Antonio Fiorito

Bone and joint disorders in the upper extremities of chipping and grinding operators

SummaryX-ray examinations of the wrists, the elbows and the shoulders were carried out on 67 vibration-exposed foundry workers and on 46 comparable referents performing heavy manual work. Both groups had a mean age of 39.6 years. Musculoskeletal symptoms, such as arthralgias of the wrist and elbow joints, muscle pain and decreased muscular force, were found to be significantly increased in the chipping and grinding workers compared with the referents. After adjustment for age, the prevalence of cysts in the metacarpal and carpal bones was almost the same in the two groups, whereas radiological signs of osteoarthritis in the wrist joint were more frequent among the vibration-exposed workers (P < 0.025). The overall prevalence of radiographic abnormalities in the elbow joint was higher in the vibration group than in the reference group (P < 0.025). Olecranon spurs were observed in 50.7% of the exposed operators and in 28.2% of the referents (P < 0.025). No difference in the prevalence of radiological changes in the shoulder could be demonstrated between the populations studied. In both groups injuries of bones and joints were not associated with age. Among the chipping and grinding operators, a slight but not significant trend in the prevalence of skeletal abnormalities with increasing vibration exposure was observed. The results of this study indicate that the foundry workers using vibrating tools were affected with bone and joint disorders in the elbow and, to a lesser extent, in the wrist, which occurred more frequently than was observed in unexposed referents, who performed solely heavy manual activity. Among the vibration-exposed workers, no relationship between radiological changes in the upper limbs and symptoms of vibration white finger was found, pointing out that different pathogenic mechanisms are involved.

Liver function alterations in synthetic leather workers exposed to dimethylformamide.

A cross-sectional study of the prevalence of chronic liver function alterations was performed in 75 workers employed in a synthetic leather factory, exposed to dimethylformamide (DMF) air concentrations below threshold limit values (30 mg/m3). Biological monitoring among workers revealed acceptable urine levels of monomethylformamide (NMF) on average, but the very wide range indicated that occasional overexposure was possible. The worker survey showed a high percentage of disulfiram-like symptoms (50%) and liver function abnormalities (22.7%), compared with a demographically similar group of unexposed workers. Covariance analysis (ANCOVA) revealed that enzyme levels were significantly higher in exposed workers than in controls after data were corrected for age, alcohol consumption, body mass index, and cholesterol levels. The authors conclude that DMF can cause liver diseases even if air TLVs are respected, because accidental contact with liquid DMF can significantly increase DMF uptake. In this situation, air monitoring is no longer sufficient to evaluate worker exposure.

Sensitization to green coffee beans and work-related allergic symptoms in coffee workers

BACKGROUND Occupational respiratory allergy to green coffee beans (GCB) and to castor beans (CB) was studied in 112 workers in a modern coffee manufacturing plant of Trieste (Italy), where the process is completely automatic, the environmental conditions are good and where exposure to CB can be considered absent because since 1970, only new sacks have been used for coffee transportation. METHODS All subjects were interviewed by a trained doctor using a questionnaire to investigate allergic symptoms and predisposing factors. Sensitization to GCB and to common allergens (pollens, molds, house dust mites) were evaluated by the skin-prick test. The serum of subjects with a positive skin-prick test to CGB or who had symptoms at work was tested for specific IgE (RAST) for GCB and CB. Lung function was evaluated by a Ponigraph spirometer. RESULTS Sensitization to GCB was found in 25.8% of green coffee workers (31 cases), in 2.7% of roasted coffee workers (37 cases) and in 4.5% of the clerks (44 cases), p < 0.01. The evaluation of IgE specific for CB gave positive results only in 3 of 10 subjects sensitized to GCB. A total of 20% of GCB workers (6 cases) complained of work-related respiratory symptoms (asthma and/or rhinitis) compared with only one subject in the roasted coffee group and one in the control group (p < 0.01). Asthma was reported by 2/31 of the green coffee workers and by 1/44 of roasted coffee workers. CONCLUSIONS There was a significant correlation between sensitization to GCB and work related symptoms (p < 0.01), common allergic symptoms (p < 0.05) and atopy by prick test (< 0.01). These results point to the need to evaluate atopic status in workers and identify the most susceptible subjects, with the aim of informing them of their at-risk status and monitoring their progress. This makes it possible to diagnose sooner those symptoms possibly indicative of a work-related disease, because even in presence of good environmental conditions and even when symptoms are mild, it is almost always the atopic subjects who are affected.

Sensitization to green coffee bean (GCB) and castor bean (CB) allergens among dock workers

SummaryDock workers (n = 218) occupationally exposed to green coffee beans (GCB) were studied, using a specific questionnaire for allergic symptoms and skin tests for common and occupational allergens. Thirty-one workers (14.3%) complained of allergic symptoms of the eye, nose and bronchial system at the workplace. The prick tests, using both commercial allergens and specific extracts prepared from the most common types of coffee and their corresponding sacks, confirmed a sensitization in 21 workers (9.6%). A positive skin reaction to castor beans (CB) was found in nearly all these cases; in ten workers there was also a positive reaction to GCB allergens and in 14 cases prick tests were positive to extracts of sacks. There was a good concordance between prick tests and specific IgE for CB (95.0%) and also, but to a lesser extent, for GCB. The authors concluded that there is a significant risk of sensitization to CB and GCB allergens in dock workers occupied in handling green coffee bean, despite the fact that the exposure is not continuous. CB emerged as a common contaminant of GCB from various countries. For effective prevention, a modification of the methods of transport is required to avoid CB contamination to other products. Eliminating environmental dust during shipping operations is the most important preventive measure and it can be achieved by the use of containers, as some exporting countries are already doing.

Effects of treatment with embryonic and uterine tissue homogenates on Lewis lung carcinoma development

Based on the hypothesis that the development of cancer is actively inhibited during embryonic life, the effects on tumor growth of homogenates of different tissues (embryos, uteri at ninth day of pregnancy, non-pregnant uteri and normal liver) were investigated in syngeneic C57BL/6 female mice. Primary tumor growth and spontaneous pulmonary metastasis formation were completely suppressed in the group of mice treated with pregnant uteri homogenates. Embryos, non-pregnant uteri and normal liver homogenates were ineffective.

The relationships between the concentrations of airborne pollen and allergic symptoms in Trieste (Northern Italy) in 1989

SummaryConcentrations of airborne pollens recorded in Trieste in 1989 are evaluated in relation to allergic complaints in 113 patients with skin prick tests positive to one pollen species. Analysis of the result enable the two most important allergens to be confirmed as: Poaceae in 70.7% of patients and Parietaria in 18.6%. Few people had monosensitation to Compositae (Artemisia), Corylaceae and Fagaceae.Sympotoms are related to the flowering period when pollen levels climbed to daily averages of 15–20 grains/m3 but they started later than airborne peak concentrations and finished later than pollen decline. Pollen concentration recording can be a useful way to predict the clinical manifestation in sensitive patients but other factors are involved in determining symptoms like subjective mucosal reactions, polysensitization, patients living and working environment.

Atopy and occupational asthma

SummaryWe evaluated atopy in 206 white collars and housewives with seasonal and perennial respiratory symptoms and in 58 workers occupationally exposed to isocyanate and flour with symptoms at work. Atopy was much less common among people with symptoms at work, but there was no significant difference in the frequency of atopics between varnishers and bakers. Self selection of atopic employees who leave their job because of respiratory symptoms may account for these results, but further studies are needed to clarify the relationship between atopic status and occupational asthma.

Storage mites sensitivity and allergic respiratory disease

SummaryIn order to evaluate the frequency of skin sensitivity to Storage Mites and the role of such sensitization in respiratory allergic disease in workers with occupational exposure to stored items we studied 217 dock workers, 93 farmers and 104 white collars.From the results of skin prick tests the sensitization to sole Storage Mites appears significantly higher among people working in docks or farms, compared with a control group. This confirms the role of the working environment in inducing sensitization to Storage Mites. Rhinitis and asthma however affect nearly always (27/29 cases) people with an associated sensitization to House Dust Mites. Further studies are needed to define the allergenic importance of Storage Mites in working environments.