A. Sancini

Occupational exposure to noise and the cardiovascular system: a meta-analysis.

The aim of our meta-analysis is to evaluate the association between the modifications of the cardiovascular system and chronic exposure to noise in occupationally exposed subjects. We considered the articles published from 1950 to May 2008. Only 15 papers were conforming to the inclusion criteria identified for this meta-analysis. A total of 18,658 workers were divided in three groups according to the level of noise exposure as measured in the original studies (High Exposure, HE, Intermediate Exposure, IE, Low Exposure, LE). A preliminary evaluation of the type of data allowed for a classification of the type of performed measurements. Two classes of variables were identified: Class I, composed by continuous variables (systolic blood pressure, SBP, diastolic blood pressure, DBP, and heart rate, HR) and Class II, composed by not continuous variables (prevalence of hypertension and prevalence of ECG abnormalities). For each variable the calculation of heterogeneity was performed. For continuous variables the calculation of ES and its significance were performed while Odds Ratio (OR) and its significance were calculated for not continuous variables. The results show a statistically significant increase of SBP and DBP in HE workers compared to LE and IE workers while HR is statistically higher in HE participants compared to LE participants. The prevalence of both hypertension and ECG abnormalities is statistically higher in HE workers compared to LE and IE workers. Taking into account both the extremely high heterogeneity among studies and the ES/OR values we suggest a particular attention to the measurement and evaluation of SBP, DBP and HR in workers with chronic exposure to noise. Also ECG for workers with chronic exposure to noise is suggested in order to identify and evaluate possible abnormalities noise could be a concurrent cause of.

Assessment of ascending aorta wall stiffness in hypertensive patients by tissue Doppler imaging and strain Doppler echocardiography

Background Aortic stiffness may be associated with an increased incidence of cardiovascular events and has been reported to be related to arterial wall motion velocities as measured by tissue Doppler imaging. Objective To investigate the potential clinical application of tissue Doppler imaging (TDI) for assessment of aortic function parameters in healthy and hypertensive adults. Methods 110 hypertensive and 80 healthy adults were examined. Pulse wave velocity (PWV) and augmentation index (Aix) were measured as standard parameters of arterial stiffness by an oscillometric system. Aortic M-mode and TDI parameters were measured. Aortic distensibility (D) and aortic stiffness index (SI) were calculated using accepted formulae. Anterior wall aortic expansion velocity (SAo), acceleration time (ATAo), early (EAo) and late (AAo) diastolic retraction velocity and peak systolic radial strain (εAo) were determined. Comprehensive echocardiography was performed for the assessment of left ventricular (LV) systolic/diastolic function. Results SAo, EAo and eAo were significantly lower in hypertensive subjects (p<.001, p<.001, and p<.0001, respectively). Reduced D (p<.05 vs controls) and increased PWV (p<.05 vs controls) and SI (p<.01 vs controls) were consistent with evidence of increased aortic stiffness in both male and female hypertensive patients. PWV and Aix increased and D decreased with increasing age or systolic blood pressure. Multivariate analysis showed εAo to be independently related (R2 = 0.63) to pulse pressure, LV mass index and diastolic function. Conclusion Ascending aorta TDI provides wall velocity and strain data differentiating hypertensive from healthy adults and reflecting aortic compliance changes related to age and sex and LV diastolic function.

Effect of plant foods and beverages on plasma non-enzymatic antioxidant capacity in human subjects: a meta-analysis.

Non-enzymatic antioxidant capacity (NEAC) represents a sensitive biomarker measuring the in vivo antioxidant potential of vegetable foods. To evaluate the effectiveness of plant-derived foods and beverages on the plasma non-enzymatic antioxidant system, we analysed all literature published upto May 2010. Data were extracted by two authors independently, and the effect size was summarised using standardised mean differences by a random-effects model. For the analysis, eighty-eight studies were included, reporting a total number of 122 interventions and involving 2890 subjects. There was overall evidence of the effectiveness of fruit, vegetables, dietary patterns based on plant foods, red wine and tea in increasing plasma NEAC. No changes were found for chocolate and fruit juices. We observed an overall effect size three times higher in subjects with risk factors when compared with healthy subjects. Total radical-trapping antioxidant parameter, oxygen radical absorbance capacity and ferric-reducing antioxidant power methods showed a similar increase in plasma NEAC following dietary supplementation, whereas Trolox equivalent antioxidant capacity did not respond to dietary supplementation. Data from the present meta-analysis show that plant-derived foods represent an effective strategy to enhance an endogenous antioxidant network in humans. This is particularly evident in the presence of oxidative stress-related risk factors.

Exposure to Arsenic in urban and rural areas and effects on thyroid hormones

Context: Arsenic is a ubiquitous element present in urban air as a pollutant, and it may interfere with thyroid hormones. Objective: To evaluate the association between the personal exposure to arsenic and levels of TSH, fT4, fT3, and Tg in urban and rural workers. Materials and methods: Total urinary arsenic and thyroid markers were obtained from 108 non-smoking traffic policemen and 77 subjects working as roadmen in a rural area. Fifty subjects were monitored to evaluate airborne exposure to arsenic. Results: The mean value of exposure to arsenic was 2.9 µg/m3 in traffic policemen, while the mean value was less than 0.1 µg/m3 in roadmen. The mean values of urinary arsenic (10.4 μg/g creatinine vs. 5.2 μg/g creatinine; p = 0.000), TSH (1.6 µlU/ml vs. 1.3 µlU/ml; p = 0.006), fT3 (3.5 pg/ml vs. 3.7 pg/ml; p = 0.000), fT4 (1.2 ng/dl vs. 1.3 ng/dl; p = 0.000) and Tg (42.8 ng/ml vs. 36.1 ng/ml; p = 0.04) were significantly different between traffic policemen and roadmen. In traffic policemen, urinary arsenic and arsenic in the air were correlated to the airborne arsenic and TSH values, respectively. Urinary arsenic was correlated to TSH, Tg, fT3, and fT4 values. The multiple linear regression models showed the following associations: i) among urinary arsenic, arsenic in the air and job title; ii) among TSH, fT3, Tg and urinary arsenic; and iii) between fT4 and both urinary arsenic and alcohol intake. Conclusion: These results provide information about the relationship between exposure to arsenic and thyroid markers and may be useful for other categories of outdoor workers who are similarly exposed.

Traffic air pollution and oxidatively generated DNA damage: can urinary 8-oxo-7,8-dihydro-2-deoxiguanosine be considered a good biomarker? A meta-analysis

Oxidative stress is one of the mechanisms through which traffic-related air pollution causes adverse effects on human health. The urinary excretion of 8-oxo-7,8-dihydro-2-deoxyguanosine (8oxodG) has often been used as a biomarker to evaluate the effect of air pollution on subjects occupationally exposed. We used a meta-analysis to evaluate the effect of traffic air pollution on urinary 8oxodG levels in healthy workers. We observed higher urinary 8oxodG levels in non-smoking exposed subjects compared with smokers. This difference was clearer when an HPLC assay was used. These results show that urinary 8oxodG can be used as a biomarker to evaluate the pro-oxidant effects of vehicle exhaust emissions on DNA in exposed workers.

Sensitive profiling of biogenic amines in human urine by capillary electrophoresis with field amplified sample injection.

In order to monitor biogenic amines in human urine, a method based on field-amplified sample injection combined with capillary electrophoresis and direct UV absorption detection was developed. Dopamine, tyramine, tryptamine, serotonin and epinephrine were effectively separated and identified in human urine samples, and detection limits were 0.072, 0.010, 0.027, 0.010 and 0.120 µmol/L, respectively. Detection limits comparable to laser-induced fluorescence detection or solid phase extraction combined with capillary electrophoresis were achieved. Parameters affecting electrophoretic system detection sensitivity were investigated. Optimal separation conditions were obtained using as background electrolyte a pH 6.5 mixture of 2-(morpholino)ethanesulfonic acid 20 mmol/L and 30 mmol/L phosphate buffer, containing 0.05% hydroxypropylcellulose and 10% v/v methanol. Injections of the sample solution were performed by applying a voltage of 12 kV for 50 s. Recovery and accuracy ranged between 89.4 and 94.9%, and 89 and 112%, respectively. The method was successfully applied on actual urine samples (from a healthy volunteer): target bioamine content was consistent with endogenous levels reported in the literature. The proposed method is simple, fast and inexpensive and can be conveniently employed in work-related stress studies. The affordability and noninvasive sampling of the method allow epidemiological studies on large number of exposed persons to be performed.

Assessment of occupational exposure to benzene, toluene and xylenes in urban and rural female workers

OBJECTIVES This is the first research study to compare among female, non-smoker workers: (a) the exposure to benzene, toluene and xylenes (BTXs) in urban air during work in the street (traffic policewomen, TP) vs. work in vehicles (police drivers, PD); (b) the exposure to BTXs in urban environments (in street and in car) vs. rural environments (roadwomen, RW); (c) the values of blood benzene, urinary trans, trans muconic acid (t,t-MA) and urinary S-phenylmercapturic acid (S-PMA) in urban areas (in street and in car) vs. rural areas. METHODS Passive personal samplings and data acquired using fixed monitoring stations located in different areas of the city were used to measure environmental and occupational exposure to BTXs during the work shift in 48 TP, 21 PD and 22 RW. In the same study subjects, blood benzene, t,t-MA and S-PMA were measured at the end of each work shift. RESULTS Personal exposure of urban workers to benzene seemed to be higher than the exposure measured by the fixed monitoring stations. Personal exposure to benzene and toluene was (a) similar among TP and PD and (b) higher among urban workers compared to rural workers. Personal exposure to xylenes was (a) higher in TP than in PD and (b) higher among urban workers compared to rural workers. Blood benzene, t,t-MA and S-PMA levels were similar among TP and PD, although the blood benzene level was significantly higher in urban workers compared to rural workers. In urban workers, airborne benzene and blood benzene levels were significantly correlated. CONCLUSIONS Benzene is a human carcinogen, and BTXs are potential reproductive toxins at low dose exposures. Biological and environmental monitoring to assess exposure to BTXs represents a preliminary and necessary tool for the implementation of preventive measures for female subjects working in outdoor environments.

Plasma cortisol concentrations and lifestyle in a population of outdoor workers

The aim of this study was to assess whether exposure to urban pollution in outdoor workers, may alter plasma cortisol concentrations also in relation to the effect of smoking and drinking habits. The research was carried out on 498 outdoor police workers, divided into three groups; Group A: traffic policemen (TP), Group B: drivers (D), Group C: Other duties (OD). To evaluate separately the effect of using alcohol and smoking, each group was divided into three subgroups: (1) non-smokers and non-drinkers, (2) smokers and non-drinkers, (3) non-smokers and drinkers. Our results show cortisol mean values were significantly higher in the TP group compared to the D and OD groups without significant differences between the last two groups. The results suggest that exposure to pollutants associated with urban psychosocial stress may play a more important role on plasma cortisol levels than smoking and alcohol.

Cadmium and hypertension in exposed workers: A meta-analysis

ObjectivesIn the general population, cadmium seems to be responsible for hypertension, atherosclerosis and an increase in acute coronary events. Therefore, the purpose of this meta-analysis was to analyze controlled studies conducted on cadmium and arterial pressure in occupationally-exposed workers.Materials and MethodsAfter analyzing all the relevant articles found in the literature, 6 publications were selected.ResultsA higher prevalence of hypertension and higher values of systolic and diastolic blood pressure were recorded in the exposed subjects.ConclusionsCadmium in occupationally-exposed individuals appears to induce an increase in systolic and diastolic blood pressure and an increase in the prevalence of hypertension.

Cardiovascular risk in rotogravure industry.

Objective: To verify whether the occupational hazards in the rotogravure industry can be associated with cardiovascular effects. Methods: We evaluated cardiovascular parameters and audiometric tests and analyzed noise, solvents, and shift work in 44 exposed and 44 unexposed workers. Results: Unlike unexposed workers, the rotogravure workers showed significant increase of mean systolic and diastolic blood pressure (BP) values (P = 0.019; P = 0.003), higher frequency of hypertension (P = 0.002) and electrocardiographic abnormalities (P = 0.0001), significant reduction or no variation of BP response to orthostatism (P = 0.0001), and association between high levels of noise and diastolic blood pressure (P = 0.0067). Subjects with hearing loss showed high frequency of hypertension and a reduction or no variation of BP response to orthostatism (both P = 0.05). Conclusions: Data obtained suggest that these are the effects on the cardiovascular system of rotogravure workers who are exposed to noise.