Bruno Papaleo

Study of some cardiovascular parameters after chronic exposure to noise

Research has focussed lately on noise as a risk factor for cardiovascular diseases. Recent findings, which have not been well confirmed, indicate that it does appear to affect heart rate, blood pressure and the electrocardiogram. This study involved two groups of subjects (with 75 and 225 in each, respectively) classified on the basis of different intensity of exposure to noise. Non-occupational risk factors studied (cholesterol, blood glucose, smoking, body mass index, family history of cardiovascular problems) revealed no significant differences between the two groups. Audiometric deficits and time exposure to noise were also studied. Blood pressure was measured at rest, an electrocardiogram was taken, and a cycloergometric stress test was made. The prevalence of hypertension and electrocardiographic modifications in basal conditions and under the stress test differed to a significant extent in relation to the different exposures to noise.

Vascular effects of noise

The possible vascular effects of noise were studied. A study of the carotid vessels was made with Doppler ultrasonography in two groups of subjects exposed to various intensity of noise. The following data were studied: age, blood pressure, serum cholesterol, blood glucose, smoking habits, excess weight, electrocardiographic anomalies, family history of vascular disease, connection with duration of exposure and the type of noise and with audiometric deficits, and cerebrovascular modifications after postural changes and after a stress test. The control group comprised subjects not exposed to noise. The findings confirm that noise does play a role in causing vascular modifications that can be detected early by use of Doppler ultrasonography. This technique is predictive and could be useful in screening campaigns, following the method suggested here.

Vascular effects of occupational exposure to low-dose ionizing radiation

Damage to the microcirculation caused by high-dose ionizing radiation is well known but data concerning low-dose exposure are scant and contrasting. We employed capillary microscopy to study dermal microcirculation damage resulting from occupational exposure to ionizing radiation doses lower than 5 rem/year (maximum permissible dose in Italy). We studied 145 physicians (60.7% radiologists, 33.8% orthopedic specialists, 5.5% cardiologists) occupationally exposed to ionizing radiation and a control group of 106 subjects in comparable but different occupations not exposed to ionizing radiation or to other skin hazards. All subjects were administered a clinical protocol and underwent capillary microscopy of the fingernail-fold. Capillary microscopy alterations were classified as absent, mild, moderate, marked and severe. Our data confirm that occupational exposure to low-dose ionizing radiation can lead to morphological and functional alterations of the dermal microcirculation, which can be identified early by capillary microscopy.

Epidemiological and clinical study of subjects occupationally exposed to noise

The role of occupational exposure to noise as a cardiovascular risk factor has not been established sufficiently. The present study investigated the blood pressure (BP) and electrocardiographic (ECG) changes in subjects exposed to different degrees of noise. The first group, comprising 105 males with a mean working life of 20.9 years, was occupationally exposed to mean 93 db(A). The second group, comprising 311 subjects, with a mean working life of 20.2 years, was occupationally exposed to a lower level of noise (15% on average). A control group included 150 clerical workers with a mean working life of 19.7 years not exposed to noise at work. The prevalence of hypertension in differences are statistically significant (p <0.02). The prevalence of orthostatic hypotension was significantly higher in the noise-exposed groups than in the controls (p<0.05). The incidence of electrocardiographic abnormalities in the three groups was 21.9%, 10.9%, and 7.9%, respectively, (p<0.01). These data demonstrate that subjects occupationally exposed to noise are at higher risk for developing certain cardiovascular disorders. The noise-related risk correlates with the intensity of noise and the duration of exposure.

Liver damage in pharmaceutical industry workers

A group of workers who were employed at a pharmaceutical manufacturing company and who participated in the entire production cycle were studied. Numerous substances, including iodo-chloro-oxyquinoline, erythromycin, disinfectants, small amounts of cortisones, and preserving agents (prevan and parabenzoates), were used in the manufacturing processes. A control group comprised individuals who were not exposed to hepatotoxic substances. This investigation was designed to determine the risk of hepatotoxicity in the pharmaceutical industry, and a protocol was used that allowed for ease of screening. In the presence of a physician, all subjects completed a clinical history questionnaire. They all underwent a general clinical examination, and specific blood chemistry tests were performed. Certain liver indices that were correlated with cytotoxicity were significantly higher in the pharmaceutical workers than among the controls. The findings confirmed that there was a problem of hepatic involvement among workers in this sector, indicating that the clinical-biohumoral screening protocol used in this study was valid for identifying subjects at risk of hepatotoxicity.

Occupational Cardiovascular Risk Factors

Despite much progress in recent years, only a few studies have looked into the relations between occupational factors and cardiovascular pathology. Rosenmann141 estimated that the traditional cardiovascular risk factors explained not more than 50% of cardiac ischemic pathology. Olsen and Kristensen119 maintained that 16% of premature cardiovascular mortality among men and 22% among women could be avoided by taking preventive measures in the workplace.

Effects of low-dose solvents on the blood of art restorers

Effects on the Blood among Art Restorers: Francesco Tomei, et al. Department of Occupational Medicine, University of Rome “La Sapienza”—Restoration of art works is usually assessed from an artistic viewpoint, and little attention is paid to the restorers’ health. There appear to be no specific published reports. Art restoration is a craftsmans job, often done by students as part of their art courses, and they are exposed to low doses of a hard‐to‐classify range of different substances. This study employed a protocol designed for use in the workplace to check whether art restoration work had effects on the blood of the young people doing it. We studied 65 art restorer students and teachers, most of them young, who did different types of restoration work: on stone and archaeological findings, frescoes, paintings on wood and canvas, paper and parchment, plaster, fabrics, metals, wood or painted linings. Seventy‐one non‐exposed workers were compared as controls. We found significant reductions in RBC, Hb and Ht among exposed workers but no change in WBC. These findings suggest there may be problems in the effect on the blood of art restorers exposed to low doses of solvents. It would appear useful for these workers to undergo periodic blood screening tests, and the protocol we employed appeared suitable for identifying subjects at risk in their workplace.