A. Capozzella

Is urinary 1-hydroxypyrene a valid biomarker for exposure to air pollution in outdoor workers? A meta-analysis

The aim of this study was to evaluate the usefulness and specificity of urinary 1-hydroxypyrene (1-OHPu) as a biomarker of the exposure from urban pollution to polycyclic aromatic hydrocarbons (PAHs) among outdoor workers in a meta-analysis. Our meta-analysis was performed according to standard methods, and the results show that the concentrations of 1-OHPu tend to be higher in exposed workers than in unexposed workers (if we exclude two highly heterogeneous articles), in exposed non-smokers than in unexposed non-smokers and in exposed than in unexposed workers who were carriers of the CYP1A1 genotype and in those with the glutathione-S-transferase M1 (−)genotype. These genotypes enhance the effect of exposure, particularly in non-smokers. Smoking reduces the differences between exposed and unexposed subjects. In conclusion, our results suggest that the use of the 1-OHPu biomarker appears to be reliable for studying occupational exposure to PAHs from urban pollution, as long as environmental and behavioural factors are considered.

Work related etiology of amyotrophic lateral sclerosis (ALS): a meta-analysis.

BACKGROUND The aim of this meta-analysis was to evaluate the association between ALS and occupational exposure to physical (ELF-EMF) and chemicals (solvents, heavy metals and pesticides) agents. METHODS We considered articles published from 1980 up to April 2013; in total, 750 publications were evaluated. The studies had to satisfy the following criteria: 1) cohort or case-control studies; 2) the presence of individual exposures; 3) clinical diagnosis of sporadic ALS or sporadic ALS on the death certificate. We followed the evaluation of quality in two steps. The first step classified studies according to a rating system based on a mix of criteria developed by scientific organizations, especially developed for studies of risk factors for ALS. The ratings obtained range from I (highest) to V (lowest). The data on risk factors derived from studies with Armon ratings of I, II, and III can reach levels of evidence A (established risk factor), B (likely risk factor), or C (possible risk factor). The second step evaluated the exposure and a score from 1 to 4 was assigned to each item; an exposure with a score of 3 or 4 was considered sufficient. Different analyses were performed on ALS and exposure to metals, solvents, pesticides and electromagnetic fields. In our study the heterogeneity was assessed both by χ2-based Q-tests and through the index of inconsistency I² while the measure RR/OR and CI of 95% to estimate the relationship between ALS and the various considered risk factors was employed. RESULTS The association between exposure to pesticides and ALS as a whole is weak and not significant. With regard to the results of individual studies the following critical synthesis can be reported: 1) the selected studies showed a low level of association between ALS and electromagnetic fields; 2) as regards the solvents, the association with ALS in some studies is combined with a slightly increased risk, particularly in women, and in others a slight but significant linear association is observed; 3) for the metals, in some cases there was a stronger association in women than in men; for individual metals, there was an association especially with chromium and lead; 4) lastly, with regard to the products of agricultural pesticides in general, there was an association with ALS in men but not in women, with a dose-response relationship. CONCLUSIONS The lack of statistically significant association between occupational exposure and ALS is mainly due to the methodological diversity of the studies and the lack of prospective studies at the workplace.

Evaluation of some cardiovascular risk parameters in health professionals exposed to night work.

BACKGROUND Shift work and night work in particular represent a risk factor for the health of exposed workers; aim of our study is to evaluate whether night work may cause alteration of some cardiovascular risk parameters in health workers. MATERIALS AND METHODS The research was carried out on 415 health workers, 163 exposed to night work and 252 not exposed. A blood sample was taken from each worker, between 8.00 a.m. and 10.00 a.m. before lunch time, to test total cholesterol, HDL cholesterol, and triglycerides. Blood pressure and heart rate were also measured. Workers with cardiovascular diseases, thyroid diseases, diabetes mellitus, dyslipidemia, those who made use of antihypertensive drugs, hypoglycemic and/or lipid-lowering drugs, subjects with body mass index (BMI) (kg/m2) higher than 30 were excluded. RESULTS In the group of exposed compared to controls, increasing values of arterial pressure and heart rate, were not significant. The mean values of total cholesterol and triglycerides were significantly higher in exposed compared to controls while values of HDL cholesterol were significantly lower. CONCLUSIONS Night workers have clinically significant changes in blood levels of total cholesterol, HDL cholesterol and triglycerides, such alterations are presumably related to poor food hygiene and to psychosocial stressors.

Plasma dopamine in workers exposed to urban stressor

The aim of this study is to evaluate if the occupational exposure to urban stressor could cause alterations in dopamine (DA) plasma levels and related diseases in traffic police officers compared to a control group. After excluding subjects with principal confounding factors, 306 traffic police officers (139 female and 167 male) and 301 controls (134 female and 167 male) were included in the study. In traffic police officers, mean DA values were significantly higher compared with controls (P = 0.006 and P = 0.000 in male and female, respectively). The distribution of DA values in traffic police officers and controls was significant ( P = 0.000 and P = 0.000 in male and female, respectively). The number of male traffic police officers with a positive response to the questionnaires items concerning anxiety, depression and panic attacks was higher than controls, though not significant (7.2% traffic police officers versus 4.2% controls). This difference was also not significant in female traffic police officers compared with controls. According to our previous researches on other neuro-immune-endocrine parameters, DA could be used as an early biological marker, valuable for the group to be employed in occupational sets, even before the onset of pathology. Toxicology and Industrial Health 2007; 23: 421—427.

Effects on Androstenedione in Male Workers Exposed to Urban Stressors

The aim of this study is to evaluate whether occupational exposure to urban stressors could cause alterations in androstenedione plasma levels in male traffic policemen compared to a control group. After excluding the principal confounding factors, traffic policemen were matched with controls by age, working life, body mass index (BMI), drinking habit, and habitual soy intake in diet. One hundred and ten traffic policemen and 110 controls were included in the study. In male traffic policemen, mean androstenedione values were significantly lower compared to controls. The distribution of androstenedione values in traffic policemen and in controls was significant. Our results suggest that the occupational exposure to chemical urban stressors, interacting with and adding to the psychosocial ones, could alter androstenedione plasma concentrations in traffic policemen compared to a control group. According to our previous research, androstenedione could be used as an early biological marker, valuable for the group to be employed in occupational settings, even before the onset of the endocrine reproductive health diseases.

Exposure to Urban Stressor and Effects on Luteinizing Hormone (LH) in Female Outdoor Workers

There are few studies in literature about exposure to urban pollutants and effects on female reproductive health. The aim of the study was to evaluate if the occupational exposure to chemical urban stressor could cause luteinizing hormone (LH) plasma levels alterations in female traffic police compared to a control group. One hundred and eighty subjects were included in the study, subdivided into three different groups according to the day of the menstrual cycle (7th, 14th, 21st) in which a blood sample was taken. In follicular and lutheal phase of ovarian cycle, the LH mean levels were significantly higher in traffic police vs. controls. The distribution of LH values in traffic police and controls was significant in follicular, and lutheal phase. In ovulatory phase, LH mean levels were lower but not significant in traffic police compared to controls. An increase was found concerning mental health disorders referred to the questionnaire items in traffic police vs. controls, although the difference was not significant. Our results suggest that occupational exposure to urban stressor in female traffic police, may alter LH plasma concentrations. LH may be used in occupational set as an early biomarker of exposure to urban stressor.

Correlation Between Cadmium and Blood Counts in Workers Exposed to Urban Stressor

The objective of this study was to assess the exposures to cadmium (Cd) in urban workers and the association between Cd exposure and values of blood counts. Urinary Cd, blood Cd, and blood counts were obtained from 355 outdoor workers; a subgroup of 99 subjects were monitored to evaluate personal exposure to airborne Cd. The mean value of personal exposure to Cd was 1.5 ng/m3 for traffic assistants and 1.2 ng/m3 for drivers. Urinary and blood Cd were correlated to the airborne Cd (respectively r =.3 and r =.4). The multiple linear regression models showed the associations among white blood cell, the percentage of neutrophils (NEU%), the percentage of lymphocytes (LYM%), and the concentrations of blood Cd (respectively R2 =.27, R2 =.37, R2 =.581). The subjects with blood Cd values higher than 1.2 μg/L showed an increase of LYM% mean values and a decrease of NEU% mean values with respect to the group with blood Cd values lower than 1.1 μg/L.

Urban stressors and plasmatic 17-β-estradiol (E2) in male exposed workers

The aim of the study is to evaluate if the occupational exposure to urban stressors could cause alterations in 17-β-estradiol (E2) plasma levels and related disorders in male traffic police compared with a control group. After excluding from the study, the subjects with the principal confounding factors, traffic police and controls were matched by age, working life, Body Mass Index (BMI), smoking and drinking habit. A total of 171 male traffic police and 171 controls were included in the study. In traffic police, mean E2 values were significantly lower versus controls (P < 0.001). The distribution of E2 values in traffic police and controls was significant (P < 0.001). No significant differences were found in percentage of traffic police versus controls concerning the following questionnaire items: fertility and mental health diseases. Our results suggest that the occupational exposure to chemical urban stressor, interacting with and adding to the psychosocial ones, could alter plasma E2 concentrations in male traffic police compared with a control group. According to our previous researches on other neuro-immune-endocrine parameters, E2 could be used as an early biological marker, valuable for the group, to be used in occupational set even before the onset of the pathologies.

Plasma IL-2, NK, IFN-γ, and C3 in male workers exposed to traffic pollutants.

The aim of the study is to evaluate if the occupational exposure to urban stressors could cause alterations in interleukin-2 (IL-2), NK, interferon-γ (IFN-γ) and C3 plasma levels in male traffic police officers compared to controls. After excluding the principal confounding factors, 108 traffic police officers were matched with 108 controls by age, working life, habitual consumption of alcohol and spirits. IL-2 mean levels were significantly higher in traffic police officers compared to controls (p=0.04). The distribution of IL-2 values in traffic police officers and in controls was significant (p=0.01). The distribution of NK value percentage in traffic police officers and in controls was significant (p=0.000). IFN-γ and C3 mean levels were not significant in traffic police officers compared to controls. Our results suggest that the occupational chronic exposure to low doses of urban stressors could affect NK and IL-2 plasma concentrations in traffic police officers of male sex.

Manual handling of patients: clinical evaluation of some parameters clinical-anamnestic in health care

Background: The necessity to help hospitalized subjects with reduced or absent walking abilities exposes the workers to the risk of lesions, above all spinal lesions. It is essential therefore to reduce the risk through the introduction of correct procedures and devices as well as health surveillance and training. The Mapo index is a synthetic index to estimate the manual handling of patients assessment and it allows to give a quantitative valuation of risk level of health workers.