rubrica

Lavoro

  • Dario Consonni1

  1. Clinica del lavoro, Milano
Dario Consonni -

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Ricerca bibliografica periodo dal 16 novembre 2013 al 31 gennaio 2014

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Stringa: ("occupational exposure"[MeSH Terms] OR "occupational diseases"[MeSH Terms]) OR "occupational health"[MeSH Terms]) OR "workplace"[MeSH Terms]) OR "accidents, occupational"[MeSH Terms]) OR "employment"[MeSH Terms]) OR occupation[Title/Abstract]) OR occupational[Title/Abstract]) OR worker[Title/Abstract]) OR workers[Title/Abstract]) AND ("italy"[MeSH Terms] OR "italy"[All Fields]) AND ("2013/11/16"[PDAT] : "2014/01/31"[PDAT])
1. Santovito A(1), Cervella P(2), Delpero M(2). Increased frequency of chromosomal aberrations and sister chromatid exchanges in peripheral lymphocytes of radiology technicians chronically exposed to low levels of ionizing radiations. Environ Toxicol Pharmacol. 2013 Dec 31;37(1):396-403. doi: 10.1016/j.etap.2013.12.009. [Epub ahead of print]
Author information: (1)University of Turin, Department of Life Sciences and Systems Biology, Via Accademia Albertina n. 13, 10123 Torino, Italy. Electronic address: alfredo.santovito@unito.it. (2)University of Turin, Department of Life Sciences and Systems Biology, Via Accademia Albertina n. 13, 10123 Torino, Italy.

Abstract
Chromosome aberrations (CAs) and sister chromatid exchanges (SCEs) frequencies were estimated in peripheral lymphocytes from 21 radiology technicians, and from 21 non-exposed control subjects. We exclusively considered individuals who neither smoke nor consume drugs or alcohol for a period of at least two years prior to the analysis. Significant differences were found between exposed and controls in terms of SCEs and CAs frequencies. Technicians showed a significant higher number of high-frequency individuals (HFIs) with respect to the control group. Nevertheless, the mean frequency of SCEs observed among technician HFIs did not significantly differ with respect to that observed among control HFIs. Vice versa, the non-HFIs belonging to technicians group showed a statistically higher difference in the SCEs/NSM value with respect to the non-HFIs belonging to control group. Since the differences in the SCEs frequencies between the two groups are due to non-HFIs, our results seem to indicate a general genotoxic effect of the IR, not affected by HFIs. Among technicians, the level of chromosome damage correlated neither with years of radiation exposure nor with the age of the subjects. Vice versa, in the control group, a positive correlation was found between the number of SCEs and age. In both samples the gender status did not influence the frequencies of CAs and SCEs. Our results suggest that chronic long-term exposure to low doses of ionizing radiation could increase the CAs and SCEs frequencies. This study reinforces the relevance of the biomonitoring of hospital workers chronically exposed to ionizing radiation.

2. Matteis SD, Consonni D, Lubin JH, Tucker M, Peters S, Bertazzi PA, Caporaso NE, Pesatori AC, Wacholder S, Landi MT, Vermeulen RCh, Kromhout H. Authors' Response to: Comment upon the article: Impact of occupational carcinogens on lung cancer risk in a general population. Int J Epidemiol. 2013 Dec;42(6):1895-6. doi: 10.1093/ije/dyt176.
Author information: Occupational and Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK, Unit of Epidemiology, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA, Institute for Risk Assessment Sciences, Environmental Epidemiology Division, Utrecht University, Utrecht, The Netherlands and Western Australian Institute for Medical Research, University of Western Australia, Nedlands, WA, Australia.
3.Giusti L, Valle YD, Bonotti A, Donadio E, Ciregia F, Ventroni T, Foddis R, Giannaccini G, Guglielmi G, Cristaudo A, Lucacchini A. Comparative proteomic analysis of malignant pleural mesothelioma evidences an altered expression of nuclear lamin and filament related proteins. Proteomics Clin Appl. 2014 Jan 10. doi: 10.1002/prca.201300052. [Epub ahead of print]
Author information: Department of Pharmacy, University of Pisa, Pisa, Italy.

Abstract
PURPOSE: Malignant mesothelioma is a neoplastic disease linked to asbestos exposure whose diagnosis is limited, so detection methods for an early diagnosis and treatment result essential. Here, we compared proteomic profiles of malignant pleural mesothelioma (MPM) and benign biopsies to search potential biomarkers useful in differential diagnosis. EXPERIMENT DESIGN: Tissue biopsies were obtained from 53 patients who were subjected to a diagnostic thoracoscopy. Two-dimensional electrophoresis/mass spectrometry based approach was used for proteomic analysis and protein validation was carried out by western blot analysis versus benign and lung carcinoma samples RESULTS: Among the proteins identified we confirmed known MPM biomarkers such as calretinin and suggested the new ones as pre-lamin A/C, desmin, vimentin, calretinin, fructose-bisphosphate aldolase A, myosin regulatory light chain 2, ventricular/cardiac muscle isoform, myosin light chain 3 and myosin light chain 6B. Ingenuity software was used to identify the biological processes to which these proteins belong and to construct a potential network. CONCLUSIONS AND CLINICAL RELEVANCE: Overall, our results suggest potential biomarkers that can be useful in occupational medicine for the early identification of the onset of disease in health surveillance of past asbestos-exposed workers, for monitoring the progress of disease and for assessing the response to treatment.

4. Bracci M, Manzella N, Copertaro A, Staffolani S, Strafella E, Barbaresi M, Copertaro B, Rapisarda V, Valentino M, Santarelli L. Rotating-shift nurses after a day off: peripheral clock gene expression, urinary melatonin, and serum 17-β-estradiol levels. Scand J Work Environ Health. 2014 Jan 8. pii: 3414. doi: 10.5271/sjweh.3414. [Epub ahead of print]
Author information: Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Tronto 10/a, 60020 Torrette, Ancona, Italy. m.bracci@univpm.it.

Abstract
OBJECTIVE: Impairment of clock gene expression and changes in melatonin and 17-β-estradiol levels may constitute biological alterations underlying the increased risk of breast cancer among shift workers. The aim of this study was to compare levels of selected core clock gene expression, 6-sulfatoxymelatonin (aMT6s), and 17-β-estradiol between rotational shift work (SW) and daytime (DT) workers after a day off. METHODS: The cross-sectional study comprised 60 nurses with ≥2 years of SW and 56 permanent DT nurses. Transcript levels of circadian genes BMAL1, CLOCK, NPAS2, CRY1, CRY2, PER1, PER2, PER3, and REVERBα were determined by quantitative real-time polymerase chain reaction (PCR) in lymphocytes. All participants were tested in the early follicular phase of the menstrual cycle. Samples were collected at the beginning of the morning-shift after a regular night's sleep on a day off. Chronotype and sociodemographic characteristics were also evaluated. RESULTS: We found a significantly higher expression of BMAL1, CLOCK, NPAS2, PER1, PER2, and REVERBα and a lower expression of PER3, CRY1 and CRY2 among SW compared to DT nurses. SW participants did not demonstrate a significant difference in aMT6s levels, but they did show significantly higher 17-β-estradiol levels compared to DT nurses. Multiple linear regression analysis confirmed the role of SW on expression of BMAL1 (β 0.21, P=0.040), CLOCK (β 0.35, P=0.008), NPAS2 (β 0.30, P=0.012), PER1 (β 0.33, P=0.008), PER2 (β 0.19, P=0.047), PER3 (β -0.27, P=0.012), CRY1 (β -0.33, P=0.002), CRY2 (β -0.31, P=0.005), REVERBα (β 0.19, P=0.045), and on 17-β-estradiol levels (β 0.32, P=0.003). The analysis also confirmed the role of chronotype as an independent factor for PER1 (β 0.48, P=0.001) and PER2 (β -0.22, P=0.022) expression, and 17-β-estradiol levels (β 0.26, P=0.011). CONCLUSIONS: Rotating SW nurses show alterations in peripheral clock gene expression and 17-β-estradiol levels at the beginning of the morning shift after a day off.

5. Filiberti R, Marroni P, Spigno F, Merlo DF, Mortara V, Caruso P, Cioè A, Michelazzi L, Bruzzone A, Bobbio B, Simonassi C, Del Corso L, Galli R, Racchi O, Dini G, Linares R, Mencoboni M. Is soluble mesothelin-related protein an upfront predictive marker of pleural mesothelioma? A prospective study on italian workers exposed to asbestos. Oncology. 2014;86(1):33-43. doi: 10.1159/000355687. Epub 2013 Dec 21.
Author information: Epidemiology, Biostatistics and Clinical Trials, IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, Genova, Italy.

Abstract
Objective: Soluble mesothelin-related peptide (SMRP) may be useful in the diagnosis and detection of early stage mesothelioma. We investigated the SMRP upfront predictive role for mesothelioma in asbestos-exposed workers. Methods: A total of 1,715 subjects underwent a first visit and were invited for a follow-up after 1 and 2 years, with a clinical examination and blood sampling. SMRP was measured by an ELISA assay. Results: Median SMRP at the first visit was 0.45 [interquartile range (IQR) i.e. 25th-75th percentile: 0.30-0.67 nmol/l]. In all, 1,676 subjects (97.8%) were followed up for a median period of 47.1 months. SMRP was measured at the first visit and at both follow-up visits in 1,536 subjects. At follow-up, 3 subjects were diagnosed with an epithelioid mesothelioma. In these cases, SMRP at the first visit ranged from 0.17 to 0.52 nmol/l. Malignant pleural mesothelioma was diagnosed 9-17 months after the last SMRP evaluation. No SMRP variation was observed during the follow-up. Other 61 miscellaneous cancers were diagnosed (median SMRP at first visit: 0.50 nmol/l, IQR: 0.34-0.71 nmol/l). Conclusions: Our results did not support the usefulness of SMRP as an early marker for the detection of the disease for a time interval of 1 year. © 2013 S. Karger AG, Basel.

6. Casale T(1), Caciari T(2), Rosati MV(2), Gioffrè PA(2), Schifano MP(2), Capozzella A(2), Pimpinella B(2), Tomei G(3), Tomei F(2). Anesthetic gases and occupationally exposed workers. Environ Toxicol Pharmacol. 2013 Dec 11;37(1):267-274. doi: 10.1016/j.etap.2013.12.003. [Epub ahead of print]
Author information: (1)Department of Anatomy, Histology, Medical-Legal and the Orthopedics, Unit of Occupational Medicine, University of Rome "Sapienza", Viale Regina Elena 336, 00161 Rome, Italy. Electronic address: info@spinoff-sipro.it. (2)Department of Anatomy, Histology, Medical-Legal and the Orthopedics, Unit of Occupational Medicine, University of Rome "Sapienza", Viale Regina Elena 336, 00161 Rome, Italy. (3)Department of Psychiatric and Psychological Science, University of Rome "Sapienza", Piazzale Aldo Moro 5, 00185 Rome, Italy.

Abstract
The aim of this study is to estimate whether the occupational exposure to low dose anesthetic gases could cause alterations of blood parameters in health care workers. 119 exposed subjects and 184 not exposed controls were included in the study. Each worker underwent the complete blood count test (CBC), proteinaemia, leukocyte count, serum lipids, liver and kidney blood markers. The liver blood markers show statistically significant differences in health care workers compared with controls (p<0.05), a statistically significant decrease in neutrophils and an increase of lymphocytes in health care workers compared with controls (p<0.05). The prevalence of values outside the range for GPT, GGT, total bilirubin, lymphocytes and neutrophils was statistically significant in health care workers compared with controls (p<0.05). The results suggest that occupational exposure to low dose anesthetic gases could influence some haematochemical hepatic and hematopoietic parameters in exposed health care workers.

7. Vineis P(1), Wild CP(2). Global cancer patterns: causes and prevention Lancet. 2014 Feb 8;383(9916):549-57. doi: 10.1016/S0140-6736(13)62224-2. Epub 2013 Dec 16.
Author information: (1)MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London; HuGeF Foundation, Torino, Italy. Electronic address: p.vineis@imperial.ac.uk. (2)International Agency for Research on Cancer, Lyon, France.

Abstract
Cancer is a global and growing, but not uniform, problem. An increasing proportion of the burden is falling on low-income and middle-income countries because of not only demographic change but also a transition in risk factors, whereby the consequences of the globalisation of economies and behaviours are adding to an existing burden of cancers of infectious origin. We argue that primary prevention is a particularly effective way to fight cancer, with between a third and a half of cancers being preventable on the basis of present knowledge of risk factors. Primary prevention has several advantages: the effectiveness could have benefits for people other than those directly targeted, avoidance of exposure to carcinogenic agents is likely to prevent other non-communicable diseases, and the cause could be removed or reduced in the long term--eg, through regulatory measures against occupational or environmental exposures (ie, the preventive effort does not need to be renewed with every generation, which is especially important when resources are in short supply). Primary prevention must therefore be prioritised as an integral part of global cancer control.

Breve commento a cura di Dario Consonni
Sebbene le malattie trasmissibili e quelle legate alla nutrizione rappresentino ancora oggi le più comuni cause di morte nei paesi a basso “indice di sviluppo umano” (un indice che tiene conto dell’educazione e dell’attesa di vita, oltre al reddito nazionale), si prevede che nel 2030 si assisterà a un “sorpasso” da parte delle malattie non trasmissibili (incluso il cancro). Per contrastare l’incremento della frequenza di cancro in questi – ed altri – paesi, in questo articolo viene sottolineato il ruolo essenziale della prevenzione primaria. La prevenzione primaria avrebbe infatti due grandi vantaggi: 1) riduzione anche di altre patologie non trasmissibili che condividono con il cancro alcuni fattori di rischio (ad esempio fumo di tabacco, dieta, obesità, bassa attività fisica); 2) maggiore efficienza: non sarebbe infatti necessario rinnovare le azioni di prevenzione (secondaria e terziaria) a ogni generazione. L’articolo inoltre ribadisce la necessità di un approccio globale al problema (intervenendo a livello della società, cioè agendo sulle “cause delle cause”), che non può essere risolto con interventi limitati al livello individuale. Tra i fattori occupazionali l’amianto rappresenta ancora oggi un problema preminente, e il picco di malattie legate all’asbesto non è ancora stato raggiunto in molti paesi. Inoltre, un problema emergente è rappresentato dall’inaccettabile esportazione di esposizioni cancerogene verso i paesi a basso indice di sviluppo umano.

8. Bertazzi PA, Cantone L, Pignatelli P, Angelici L, Bollati V, Bonzini M, Carugno M, Mannucci PM, Violi F. Does Enhancement of Oxidative Stress Markers Mediate Health Effects Of Ambient Air Particles? Antioxid Redox Signal. 2013 Dec 18. [Epub ahead of print]
Author information: Università degli Studi di Milano and Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Center of Molecular and Genetic Epidemiology, Department of Clinical Sciences and Community Health, Milan, Italy ; pieralberto.bertazzi@unimi.it.

Abstract
Evidence indicates that oxidative stress generation may contribute to health effects associated with particulate matter (PM) exposure. We investigated oxidative stress markers in 113 workers exposed to metal-rich PM and 61 non-exposed comparable volunteers. The plasma levels of soluble NOX2-derived peptide (sNOX2-dp) and two oxidative stress markers, urinary 8-hydroxydeoxyguanosine (8OH-dG) and 8-iso-prostaglandinF2alpha (8-iso-PGF2), were analysed. The plasma levels of the antioxidant alpha-tocopherol were also evaluated. The workers' average exposure to PM with aerodynamic diameter <10 μm (PM10) was much higher at the workplace than in the city where the volunteers lived. Workers had significantly higher urinary 8-iso-PGF2 and 8-OHdG and plasma sNOX2-dp levels than non-exposed subjects. Alpha-tocopherol was much lower in workers compared to non-exposed subjects. In multivariable regression models adjusted for age, body mass index and smoking, 8-iso-PGF2α increased in workers in association with PM10 and metal exposure; 8-OHdG and sNOX2-dp were associated only with iron. Alpha-tocopherol was inversely associated with each of the oxidative stress markers. Our observation leads to the hypothesis that the enhancement of oxidative stress markers associated with exposure to high metal-rich PM levels represents a possible step in the pathways leading from particle exposure to systemic (e.g., cardiovascular) effects.

9. Acri G, Testagrossa B, Causa F, Tripepi MG, Vermiglio G, Novario R, Pozzi L, Quadrelli G. Evaluation of occupational exposure in magnetic resonance sites. Radiol Med. 2013 Dec 12. [Epub ahead of print]
Author information: S.A.S.T.A.S Department-Section of Protezionistica A.S.S.I, University of Messina, Viale Gazzi-Policlinico Universitario, Torre Biologica, 98125, Messina, Italy, gacri@unime.it.

Abstract
PURPOSE: In an attempt to evaluate the exposure level of magnetic resonance imaging (MRI) workers to static magnetic fields, the isotropic magnetic flux density values were integrated over time to produce the cumulative exposure. To protect occupational staff a further precautionary step is proposed by introducing a weighting function incorporating the limits imposed by the Italian legislation. The results obtained should be reported, at the end of each working day, on a special dose card, in order to record each worker's exposure to the static magnetic field. Moreover, this dose card could be an important tool if long-term effects occur because it provides a complete history of the occupational exposure in an MRI site. MATERIALS AND METHODS: To conduct measurements, three Hall-sensor probes were used. The consistency of experimental data, tools and methodologies used was evaluated by performing the Kruskal-Wallis test. Finally, the weighted magnitude of the magnetic flux density was integrated over time to obtain global exposure. RESULTS: Measurements were performed on different MRI scanners ranging from 0.25 up to 3.0 T. The results obtained were compared with the 200 mT•h, which represents the upper limit of the Italian regulation. In no case was the 200 mT•h per day exposure exceeded: however, when the strength of the magnetic field was >200 mT the weighted function overestimated the exposure, so that it represents a highly precautionary measure taking into account possible acute and long-term effects. In addition, from the data recorded during patient positioning operations by MRI staff the dB/dt curve was obtained. CONCLUSIONS: The areas obtained from the integral of the weighted static magnetic field strength over time can be indicative of the global exposure of the occupational staff. These values should be reported on a special dose card that could be considered as an important tool if long-term effects occur because it provides a complete history of the occupational exposure in an MRI site.

10. Marinaccio A, Ferrante P, Corfiati M, Di Tecco C, Rondinone BM, Bonafede M, Ronchetti M, Persechino B, Iavicoli S. The relevance of socio-demographic and occupational variables for the assessment of work-related stress risk. BMC Public Health. 2013 Dec 10;13:1157. doi: 10.1186/1471-2458-13-1157.
Author information: Italian Workers' Compensation Authority, Research area, Occupational medicine department, Via di Fontana Candida 1, Rome 00100, Monteporzio Catone, Italy. s.iavicoli@inail.it.

Abstract
BACKGROUND: Work-related stress is widely recognized as one of the major challenges to occupational health and safety. The correlation between work-related stress risk factors and physical health outcomes is widely acknowledged. This study investigated socio-demographic and occupational variables involved in perceived risk of work-related stress. METHODS: The Italian version of the Health and Safety Executive Management Standards Indicator Tool was used in a large survey to examine the relationship between work-related stress risks and workers' demographic and occupational characteristics. Out of 8,527 questionnaires distributed among workers (from 75 organizations) 6,378 were returned compiled (74.8%); a set of mixed effects models were adopted to test single and combined effects of the variables on work-related stress risk. RESULTS: Female workers reported lower scores on control and peer support and more negative perceptions of relationships and change at work than male workers, most of them with full-time contracts. Age, job seniority, and educational level appeared positively correlated with control at work, but negatively with job demands. Fixed-term workers had positive perceptions regarding job demands and relationships, but more difficulties about their role at work than permanent workers. A commuting time longer than one hour and shift work appeared to be associated with higher levels of risk factors for work-related stress (except for role), the latter having more negative effects, increasing with age. CONCLUSIONS: The findings suggest that the assessment and management of work-related stress risk should consider specific socio-demographic and occupational risk factors such as gender, age, educational level, job status, shift work, commuting time, job contracts.

11. Magnavita N, Fileni A. Association of work-related stress with depression and anxiety in radiologists. Radiol Med. 2013 Dec 3. [Epub ahead of print]
Author information: Dipartimento di Sanità Pubblica (Department of Public Health), Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy, nicolamagnavita@gmail.com.

Abstract
PURPOSE: Since radiologists and radiotherapists can be occupationally exposed to significant psychosocial risk factors, some may find themselves in a state of distress. The aim of this study was to investigate the association of work-related stress with the presence of symptoms of anxiety, depression and psychological malaise and to evaluate the risk of psychic disorder in radiologists suffering from work-related stress. METHODS: A total of 654 radiologists responded to our invitation to complete a questionnaire designed to evaluate work-related stress and associated medical conditions: the General Health Questionnaire and Goldberg's Anxiety and Depression scales. RESULTS: Scores on the anxiety, depression and psychological malaise scales rise with an increase in effort and over-commitment, while control and support exert a protective effect. In radiologists who are aware of an effort/reward imbalance, there is a marked increase in the risk of anxiety [odds ratio (OR) 14.14, 95 % CI 9.15-21.86], depression (OR 7.00, 95 % CI 4.76-10.30) and psychic disorders (OR 3.95, 95 % CI 2.62-9.57). Radiologists who perceive demand as excessive in relation to their power of control also have an increased risk of being anxious (OR 2.98, 95 % CI 2.05-4.31), depressed (OR 1.73, 95 % CI 1.21-2.48) and affected by psychic disorders (OR 2.26, 95 % CI 1.48-3.45) compared to fellow workers who are not in a state of distress. CONCLUSIONS: Outstanding technical progress has been made in the field of radiology which today plays an invaluable role in public health. Now a major effort must also be made to improve the mental wellbeing of radiologists, both in the interests of the workers themselves, and also in those of their patients and the quality of the treatment they have the right to receive.

12. Magnavita N, Fileni A. Work stress and metabolic syndrome in radiologists: first evidence. Radiol Med. 2013 Dec 3. [Epub ahead of print]
Author information: Department of Public Health, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy, nicolamagnavita@gmail.com.

Abstract
PURPOSE: Scientific data have amply demonstrated that work stress increases the risk of cardiovascular disease. However, less attention has been given to the association between stress and metabolic syndrome. In this study, our aim was to investigate the relationship between work stress and metabolic syndrome in a population of radiologists. MATERIALS AND METHODS: Radiologists and radiotherapists taking part in scientific conferences were invited to compile a questionnaire to evaluate work stress and the main parameters for diagnosing metabolic syndrome (obesity, hypertension, elevated cholesterol level, elevated triglycerides, and hyperglycemia). RESULTS: Most of the doctors taking part in the survey (n = 383, 58.6 %) were found to have at least one pathological component; 47 subjects (7.1 %) had metabolic syndrome. All the variables indicating work stress, whether derived from Karasek's demand/control model or from the effort/reward model devised by Siegrist, were significant predictors of metabolic syndrome components. Radiologists with elevated levels of stress had a significantly higher risk of being affected by metabolic syndrome than colleagues with lower stress levels, whether stress was defined as "job strain", i.e., elevated work load and reduced discretionary power (OR 4.89, 95 % CI 2.51-9.55), or as "effort reward imbalance", i.e., mismatch between effort and reward for the work performed (OR 4.66, 95 % CI 2.17-10.02). CONCLUSIONS: Should the results of this cross-sectional study be confirmed by a subsequent longitudinal survey, they would indicate the need for prompt organizational intervention to reduce occupational stress in radiologists.

13. Criscuolo M, Valerio J, Gianicolo ME, Gianicolo EA, Portaluri M. A Vinyl Chloride-exposed Worker with an Adrenal Gland Angiosarcoma: A Case Report. Ind Health. 2013 Dec 2. [Epub ahead of print]
Author information: Pathology Department, "Perrino" Hospital, Italy.

Abstract
Adrenal epithelioid angiosarcoma (AEA) is a rare neoplasm that accounts for less than 1% of sarcomas. Due to its rarity, it can easily be misdiagnosed, both by the clinician and the pathologist. Data on the patient's occupational history was collected and analyzed. The bibliographic data was found on the PUBMED bibliographic search site after entering the word "extrahepatic angiosarcoma". We report a case of adrenal epithelioid angiosarcoma (AEA) in a 68-yr-old Caucasian male factory worker exposed to Vinyl Chloride (VC) for 15 yr. He underwent surgery, chemotherapy and radiotherapy. Hepatic angiosarcoma is a known consequence of VC exposure, but occupational causality of extra-hepatic angiosarcoma is controversial. Extra-hepatic angiosarcomas have been reported in VC workers, but never AEA. Cancerogenic effects of VC involve all endothelial areas of the body and extra-hepatic endothelial tumors may also be caused by this substance. This is the first published report of AEA diagnosed in a worker exposed to VC.

14. Santovito A, Cervella P, Delpero M. Chromosomal damage in peripheral blood lymphocytes from nurses occupationally exposed to chemicals. Hum Exp Toxicol. 2013 Nov 25. [Epub ahead of print]
Author information: Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy.

Abstract
In the present study, we evaluated the induced genome damage in peripheral blood lymphocytes from a sample of nurses occupationally exposed to low doses of different chemicals. A comprehensive multi-biomarker approach using cytogenetic endpoints was employed for analyzing chromosomal aberrations (CAs) and sister chromatid exchange (SCE) assay. The study included 20 nurses and 20 control subjects matched in age, gender and smoking habits. Nurses were exposed to different chemicals, such as cytostatic drugs, anaesthetics, formaldehyde and other sterilizing gases. Significant differences were found between exposure group and control group in terms of SCEs frequency (p < 0.001) but not in terms of replication index value (p = 0.845) and CAs (p = 0.236). Regression analyses indicated that the age and the exposure years did not influence the amount of the chromosomal damage among nurses. Vice versa, among controls, a positive correlation was found between the number of SCEs and age. In conclusion, our results suggest that a continuous long-term exposure to low doses of chemicals could result in increased levels of SCEs among nurses. This data emphasize the importance of biomonitoring nurses and other hospital workers handling drugs.

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