedures the essential data on instruments and methods are reported. During studies on production, separation of fine dusts and their characterization, partly performed with support from the European Community (EEC/European Coal and Steel Commission), the following topics in particular were addressed: connections between particle size and free silica content in the measurable dust size fraction of the grinding products and in airborne dusts; characteristics of the dusts and risk indices in Italian iron and pyrite mines; possibility of abatement of the ultrafine classes of airborne dusts in pneumatically filled stopes by the addition of salts; comparison of the latest dust selectors used within the European Community; influence of the grinding methods on the results of fibrous and soft mineral measurement using X-ray diffraction analysis.
Academies and Institutes↗
[Urinary excretion of arsenic and its metabolites in a population of adult males not occupationally exposed in the province of Bari].
Urinary excretion of total arsenic (AsT) and other relevant arsenic species, i.e. inorganic arsenic (AsI), monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), was assessed in 5 groups of subjects with different both seafood consumption and smoking habits. All 137 subjects were young (mean age +/- S.D = 21.7 +/- 2.1), without occupationally exposure to arsenic, males living in the province of Bari, South Italy. The separation of arsenic species was achieved by ion exchange chromatography and the eluted fractions were then analysed by means of Hydride generation-AAS. A quality control of the analytical data was performed jointly to a Belgian laboratory. Statistical analysis of collected data showed that the excretion of AsT is increased in the group with regular consumption of fish and shellfish.
Adult↗
[Bernardino Ramazzini and "Medicina del Lavoro"].
Three hundred years after the first edition of Ramazzini's "De Morbis Artificum Diatriba", this paper reviews all the articles on the work of the great Master of Carpi that have been published over a century in the ninety volumes of "La Medicina del Lavoro". Since the first issue of the journal in 1901, many authors have submitted papers which revisited and commented on the work of Ramazzini, particularly in anniversary years (1914, the anniversary of his death, 1933 and 1983, anniversaries of his birth), but only Luigi Devoto was capable of fully understanding the methodology introduced by Ramazzini, transforming it into practical applications which he listed in ten fundamental actions. Mainly for this reason and considering that Ramazzini had been practically ignored for two centuries, it was decided to consider the Devoto period as the "true Ramazzini era". The death of the founder of the journal in 1935 marked the unexpected beginning of a long silence, lasting up to 1983, during which not one paper on Ramazzini was published in "La Medicina del Lavoro". It is concluded that a comparison between the diseases described by Ramazzini and those of to-day is of no practical use and that a tribute to Ramazzini is simply necessary in recognition of his contribution to the birth and development of occupational medicine, but is nonetheless insufficient. What is also needed, following in the footsteps of the founder of this journal and of the Clinica del Lavoro of Milan, is to reinterpret Ramazzini's methods in modern terms in the perspective of the ten actions he proposed, bearing in mind that possibilities exist to-day whereby his efforts can be completed and further enlarged in terms of practical applications.
History, 18th Century↗
[Proposals on health surveillance contained in the bill No. 2389 presented by Senator Smuraglia].
The Italian Interassociative Council for the Prevention has examined the bill n. 2389 of senator Smuraglia, expressing appreciation for the initiative (demanded since a long time by the operators of the field) and for the remarkable commitment in the drawing up of such an extensive and well-organized text. At the same time the IICP set up and forwarded to senator Smuraglia some notes and additional proposals, as well as proposals for partial changes, on the following topics:--employer's functions--relationship between the employer and the surveillance bodyprevention and protection service--medical surveillance and "Competent Doctor" threshold limit values--informational system--institutional expertise--omologation--penalty system. In this report we quote the notes expressed with reference to the chapter about the medical surveillance and the competent doctor, of interest of this meeting. We can anticipate with satisfaction that senator Smuraglia admitted many of our proposals and that on their basis he signed a few amendments. Between the proposals we suggested I would like to mention the one concerning the overcoming of the existing medical surveillance system. This is a strict system, essentially outlined by the Law 303/56 (article n. 33) and by the Law 1124/65, by now inadequate with reference to the new working reality and to the current pathology correlated to it. We submit some considerations and the first hypothesis on the constructions of a model of medical surveillance more flexible and open, in conformity with the new reality and the recommendations of the E.U.
Clinical Competence↗
[Assessment of occupational exposure to aromatic polycyclic hydrocarbons determining urinary levels of 1-pyrenol].
In conformity with Italian law 626/94, occupational exposure to Polycyclic Aromatic Hydrocarbons (PAH) in several types of work environments was assessed by analysing urinary levels of 1-pyrenol. A total of 231 non-smokers exposed to PAH (82 workers, employed in two different thermoelectric power plants using combustible oil (30 subjects from plant A and 52 from plant B), 18 subjects working for a company recovering exhausted oils, 12 working on rubber production, 10 on road surface asphalting operations, 22 working in the anodizing section of an aluminium plant, 27 chimney-sweeps, and 60 coke-oven workers (30 topside workers, and 30 doing other jobs)) were enrolled. There were also 53 non-smoker control subjects, not occupationally exposed to PAH. Current smokers were excluded, since smoking is an important confounding factor when occupational exposure to low PAH concentrations are monitored. Confounding factors, i.e., diet and passive smoking, were checked by means of a questionnaire which, in addition to personal data and habits, also requested specific details about the type of diet followed and possible exposure to passive smoking during the 24-hour period preceding urine collection. In controls, exposure to PAH in the diet significantly increased 1-pyrenol levels in urine: in subjects introducing > or = 1 microgram of pyrene with the diet, the mean urinary level of 1-pyrenol was significantly higher than that introduced with < 1 microgram (high versus low dietary intake, mean +/- SD, 0.08 +/- 0.13 and 0.04 +/- 0.06 1-pyrenol mumoles/mole of creatinine, respectively; Mann-Whitney U-test Z = 2.67, p < 0.01). Conversely, passive smoking did not influence 1-pyrenol levels. In the overall population (controls and exposed), multiple linear regression analysis showed that levels of urinary 1-pyrenol were significantly influenced by occupational exposure to PAH in asphalt workers, anodizing plant workers, chimney-sweeps, and coke-oven workers, both those working at the top side of the oven and those doing other jobs (t = 2.19, p = 0.02; t = 2.56, p = 0.01; t = 5.25, p = 0.001; t = 3.34, p = 0.001; t = 7.82, p = 0.001, respectively; F = 9.7, p < 0.01), but not in power plant workers in contact with combustible oils, workers recovering exhausted oils, or rubber production workers. Diet and passive smoking did not influence urinary 1-pyrenol levels in the entire sample population. This biomarker also allowed an assessment of exposure levels among certainly exposed subjects. The percentage of subjects with urinary 1-pyrenol values higher than the 99th percentile of the reference population (0.67 mumoles 1-pyrenol/mole of creatinine) was significantly higher than that of controls in asphalt workers (20%), anodizing plant workers (14%), chimney-sweeps (13%) and coke-oven workers (33%) (chi-square test: asphalt workers = 6.1, p = 0.01; anodizing plant workers = 4.3, p = 0.04; chimney-sweeps = 7.1, p = 0.008; coke-oven workers with other duties = 4.4, p = 0.04; top side workers = 16.5, p < 0.001). In chimney sweeps and top side workers, respectively 2 and 4 subjects (7% and 13%) exceeded the precautionary level of 1.4 mumoles 1-pyrenol/mole of creatinine; of these, 1 chimney sweep and 3 top side workers (4% and 10%) exceeded the recommended biological threshold of 2.3 mumoles 1-pyrenol/mole of creatinine.
Humans↗
[Establishment of a model of an individual health and risk record in an artificial abrasive grinding-stone factory].
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Medical Records↗
[Diseases due to vegetable textile fibres].
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Byssinosis↗
[The scientific progress of the "Clinica del Lavoro Luigi Devoto" as seen through the contents of the journal "La Medicina del Lavoro". ].
On occasion of the Centenary of the "Clinica del Lavoro Luigi Devoto", its researchers suggested that awareness of its historical identity and scientific development should constitute the basis for the future of the Institution. The directors of the Institute who have succeeded one to the other over the years have left a vivid report of the vast amount of work developed in several research fields and also of the original results achieved with significant impact on the scientific community and on society. Content analysis of "La Medicina del Lavoro" allowed us to shed light on strong bonds existing between manufacturing techniques, work organization and health, in the different political and social periods in which they developed. Many actions have been defined and several research subjects have been renewed (according to current demands and new methodological possibilities) between the past and the present, nevertheless many new approaches need to be taken in the fields of epidemiology, indoor air quality, ergophthalmology, muskuloskeletal disorders, environmental and molecular toxicology, and further research will be undertaken thanks to the potential of this discipline for the future. The aim of this report is also to express our thanks to all the medical and non-medical staff who have made their contribution over 100 years of engagement.
Ambulatory Care Facilities↗
[The precautionary principle: is it applicable to occupational medicine?].
Precautionary Principle (PP) and its application to environmental and health policy appear in the 70's and from that time is introduced more and more frequently in different international treaties and conferences on environment and health. PP is a risk management policy applied to scientifically uncertain circumstances where it is necessary to act against a potentially harmful risk factor without waiting for more accurate information. When this situation takes place at the workplace, the risk management is an Employer's task. The employer can use different instruments, including the occupational physician's advise, to reach their target. After identification of possible health and safety risk factors and after characterisation of a non-admissible risk for worker's health, the Employer must chose which precautionary actions to take, also in function of economic, technical and judicial needs and restrictions. This action can be the application of measures of "prudent avoidance" through steps such as health surveillance, until more radical measures are taken by using P.P. The Occupational health specialist that is already operating of the work place with characterised and well known risk factors should introduce the instruments, in the health surveillance activities, that may detect possibly adverse effects related to risk factors characterised by scientific uncertainty. This is very important whenever the employers don't have the possibilities or are not sensitive enough to take other kinds of precautionary measures. Moreover, the occupational physician should play an active role also in the risk assessment phase by defining those chemicals or physical agents still characterized by scientific uncertainty.
Humans↗
[Assessment of exposure to polycyclic aromatic hydrocarbons during road paving].
Asphalt is a mixture of bitumen, (its fumes contain about 1% of polycyclic aromatic hydrocarbons, PAH), and mineral matter. 18 Workers were investigated during road paving to assess PAH exposure by environmental air-monitoring (the 16 most relevant, according to the American Environmental Protection Agency, EPA) and biological monitoring (urinary 1-hydroxypyrene excretion). Our results show that PAH exposure in these workers is not higher than that observed in traffic policemen working in urban areas.
Adult↗
[Lombardy regional project: prevention of occupational tumors].
In Lombardy, the regional project "Prevention of occupational cancers" is ongoing. The main objectives of this project are to identify work environments in which there might be a possible exposure to carcinogenic substances and to elaborate preventive measures. A casual sample of 250 working settings representing the different economic activities has been selected and evaluated. The 10% of the examined workplaces showed a possible exposure to chemical carcinogens. The most common carcinogens were trichloroethylene, preparation of plastics materials containing acrylonitrile-butadiene-stirene, formaldehyde, wood dust, hexavalent chromium, silica and polycyclic aromatic hydrocarbons. Galvanic industries, Bitumen production and placing companies and Plastics processing plants will be studied for environmental and biological monitoring and for the development of preventive measures.
Humans↗
[New biomarkers of exposure].
In this paper we have defined the new biomarkers of exposure (NBE) as those biomarkers discovered in the last five years and, among previously validated biomarkers, also those applied in different ranges of doses or those determined in biological matrices which differ from matrices originally considered. We examined the results from the surveys carried out by the main Italian research units involved in biological monitoring, i.e. those from the Universities of Brescia, Milan, Naples, Padua, Parma, Pavia, Turin and Verona. The data were collected using a standardized model and included the following: type of element or organic compound, type of biomarker, analytical technique and method, their relationship with environmental monitoring data, their relationship with effect indicators or effects in general, improvement with respect to old biomarkers, reference values. Twenty two NBEs were identified: 14 elements and chemical compounds as such or as metabolites, 4 examples of mixtures, 3 of new matrices, one of speciation. Among the others, aspects such as interest in requiring NBE, quality assurance, availability, cost-benefit ratio were discussed. We conclude that development of this specific field of research appears to be a crucial point for future improvement in risk assessment and health surveillance procedures.
Animals↗