Gianfranco Tomei

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.

Exposure to cadmium in male urban and rural workers and effects on FSH, LH and testosterone

OBJECTIVE This cross-sectional study was conducted to assess the relationship between exposure to cadmium and circulating reproductive hormone levels in urban and rural male workers. MATERIALS AND METHODS Urinary cadmium, blood cadmium, luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were obtained from 86 non-smoking traffic policemen and 86 subjects working as roadmen in a rural area. All subjects were monitored to evaluate airborne exposure to cadmium. RESULTS The mean value of exposure to cadmium was 1.3 ng m(-3) in traffic policemen, while the mean value was less than 0.5 ng m(-3) in roadmen. The mean concentrations of urinary cadmium (1.4 vs. 0.9 μg g(-1) creatinine; p=0.001), blood cadmium (1.1 vs. 0.7 μg l(-1); p=0.000), FSH (2.6 vs. 3.2 μlU ml(-1); p=0.02) and LH (2.6 vs. 3.1 μlU ml(-1); p=0.03) were significantly different between traffic policemen and roadmen. No differences were found in the mean values of testosterone between the two groups. Multiple linear regression models showed associations between (a) urinary cadmium, airborne cadmium, working life, job category and consumption of water from water supply (b) blood cadmium, airborne cadmium and job category (c) the values of FSH and age, working life, job category, urinary cadmium and blood cadmium (d) the values of LH and both the age and working life. CONCLUSION The above results must be confirmed by further studies, but they indicate the influence of exposure to the cadmium present in urban air on the circulating FSH, even at low doses.

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.

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.

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.

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.

Prolactin levels in workers exposed to chemical, physical and psycho-social urban stressors.

Prolactin Levels in Workers Exposed to Chemical, Physical and Psycho‐Social Urban Stressors: Francesco Tomei, et al. Department of Occupational Medicine, University of Rome “La Sapienza”, Italy—The aim of this study was to evaluate whether traffic police officers exposed to chemical, physical and psycho‐social stressors, are at risk for alterations in plasma levels of prolactin (PRL) compared to a control group. Plasma PRL levels were evaluated in 92 male and 51 female, non‐smoker, traffic police officers exposed to urban stressors and in 92 male and 51 female controls, matched by sex, age and working life (mean, SD and distribution), after excluding workers with the principal extra‐occupational confounding factors. Mean PRL levels were significantly higher than controls in non‐smoker, male and female traffic police officers (respectively, p=0.000 and p=0.013). The number of non‐smoker, male and female traffic police officers with PRL values outside the upper normal limit for our laboratory was higher than, but not significantly different from controls. Mean PRL levels were not significantly higher than controls in smoker, male and female traffic police officers. The number of smoker, male and female traffic police officers with PRL values outside the normal limit for our laboratory was not significantly different from controls. The results suggest that exposure to urban chemical and physical stressors, interacting with psychosocial factors, may have an influence on PRL levels in traffic police officers. The level of plasma PRL might be a useful early biological marker for workers exposed to urban stressors.