• Dario Consonni1

  1. Clinica del lavoro, Milano
Dario Consonni

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Ricerca bibliografica periodo 2 aprile 2011 – 1 giugno 2011

Per leggere le caratteristiche di questa ROUTINE di ricerca clicca qui

Database: Pubmed/MEDline
(Occupational Exposure [MESH] or Occupational Diseases [MESH] or Occupational Health [MESH] or Workplace [MESH] or Accidents, Occupational [MESH] or Employment [MESH] ) AND (Italy [MESH] or italy [termine libero]).
Limiti: pubblicati dal 2 aprile 2011 all'1 giugno 2011

Database: Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations .
Strategia di ricerca:
occupation (titlo/abstract) or occupational (titolo/abstract) or worker (titolo/abstract) or job (titolo e abstract) and italy (tutti i campi).

Di ogni articolo è disponibile l'abstract. Per visualizzarlo basta cliccare sul titolo.

1 Porru S, Calza S, Arici C. An effectiveness evaluation of a multifaceted preventive intervention on occupational injuries in foundries: a 13-year follow-up study with interrupted time series analysis. Int Arch Occup Environ Health. 2011 Apr 17. [Epub ahead of print]
Department of Experimental and Applied Medicine, Section of Occupational Medicine, University of Brescia, P.le Spedali Civili, 1, 25125, Brescia, Italy,
PURPOSE: Few intervention studies aimed at preventing occupational injuries (OI) are available, particularly in the foundry sector. Evaluation of effectiveness of an intervention to prevent OI was carried out in two foundries (cast-iron = A, non-ferrous = B).
METHODS: A multifaceted intervention was developed by a team composed of occupational physician, safety personnel and workers' representatives. Intervention focused on safety procedures, education, health surveillance (HS), fitness for work and first aid. Mandatorily registered OI data were collected. Primary outcome was reduction in injury rates. Before-after, pre-peri-post and interrupted time series (ITS) analyses were performed. Secondary outcomes mainly regarded re-injury rates and lost workdays (LW) reduction, access to HS, implementation of good practices and insurance litigation costs.
RESULTS: In 1997-2009, 556 and 97 OI occurred in A and B, accounting for 11,597 and 2,567 LW, respectively. A significant (P < 0.01) decrease in OI incidence (-57% in A and -51% in B) and frequency (-56% in A and -46% in B) was shown. ITS analysis displayed a significant (P < 0.01) long-term decreasing trend for incidence (-0.29), frequency (-0.35) and severity (-0.55) rates in foundry B. Upper and lower extremity, eye, hand and head injuries were reduced. HS allowed focused human factor and fitness for work evaluation. Positive changes in safety culture and procedures were obtained.
CONCLUSIONS: The intervention showed effectiveness in reducing OI rates and in improving quantitative and qualitative outcomes in two representative foundries. Challenges and limitations of interventions to assess effectiveness in preventing OI were evaluated and solutions applied.

Breve commento a cura di Dario Consonni
Un raro esempio di valutazione di efficacia di interventi preventivi attraverso appropriati metodi epidemiologico-statistici.

2 Ferraro PM, Bonello M, Frigo AC, D'Addessi A, Sturniolo A, Gambaro G. Cadmium Exposure and Kidney Stone Formation in the General Population-An Analysis of the National Health and Nutrition Examination Survey III Data. J Endourol. 2011 May;25(5):875-80. Epub 2011 Apr 20.
Division of Nephrology, Department of Internal Medicine and Medical Specialties, Renal Program, Columbus-Gemelli University Hospital, Catholic University of the Sacred Heart , Rome, Italy.
BACKGROUND AND PURPOSE: Cadmium exposure has been associated with a greater risk of kidney stone formation in occupational exposure studies, but data on such an association in the general population are scarce.
SUBJECTS AND METHODS: We assessed the National Health and Nutrition Examination Survey data from 1988 to 1994 in terms of the risk of stone formation. Persons reporting a history of kidney stones were defined as stone formers (n=749), and the association between a positive history of kidney stones and high environmental cadmium exposure levels (defined as urinary cadmium >1 μg/g) was analyzed by logistic regression analysis, stratifying by sex and adjusting for age, race/ethnicity, body mass index, smoking habits, region of residence, and daily intake of calcium and sodium.
RESULTS: The odds ratio of lithiasis associated with urinary cadmium >1 μg/g was 1.40 (95% confidence interval 1.06, 1.86) in females (P=0.019). The association between urinary cadmium and kidney stones was not significant in males.
CONCLUSIONS: These findings suggest that moderately high levels of urinary cadmium are associated with a greater propensity for kidney stone formation in females in the general population.

Breve commento a cura di Dario Consonni
Interessante esempio di uso di dati correnti a fini di epidemiologia eziologica.

3 Moscato G, Pala G, Boillat MA, Folletti I, Gerth van Wijk R, Olgiati-Des Gouttes D, Perfetti L, Quirce S, Siracusa A, Walusiak-Skorupa J, Tarlo SM. EAACI Position Paper: Prevention of work-related respiratory allergies among pre-apprentices or apprentices and young workers. Allergy. 2011 May 10. doi: 10.1111/j.1398-9995.2011.02615.x. [Epub ahead of print]
Allergy and Immunology Unit, Fondazione 'Salvatore Maugeri', Institute of Care and Research, Scientific Institute of Pavia, Italy Institute for Work and Health, Lausanne, Switzerland Occupational Medicine, Terni Hospital, University of Perugia, Perugia, Italy Section of Allergology, Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands Medical Group Practice Allergology and Pneumology, Delémont, Switzerland Department of Allergy, Hospital La Paz-IdiPAZ CIBER of Respiratory Diseases CIBERES, Madrid, Spain Department of Occupational Diseases, Institute of Occupational Medicine, Lodz, Poland Department of Medicine and Dalla Lana School of Public Health, University of Toronto, Respiratory Division Toronto Western Hospital Gage Occupational and Environmental Health Unit, St Michael's Hospital, Toronto, ON, Canada.
Apprenticeship is a period of increased risk of developing work-related respiratory allergic diseases. There is a need for documents to provide appropriate professional advice to young adults aiming to reduce unsuitable job choices and prevent impairment from their careers. The present document is the result of a consensus reached by a panel of experts from European and non-European countries addressed to allergologists, pneumologists, occupational physicians, primary care physicians, and other specialists interested in this field, which aims to reduce work-related respiratory allergies (rhinoconjunctivitis and asthma) among allergic or nonallergic apprentices and other young adults entering the workforce. The main objective of the document is to issue consensus suggestions for good clinical practice based on existing scientific evidence and the expertise of a panel of physicians.
4 Ciarrocca M, Caciari T, Ponticiello BG, Gioffre PA, Tomei G, Sancini A, Schifano MP, Palermo P, Nardone N, Scimitto L, Fiaschetti M, Tomei F. Follicle-stimulating hormone levels in female workers exposed to urban pollutants. Int J Environ Health Res. 2011 Apr 28:1-11. [Epub ahead of print]
Departments of Occupational Medicine, University of Rome "Sapienza", Rome, Italy.
The aim of this study was to evaluate if there were alterations in FSH plasma levels in female outdoor workers (traffic policewomen and drivers) exposed to chemical urban stressors vs. control group. After excluding subjects with main confounding factors, traffic policewomen, drivers and indoor workers were matched by age, working life, socioeconomic status, marital status, menstrual cycle day, age of menarche, habitual consumption of Italian coffee and soy. A total of 129 female subjects were included in the study: Some 63 workers studied during proliferative phase and 66 during secretory phase of menstrual cycle. Proliferative phase of menstrual cycle: FSH mean values were significantly higher in traffic policewomen compared to controls (p < 0.05). Results suggest that in outdoor workers exposed to urban chemical stressors there are alterations in FSH levels; therefore FSH may be used as an early biological marker, valuable for the group, used in occupational set.
5 Magnavita N, Elovainio M, De Nardis I, Heponiemi T, Bergamaschi A. Environmental discomfort and musculoskeletal disorders. Occup Med (Lond). 2011 May;61(3):196-201.
Institute of Occupational Medicine, Catholic University School of Medicine, Largo Gemelli 8, 00168 Rome, Italy.
BACKGROUND: Musculoskeletal disorders (MSDs) are the most common occupational disease in Europe, with high prevalence among hospital workers. Both environmental and psychosocial work factors may impact significantly on the development and exacerbation of MSDs. AIMS: To evaluate whether environmental factors at work are associated with MSDs in hospital workers and to investigate potential interactions between environmental and psychosocial risk factors in the workplace that are associated with MSDs. METHODS: A cross-sectional investigation was performed using the Nordic questionnaire to assess MSDs, the IAQ/MM-040 indoor air questionnaire for environmental factors, the demand-control model for job strain and the Goldberg questionnaire for anxiety and depression. The association between environmental factors and MSDs was studied using logistic regression analysis. In addition, the interactions of environmental factors with strain, anxiety and depression for MSDs were examined. RESULTS: Environmental complaints were associated with MSDs. The strongest associations were found between temperature complaints (OR 2.73), noise and light complaints (OR 2.22), other environmental complaints (OR 3.12) and upper limb disorders. A significant interaction between temperature complaints and strain for upper limb disorders (F = 9.52, P < 0.05) was found. CONCLUSIONS: To prevent MSDs, a multi-level approach is needed, including environmental measures and interventions directed to both psychosocial and organizational factors.
6 Siani AM, Casale GR, Sisto R, Colosimo A, Lang CA, Kimlin MG. Occupational exposures to solar ultraviolet radiation of vineyard workers in Tuscany (Italy). Photochem Photobiol. 2011 Apr 18. doi: 0.1111/j.1751-1097.2011.00934.x. [Epub ahead of print]
Sapienza University of Rome, Physics Dept, P.le A. Moro 2, I-00185 Rome (Italy) ISPESL (Istituto Superiore per la Prevenzione E la Sicurezza del Lavoro), Occupational Hygiene Dept., Via Fontana Candida 1, I-0040 Monteporzio Catone (Italy) Sapienza University of Rome, Dept. of Human Physiology and Pharmacology, P.le A. Moro 2, I-00185 Rome (Italy) A NHMRC Centre for Research Excellence in Sun and Health, Queensland University of Technology, Institute of Health and Biomedical Innovation, Brisbane (Australia).
A study to quantify the UV exposure of vineyard workers was carried out using polysulphone dosimetry. The study took place in Tuscany (Italy) involving 32 vineyard workers and covering three different stages of the vines growth. The level of personal exposure expressed as a function on the available ambient UV radiation, was determined. We also assessed skin reflectance parameters, pre and post exposure. It was found that during spring backs receive between 53% and 87% of ambient exposure and arms between 30% and 60%. During summer the workers received on the back between 36% and 77% of ambient exposure and between 19% and 43% of ambient exposure on the arm. The comparison with the occupational UV exposure limit showed that all subjects received UV exposures in excess of the limit. The exposure of back of neck exceeded 10 SED (assumed as a threshold level of sun-adapted skin for Mediterranean subjects) in spring, which means that in the case of non sun-adapted skin and without sun protection, erythema can be induced in this targeted population. The cumulative exposure was also estimated under specific assumptions of UV exposure giving values in some cases higher than previous studies.
7 Kazanga I, Tameni S, Piccinotti A, Floris I, Zanchetti G, Polettini A. Prevalence of drug abuse among workers: Strengths and pitfalls of the recent Italian Workplace Drug Testing (WDT) legislation. Forensic Sci Int. 2011 Apr 7. [Epub ahead of print]
Erasmus Mundus Master in Sustainable Regional Health Systems, Department of Public Health & Community Medicine, University of Verona, Italy.
BACKGROUND: In 2008 a Workplace Drug Testing (WDT) law became effective in Italy for workers involved in public/private transportation, oil/gas companies, and explosives/fireworks industry with the aim to ensure public safety for the community.
AIMS: To examine and elaborate WDT data collected on a large group of workers (over 43,500) during March 2009-February 2010 in order to highlight pros and cons and to draw suggestions for policies in the field.
: Northern Italy.
: After =<24h notification, workers provided a urine sample screened for opiates, methadone, buprenorphine, cocaine, amphetamines, ecstasy, and cannabinoids (THC) by immunoassay. Positives were confirmed by GC-MS.
RESULTS: The positive rate was 2.0%, THC being most frequent drug (1.3%; cocaine, 0.4%; opioids, 0.3%). 6.9% of the positive workers tested positive for >=2 classes (most often THC+cocaine). Gender ratio and mean age were significantly lower in positives (F/M=0.007; 35.5±8.3years) than negatives (0.016 and 40.7±9.5, respectively). No decline in rates of positives and an increase of diluted samples over time were observed. The highest rates of positives were detected when sampling was performed just before/after week-end and during morning hours. Possible correlation between job type and drugs used were observed (e.g. more cocaine positives among road vehicle-drivers than among lift truck-drivers). Declared use of medicine/illicit drugs during the preceding week showed that illicit drug use was likely not always detected in urine and that almost 4% workers declared use of medicine drugs possibly affecting performance.
CONCLUSIONS: This survey enabled to evidence relevant pitfalls of the law and to define strategies to improve the outcomes of WDT policies.
8 Sottani C, Porro B, Imbriani M, Minoia C. Occupational exposure to antineoplastic drugs in four Italian health care settings. Toxicol Lett. 2011 Apr 6. [Epub ahead of print]
Laboratory for Environmental and Toxicological Testing, IRCCS Pavia. S. Maugeri Foundation, via S. Maugeri 10, Pavia, Italy.
Exposure assessment of health care workers to antineoplastic drugs (ADs) is still an open issue since new, critical, and emerging factors may put pharmacists who prepare hazardous drugs or nurses who administer anti-cancer agents to an increased risk of developing adverse health effects. Overall, eight pharmacies and nine patient treatment areas have been surveyed in this study. Wipe and pad samples were experienced during the surveillance program in four Italian health care settings. Urine samples were collected from workers handling ADs. Cyclophosphamide (CP), ifosfamide (IF), and gemcitabine (GEM) were detected in all the work environments by using a LC-MS/MS method-based capable of analysing all the three drugs simultaneously. In total, 54% of wipe samples were positive for at least one drug and 19% of pad samples were shown to be contaminated by cyclophosphamide. Pharmacies were generally more contaminated than nursing patient areas with the exception of one site where a nurse had an acute exposure during the cleaning-up of a hazardous drug solution spill. In total, 22 urine samples collected from pharmacists and 78 biological specimens from nurses had no detectable concentrations of any antineoplastic drugs. Despite the adherence to the recommended safety practices residue contamination on surfaces and floors has continued to be assessed in all the investigated sites.
9 Mastrangelo G, Marangi G, Ballarin MN, Michilin S, Fabricio AS, Valentini F, Lange JH, Fedeli U, Cegolon L, Gion M. Osteopontin, asbestos exposure and pleural plaques: a cross-sectional study. BMC Public Health. 2011 Apr 8;11:220.
Department of Environmental Medicine and Public Health, Padua University, Padua, Italy.
BACKGROUND: Osteopontin (OPN) is a plasma protein/cytokine produced in excess in several malignancies. In a recent study OPN was reported as being related to the duration of asbestos exposure and presence of benign asbestos-related diseases; however, it was unclear whether this protein was an indicator of exposure or effect.
METHODS: In 193 workers, 50 with pleural plaques (PP), in whom different indicators of past asbestos exposure were estimated, OPN plasma levels were assessed using commercial quantitative sandwich enzyme immunoassays according to the manufacturer's instructions.
RESULTS: Osteopontin increased with increasing age and several aspects of asbestos exposure, without differences related to the presence of pleural plaques. At multivariable regression analysis, the explanatory variables with a significant independent influence on OPN were length of exposure (positive correlation) and time elapsed since last exposure (positive correlation).
CONCLUSIONS: Since asbestos in lung tissue tends to wane over time, OPN should decrease (rather than increase) with time since last exposure. Therefore, OPN cannot be a reliable biomarker of exposure nor effect (presence of pleural plaques).
10 Gobba F, Bravo G, Rossi P, Contessa GM, Scaringi M. Occupational and environmental exposure to extremely low frequency-magnetic fields: a personal monitoring study in a large group of workers in Italy. J Expo Sci Environ Epidemiol. 2011 Apr 6. [Epub ahead of print]
Department of Public Health Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41100 Modena, Italy.
An inaccurate evaluation of exposure is considered a possible cause for the inadequate conclusiveness of epidemiological research on adverse effects of extremely low frequency-magnetic fields (ELF-MF). The objective of this study is to provide an evaluation of current ELF-MF exposure in workers, the specific contribution of occupational exposure to overall 24-h exposure, and the representativeness of a job exposure matrix (JEM). ELF-MF exposure was monitored in 543 workers for 2 days using personal meters. Time-weighted average (TWA) levels at work, at home and outside the home were calculated. A JEM based on the 1988 International Standard Classification of Occupations (ISCO 88) was created. Median exposure at work, at home and outside the home were 0.14, 0.03 and 0.05 μT, respectively. Occupational exposure accounted for about 60% of 24-h exposure. In the JEM, about 50% of the classified occupations included significantly different individual TWAs. Occupational exposure to ELF-MF appeared low. Median exposure levels at home and outside were 20-28% of the occupational level, giving a minor contribution to overall day-to-day exposure. The frequent occurrence of workers with different TWA included under the same job title highlights the risk of misclassification in epidemiological studies on ELF-MF effects based on JEM.Journal of Exposure Science and Environmental Epidemiology advance online publication, 6 April 2011; doi:10.1038/jes.2011.9. PMID: 21468121 [PubMed - as supplied by publisher]

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